Comparative analysis of four biomarkers in diagnosing premature rupture of membranes and their correlation with onset of labour

Background: The diagnosis of equivocal cases of premature rupture of membranes (PROM) with traditional methods has been unreliable therefore various biochemical markers have been sought to confirm the same. This study aims to determine the most reliable marker amongst β human chorionic gonadotropin (βhCG) ά fetoprotein (AFP), prolactin and creatinine in vaginal washing for diagnosing PROM and to establish the correlation between the level of these markers and the onset of labour.Methods: Fifty pregnant women between 20 and 40 weeks of gestation with history of leaking per vaginum (study group) and an equal number of gestation matched pregnant women without leak (control group) were recruited to the study. All women underwent speculum examination aiming to sample and assay the two markers. The duration from PROM to onset of labour was recorded in the study group. Data was analyzed by student’s t-test, receiver operator curve and chi square test.Results: Vaginal washing concentration of the markers were significantly higher in the study group (p<0.01) thereby rendering them as markers for diagnosing PROM. There was negative correlation coefficient between the levels of markers and duration from PROM to onset labour, denoting early onset of labour in patients with higher levels of markers.Conclusions: AFP and creatinine were better markers for diagnosing premature rupture of membranes while β human chorionic gonadotropin was the better predictor of onset of labour.

Sarcoma botryoides in a 14 year old girl: a rare case

Embryonal rhabdomyosarcoma (Sarcoma botryoides) of the uterine cervix is an uncommon entity. Because of extreme rarity its discussion has mainly been in the light of individual case reports. We report a case of a 14-year old female who presented with irregular vaginal bleeding and cervical polyp. Her biopsy specimen confirmed sarcoma botryoides and she underwent abdominal hysterectomy with wide excision of vaginal cuff after a multidisciplinary consultation

Henoch schonlein purpura in pregnancy: a lesser known phenomenon

Henoch Schonlein Purpura is a rare disease and its occurrence during pregnancy is exceptional. Very little information is found in the literature regarding this topic and only handful of case reports are available to throw light upon the same. Presented here is a case of a 30 year old primigravida with pre-existent disease with successful fetomaternal outcome subsequently

A rare case of chronic ectopic pregnancy mimicking ovarian tumor: a diagnostic dilemma

Clinical presentation of chronic ectopic pregnancy is often perplexing. The diagnosis becomes difficult due to paucity of classical signs and symptoms and at times the relevant investigations turn out to be falsely negative. We present one such case, reporting to our hospital which serves the underprivileged North Eastern population of India. The low resource set up led to limitations in our approach and here we point out the factors which led to the diagnostic dilemma. We are reporting this case because similar challenges can be faced by other clinicians who are working in set up like ours