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Gestational trophoblastic disease (GTD) refers to a group of pregnancy-related tumors that are recognized as the most curable gynecologic malignancies. Diagnosing GTD can be challenging, particularly after a non-molar pregnancy, due to its various presentations, which may mimic retained products with hypervascularity or arteriovenous malformation. Human chorionic gonadotropin (HCG) serves as an excellent biomarker for monitoring disease progression, response to treatment, and post-treatment surveillance. A plateaued or rising HCG level can facilitate the early detection of progression from complete or partial hydatidiform mole to GTD. Here, we present a case series involving six patients with GTD who initially presented with elevated beta-HCG levels and abnormal bleeding. Of these six patients, five were initially diagnosed with hypervascular retained products following a first-trimester abortion and underwent surgical evacuation. However, due to persistently elevated beta-HCG levels and evidence of myometrial invasion, the diagnosis was later revised to GTD. All patients were successfully managed with chemotherapy. Methotrexate, as a first-line treatment, is effective in achieving complete remission in most non-metastatic and low-risk cases. It has minimal severe toxicity, excellent cure rates, and does not appear to affect fertility. In summary, gestational trophoblastic diseases represent a diagnostic conundrum for clinicians due to their diverse presentations and potential for mimicking other conditions. Nevertheless, when these diseases are identified and managed in a timely manner, the prognosis is highly favorable, underscoring the importance of vigilant monitoring and early intervention. [ABSTRACT FROM AUTHOR]

Background: Over the last decade, the rate of cesarean sections has steadily increased owing to various reasons, and along with it the incidence of wound sepsis. Different risk factors identified are maternal age, socioeconomic status, educational status, antenatal visits, pregestational diabetes, obesity, recurrent pregnancy losses, duration of surgery, preterm rupture of membranes, etc. Hence, assessing infections and their management is an integral part of health care, as it helps develop strategies for prevention, better management of infection, reducing the hospital stay, and cost of healthcare. Aims and Objectives: The aim of the study was to assess and note the variability of social and demographic profiles of patients undergoing cesarean sections and developing wound infection, along with its various presentations and categories. Materials and Methods: A prospective observational study was conducted on patients who developed wound sepsis after undergoing cesarean section at a tertiary center in India. Results: Among the patients enrolled, 35.83% were illiterate and 45.83% were educated up to the tenth standard. About 74% of patients were not registered during the antenatal period. Furthermore, the majority of patients were overweight and obese (74%) and were from lower socioeconomic strata. About 85% of the patients who developed wound infection had their surgery lasting for more than 60 minutes. About 87.50% developed a superficial category of infection, and 68.33% presented within the first 5 days of surgery. Patients with deep infected wounds had significantly bigger wounds and longer hospitalization. Conclusion: Illiteracy and lower socioeconomic conditions predispose women to wound sepsis. A longer duration of surgery was associated with a higher risk of infection. Superficial wounds are the most common type of infection encountered. Deep and organ space categories of wound infection are associated with increased morbidity and longer hospitalization warranting aggressive management. Reducing the incidence of wound sepsis can help to reduce morbidity by identifying risk factors before pregnancy and supporting the implementation of preconception counseling centers and prenatal programs to educate and raise awareness among patients. [ABSTRACT FROM AUTHOR]

Introduction: This article aims to discuss all the challenges faced in the diagnosis of coronavirus disease 2019 (COVID-19) in pregnancy, isolation of suspected and positive patients, their management, and the strategies to prevent the transmission of infection among the healthy population and medical fraternity. The diagnosis of COVID in pregnancy is influenced by many factors, including normal physiological changes in pregnancy, comorbid conditions associated with pregnancy, and the presence of asymptomatic infection in patients. Suspicion of COVID-19 in pregnant females is of utmost importance at a primary health center for risk mitigation of exposure to medical personnel. Material and Methods: A retrospective study was carried out in the labour room in a tertiary care center in India. Two groups were made, suspected COVID and confirmed COVID in pregnant patients. The case records were analysed. Results: Out of a total of 5164 admissions, 95 patients were admitted as suspected (1.8%), but only two patients were COVID-positive amongst them. 84% of COVID-positive patients were asymptomatic. Fever was the most common symptom in both groups (P-value: 0.15). Preeclampsia and anaemia were the most common comorbidities in both groups, not statistically significant. There were 32% of intensive acre unit (ICU) admissions in suspected COVID patients, and 77% of them were having respiratory distress. Conclusion: COVID-19 presents as an asymptomatic infection in most pregnant patients. Physiological changes to the cardiorespiratory and immune systems along with associated comorbidities in pregnancy, increase a woman's susceptibility and delay diagnosis. Consideration of patients as suspected COVID at triage stations on the basis of only contact or travel history poses a great burden on the health care system. Although triage is an essential tool to identify symptomatic COVID patients, universal testing strategies should continue simultaneously. Streamlining medical care professionals into self-sufficient teams ensures adequate clinical coverage amongst the suspected COVID, confirmed COVID, and routine labour room admissions. [ABSTRACT FROM AUTHOR]

The main causes of secondary dysmenorrhoea are uterine and vaginal anomalies, menstrual outflow obstruction, endometriosis, adenomyosis and uterine myoma. This study reports a rare case of accessory and cavitated uterine mass (ACUM), a rare mullerian anomaly, related to dysfunction of gubernaculum which is a new but significant entity causing severe dysmenorrhoea and chronic pelvic pain. ACUM was diagnosed in a multiparous female who was being treated on the lines of endometriosis without relief in symptoms. [ABSTRACT FROM AUTHOR]