Subrat Panda

Case report of a primary ovarian pregnancy in a primigravida.

Primary ovarian pregnancy occurs quite rarely and that too usually in young highly fertile multiparous women using intra uterine device. We present a case where a young primigravida presented with abdominal pain and was diagnosed as ectopic pregnancy and was confirmed intra-operatively and histopathologically as primary ovarian pregnancy, managed with partial ovariectomy.

Vaginal pH: A marker for menopause

Introduction: Menopause is suspected with age, cessation of menstruation for more than a year and presence of symptoms. The diagnosis of menopause is confirmed by follicle stimulating hormone (FSH) levels >40 IU/L. Few studies have focused on vaginal pH for menopausal diagnosis. It is a simple, non-invasive and inexpensive method for this purpose. Aim of the Study: The following study is to correlate the serum follicle stimulating hormone (FSH) level with vaginal pH estimation in menopause. Materials and Methods: This is a cross-sectional descriptive study conducted in 173 women aged 31-60 years with menopausal symptoms who attended the Menopausal Clinic of our hospital from January 2012 to January 2013. Vaginal pH was measured using pH micro-meter strips and serum FSH levels were measured using immunoassay methods. The data obtained was then analyzed using Statistical Package for the Social Sciences software (version 17) and results were evaluated statistically by the Chi-square and Kappa tests. P ≤ 0.05 was considered to be statistically significant. Results: According to our study of the 173 women studied, mean FSH level was 46.5 IU/L and mean vaginal pH was 5.3. If the menopausal hallmark is considered to be vaginal pH >4.5 and serum FSH ≥40 IU/L, the sensitivity of vaginal pH for menopausal diagnosis was 84.9% and of serum FSH is 77.4%, respectively. Conclusion: Vaginal pH is a simple, accurate and cost-effective tool that can be suggested as a suitable and better alternative to serum FSH estimation for the diagnosis of menopause.

Role of Admission Tests in Predicting Perinatal Outcome: A ProspectiveStudy

Background: Predicting adverse outcome is important in low risk pregnancies also. We tried to determine the role of admission test on foetal and maternal outcome of pregnant women attending labour room as a part of promotion of institutional delivery. Methods: It is a prospective study conducted for a period of 1 year 6 months, where 100 pregnant women attending labour room with gestational age between 37-42 weeks in early or pre labour are selected randomly. Admission tests were performed in them and the results were statistically analysed. Results: For predicting the outcome in low risk pregnancy, we adopted combined admission tests, i.e., NST, AFI and Umbilical artery Doppler in low risk pregnant women. In our study NST shows a sensitivity of 57.89% and a specificity of 96.30%, while, Positive Predictive Value and Negative Predictive Value is 78.57% and 90.70%, respectively. This study indicates NST is a test with high specificity and negative predictive value, with diagnostic accuracy of 89%. Conclusion: NST, AFI, Umbilical Artery Doppler can be done altogether as an admission test on pregnant patients, for prediction of perinatal outcome.

A case of unilateral dysmenorrhea

Unilateral dysmenorrhea in an adolescent may be associated with uterine malformation. Relevant investigations in suspected cases and timely intervention can prevent future complications in such cases. Here, we present a case of unicornuate uterus with rudimentary horn in an adolescent complaining of unilateral dysmenorrhea.

Steroid cell tumor: A rare virilizing ovarian tumor.

Steroid cell tumors of the ovary account for less than 0.1% of all ovarian tumors. These tumors may present at any age with presentations related to the hormonal activity and virilizing properties of tumor. We present a case report of a young girl with ovarian steroid cell tumor, who had a complete and dramatic response to surgery alone.

Acute abdomen with hemoperitoneum in a postmenopausal woman.

Gynecological emergencies may be encountered in postmenopausal ladies like that of ruptured ectopic pregnancy in the reproductive age group. We report a case of ruptured granulosa cell tumor in a 70-year-old woman who presented with acute abdomen and hemoperitoneum.

An Audit of primary ovarian pregnancy in a tertiary care hospital

Intrauterine contraceptive devices (IUCD) and fertility treatments remain important associated risk factors. Risk factors like previous ectopic pregnancy, pelvic inflammatory disease (PID), and endometriosis have been implicated in the pathogenesis. These pathologies cause damage to epithelial lining of the fallopian tubes that impairs the normal ovum migration. The criteria for diagnosis of primary ovarian pregnancy were originally provided by Spielberg in the year 1878.