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Intra uterine devices (IUD) are the second most common accepted methods of contraception worldwide after sterilization. It is a long acting reversible contraceptive (LARC) which is now being promoted as a simpler, safer and effective method of contraception for those women who do not want a permanent method of contraception. Missing thread is the most common complaint seen within 6 weeks of insertion and may be the only presentation of misplaced IUD. Most women who spontaneously expel the IUD are unaware of the situation. We are presenting a case of misplaced IUD which was partially expelled and got embedded in the vagina which is a rare site of misplaced IUD.

Bartsocas-Papas Syndrome (BPS) is a very rare autosomal recessive syndrome characterised by marked craniofacial deformities, multiple pterygia of various joints, limb and genital abnormalities. It is mostly associated with mutation in the gene encoding Receptor Interacting Serine/Threonine Kinase 4 (RIPK4) required for keratinocyte differentiation. The syndrome is generally lethal and majority of babies die in-utero or in the early neonatal period. This is a report about a neonate born with characteristic clinical features of BPS including severe craniofacial and ophthalmic abnormalities, limb deformities and multiple pterygia at popliteal, axillary and inguinal region. The baby had respiratory distress at birth and was managed conservatively on Continuous Positive Airway Pressure (CPAP)/Oxygen hood and injectable antibiotics for two weeks and then referred for further work-up to a tertiary hospital. The parents took the baby home against the advice of the treating doctors and she subsequently died after 10 days. BPS is associated with high mortality and so all efforts should be directed towards diagnosing it early antenatally when termination of pregnancy is a viable option. This is possible by having a high index of suspicion in couples with consanguineous marriages or with a positive family history.

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