A histopathological study of hysterectomy specimens and their clinical correlation in patients at tertiary health care setup in Bundelkhand region of Uttar Pradesh

Background: Women in their life time are prone to develop several neoplastic and non-neoplastic lesions in her uterus and cervix basically due to hormone responsiveness of female genital tract system. The aim of the study was to evaluate all hysterectomy specimens and to study the pattern of pathological changes of different lesions occurring in cervix and uterus associated with different age groups. Methods: This retrospective cross-sectional, study was conducted on patients undergoing hysterectomy in department of obstetrics and gynecology in MLB Medical College Jhansi and hysterectomized specimens reported to department of pathology for further evaluation. Total 35 hysterectomy specimens were included in the study with age of patients varying from 30 years to 60 years. Detailed clinical and other relevant history were taken followed by thorough gross examination and histopathological evaluation. Results: Majority of hysterectomy specimens were sent for histopathological examination in the department of pathology, out of these 30 (85%) were total abdominal hysterectomy specimen, 5 (14.28%) were of vaginal hysterectomy specimens. Out of all these cases, in 7 (20%) cases bilateral or unilateral salpingopherectomy done. Conclusions: In our study, most common surgical procedure for hysterectomy was abdominal hysterectomy 30 (85.7%) followed vaginal hysterectomy 5 (14.28%) All the vaginal hysterectomy was done for second- and third-degree utero-vaginal prolapse. Most prevalent endometrial histopathological finding in our study is non-secretive 15 (42.8%), secretive 7 (20%) followed by atrophic 6 (17.1%) as most of the patients in our study presents with abnormal uterine bleeding and menorrhagia 23 (65.7%)

Interesting rare case of recurrent puerperal uterine inversion: a case report

Uterine inversion is a rare obstetric emergency that may lead to severe haemorrhage, shock and eventually death. The incidence of uterine inversion varies from one in 2,000-20,000 deliveries. Recurrent uterine inversion is still rare with no exact reported incidence so far. We report a case of a near miss patient, 28 years old primiparous with complete uterine inversion with atonic postpartum haemorrhage and shock, managed by manual repositioning and tamponade insertion which got corrected. Patient had recurrent uterine inversion twice in the puerperal period on 5th and 7th postpartum day. A new approach to management was taken. Rather than going for laparotomy, vaginal manual correction followed by intrauterine tri-way foley catheter insertion was done. Gradual deflation was done leading to final permanent correction. Uterine inversion is a rare but potentially deadly complication post vaginal delivery. Mortality and morbidity can be reduced by rapid recognition and immediate replacement. For recurrent inversion prolonged intrauterine balloon placement may be needed in rare cases

A comparative study on maternal and foetal outcome between low and normal amniotic fluid index in term pregnancies

Background: Amniotic fluid index (AFI) approximates amniotic fluid volume. It measures the overall well-being of the foetus. objective of the study was to determine Maternal and Foetal outcome in oligohydramnios pregnancies and compare them with cases of normal amniotic fluid volume full term pregnancies. Methods: This hospital based prospective comparative study included 300 pregnant women with full term pregnancies. Distributed equally into two groups, cases (AFI ≤5 cm) and controls (AFI: 6 to 24 cm). AFI measured using Phelan's four quadrant method. Detailed history, a clinical assessment and obstetric examination done for participants. Labour onset, amniotic fluid type, reason for LSCS, mode of delivery, birth weight, APGAR score, NICU admission, and delivery outcome were the outcome measures studied. Results: Mean age for case group was 24.36±4.23 years and 25.82±3.45 years for control group. For case group 36% and 30% of control group were induced. In case group liquor in 26% was significantly meconium soiled, compared to 7.3% of control group. Case group had 38% Caesarean procedures due to foetal distress. For case group 38% births were vaginal, while 62% in control group. In case group 30% of newborns were under 2.5 kilogram, compared to 16% in control group. In case group 17.33% participants had APGAR scores <7 compared to 2% in the control group. Case group lost 3.33% of infants, whereas the control group lost 1 (0.70%). Conclusions: Oligohydramnios is a high-risk pregnancy and that patients with this condition require appropriate antepartum care, intensive foetal monitoring, and intrapartum care