A 25-year-old female second gravida with one live deliver with previous one lower segment caesarean section at 36 weeks six days pregnancy reported to the emergency with chief complaint of decreased foetal movements for the past two weeks. Patient perceived 3-4 foetal movements per day in last two weeks.On examination her vitals were normal. Her systemic examination revealed no positive abnormal finding. On per abdominal examination uterine height was corresponding to term pregnancy and foetal heart rate was regular, cardiotocography was done which showed accelerations of foetal heart rate coinciding with foetal movements, indicating healthy foetus with normally functioning autonomic nervous system. However, patient was not able to feel any movement during the cardiotocography. In view of this and to rule out additional risk factor, ultrasonography was undertaken. Ultrasonography revealed amniotic fluid volume of 15, expected baby weight of 3.1 kilogram and manning score of 10/10.Patient was unsatisfied after sonographic confirmation of foetal well being saying that the movements are not good enough as earlier. This was followed by repeated admissions for the same complaint three times a week.Similar complaint of decreased foetal movement was also present in her previous pregnancy. At that time she was induced with three doses of dinoprostone gel 0.5 mg which was followed by syntocinon augmentation. However, she had undergone lower segment caesarean section due to foetal distress but she was not informed about the uterine anomaly at that time.Keeping a track of foetal movement and responding to change in movement as first line of defence against still birth and perinatal hypoxia, decision was taken to induce the patient with dinoprost gel at 37 weeks four days after well informed patient consent. After receiving two doses at eight hour interval, patient was taken up for lower segment caesarean section in view of non reassuring cardiotocography. Peroperative findings revealed partial uterine septum. Birth weight of the foetus was 3.1 kg with APGAR score of 6,8,10 at 0, 1, and 5 minute respectively. Both mother and baby were healthy in post operative period. DISCUSSIONIncidence of mullerian duct anomaly is 1-3% in women.[1] Literature have reported septate uterus as one of the most common types of mullerian anomaly [1]. Uterine septum may be incomplete in which wedge-like partition may involve only the superior part of the cavity. Less frequently, it may involve the whole length of the uterine cavity (complete septum) or even cervix leading to morphologically double cervix. This septation may also continue into the vagina resulting in a double vagina. Serosal surface of the uterus is usually normal but less commonly may have a groove or indurations.[1] Congenital uterine anomaly has been well established as cause of infertility and recurrent pregnancy loss [2]. However, only few studies [2,3] have reported the adverse pregnancy outcome of mullerian anomaly in third trimester which include pre term labour, pre ter...

Pregnancy implanted in the rudimentary horn of unicornuate uterus is very rare with an incidence of 1 in 75,000 to 1 in 150,000 pregnancies. Half of them rupture, and 80% of the rupture occurs in first and second trimesters. Atrocious outcomes are reported. Horn pregnancy rarely reaches third trimester and when it does the diagnosis becomes more challenging. Ectopic in unicornuate rudimentary horn of uterus is difficult to diagnose even with best facilities available. Consequences are grave with slightest error of radiological and clinical judgment. Here we present case series of women who had rudimentary horn pregnancy and presented with varied clinical presentation, however they went undiagnosed even after radiological assessment and it lead to exaggerated maternal morbidity. The purpose is to spread awareness of all such rare cases where maternal and fetal wellbeing is jeopardized, and accentuates the significance of high index of suspicion in all such cases

Objectives:To determine the correlation of subclinical hypothyroidism (SCH) with polycystic ovarian syndrome (PCOS) and to assess its impact on the clinical, biochemical and hormonal features in polycystic ovarian syndrome. Background:PCOS is one of the most common endocrinopathies seen in women of the reproductive age group with a prevalence ranging from 2.2% to 26% globally (Joshi et al., 2014) and 3.7% to 22.5% (Malik et al., 2014) in the Indian population. Thyroid disorders are quite commonly seen in PCOS patients, SCH are seen in up to 5-10% of this population (de Medeiros et al., 2018). Its association with PCOS has been insufficiently explored and therefore this study was designed to better understand the correlation. Methodology:This was a cross-sectional study conducted from November 2019 to 2021 in the Department of Obstetrics and Gynecology of Jawaharlal Nehru Medical College and Hospital, Aligarh, India, on 150 PCOS women in the age bracket of 18–35 years. They were divided in two groups: one with normal thyroid levels and the other with SCH. Measurement of clinical, anthropometrical, biochemical and hormonal profile was made in both groups and comparison was made using appropriately matched tests of significance and coefficient of correlations. Results:Notable findings included a positive and statistically significant correlation between SCH and menstrual cycle irregularities ([Formula: see text] = 0.167, [Formula: see text] < 0.05), infertility ([Formula: see text] = 0.299, [Formula: see text] < 0.05), body mass index ([Formula: see text] = 0.172, [Formula: see text] < 0.05), waist to hip ratio ([Formula: see text] value = −2.952, [Formula: see text] < 0.01), testosterone( [Formula: see text] = 0.246, [Formula: see text] < 0.01), total cholesterol ([Formula: see text] = 0.205, [Formula: see text] < 0.05), triglyceride values ([Formula: see text] = 0.305, [Formula: see text] < 0.01), fasting insulin ([Formula: see text] = 0.219, [Formula: see text] < 0.01) and HOMA-IR ([Formula: see text] = 0.221, [Formula: see text] < 0.01). A positive but statistically insignificant correlation was found with hirsutism ([Formula: see text] = 0.116, [Formula: see text] > 0.05), luteinizing hormone ([Formula: see text] = 0.122, [Formula: see text] > 0.05), follicle-stimulating hormone ([Formula: see text] = 0.113, [Formula: see text] > 0.05), prolactin levels ([Formula: see text] = 0.109, [Formula: see text] > 0.05), high-density lipoprotein ([Formula: see text] = 0.050, [Formula: see text] > 0.05), low-density lipoprotein ([Formula: see text] = 0.136, [Formula: see text] > 0.05) and fasting blood sugar values ([Formula: see text] = 0.046, [Formula: see text] > 0.05). No statistical significance with systolic blood pressure ([Formula: see text] value = −0.502, [Formula: see text] > 0.05) and diastolic blood pressure ([Formula: see text] value = −1.643, [Formula: see text] > 0.05) was found. Conclusion:The study showed a significant correlation between SCH and multiple variables in PCOS and thereby necessitating thyroid screen in PCOS population.