Usha Manaktala

Uterine tamponade using condom catheter balloon in the management of non‐traumatic postpartum hemorrhage

Aim:  To study the efficacy and complications of uterine tamponade using condom catheter balloon in non‐traumatic postpartum hemorrhage (PPH).

Conservative management of corpus luteum haemorrhage in patients on anticoagulation: a report of three cases and review of literature.

IntroductionSevere bleeding into the peritoneal cavity from a ruptured corpus luteum cyst is a rare complication in women receiving anticoagulation therapy. Surgical management has been a traditional approach in managing corpus luteum haemorrhage, however, conservative management is now dominating the trend in carefully selected patients.Material and Methods We report here a series of three cases of corpus luteum haemorrhage with variable presentation. Conservative management was started in all the three patients and was successful in two cases. Finding a safe, effective, and acceptable method to inhibit ovulation in women on anticoagulation for mechanical heart valve is a challenge. All three patients were prescribed cyclical oral Desogestrel for long-term ovulation suppression.ConclusionSelected patients with haemorrhage secondary to deranged coagulation can undergo conservative management in consultation with cardiologist and hematologist.

Fetal scalp stimulation test: An adjunct to intermittent auscultation in non‐reassuring fetal status during labor

Aims:  To evaluate fetal scalp stimulation test (FSST) as an adjunct to intermittent auscultation in diagnosis of intrapartum fetal acidosis and associate result of FSST with cord blood pH and immediate neonatal outcome.

Clinical, radiological, and histopathological analysis of paraovarian cysts

Introduction: Paraovarian cyst arise from either mesothelium or from paramesonephric remnant. These present as either adneal mass or as an incidental finding. Diagnosis is usually established on ultrasound and it is important to differentiate these from ovarian cyst. Material and Methods: The present study is a retrospective analysis of 32 women with a confirmed diagnosis of paraovarian cyst after surgery. The clinical profile, symptoms and radiological findings of these patients were noted from the hospital records. A correlation was made with the surgical findings and the final histopathological diagnosis. Results: Only 2 patients were postmenopausal and one case was diagnosed during pregnancy. Ultrasound accurately diagnosed paraovarian cyst in 87.5% patients. 78% paraovarian cysts were found to be simple and none had any malignant change. We reported a higher incidence of cystic adenomatoid tumor in these paraovarian cysts. Conclusion: In our study, most paraovarian cysts occur in reproductive age group and present as an adnexal mass. Ultrasound is the diagnostic modality and a paraovarian cyst needs to be differentiated from ovarian cyst. Most of them were simple cysts on histopathology.

Varied Clinical Presentations, the Role of Magnetic Resonance Imaging in the Diagnosis, and Successful Management of Cervical Leiomyomas: A Case-Series and Review of Literature

Cervical leiomyomas or fibroids constitute a rare variety of benign pelvic tumors. The symptoms may vary from urinary retention, frequency, dyspareunia to rare clinical presentations such as prolapsed cervical fibroid polyp which may mimic procidentia or even uterine inversion. Preoperative clinical evaluation, radiological imaging, and proper intra-operative delineation of pelvic anatomy can help in their successful management. We are presenting a series of three cases of cervical leiomyomas which presented as a diagnostic challenge but their proper evaluation ultimately led us to manage these cases judiciously. The first case of cervical fibroid polyp mimicked incarcerated procidentia, the second case mimicked pelvic organ prolapse while the third case presented with acute urinary retention. All these cases were evaluated by ultrasound as well as magnetic resonance imaging (MRI) and were managed surgically without any complications. The MRI features of all the cases have been described. One should be aware of the uncommon presentations of cervical fibroid and should consider it in the differential diagnosis of any pelvic mass.

Coexisting genital malignancies with tuberculosis: A case series with review of literature

Objective: To study a case series of genital malignancies coexisting with genital tuberculosis. Materials and Methods: A series of three cases with known genital malignancies were found to have coexisting genital tuberculosis on subsequent workup. Results: First case was a 45 years old lady who underwent staging laparotomy for ovarian cancer. On histopathology examination, there was coexisting tuberculosis with papillary serous carcinoma. Second case was 53 years old postmenopausal lady who underwent extrafascial hysterectomy along with pelvic lymph node dissection. Histopathology showed tubercular changes along with endometrial malignancy. Third patient was a 50 years old postmenopausal lady with stage IIA carcinoma of cervix. She underwent radical hysterectomy and histopathology revealed tubercular changes in pelvic lymph nodes. All patients were given antitubercular therapy for 9 months in postoperative period along with adjuvant therapy. Conclusion: Although diagnosed as an incidental finding in the case series, genital tuberculosis may present in patients with malignancies as a result of immunosupression.

Primary ovarian abscess arising spontaneously within an endometrioma: a rare case

We report a very rare case of de novo abscess formation inside an endometrioma without any prior intervention in a 32-year-old woman. She presented with acute abdominal pain and persistent high-grade fever. A lump was palpable and tender and showed features of endometrioma on ultrasound. Laparotomy was conducted, as her clinical condition deteriorated despite broad spectrum antibiotics, and her fever did not subside. Thick foul-smelling pus was drained from the endometrioma, and the abscess wall was removed, followed by cystectomy. The patient improved markedly and did well in the postoperative period.