Introduction: Ovarian fibroma is a benign stromal tumor composed of spindle fibroblasts like cells that produce collagen. It is seen in perimenopausal and postmenopausal women and is seldom seen in women with the age of less than 30 years. Case description: A young lady presented with irregular menses and secondary amenorrhoea of 8 months with gradual distension of abdomen. Raised Ca-125 levels with CECT impression raised the suspicion of malignant right ovarian tumor. Staging laparotomy was done followed by right salpingo-ovariotomy. Histopathology with immunohistochemistry confirmed the diagnosis of ovarian fibroma. Conclusion: There are no specific markers for an accurate pre-operative diagnosis of an ovarian fibroma. Improved understanding of this entity is essential to prevent misdiagnosis and missing the diagnosis.

Aim and objective: To understand and be efficient enough to deal with rare maternal and fetal complications of obstetric analgesia. Background: Epidural analgesia is the most effective method for pain relief during labor. Although complications related to this procedure are rare nowadays due to the expertise achieved, but a potential life-threatening complication of unexpected high block cannot be neglected. Case descriptions: We have encountered two normal parturients who developed sudden cardiorespiratory disturbance within few minutes of administration of epidural analgesia. On a background of worsening maternal clinical status, an emergency cesarean section was performed for severe persistent fetal bradycardia. While one patient recovered completely with no intraoperative complications, the other patient required intubation and intensive care. Postoperatively, echocardiography revealed decreased left ventricular ejection fraction with generalized left ventricular hypokinesia which improved subsequently on medical management. Working hypothesis for cardiomyopathy (Takotsubo) was considered in this case. Conclusion: We should not underestimate the complications that can arise with epidural analgesia, and hence it should always be provided by expert anesthetists in an appropriate set up with resuscitation equipment and drugs. An awareness of such rare complications can prepare obstetricians and nursing staff along with anesthetists to tackle them. Clinical significance: Along with the anesthetists, the obstetrics team should also be able to anticipate such rare entities and take appropriate steps for favorable maternal and fetal outcome.

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