Study Objective: The objective of this study is to describe the maternal and perinatal outcome of conservative managementin PPROM. Design: Descriptive prospective study. Period: One year from August 2006 to August 2007. Setting: Maternal and child health(MCH) Centre PIMS Islamabad. Material and Methods: 50 patients between 28-36 weeks of gestation presenting with PPROM. Results:The mean age was 27+5.1 years, 14(28%) were having gestational age between 28to 32 weeks and 36 (72%) were between 33 to 36weeks of gestation. 34 (68.0%) of the mothers had no history of abortions while 10 (20.0%) had 1-2 abortions and 6 (12.0%) had 3 ormore abortions. Sixteen (32.0%) women had previous PRROM while 10 (20.0%) had previous history of preterm labor. Inversecorrelation was observed between latency period and gestational age. Among 14(28%) women with gestational ages between 28 to 32weeks 10 delivered within 48 hours and 4 after 48 hours. Among 36(72%) women with gestational ages between 33-36 weeks 31(62%)delivered in less than 48 hours and 5 (10 %) women delivered after 48 hours.14(28%) of the 50 babies were admitted in NICU withsepticemia, 7(14.0%) with RDS, hypoglycemia in 2(4.0%) and necrotizing enterocolitis in 3(6.0%). 3 neonates died from septicemia and2 from RDS. On first follow-up 34.0% mothers had infections and 8.0% had post-partum hemorrhage. Conclusions: Expectantmanagement till 36 weeks is a suitable option as gestational age at delivery and birth weight both affect neonatal survival and offer time toadminister corticosteroids to allow foetal lung maturity. Foetal deaths occurred due to septicaemia and RDS with direction co-relationshipwith low birth weight.

Aim and background: Parasitic leiomyoma is an extremely rare variant of uterine leiomyoma occurring outside the uterus. The majority of the patients with uterine leiomyoma are asymptomatic. However, it may present with vague symptoms. Case description: We present a case report of parasitic leiomyoma in a 39-year-old pregnant woman at 38 + 6 weeks who presented with a complaint of discomfort in the lower abdomen. On abdominal ultrasound, there was a large mass measuring about 12.7 cm × 9.6 cm × 13.6 cm in the anterior wall of the uterus in the lower uterine segment on the right side, abutting and indenting the posterior wall of the urinary bladder. During cesarean section, the growth was noted to be hooked to the dome of the bladder instead of the uterus. Histopathological examination confirmed the diagnosis of parasitic leiomyoma. Clinical significance: Although, parasitic leiomyoma is an infrequent subtype of uterine leiomyoma, we report a challenging case of parasitic leiomyoma with all its particularities.