No abstract

Pregnancy in a caesarean scar is a rare entity where the pregnancy is implanted into a prior caesarean delivery uterine scar and located outside the normal uterine cavity. We report a case of caesarean scar ectopic pregnancy occurring in the scar of a previous caesarean section, diagnosed by ultrasonography and Doppler and the surgical management of such a case following failure of medical therapy. We present history, clinical findings and imaging of our case followed by discussion about, diagnosing and management of such a case and the options available.

Pelvic organ prolapse is a less commonly cited cause of female factor infertility. This could be attributed to cervical factor or to distorted utero tubal relationship. When the cervix constantly lies outside the vagina, there is impaired venous return resulting in congestion, inflammation and ulceration, which is further aggravated by friction. Cervical dryness even hampers sperm and cervical mucus interaction leading to impaired capacitation. Here, we present 4 cases of cervico vaginal descent where main presenting complain was inability to conceive and were diagnosed to have prolapse on clinical workup. These cases had successful pregnancy outcome after conservative management with the placement of vaginal ring pessary of appropriate size. This reposits the cervix inside vagina, reduces cervical oedema, dryness and restores cervical mucus formation.

Background: Vitamin B12 deficiency (serum vitamin B12 <148pmol/L) is considered to be an important cause of anaemia in pregnancy. Pregnant women with this deficiency have an increased risk of developing preeclampsia, intra-uterine growth retardation and preterm labour. The current study was undertaken to determine the prevalence of vitamin B12 deficiency in pregnant women and its association with their dietary habits and socioeconomic status.Methods: This was a cross sectional study conducted in a tertiary care institute over a period of 2 months. Pregnant women visiting antenatal OPD were included in the study and those receiving vitamin B12 supplements, antacids, antiepileptic medication or methotrexate were excluded. Each participant was subjected to a predesigned structured questionnaire and their serum vitamin B12 concentration was done using quantitative determination by microplate enzyme immunoassay.Results: Of the 97 women included, majority were in the age group 20-25years (57.73%). 87.62% (85 women) were found to have anaemia and a total of 44women (45.36%) had vitamin B12 deficiency.Conclusions: The prevalence of vitamin B12 deficiency in north India is considerably high, which may be the cause of neural tube defects and poor birth outcomes and neurological deficit in children born to these mothers.