No abstract

Gestational trophobalstic neoplasia encompasses invasive mole, placental site trophoblastic tumor, epitheloid trophoblastic tumor and choriocarcinoma. Here we report a 27 year old woman with invasive mole with severe anaemia who was initially misdiagnosed as a case of incomplete abortion with vascular malfomarmation of uterus. In view of uncontrolled bleeding per vaginum, nonspecific ultrasound findings and H/O failed dilatation and evacuation, exploratory laparotomy was decided upon and intraoperative finding was invasive mole. Hysterectomy was done.

Conjoined twins or Siamese twins are identical twins that are joined in utero. The original Siamese twins were born in Siam (now Thailand) in 1811. They were males and lived for about 62 years. Incidence being 1 in 49,000 births to 1 in 1,89,000 births, this phenomenon is very rare. Approximate half are stillborn and one- third die within 24 hours of birth. Five types of conjoint twins are classically described, thoracopagus, omphalopagus, pygopagus, ischiopagus and craniopagus. With a reported incidence of 74-75% of all conjoint twins, Thoracopagus is the most common type. Omphalopagus with an incidence of 0.5% is the least common. Here we are reporting a case of thoraco-omphalopagus twin pregnancy with intra uterine death delivered by hysterotomy.

Heterotopic pregnancy refers to condition where two pregnancies are present simultaneously at different implantation sites mostly manifested as intrauterine and ectopic pregnancies. First heterotopic pregnancy after in vitro fertilization was reported in 1972. Mostly it is a sporadic condition. The most common ectopic site is the fallopian tube, both in spontaneous and assisted reproductive technology (ART) heterotopic pregnancies. Almost 60-70% of heterotopic cases result in live childbirth with outcomes similar to that of singleton pregnancies. Spontaneous heterotopic pregnancy is a rare and potentially dangerous condition in which intrauterine (IU) and extrauterine pregnancies occur at the same time. It can be a life-threatening condition and can be missed, with the diagnosis being overlooked. A high suspicion is needed in women with risk factors for an ectopic pregnancy and in low-risk women with an intrauterine gestation who have free fluid with or without an adnexal mass or in those presenting acute abdominal pain and shock. The ectopic component is usually treated surgically and the intrauterine one is expected to continue normally.