No abstract

Umbilical cord contains two arteries and one vein connecting fetus to the placenta and is responsible for blood flow between the two. It is surrounded by Wharton’s jelly which is a gelatinous substance and functions as adventitia layer of umbilical vessels, thereby providing insulation and protection to the umbilical cord. Umbilical cord abnormalities are associated with poor perinatal outcomes. Very few cases of absent Wharton’s jelly are reported in literature. Ours might be the 8th one in which we did a lower segment caesarean section for meconium stained liquor but the baby died after 12 hours.

Conjoined twins are a rare deviation of monozygotic monoamniotic twins which results from fusion of the two at any part of their body. The prognosis is not good and associated with high mortality. Here we report a case of conjoined twin which was referred to our tertiary care hospital as twin pregnancy with impacted breech in obstructed labour. Taking mothers condition into account, she was taken for emergency caesarean section, performing which we realised that it was a conjoined twin. The baby were still born and conjoined at thorax and abdomen (thoraco-omphalopagus) with anterior abdominal wall defect in one and unrevealed sex in other. Current report emphasizes on making an early diagnosis of conjoined twin pregnancy, so that it can be managed at the earliest according to the gestational age.

Background: To study the effect of human immunodeficiency virus (HIV) infection on pregnancy outcomes and new born as mother to child transmission of HIV is a major route on new infections in children and compare it with HIV uninfected pregnancies.Methods: Prospective comparative study conducted on 40 HIV seropositive and 40 HIV seronegative pregnant women attending ANC and delivering in the department of obstetrics and gynecology, S. M. S. Medical College, Jaipur, Rajasthan, India.Results: CD4 count had no effect on birth weight of baby or term of delivery. HIV seropositive pregnancies were more prone to IUD, still birth and preterm birth (p=0.029). Mother to child transmission was 2.7%.Conclusions: HIV infection increases the risk of adverse foetal outcome in terms of intrauterine demise, still birth and preterm labour.

Sirenomelia also known as Mermaid syndrome is a rarely encountered fusion anomaly of the caudal region of body often associated with Potter’s facies, single umbilical artery and various visceral abnormalities which make it irreconcilable with life. Here we report a case of sirenomelia delivered in our tertiary care hospital by lower segment cesarean section to a 24 year old third gravida with no previous live issues. No high risk factors could be identified with the mother including diabetes mellitus. Baby was born alive with Potter’s facies. Both the lower limbs were merging into each other like a mermaid’s tail (hence called mermaid syndrome). Sex of the baby could not be identified and the urogenital and anal orifices were absent. Umbilical cord stump had two umbilical arteries. The baby died after 20 hours of life. There appears to be no definitive modality for diagnosing sirenomelia in the antenatal period. However, if a patient has consistently low AFI without any history of leaking per vaginum, high resolution USG or colour Doppler should be done at the earliest to look for the cause.