A clinical study of ectopic pregnancy in a tertiary care centre in Hubli

Background: To evaluate the burden of ectopic pregnancies in our hospital over the period of one year and to evaluate the risk factors, mode of intervention and outcomes of those cases.Methods: A retrospective analysis was conducted in Karnataka Institute of Medical Sciences, Hubli over the period of one year from January 2015 to December 2015. All patients admitted with a diagnosis of ectopic pregnancy, either ruptured or unruptured were included in the study. Their history, risk factors, outcome and complications were also evaluated in detail.Results: 40 patients with diagnosis of ectopic pregnancy were admitted, yielding to an incidence of 3.76/1000. Most patients presented to our hospital in a state of shock. 26(65%) were ruptured, 10(25%) were unruptured and 4(10%) were chronic ectopic pregnancies. 39 cases were managed by laparotomy and one patient by conservative method using methotrexate. Most common risk factor noted in our study was history of tubal sterilization, noted among 12(30%) women. No mortality was noted in our study.Conclusions: Ectopic pregnancy is a significant cause of morbidity and mortality in first trimester. High degree of suspicion and early detection can prevent a great degree of morbidity among women, especially in women with prior tubal sterilization procedure

Clinical study of cardiac diseases during pregnancy

Background: Objective of the study was to evaluate the burden of cardiac diseases in pregnancy in our hospital, their clinical presentation, type of cardiac lesion, complications, maternal and neonatal outcome.Methods: A prospective analysis conducted at Karnataka Institute of Medical Sciences, Hubli, a tertiary care center in Karnataka, between July 2014 to June 2015. All patients with cardiac diseases during pregnancy and developed during postpartum period were included in the study. Age, parity, mode of delivery, perinatal outcome, complications intra-partum and post-partum were analyzed in detail.Results: 35 cases with cardiac disease in pregnancy were noted. Valvular heart disease accounted for 18 cases (51.4%), acyanotic CHD were 11 (31.4%) , cyanotic CHD were 2 (5.7%). 2 developed peripartum cardiomyopathy during their post natal period (5.7%) , 2 were admitted with previous history of peripartum cardiomyopathy. Most common lesion noted was mitral stenosis (40.5%). 26 had term deliveries and 7 had preterm. One maternal mortality was noted (2.8%).Conclusions: Cardiac diseases in pregnancy constitute high risk pregnancy and require special attention during antepartum, intrapartum and postpartum period. Rheumatic heart disease was the major contribution of cardiac diseases in pregnancy and is seen to be associated with increased maternal morbidity

Rupture uterus: a prospective observational study of 25 consecutive cases in a tertiary referral centre in South India

Background: Uterine rupture in pregnancy is a rare though catastrophic complication with a high incidence of foetal and maternal morbidity. It appeared to be on the decline in recent times, prompting us to analyse the clinical picture now. The objective of the study was to study the risk factors, clinical profile and consequences of uterine rupture on maternal and perinatal outcome.Methods: A prospective observational study of 25 consecutive cases of uterine rupture was carried out between July 2013 and October 2015. All the cases of rupture uterus either referred or diagnosed after admission were included. Detailed demographic data, past and present obstetric events, time taken to reach the referral centre, the reasons for any delay, mode of presentation, type of rupture, management and maternal and foetal outcomes were analysed.Results: The incidence of rupture was 1 in 915 deliveries. Seventy-two per cent of them were referred cases. Average time to reach from referral centre was 4.3 hours, the common reasons for delay being patient factors (33%), transport problems (38%) and delayed referrals (22%). Previous caesarean section was the most common predisposing factor (56%). Sixty-four per cent of the ruptures were diagnosed clinically. Eighty-four per cent of the ruptures were complete. Sub-total hysterectomy was carried out in 14 (56%) patients. Internal iliac artery ligation (20%) and bladder repair (8%) were sometimes required. All women required blood transfusion.  Perinatal mortality was seen in 76%. There was no maternal mortality.Conclusions: Uterine rupture is a cause of severe acute maternal morbidity and very high perinatal mortality.  Delay in referral and diagnosis can lead to significant maternal morbidity and hysterectomy

Rare metastasis of carcinoma ovary

This is a case report of a 64 year old para 5 operated 2 years back for ovarian papillary adenocarcinoma presenting 2 years later with cutaneous metastases over anterior abdominal wall.

Rare case report of metastatic cervical carcinoma

Although carcinoma of cervix is among the most common malignancies in women, cutaneous metastasis is very unusual. Here we report a case of a parous woman diagnosed with adenocarcinoma of cervix who did not undergo chemotherapy in spite of being advised after initial surgery, presenting with cutaneous metastasis at the operative scar site 2 years later

Pregnancy outcome in a rare case of complex cyanotic congenital heart disease

A 28 year old primigravida with the very rare congenital heart condition of single ventricle with single atrium presented with 34 weeks gestation, and underwent caesarean section with minimal morbidity. As the condition is not known for survival into adulthood, the carrying of a pregnancy successfully to near term makes this an even rarer case