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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.

The aim of this study is to observe rise in haematological parameters after treatment with iron sucrose in antenatal patients with moderate anemia with period of gestation 32 to 35 weeks. The study included 45 antenatal patients with period of gestation from 32 to 35 weeks having iron deficiency anemia with haemoglobin levels 7–9 g% and serum ferritin levels less than 12 ng/mL. Intravenous iron sucrose was given in the dose of 200 mg on alternate days, according to the calculated dose. The mean haemoglobin and red blood cell indices were compared on days 7, 14, 21, 28 and at the time of delivery from the baseline value. There was a statistically significant rise in haemoglobin value from baseline on days 14, 21, 28 as well as at the time of delivery (p value

We present a rare case of vaginal leiomyoma presenting as prolapsed vaginal mass in a 45 years old woman. The leiomyoma was found to arise from the right lateral vaginal fornix with a vascular stalk. MRI showed homogenous hypointense signals on T1W1 and iso to hyperintense signals on T2W1 images with moderate heterogenous enhancement on post contrast images. It was enucleated via vaginal route and the histopathological examination confirmed the diagnosis of vaginal leiomyoma.

Severe 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.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.Selected patients with haemorrhage secondary to deranged coagulation can undergo conservative management in consultation with cardiologist and hematologist.

The aim of this study was to compare the efficacy and safety of intravenous iron sucrose with oral iron therapy in pregnant patients with anemia. The primary outcome of the study was increase in haemoglobin on day 7, 14 & 28 and rise of serum ferritin over 28 days. The study population consisted of 100 patients with singleton pregnancy between 24 and 34 weeks, hemoglobin levels between 7.0–9.0 gm/dL and serum ferritin levels less than 15 ng/mL. The participants in the oral group were given daily 180 mg elemental iron in three divided oral doses for 4 weeks. Total calculated dose of iron sucrose with a target hemoglobin of 11 gm %, was given in 200 mg dose on alternate days. Mean haemoglobin rise was 0.58 gm/dL in the IV group as compared to 0.23 gm/dL in the oral group on day 14 and 1.9 gm/dL in the IV group & 1.3 gm/dL in the oral group on day 28, (p

Lymphangioma of the fallopian tube is very rare. Only one such case has been reported. A 30-years-old female with lymphangioma of the left fallopian tube is described here. She presented with fever, vaginal bleeding and foul smelling discharge. A mass was felt in left fornix. On exploratory laparotomy, a left tubo-ovarian mass adherent to the surrounding structures was seen. Clinical diagnosis was septic abortion with adhesions. Left-sided partial tubectomy was performed. Histology of the left tube revealed large dilated channels containing lymph in the submucosa. Lymphocytes were also seen in some channels. Histogenesis of lymphangioma remains uncertain. Presence of adhesions in this case suggests a reactive origin. Histopathology is confirmatory for diagnosis.

Aim: To study the various causes of inadequate antenatal care in pregnant females and to evaluate the effect of inadequate antenatal care on delivery outcome.Methods: This was a case control study in which 220 women with inadequate antenatal care and 1780 women with adequate care presenting to the Department of obstetrics and gynecology, LNJP hospital, MAMC, New Delhi were evaluated in the immediate postpartum period with the help of a questionnaire to evaluate patient related factors and quality of care issues in inadequate antenatal care. The study was conducted from July 2011 to July 2012.Results: In the 220 women with inadequate antenatal care, patient related factors were responsible in 92.1% cases and in 7.9% there was deficiency in the quality of antenatal care they received. Fifty five (24.09%) women in the inadequate antenatal care had no knowledge about any component of antenatal care. Rate of maternal complications like eclampsia (p

Objectives: To study the causes of abnormal uterine bleeding in perimenopausal women and to correlate their clinical evaluation with ultrasonographic and histopathological examination. Method: This is a retrospective study of 100 perimenopausal women with complaint of abnormal bleeding in the age group ranging from 40 years till 1 year within the menopause, who underwent hysterectomy at Lok Nayak Hospital. The age, parity, menstrual complaints of these patients were noted & clinical diagnosis and ultrasonography were analysed. Finally, histopathology report of the hysterectomy specimen was correlated with the clinical profile of the patient and ultrasonographic findings. Results: Maximum frequency of abnormal uterine bleeding was seen in the age group 40– 45 years. Most of the patients were para 3. Menorrhagia was the commonest complaint & fibroid uterus was responsible for abnormal uterine bleeding in 53% of women. Out of 39 women labelled clinically as dysfunctional uterine bleeding, 8 patients were diagnosed with fibroid uterus on ultrasound & in rest of the 31 patients, no organic cause was found. Out of these 31 patients, 4 patients were diagnosed to have adenomyosis on histopathology & in rest, no gross pathology was detected. Suspected malignancy in all the 3 patients was confirmed on histopathology. Simple endometrial hyperplasia without atypia was present in 19% patients. Conclusion: Clinical, radiological & pathological evaluation correlated well to diagnose fibroids, however clinically as well as ultrasound proved to be of little help in diagnosing adenomyosis.

A retrospective cohort study was conducted including 45 patients who received cerclage between 13 to 26 weeks for cervical insufficiency. The 14 women (cases) delivering before 34 weeks were compared with control group including those who delivered after 32 weeks. Our study identified 4 risk factors associated with preterm birth at less than 34 weeks period of gestation : cervical length