Successful vaginal delivery of spontaneously conceived twins in each horn of a bicornuate uterus with previous caesarean: a case report

Mullerian duct fusion anomalies resulting in uterine malformations have prevalence of 3-4%. Among this, bicornuate uterus has a rare incidence of 0.4%. Uterine malformations pose significant threat in terms of obstetric outcomes. We report an extremely rare case of spontaneous conception of twin pregnancy with the fetus occupying each horn of a bicornuate uterus (bicornis unicollis), in a woman with a history of previous caesarean section. She was booked at our hospital and the pregnancy remained uneventful. At 35 weeks she went into spontaneous labour and delivered vaginally without any maternal-fetal complications. The case is unique and the management is worth discussing as till date no protocols or guidelines have been proposed for the mode of delivery of bicornuate uterus with twins with previous cesarean.  Only 12 cases of twins with bicornuate uterus have been reported till date. This is the first case in literature in which a successful VBAC has been conducted in a woman with bicornuate uterus with twins with previous caesarean

Varied clinical presentations of scar endometriosis: case reports

Endometriosis is the second most prevalent benign gynaecological condition, in reproductive age women, defined as the presence of functioning endometrial tissue outside uterine cavity. Scar endometriosis is a rare entity with an incidence of 0.3-1% among reproductive age women following obstetric and gynaecologic surgeries. Complaints of pain, tender mass, cyclical association with menstrual cycle is almost pathognomonic. Here we present two case reports of scar endometriosis recently encountered at our institute – caesarean scar endometriosis and episiotomy scar endometriosis. The quoted episiotomy scar endometriosis incidence is about 0.06 - 0.07% while that of caesarean scar endometriosis is 0.03-0.4%

Female paraurethral leiomyoma: a case report

Abstract Background Leiomyoma is a benign fibromuscular neoplasm originating from smooth muscle cells. Paraurethral leiomyoma is an extremely rare, benign, hormone-dependent growth from the mesenchymal cells in paraurethral space of female urethra. They usually appear in the reproductive age group women, mean age of presentation being approximately 41 years. Case presentation A 48-year-old woman presented with palpable mass at vagina and weak urinary stream. She underwent clinical examination and CT scan and MRI imaging followed by transvaginal excision of the mass. Histopathological examination confirmed paraurethral leiomyoma. Conclusions Paraurethral leiomyoma owing to its rare incidence poses a diagnostic dilemma for the gynecologists. Radiological imaging techniques help in diagnosis. Surgical excision via vaginal route is the treatment of choice. Diagnosis is confirmed by histopathology