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Context: Endometrial cancer is a frequently encountered gynecological malignancy. An adverse prognostic immunohistochemical marker had not been identified until recently. Recent studies have used human epidermal growth factor receptor 2 (HER2)/neu expression as a marker for adverse outcomes in carcinoma endometrium, as proven in carcinoma breast. Aim: The present study was undertaken to correlate HER2/neu expression with prognostic factors in cases of endometrial carcinoma. Materials and Methods: This was a prospective study on evaluation of HER2/neu expression done on 30 patients with biopsy-proven carcinoma endometrium admitted in the hospital for staging laparotomy. Histopathological examination was performed and HER2/neu expression was assessed by immunohistochemistry and was categorized into (1) Group 1: HER2/neu 0/1+ (negative), (2) Group 2: HER2/neu 2+ (equivocal), and (3) Group 3: HER2/neu 3+ (positive). All the cases were followed up for a period of 1 year. Statistical Analysis: All data analyses were carried out using statistical software SPSS, IBM version 21.0. P< 0.05 was considered as significant. Results: 0/1+ HER2/neu expression (negative) was detected in 19 patients (63.33%), 2+ HER2/neu expression (equivocal) was detected in 4 patients (13.33%), and 3+ HER2/neu expression (positive) was detected in 7 patients (23.33%). HER2/neu 3+ group was significantly associated with non-endometrioid histology (P = 0.003) and high tumor grade (P = 0.005). The association of HER2/neu 3+ group with advanced disease and lymph node involvement showed a trend, but it was not statistically significant. No association was found between HER2/neu overexpression and extent of myometrial invasion. There were two recurrences in 1 year follow-up period. HER2/ neu expression (2+ and 3+) was seen the recurrence cases. Conclusion: HER2/neu overexpression was found to be an adverse prognostic marker in carcinoma endometrium, which could form the basis of targeted chemotherapy.

The purpose of the present report is to highlight the challenges in diagnosing interstitial ectopic pregnancy and to describe its management by laparoscopic cornuostomy. A 28-year-old gravida 3, para 1 woman was referred to us at 12 weeks period of gestation after failed medical termination following a diagnosis of missed abortion. On presenting to us, a large interstitial ectopic pregnancy was diagnosed by ultrasonography and managed by laparoscopic cornuostomy. Intra myometrial vasopressin and purse string sutures at the base of ectopic pregnancy bulge were used to reduce intra-operative bleeding. Intra-operative blood loss was 50 ml. Patient was discharged after two days of surgery. Interstitial pregnancy may be misdiagnosed as an intrauterine pregnancy, due to lack of suspicion and expertise. Large interstitial ectopic pregnancies can be successfully managed by a conservative surgical approach such as laparoscopic cornuostomy instead of cornual resection or hysterectomy.

Objective Pregnancy with an autoimmune disorder is faced with several risks for mother and fetus. The aim of the present study is to analyze the course and outcome of pregnancy in women with autoimmune disorders (AIDs). Methods A retrospective cohort study was conducted at a tertiary care teaching hospital. The hospital records of 153 pregnancies with autoimmune disorders and 1095 low-risk pregnant women who served as controls were reviewed. An adverse perinatal outcome was defined as the presence of any obstetric complications, including preeclampsia, eclampsia, abruption, antepartum hemorrhage (APH), prematurity, fetal growth restriction (FGR), intrauterine death (IUD), intrapartum event, mode of delivery, birth weight, neonatal intensive care unit (NICU) stay, or disease-specific neonatal complications. For all statistical tests with two-tailed probability, p

Cervical ectopic pregnancy is an extremely rare form of ectopic pregnancy with potential risk of massive bleeding and associated morbidity. Managing this condition is challenging for clinicians due to the serious risk to patient and dilemma faced in deciding the appropriate management plan. This case report describes the role of uterine artery embolisation in managing a case of cervical ectopic pregnancy with heavy bleeding per vaginum post methotrexate treatment with falling beta human chorionic gonadotropin (HCG) levels. It highlights the unpredictable nature of this condition and need for prompt intervention in an emergency situation.

Background: Based on the role of bone marrow (BM) stem cells in regeneration of endometrium, refractory cases of Asherman's syndrome (AS) and endometrial atrophy (EA) may benefit with BM-derived intrauterine stem cell instillation. Aims and Objectives: To evaluate the role of BM-derived autologous stem cell therapy in endometrial regeneration and restoration of menstruation and fertility in refractory cases of AS and EA. Setting: This study was conducted at a tertiary care center. Design: This was a prospective, single-arm longitudinal study. Materials and Methods: Twenty-five cases with refractory AS or EA were included. BM-derived mononuclear stem cells were instilled into the subendometrial zone followed by oral estrogen therapy for 3 months. Menstrual flow and endometrial thickness (ET) were assessed at 3, 6, and 9 months and 5 years. Results: Statistical analysis was carried out using statistical software STATA version 12.0. Mean prestem cell transfer ET (mm) was 3.3 ± 1.0. At the end of 3 months, there was a significant increase in ET (mm) to 5.1 ± 1.9 (P = 0.001), but there was no significant change at 6 months (5.6 ± 1.5; P = 0.164), at 9 months (6.1 ± 1.7; P = 0.135), or at the end of 5 years. Six of the seven amenorrheic patients resumed menses. Three patients had a successful pregnancy outcome. Conclusion: Intrauterine stem cell treatment is a promising novel approach for refractory cases of AS and EA.

Background. Pregnancy with massive splenomegaly is a rare entity and is associated with increased risk to both mother and foetus. There is paucity of studies in the literature to guide clinicians for the management of this condition. Methods. We reviewed the course of pregnancy, maternal and foetal outcomes of 5 pregnant women with massive splenomegaly who were managed in our unit during 2015–16. Results. All 5 women had anaemia and thrombocytopenia, and had different causes for splenomegaly. One patient had chronic malaria, 2 had portal hypertension with cirrhosis and the remaining 2 had non-cirrhotic portal hypertension. Life-threatening complications were present in 2 patients; one of them had severe pre-eclampsia complicated by pulmonary oedema, cardiac arrest and the other patient developed spontaneous bacterial peritonitis. Intrauterine growth restriction and meconium-stained liquor were the most common perinatal complications. Two patients had vaginal delivery and 3 required emergency caesarean section. Postpartum haemorrhage was present in 2, and the hospital stay was prolonged in all the patients. All mothers and babies were discharged in a satisfactory condition. Conclusion. Pregnancy with massive splenomegaly poses a challenge because of diverse aetiology and potentially adverse outcomes. Multidisciplinary care in a tertiary centre can help optimize the outcome.