Placenta percreta is the most severe form of abnormal placental attachment. It is a variant of placenta accreta in which chorionic villi penetrate the entire thickness of the myometrium through the uterine serosa and may involve the adjacent structures. Literature review shows very few cases encountered during the first trimester of pregnancy. A-20-year-old woman with previous one cesarean section presented with continuous vaginal bleeding beginning after incomplete abortion at seven weeks and six days period of gestation for which she underwent dilatation and curettage. MRI revealed irregular heterogeneous signal intensity mass with large area of hemorrhage in lower anterior wall extending towards the endometrial cavity suggestive of morbid adherent placenta. Following continuous bleeding after repeated curettage for retained, adherent placenta her coagulation profile got deranged and DIC developed. Correction of coagulopathy and emergency hysterectomy as a life saving measure for placenta percreta was done in our case.
Background: the aim was to study the prevalence of abnormal thyroid function and thyroid autoimmunity in infertile women and in general population (control group) and to correlate the thyroid dysfunction with presence of anti-thyroid antibodies. It was a case control study. The study was carried out at Department of obstetrics and gynaecology, Kasturba Hospital, Delhi. Population of the study was fifty infertile women in whom other causes of infertility are excluded and fifty fertile women attending out- patient department with other complaints.Methods: All the women enrolled in the study were non pregnant, clinically euthyroid (with no signs and symptoms of thyroid disorders and no documented abnormal thyroid function test) and no known autoimmune disorder. Detailed history and a thorough general physical examination, including thyroid examination was done. Haemogram, blood group, fasting and post prandial blood sugar, VDRL, transabdominal ultrasound, TSH, free T3, free T4, and antithyroid per-oxidase antibody assay was done using the ELISA technique.Results: The mean age of the study group was found 28.38±2.45 years, 22% had abnormal thyroid function, 20% had antithyroid antibodies positive and the mean TSH of the study group was 4.61±1.72µIU/ml. The mean age of the control group was found to be 29.10±2.01 years, 12% had abnormal thyroid function, 10% had antithyroid antibodies positive and the mean TSH of the control group was 3.89±1.56µIU/ml.Conclusions: Thyroid dysfunction and anti-thyroid antibodies were more prevalent in patients with infertility. A statistically significant correlation was established between thyroid autoimmunity and thyroid dysfunction in infertile women in the study.
Background: Purple color of urine is alarming and may indicate a serious underlying pathology. Purple discoloration of the urinary catheter bag is uncommon and is caused by urinary tract infection with certain organisms. Case presentation: We present a case of this rare phenomenon in a benign prostate hyperplasia patient with indwelling catheter who also has diabetes mellitus and chronic renal disease. We also discussed proposed etiology and pathophysiology of purple urine bag syndrome. Conclusion: Attempt to make the patient catheter free after stabilizing the patient is also the key point in its management. Although purple urine bag syndrome is not an aggressive pattern, it is an indicator for urosepsis.
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