No abstract

Small fimbrial cysts are most commonly seen, sometimes become larger and presents with symptoms. Here we presents a case of huge fimbrial cyst detected incidentally in a 20 year nulligravida came to out patient department with abdominal distention. Examination and imaging revealed large abdominopelvic cystic mass with no solid areas or septations. Minilaparotomy done, right fimbrial cyst was evident, cyst wall removed intoto. Histopathology confirmed fimbrial origin. Paraovarian cyst should be included in the differential diagnosis of a cystic mass visualized on ultrasound.

Objective: Though unusual in modern obstetrics, emergency obstetric hysterectomy remains a lifesaving procedure in case of uncontrollable postpartum hemorrhage. Decision of proceeding for obstetric hysterectomy on time will save one life. Because of its own significance, a study was conducted to analyse emergency obstetric hysterectomy in various aspects. Here we sought to determine incidence, risk factors, age distribution, parity association, feto-maternal outcomes, indications, post-operative complications and prognosis associated with emergency obstetric hysterectomy. Materials and Methods: A descriptive observational study was conducted as a retrospective analysis of 34 patients over a span of 2 years from January 2018 to December 2019 in the department of obstetrics and gynecology at Government Medical College & hospital a tertiary care centre in Latur, Maharashtra. All the peripartum hysterectomy cases were analysed under various factors and its outcome regarding maternal morbidity and mortality. Results: The incidence of obstetric hysterectomy was 2.03 per 1000 confinements. Majority of the women were in the age group of 21 to 25 years contributing 35.20% and belonged to parity two and above. The commonest indication was postpartum hemorrhage (64.70%) followed by morbidly adherent placenta (17.64%). Previous cesarean section was the most common risk factor (35.29%). Among the post operative complications, febrile morbidity remain the most common (35.29%). There were five maternal deaths (14.70%). Conclusion:Providing the universal proper antenatal care to identify the risk pregnancy, there should be increased frequency of ANC visits in case of high risk cases for timely diagnosing the condition and to prevent the deadly complication further. Referral to higher centre for medically supervised delivery for timely intervention if needed and that can reduce emergency obstetric hysterectomy and finally lead to reduction in maternal morbidity and mortality.

Background: Death of a woman during pregnancy and child birth is an extremely tragic event. It is a waste of a precious life that leaves great feeling of grief and pain for the family and hospital staff and has devastating influence on the community overall. Maternal Mortality Ratio (MMR) is a very sensitive index that reflects the quality of reproductive care provided to the pregnant women in that country. Maternal morbidity and mortality can be prevented by awareness of reproductive health in a community, availability, and utilization of organized antenatal care, skilled intrapartum management and careful postnatal follow up.Aim: Objective of the study was to analyze the pattern of maternal mortality over the period of five years in a tertiary level hospital in rural Maharashtra receiving high risk referred patients form periphery. Methods: A retrospective hospital based study of 81 maternal deaths over a period of 5 years from January 2012 to December 2016 is carried out. The information regarding demographic profile and reproductive parameters were collected and results were analyzed by using percentage and proportion. Results: Over the study period, there were 37242 live births, giving a MMR of 217.4/1,00,000 live births. Postpartum hemorrhage and sepsis were the leading direct causes while anemia was indirect leading cause. Most of the women died within 24 hours of admission. The 20 to 24 years age group and illiterate group was mainly affected. Conclusions: Hemorrhage, Eclampsia and sepsis are the major causes of maternal deaths. Improvement in primary health care in rural areas and proper implementation of NRHM programs and up gradation of hospitals in rural areas can definitely bring down the number of maternal deaths.