Adenomyosis is the presence of endometrial glands and stroma in the context of the myometrium, with adjacent smooth muscle hyperplasia. It may be diffuse or cystic. Adenomyotic cysts of the uterus are extremely rare. A 31 years old nulligravida woman presented to our OPD with complaints of severe dysmenorrhea and back pain since 8 months. Transvaginal ultrasound revealed retroverted uterus with diffuse adenomyosis with intramyometrial endometriotic cysts in both cornual areas, both adnexa showing multiple small endometriotic cysts. On Laparoscopy – cystic masses around 5x4cm was found near the cornua and anterior uterine wall, which were excised and diagnosed as adenomyotic cyst on histopathology.
Background: Pre-eclampsia is a disorder peculiar to human pregnancy and accounts for a considerable proportion of both maternal and perinatal deaths. This study was undertaken to compare the efficacy of labetalol versus nifedepine in the treatment of hypertensive crisis, maternal and fetal outcomes and also prevention of further complications in patients admitted to department of OBG, VIMS, Ballari.Methods: Total 100 women with severe preeclampsia and eclampsia who were admitted in the labour room at the Vijayanagar institute of medical sciences, Ballari over a period ranging from April 2013 to September 2014 who fulfilled the inclusion and exclusion criteria were included in this Open Label, prospective, randomized study. Patients were allocated into two groups; group A and group B and managed with Intravenous labetalol and oral nifedipine respectively after proper history, examination and investigations.Results: We found that less number of doses were required to achieve target blood pressure in labetalol group (2.4±0.99) compared to nifedipine group patients who required more number of doses. (2.56±0.84) Even with fixed dose regimen (VIMS Regimen) of labetalol, our study showed more rapid decrease in blood pressure to target level with labetalol group (36±14.85 min) compared to nifedipine group (68.1±27.64 min) which was statistically significant (p=0.000).Conclusions: The goal of treatment is to maintain BP at a level that minimizes maternal cardiovascular and cerebrovascular risk. Labetalol is better than nifedipine in the management of hypertensive crisis in severe preeclampsia and eclampsia.
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