Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. Intramuscular methotrexate has the advantage of tubal conservation and saves patients from requiring surgery. It is easier to administer than intraoperative route, which is by laparoscopy and needs expertise. Our study showed single dose methotrexate to be an effective treatment option for selected patients with unruptured tubal ectopic pregnancy.

Rudimentary horn is a developmental anomaly of the uterus. Pregnancy in a non-communicating rudimentary horn is very difficult to diagnose before it ruptures. A case of undiagnosed rudimentary horn pregnancy at 22 weeks presented to Nizwa regional referral hospital in shock with features of acute abdomen. Chances of rupture in first or second trimester are increased with catastrophic haemorrhage leading to increased maternal and perinatal morbidity and mortality. Management of such cases is a challenge till today due to diagnostic dilemma. Expertise in ultrasonography and early resort to surgical management is life saving in such cases.

Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis (OHVIRA Syndrome) is a rare congenital anomaly of the female genital tract. Uterus didelphys occurs when the midline fusion of the mullerian ducts is arrested, either completely or incompletely. Women with didelphic uterus may be asymptomatic and unaware of having a double uterus. They may present with complaints of dysmenorrhoea and dyspareunia. A 25 year old woman attending the infertility clinic at Nizwa regional referral hospital presented with history of dysmenorrhoea and foul vaginal discharge with right cystic pelvic mass. She was diagnosed as a case of double uterus with obstructed right hemivagina and right pyocolpos with ipsilateral renal agenesis after routine ultrasonography in the clinic followed by MRI. Excision of the right vaginal septum with drainage of 200 ml of purulent discharge was performed. She was relieved of her symptoms and conceived promptly after the surgical excision of the partial vaginal septum.

Chorioangioma of the placenta is a common benign vascular tumour of the placenta consisting of blood vessels and stroma. Most of these tumours are small and have no adverse impact on the fetus. Large tumours are associated with complications affecting mother and the fetus which may cause intrauterine fetal death. Chorioangiomas probably act as peripheral shunts between arteries and veins (arteriovenous shunts) leading to progressive heart failure of the fetus. Prenatal diagnosis is achieved by ultrasonography and Doppler studies will confirm the highly vascular nature of the mass.As the tumour is associated with unfavourable effects on the mother and fetus like polyhydramnios, prematurity, toxaemia, hydrops and fetal heart failure pregnancy needs to have regular surveillance to detect and manage complications early. A case of giant placental chorioangioma in a primigravida associated with intrauterine fetal death at 30 weeks of gestation is reported._______________________________________________________________________________________Keywords: Chorioangioma, hydrops fetalis; intrauterine fetal death; placental tumors._________________________________________________________________________________

A 32 years old omani woman G6P4A1 at 39 weeks of pregnancy presented with complaints of headache and picture of eclampsia. Emergency caesarean section was done for maternal and foetal distress. Post caesarean section patient could not be extubated from general anaesthesia. Emergency computed tomography scan of the brain was done which revealed colloid cyst of the third ventricle with severe acute obstructive hydrocephalus leading to irreversible brain damage and death. Colloid cyst of the third ventricle is a rare benign intracranial tumour, and pregnancy often masks the symptoms. High index of suspicion and early detection of tumour may be life saving.