Factor V deficiency is a rare autosomal recessive coagulation disorder. We report a case with inherited factor V deficiency presenting as life-threatening recurrent hemoperitoneum, following bleeding from ruptured corpus haemorrhagicum. Prolonged prothrombin and activated partial thromboplastin times, normal thrombin time and a normal platelet count pointed towards a disorder of coagulation. Mixing studies with factor V deficient plasma and coagulation factor assay revealed markedly reduced plasma factor V clotting activity. The management included blood, plasma and tranexamic acid. Family screening revealed low factor V levels in her parents. Although her brother had significant Factor V deficiency and epistaxis, he did not need hospitalization or replacement, indicating the varied manifestation of this bleeding defect in this family.

Background: India has one of the highest Vitamin D deficiency rates in pregnancy in the world and yet we have limited research to study its various effects from our country. We aim to study the prevalence of Vitamin D deficiency in pregnancy and effect on neonatal outcome after supplementation.Methods: 200 pregnant women were recruited at 26 weeks and more. They were divided into sufficient group (normal levels of the vitamin), supplemented group (recruited at 26 weeks and supplemented for 8 weeks) and unsupplemented group (recruited after 34 weeks and so could not be supplemented) based on time of recruitment and levels of vitamin D. They were followed up till discharge of newborn from the hospital. Neonatal outcomes were noted.Results: The prevalence of Vitamin D deficiency in pregnancy in present study was 94.5%. Vegetarians and urban residents were more likely to have this deficiency. Admissions to NICU were significantly less in neonates of vitamin D supplemented women.Conclusions: The prevalence of vitamin D deficiency is very high during pregnancy and further studies are needed to clearly define its role in neonatal outcome.

Background: Unruptured ectopic pregnancy can be managed with surgery as well as systemic methotrexate. We aimed to study efficacy of medical management and factors affecting success in strictly selected patients.Methods: It was a three-year prospective observational study. 171 patients with ectopic pregnancy were screened and those fulfilling the strict study criteria were given systemic methotrexate. The single dose regimen was followed. Patients were observed for side effects and signs of rupture. Serial measurement of HCG levels was done to determine success or failure. Various factors were studied which had potential bearing on results.Results: Thirty-one patients received methotrexate. We had an overall success rate of 93%. Two of the participants had surgery due to failure. No major side effects were observed.Conclusions: Carefully selected patients of unruptured ectopic pregnancy can be safely and successfully treated with systemic methotrexate.

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