Convulsions in early post-partum period, a diagnostic dilemma

Neurocysticercosis is the most common helminthic (tapeworm) infection of the brain worldwide. It presents as hydrocephalus and acute onset seizures. A 28-year-old para 3 live 3 [P3L3], post-partum [day 7], resident of Arvi, presented in casualty during emergency hours with headache and fever since 7 days. She presented with h/o convulsions 2 episodes, one on day 5 and one on day 7 of her full term vaginal home delivery. She presented to the Emergency Department on day 7 with generalised tonic-clonic seizures preceded by nausea and headache. All her blood investigations were within normal limits except an extremely surprising finding on CT scan. 40% of patients having postpartum convulsions do not experience preeclampsia, clinical awareness is essential for early treatment and care

Successful maternal and fetal outcome of Guillain-Barre syndrome complicating pregnancy: a case report

Guillain-Barré syndrome rarely complicates pregnancy, incidence being 2/100000 population. We report a case of 23-year-old 2nd gravida who developed a progressive ascending paralysis during the second trimester of pregnancy. The worsening of the respiratory insufficiency required transfer to an intensive care unit but did not require artificial ventilation. Cerebrospinal fluid examination revealed albumin-cytological dissociation and repeated electrophysiological studies showed typical features of demyelinating neuropathy with conduction blocks. Biological investigations, especially CMV and campylobacter jejuni serologies, were all negative. Intravenous immunoglobulin infusions resulted in rapid improvement in the patient. This case raises the question of the relationship between the Guillain-Barré syndrome and pregnancy. The occurrence of the disease, as well as the rapid recovery in antenatal period could be consecutive to a partial failure of the maternal immunological tolerance toward the fetus

Correlation of diagnostic efficacy of unhealthy cervix by cytology, colposcopy and histopathology in women of rural areas

Background: The objective was to assess the sensitivity and specificity of pap smear and colposcopy and to study the socio demographic parameters of women with unhealthy cervix. Methods: This was a prospective observational study conducted from August 2011 – August 2013 in the Department of Obstetrics and Gynaecology. Pap smear was performed by the conventional method and colposcopy was done for all 200 sexually active women who came with complaints of discharge per vagina, inter menstrual or post coital bleeding. Colposcopy results were analysed. Final correlation of pap smear and colposcopy were based on histopathology.Results: There were 200 samples that were suitable for statistical analysis. The sensitivity of colposcopy was 79.37%, specificity 81.02%, positive predictive value 65.79%, negative predictive value 89.52% respectively and accuracy was 80.5%. Pap smear had a sensitivity of 25.4%, specificity of 99.27%, positive predictive value of 94.12%, negative predictive value of 74.32%, and accuracy of 76.0% respectively.Conclusions: Pap smear had a poorer sensitivity compared to Colposcopy but a better specificity than colposcopy. Hence it may be better to utilise both tests as they complement each other in screening of premalignant lesions of cervix

A thoracophagus conjoined twins with myelomeningocele: an unusual case

Conjoined twins represent one of the rarest forms of twin gestation. Conjoined twinning is rare, occurring in about 1% of monochorionic twins with an estimated incidence ranging from 1:30,000 to 1:2,00,000 live births and 1 in 650 to 900 twin deliveries. A 21 year old gravida 2, with an abortion, a resident of Ginjakheda, Deoli Wardha came to our hospital, AVBRH Sawangi and presented with history of amenorrhoea of six months. She had her first ultrasonography done which demonstrated thoracophagus conjoined twins. Patient was admitted in view of management of conjoined twins. She was posted for elective caesarean section on 5/11/11. A conjoined twin of combined weight around 2 kgs was extracted out. Both the foetuses were female with multiple congenital anomalies. In conclusion, conjoined twins are associated with a high perinatal mortality; therefore making an early diagnosis by means of ultrasonography, gives parents a chance to elect pregnancy termination

Status of Maternal Serum Vitamin D Levels in Rural India

Background: The role of Vitamin D during pregnancy and its effect on maternal and fetal health is just beginning to be understood. What is clear, however, is that Vitamin D deficiency during pregnancy is rampant throughout the world. Vitamin D deficiency is prevalent in India, a finding that is unexpected in a tropical country with abundant sunshine. Various studies have shown an intrinsic relation between various parameters of maternal and fetal wellbeing with maternal Vitamin D status during pregnancy.Aim: To determine the status of Vitamin D levels in pregnancy among rural mothers.Methods: A total of 60 pregnant females, aged 20-35 years were studied during the third trimester of pregnancy. Serum Vitamin D was measured by chemiluminescent immunoassay.Results: 65% subjects were found to have Vitamin D deficiency and 26.67% were found to have Vitamin D insufficiency whereas 8.33% had normal Vitamin D levels. Mean maternal serum Vitamin D level was 15.97±9.216 ng/mL.Conclusions: We observed a high prevalence of physiologically significant hypovitaminosis D among pregnant women attending rural hospital. As mentioned in literature, Vitamin D deficiency is associated with adverse fetomaternal outcome, the magnitude of hypovitaminosis D in antenatal period warrants public health intervention