Study of effect of intravenous iron sucrose on different haematological parameters in patients of anaemia in pregnancy

Background: The objective of this study was to evaluate the efficacy of intravenous Iron sucrose by comparing the various hematological parameters before and after infusion of intravenous iron sucrose and also the safety and compliance in cases of pregnancy with anaemia.Methods: One fifty patients visited in OPD with haemoglobin level <7 gm/dl during 1st and 2nd trimester of pregnancy and all patients of 3rd trimester with mild, moderate or severe anemia after satisfying the inclusion criteria were included. These patients were investigated with different hematological parameters. Patient’s hemoglobin, serum iron, total iron binding capacity, peripheral blood smear repeated after the completion of doses after 21 days.Results: Results were significant with increase in haemoglobin from baseline 6.7 ± 1.2 to 10.2 ± 1.9 after 21 days of treatment. There was significant rise of serum iron levels (93.14 ± 1.9 mcg/dl) post treatment. However repeat TIBC (94.66%) significantly decreased from baseline, mean TIBC was 314.66 ± 1.8 mcg/dl. Significant increase was also noted in MCV, MCH and PCV.Conclusions: This study showed significant improvement of hemoglobin and iron stores in pregnant women given calculated dose of iron sucrose complex infusion. It was safe for mother and fetus and is well tolerated

A rare case of primary amenorrhea

Crytomenorrhea arises usually due to the imperforate hymen, sometimes due to vaginal septum, rarely due to cervical agenesis. Here, we present a case of primary amenorrhea resulting from cervical agenesis in a 38-year-old woman. She presented with primary amenorrhea and cyclic lower abdominal pain. She had undergone some surgery 5 years back, details of which were not available. On examination secondary sexual characters were normal, per abdomen there was an 18 weeks size firm abdominopelvic mass. Local vaginal examination showed a blind vaginal pouch. A clinical diagnosis of hematometra due to transverse vaginal septum was made. However, magnetic resonance imaging pelvis suggested hematometra with cervical stenosis. The patient was taken up for examination under anaesthesia (EUA) and exploratory laparotomy. On opening the abdomen uterus found to be enlarged with dense adhesions all around and signs of endometriosis. Extensive adhesiolysis revealed bilateral chocolate cysts of ovaries with hematosalpinges and peritubal adhesions. Hysterotomy and drainage of tarry contents were followed by an exploration of the uterine cavity. The lower pole ended blindly with no evidence of any cervix. Peroperative diagnosis of cervical agenesis leading to hematometra and endometriosis was made. A subtotal hysterectomy with bilateral salpingo-oophorectomy was done. Histopathological examination confirmed ovarian endometriosis and adenomyosis of uterus. Though reconstructive surgery for cervical dysgenesis has been successful in some cases, hysterectomy is generally recommended for cervical agenesis