Gestational trophoblastic neoplasms include the tumour spectrum of hydatidiform mole (complete and partial), invasive mole, (chorioadenoma destruens), placental site trophoblastic tumour and choriocarcinoma. Here a case is reported as invasive hydatidiform mole presenting as an acute haemoperitoneum. The patient presented with acute abdominal pain and signs of haemoperitoneum. Emergency laparatomy releaved a perforating molar pregnancy, resulting in massive haemoperitoneum. Total hysterectomy was done, 5 units blood were transfused. Serum _HCG levels regress quickly and spontaneously.Mediscope Vol. 4, No. 1: Jan 2017, Page 38-39

The objective of this present study was to compare the efficacy of three oxytocic regimens to prevent primary postpartum haemorrhage (PPH) at caesarean section. A randomized controlled trial including 90 patients who underwent caesarean section were selected according to inclusion and exclusion criteria assigned randomly into three groups (30 patients in each group) was conducted. Group 1 and group 2 were exposure groups and group 3 was control group. All patients were given 10 units intravenous (IV) bolus oxytocin immediately after delivery of baby. Group 1 was given additional 20 units oxytocin in each 1000 ml fluid for 24 hours. Group 2 received additional 1000 microgram misoprostol per rectal. Group 3 did not receive any additional oxytocic drug. Background characteristics of all the three groups were similar. It was observed that 501-1000 ml blood loss was found among 25 (83.3%) cases in group 1, 27 (90.0%) in group 2 and 27 (90.0%) in group 3. The mean (SD) amount of blood loss was found 733 (190) ml in group 1792 (187) ml in group 2 and 818 (14) ml in group 3. Occurrence of PPH and blood transfusion needed among 1 (3.3%) in group 1, 2 (6.7%) in group 2 and 3 (10.0%) in group 3. Side effects occurred in 7 (23.3%) patients of group 1, 18 (60.0%) in group 2, and 6 (20.0%) in group 3. Shivering was found among 4 (13.3%) in group 1, 10 (33.3%) in group 2 and 3 (10%) in group 3. Vomiting was found among 2 (6.7%) in group 1, 4 (13.3%) in group 2, and 2 (6.7%) in group 3. Pyrexia was 1 (3.3%) in group 1, 4 (13.3%) in group 2 and 1 (3.3%) in group 3. Side effects were more in the group where misoprostol was used. Except side effects there was no statistical difference of occurrence of different events among the three groups. Only bolus IV oxytocin appears to be as effective as oxytocin infusion in addition to bolus IV oxytocin or per rectal misoprostol in addition to bolus IV oxytocin to prevent primary PPH at caesarean section. But occurrence of transient side effects such as shivering, pyrexia and vomiting were noted more frequently with the use of misoprostol.Mediscope Vol. 4, No. 2: Jul 2017, Page 5-11

The risk of gallstones is thought to increase with number of pregnancies. Cholesterol gallstones are more prevalent in women than men and primarily related to sex steroids, particularly progesterone. During pregnancy there are changes in bile composition and gallbladder motility that promote gallstone formation. This study was conducted to determine incidence and outcome of pregnancy related biliary sludge and gallstone formation. Two hundred and nine consecutive expectant women were evaluated by ultrasonography at 1st trimester, 3rd trimester and at 4-6 weeks after delivery. Socio-demographic, medical and obstetrical history were taken and recorded. Incidence of gallstone and sludge formation were found 5.7% and 2.9%, respectively. The results suggest that pregnancy may be a risk factor for gallstone and biliary sludge formation.Mediscope Vol. 4, No. 2: Jul 2017, Page 21-24

Ovarian luteinized follicular cyst is a relatively uncommon benign condition characterized by bilateral or solitary ovarian enlargement during pregnancy. A large luteinized follicular cyst can rupture or twist during pregnancy. Few cases of this clinical condition have been reported in literature. A large (12.5 × 9 cm) cyst and a live fetus of 8 weeks were detected on ultrasound scan of a 28 year old lady who had lower abdominal pain was the subject of this case report. The cyst was growing rapidly. Laparotomic excision of the cyst, and dilation and curettage was performed. Macroscopically the cyst was 15 cm in length with smooth regular outer and inner wall. Microscopic examination revealed a large luteinized follicular cyst of pregnancy. A rapidly enlarging ovarian mass in pregnancy poses significant diagnostic problems. Large luteinized cysts of pregnancy are thought to involve stimulation by human chorionic gonadotropin (hCG), or increased tissue sensitivity to hCG. A literature search identified eight previous cases that had been detected prenatally. In summary, large luteinized cysts of pregnancy are an uncommon type of cystic mass particular to pregnancy, characterized by the combination of a benign appearance and a tendency to enlarge rapidly, eventually becoming symptomatic and most often necessitating surgery.Mediscope Vol. 5, No. 1: Jan 2018, Page 38-41