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A young female presented with an acute abdominal pain and oliguria for 1 week following normal vaginal delivery. No history of hematuria was present. Patient was having lochia rubra. Sealed uterine rupture was suspected clinically. Initial ultrasound of the patient showed distended urinary bladder containing Foley catheter ballon with clamping of Foley catheter and particulate ascites. Abdominal paracentesis revealed hemorrhagic fluid. Contrast-enhanced computed tomography of abdomen revealed ascites, distended urinary bladder and no extraluminal contrast extravasation in delayed scan. As patient condition deteriorated, repeat ultrasound guided abdominal paracentesis was done which revealed transudative peritoneal collection with distended bladder. Cystoscopy revealed urinary bladder ruptures with exudate sealing the rupture site. Exploratory laparotomy was done and a diagnosis of extraperitoneal bladder rupture was confirmed. The rent was repaired in layers. She was put on continuous bladder drainage for 3 weeks followed by bladder training. It presented in a unique way as there was hemorrhagic peritoneal tap, no macroscopic hematuria and urinary bladder was distended in spite of urinary bladder wall rupture which delayed the diagnosis and treatment. Complete emptying of urinary bladder before second stage of labor and during postpartum period with perineal repair is mandatory to prevent urinary bladder rupture.

Background: Cervical Pap smear is a form of exfoliative cytology and has been widely accepted as a screening tool for cervical cancers. Among the various devices for collecting samples from cervix, wooden Ayre spatula and cytobrush are used commonly. Ayre spatula collects cells from the ectocervix whereas cytobrush from the transformation zone (TZ) and this study compares both techniques.Methods: A retrospective study was done by comparing two conventional Pap smears from all consecutive samples received in the cytopathology section of department of pathology (n=388); one with Ayre spatula and one with endocervical brush.  They were compared for quality parameters like spreading and staining of cells, morphologic preservation, presence of TZ component, degree of inflammation, presence of infection and predominant cell population. Appropriate statistical analysis was performed.Results: The smears made out of Ayre spatula showed better spreading (p≤0.00001) and staining (p=0.00022) as compared with those made using endocervical brush. However, the morphological preservation was equally comparable in both. The TZ component was significantly higher in the endocervical brush smear (p=0.00001). Inflammation was comparable in both (p=0.1916). Infection was detected more in ectocervical smears (p=0.00001). The cytobrush smears showed a significantly higher detection rate of endocervical cells (p≤0.00001).Conclusions: Based on our study, we conclude that the use of both Ayre spatula and endocervical brush together ensures higher efficiency than using a single method.

Hematological complications can complicate the postoperative period following myomectomy. Clinicians should keep such rarer possibilities in mind which will help them identify the complications correctly and manage appropriately. We managed a case of disseminated intravascular coagulation following myomectomy which was promptly diagnosed and managed. How to cite this article Kamath MS, Acharya M, Kamath V, Aleyamma TK. Disseminated Intravascular Coagulation after Myomectomy: A Case Report and Review of Literature. Int J Infertility Fetal Med 2013;4(1):31-33.

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