Uterine rupture is a rare and catastrophic event with high fetal and maternal morbidity rate. It is most commonly seen in scarred uterus. Here we present a case of 30 years old female, gravida 3 para 2 living 0 with previous spontaneous uterine rupture at 28-30 weeks with still birth 3 years ago. She underwent emergency laparotomy with repair. She conceived spontaneously, admitted at 20 weeks of gestational age and close antenatal surveillance was done throughout the pregnancy. Corticosteroids was administered. At 36 weeks elective caesarean was planned, delivering via breech presentation to a live male baby of 2.5 kg, Apgar score of 8/10,9/10 at 1 and 5 minutes.
A 22 years old primipara presented after 1.5 years of uncomplicated normal vaginal delivery with complaints of difficulty during intercourse and inability to conceive. Examination revealed labial adhesion connecting left and right labia minora with only 5 mm pinhole opening at the posterior end. Surgical division under anaesthesia resulted in successful complete recovery.
An ovarian dysgerminoma is a rare, malignant tumour occurring in young women, accounting for 1% to 2% of all primary ovarian neoplasms. A 22 years old female presented with 6 months of amenorrhea and lump in the abdomen. Her physical examination was remarkable with 36 weeks sized huge abdominal mass. Subsequent computed tomography revealed 22×23×32.4 cm mixed density lesion in pelvi-abdominal region and multiple paraaortic and mesenteric lymph node with gross pleural effusion. On further evaluation raised beta-hcG and LDH were noted and hence dysgerminoma was suspected. Total abdominal hysterectomy with right salpingo-ophorectomy with resection of tumour mass with partial omentectomy and lymphadenectomy was performed. Histopathology reports were suggestive of dysgerminoma.
Myxoid leiomyosarcoma is an uncommon tumour and in most cases, it is recognised only after the surgery. A 65 years old female patient got admitted at our hospital with history of rapidly growing abdominal mass with pain in abdomen since last 3 months. During abdominal examination 32 weeks huge mass was noted and on prevaginal examination mass couldn’t be separated from uterus. LDH was elevated, USG suggestive of vascular tumour of with neoplastic etiology of ovarain origin. CECT was done and findings suggestive of uterine adenocarcinoma with peritoneal carcinomatosis. Exploratory laparotomy with total abdominal hysterectomy with bilateral salphingoopherectomy with omentectomy with debulking surgery was performed. HPR reports suggestive of myxoid leiomyosarcoma with mitotic index of 10 with tumour cell necrosis suggestive of poor prognosis. Post-operative period patient had developed sudden myocardial infarction and shifted to ICU where she died due to ventricular fibrillation.
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