In women, the most common solid tumor of the pelvis is a uterine fibroid. A large cervical fibroid can also cause urinary incontinence in women. We report a case of a 45-year-old woman with urinary retention that was initially diagnosed as an anterior wall uterine fibroid in the peripheral health center but turned out to be a massive cervical fibroid. After the initial evaluation, it was determined that the cervical fibroid was huge and impacted the pelvis, and there was a possibility of a torrential operative hemorrhage. Thus, preoperative uterine artery embolization (UAE) was performed to prevent intraoperative blood loss, and Double-J (DJ) stenting was performed to avoid ureteric injury. This was followed by a total abdominal hysterectomy, without facing any intraoperative complications. This case demonstrates the importance of proper clinical assessment and the use of skilled interventional radiology procedures such as UAE and DJ stenting in the treatment of a massive cervical fibroid.

BackgroundPolycystic ovarian syndrome (PCOS), which affects women of reproductive age, is the most prevalent endocrine disorder. Signs of excessive androgen, irregular menses, prolonged anovulation, and infertility are characteristics of the clinical phenotype. Women with PCOS are more likely to have diabetes, obesity, dyslipidemia, hypertension, anxiety, and depression. PCOS affects women's health starting before conception and continuing through their post-menopausal years. MethodsNinety-six study subjects were recruited from women visiting the gynaecology clinic according to the Rotterdam criteria for PCOS. Study subjects were then divided into lean and obese groups according to their body mass index (BMI). Demographic data, and obstetrical and gynaecological history were obtained including marital status, menstrual cycle regularity, recent abnormal weight gain (in the preceding six months), and subfertility. To identify any clinical signs of hyperandrogenism such as acne, acanthosis nigricans, or hirsutism, a general and systemic examination was conducted. Data were analyzed after the clinico-metabolic profile was assessed, compared, and contrasted between the two groups. ResultsThe findings showed a significant correlation between obese women with PCOS and the clinical profile of PCOS i.e. menstrual irregularities, acne vulgaris, acanthosis nigricans and hirsutism; the waist-hip ratio was higher in both groups. Higher levels of fasting insulin, fasting glucose: insulin ratio, postprandial sugars, homeostasis model assessment of insulin resistance (HOMA-IR) index, total testosterone, free testosterone, and luteinizing hormone/follicle-stimulating hormone (LH: FSH) ratio were seen in obese women with PCOS, whereas the levels of fasting glucose, serum triglycerides, serum high-density lipoprotein cholesterol (HDL) were higher in all the study subjects irrespective of BMI. ConclusionThe study showed that women with PCOS have a deranged metabolic profile like abnormal blood sugar, insulin resistance (IR), and hyperandrogenemia with clinical derangements like irregular menses, subfertility, and recent weight gain more frequently with higher BMI.

The most usual pregnancy-specific liver condition that commonly exhibits in the third trimester is intrahepatic cholestasis (IHC). Maternal non-pruritic rash and jaundice are clinical signs; and abnormal liver function tests, especially elevated blood bile acids, are the laboratory findings. Pregnancy-related IHC is linked to a higher risk of unfavorable perinatal consequences including stillbirth, meconium-stained amniotic fluid, and spontaneous premature delivery especially when combined with COVID-19 infection. The treatment for it typically involves ursodeoxycholic acid. There is mounting evidence that IHC during pregnancy may have long-term effects on the health of both the mother and the fetus. Therefore, to have a better understanding of the etiology, management and consequences on maternal and fetal wellbeing, with concurrent COVID-19 infection; here is a case of a 25-year-old second gravida with IHC with concurrent COVID-19 infection in the discussion.

Women with native heart valve disease who are considering getting pregnant should have a complete risk estimation to determine whether an intervention is required prior to becoming pregnant and, if so, to determine when it should be performed and what kind of surgical therapy will be used. Pregnancy is linked to early and late structural valve degeneration in women who have bioprostheses, suggesting a high reoperation rate. A mechanical valve during pregnancy increases the risk of maternal complications such as valve thrombosis and mortality. The claim that women with defective hearts should not become pregnant was driven by the high maternal death rate among cardiac patients who became pregnant. A preoperative anticoagulation therapy trial helped women scheduled for valve replacement to acquire complete information as to the choice of the prosthetic device. Integrated risk stratification scheme for pregnant patients with valvular heart disease, with WHO classification and an algorithmic approach to both preconception counseling and anticoagulation strategy as outlined here, as well as early referral to a cardiologist with expertise in the management of cardiac disease and pregnancy for these complex patients is recommended. However, in reality, some women present while pregnant and valve disease needs to be managed, balancing maternal outcome and fetal risk. In general, optimizing the hemodynamic situation of the mother is also beneficial to the fetus. However, cardiac surgery carries a high risk for the fetus. No anticoagulant regimen can be said to be entirely safe for use during pregnancy, as there is a degree of risk with each regimen. Therefore, this review has been done to find appropriate management for women dealing with such conditions.

Background: Polycystic ovarian syndrome (PCOS) is a diverse condition marked by irregular menstruation, hyperandrogenism, and recurrent anovulation. An incidence of 6% to 20% of PCOS in women of reproductive age has been reported. Nesfatin-1 is a potent anorexigenic peptide having antihyperglycemic effects and is associated with energy balance and homeostasis, glucose metabolism, obesity, and probably gonadal functions. Nesfatin-1 is related to obesity, insulin resistance, and appetite. Nesfatin-1 is associated with insulin resistance, body mass index, diabetic inflammatory stimulation, hypertension, and PCOS. This study aims to evaluate the serum Nesfatin-1 levels in women with Polycystic Ovarian Syndrome and correlate with Body Mass Index, clinical and metabolic profile. Materials and Methods: This will be a prospective Hospital-based observational study conducted at  AVBRH in the Department of Obstetrics and Gynecology. A total of 96 women of reproductive age (15-45 years) will be enrolled. Detailed history of the menstrual cycle, obstetric history, background, medical and family history, and any primary care and inquiries will be documented. The general and systemic examination will be done to note any clinical evidence of hyperandrogenisms like acne, alopecia, acanthosis nigricans or hirsutism. The Ferriman-Gallwey Score (FGS) will be calculated. The ELISA method will be used for the calculation of N1. Serum Nesfatin-1 values will be correlated with clinical and metabolic profiles divided in the lean versus obese PCOS group. Data will be entered into a predetermined, pretested proforma and analyzed with appropriate statistical tests. Expected Results: The levels of Serum Nesfatin in PCOS patients are expected to be abnormal. We will measure sensitivity, specificity, positive and negative predictive value, and efficacy. We will analyze the difference of results between lean PCOS and Obese PCOS and association with the clinico-metabolic profile.