Background: Ectopic pregnancy is one of the common acute abdominal emergencies posing a serious threat to life. The overall incidence of ectopic pregnancy is on a steady increase over the last two decades. Yet the case fatality rate has come down due to early diagnosis and management. 95% of ectopic pregnancies occur in the fallopian tube, and rest 5% cumulatively in the ovary, cervix, peritoneal cavity and previous caesarean section scar. The present study was done to analyse the associated risk factors, clinical manifestations and management options of ectopic pregnancy.Methods: This retrospective observational cohort study was done in the Department of Obstetrics and Gynaecology, at Sri Venkateshwaraa Medical College, Hospital and Research Centre, Ariyur, Puducherry, between January 2018- November 2021. Data was collected from the case sheets, operative notes and a retrospective analysis of the cohort of patients with ectopic pregnancy was done.Results: This retrospective study was conducted from January 2018 to November 2021 involving a total of 50 cases. We found that majority of tubal gestation occurred in the age group 26-30 years 58.6% and 13.7% in the age group more than 30 years. Majority of patients 65.5% underwent U/L salpingectomy.10.34% underwent salpingo oophorectomy. Fimbrial expression was done for two patients. Two patients underwent fimbriectomy. Cornual stump excision was done in two patients. Hemoperitoneum was detected in 55.17% of cases.Conclusion: Ectopic gestation can become an obstetrical emergency and reproductive capacity hampering morbidity if not diagnosed and treated on time. However having a high vigilance and evaluating every woman in the reproductive age group who presents with the classical clinical triad of amenorrhea, pain abdomen and bleeding per vagina can help in curbing the incidence in future.

Background: Postpartum hemorrhage (PPH) accounts for 25% to 33% of obstetric deaths every year. Anemia is a cause and consequence of PPH. Despite intense efforts to prevent anemia, many Indian women labour with low hemoglobin levels. Tranexamic acid (TXA), an antifibrinolytic, have been demonstrated to reduce blood loss and transfusion requirements in various surgeries including cesarean section. Objectives were to study the efficacy of TXA in effectively reducing blood loss in Indian women following vaginal delivery.Methods: This randomized, double-blind, placebo-controlled study was conducted on 200 patients scheduled for vaginal delivery. In addition to oxytocin 10 units, group T received TXA 15 mg/kg and group P received normal saline administered over 5 minutes. Estimated blood loss, Hemoglobin deficit, need for additional uterotonics, need for blood transfusion, incidence of PPH and adverse events were noted.Results: The fall in hemoglobin was significantly higher in group P (p<0.00001). Estimated 24 hour blood loss was significantly higher by a mean blood volume of 86.99 ml in group P compared to group T (p<0.00001). The incidence of PPH was lower in group T (2.8% versus 11.3%). There were no significant difference in the need for supplementary uterotonics (9.9% versus 15.5%) and the incidence of blood transfusion (2.8% versus 8.5%). No adverse maternal and fetal outcomes were noted.Conclusions: To reduce blood loss following vaginal delivery, TXA may be safely recommended as standard adjunct to Oxytocin for regular management of third stage of labour, especially in developing countries like India.

Pelvic organ prolapse (POP) is the descent of pelvic organs through the vagina, which sometimes causes hydronephrosis. Here authors report a case of an eighty five year old woman with a fourth degree uterine prolapse with obstructive uropathy. She was treated with a conservative surgery Le Fort’s colpocleisis. Following which the patient’s renal functions and symptoms improved. Hence authors conclude that colpocleisis can be considered as the option for elderly women who have completed the family with no desire to preserve the sexual function especially in women with co morbities where pelvic reconstructive surgeries pose a challenge.

Scar ectopic pregnancy is a condition where the gestational sac implants into the previous caesarean scar site. Although it is a rare entity, its incidence is increasing due to rising rates of caesarean deliveries. Here authors report a case of caesarean scar ectopic pregnancy managed by laparotomy with caesarean scar ectopic excision following failed medical management. The patient recovered without any intraoperative or postoperative complications. An early diagnosis and management are vital in preventing maternal morbidity and mortality.

Gartner’s cyst accounts for 11% of all vaginal cysts. It results from total or partial occlusion of Gartner’s duct, the mesonephric duct remainder. It is often located in the anterior or lateral wall of the vagina from the cervix to the introitus, however it has exceptionally been described in the posterior location also.It is typically small and asymptomatic and occurs along the lateral walls of the vagina, following the course of the Gartner’s duct. Rarely it can be congenital., , ,