Khushpreet Kaur

Clinical significance of nonspecificity of antiphospholipid antibodies in recurrent abortions and unexplained infertility

Background: Antiphospholipid antibodies (APLA) are acquired autoantibodies directed to phospholipids which are associated with slow progressive thrombosis and infarction of placenta. Infertility and recurrent pregnancy loss may occur because of impaired trophoblast function, placental infarction, and abnormal blood clotting. Aim: To evaluate APLA (IgG and IgM) in cases of infertility and recurrent abortions. Materials and Methods: A prospective study comprising 70 subjects was carried out. Fifty cases of unexplained infertility and recurrent abortions (25 each) constituted the study group. Twenty healthy multipara females of same reproductive age group constituted the control group. Venous blood samples were collected, and serum was analyzed for two types of APLA (IgG and IgM) by ELISA method. Results: The mean IgM and IgG levels in recurrent abortions group were 8.10 MPL-U/ml and 6.17 GPL-U/ml, respectively whereas in control group, the levels were 4.67 MPL-U/ml and 4.53 GPL-U/ml, respectively. The difference was statistically nonsignificant. The mean IgM and IgG levels in unexplained infertility group were 7.30 MPL-U/ml and 6.12 GPL-U/ml, respectively whereas in control group, the levels were 4.67 MPL-U/ml and 4.53 GPL-U/ml, respectively. Again the difference was statistically nonsignificant. Conclusions: The present study concludes that there is no significance of raised APLA in cases of infertility and recurrent abortions.

An Intrauterine Pregnancy with Tubo-ovarian Torsion mimicking Ruptured Tubal Ectopic Pregnancy

56 ABSTRACT Aims and objectives: Adnexal torsion is a rare gynecological emergency that requires an early surgical intervention to save the adnexa from irreversible damage. Our study is about the clinical presentation and management of adnexal torsion in a pregnant woman in a tertiary care center. Materials and methods: This case study was done in a pregnant woman who came with adnexal torsion in the first trimester in the labor room of Government Medical College and Patiala, Punjab, India. Results: Torsion ovarian cyst is found in 5 per 10,000 women in pregnancy. The woman was suspected of having heterotopic pregnancy (an intrauterine pregnancy with ruptured tubal ectopic pregnancy). However, she was diagnosed as intrauterine pregnancy with adnexal torsion during laparotomy. Conclusion: Adnexal torsion is a rare emergency, which requires a high index of clinical suspicion for diagnosis as the symptoms are nonspecific. Imaging helps in diagnosis, but most of them are diagnosed intraoperatively. Diagnosis is made clinically along with imaging modalities. Ultrasound with color Doppler is the most commonly used imaging modality. An early surgical intervention helps in salvaging the adnexa and prevents further complications.