Renuka Malik

Hypergammaglobulinemic Purpura of Waldenstrom (HGPW) in Pregnancy: A Rare Case Report

Hypergammaglobulinemic purpura of Waldenstrom (HGP) is a rare skin condition first described by Waldenstrom in 1943. It presents as recurring purpura, elevated erythrocyte sedimentation rate, mild anemia, hypergammaglobulinemia and the presence of circulating immune complexes. It can be primary or secondary when associated with other autoimmune diseases, especially Sjogren’s and lupus erythematosus. It usually affects females of reproductive-age group, i.e., between 18 to 40 years of age. It is usually a benign condition which does not require extensive investigation and treatment in its primary form. Limited literature is available of its occurrence in pregnancy in which case HGPW requires prompt diagnosis and treatment for better fetal and maternal outcome. The presence of anti-Ro antibodies in the maternal serum may lead to congenital Dr. Renuka Malik, MD, DGO, is a Consultant, Department of OBGYN, PGIMER and DrRML Hospital, New Delhi. Dr. Avani Goyal is a Resident, OB-GYN, PGIMER and DrRML Hospital, New Delhi. Dr. Veena Ganju, MD, is a Consultant, Department of OB-GYN, PGIMER and DrRML Hospital, New Delhi. Dr. Kabir Sardana, MD, is a Professor, Department of Dermatology, PGIMER and DrRML Hospital, New Delhi.

Antenatally Diagnosed Binder Syndrome in Newborn Following Maternal Warfarin Intake in First Trimester

Corresponding Author: Dr. Renuka Malik Email: renucam@yahoo.co.in Received: December 16, 2015 | Accepted: January 6, 2016 | Published Online: January 25, 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (creativecommons.org/licenses/by/3.0) Conflict of interest: None declared | Source of funding: Nil | DOI: http://dx.doi.org/10.17659/01.2016.0010

Ruptured primary ovarian pregnancy: a rare cause of haemoperitoneum - two case reports and review of literature

Primary ovarian ectopic pregnancy remains a rare type of ectopic pregnancy which is normally diagnosed at surgery. Preoperative diagnosis by ultrasound is difficult, though now is being reported. Intraoperative diagnosis of ovarian pregnancy is difficult, as it can be confused with bleeding corpus luteum. The etiology of ovarian pregnancy is unknown. Fertility treatments and intrauterine contraceptive devices remain important associated risk factors Medical management and laparoscopy in unruptured cases can conserve ovary but ruptured ectopic still report in causality of government hospital. Two case reports are discussed. Both patients presented with ruptured ovarian ectopic needing laparotomy. There was no history of IUCD use or fertility treatment in either of them. Preoperative ultrasound in both patients was suggestive of ruptured tubal ectopic. Both were only diagnosed intraoperatively and met speigelberg criteria. A review of the literature, the specific symptoms, diagnostic criteria, and treatment of primary ovarian ectopic is discussed. Ovarian conservation should remain the aim in ovarian ectopic. However, cases with advanced gestation with massive haemoperitoneum can make ovarian conservation difficult. Early diagnosis in unruptured ovarian ectopic can conserve ovary.