Silent uterine rupture of scarred uterus--an unusual presentation as amniocele

Obstetricians should be aware of the possibility of silent rupture of scarred uterus. Ultrasound has an important role in the diagnosis of silent uterine rupture. A case of silent uterine rupture with foetal demise, that remained undiagnosed for many weeks, is described

Spontaneous bilateral tubal pregnancy

With the increase in incidence of ectopic pregnancy over the decades, bilateral ectopic pregnancy is also increasing. It is usually associated with assisted reproductive techniques (ART) but in recent years few cases of spontaneous bilateral ectopic pregnancy have been reported. Gynaecologists should be aware of this and that ultrasonography has limitations in diagnosis. In cases of ectopic pregnancy where contralateral adnexa is not clearly identified on ultrasound and fertility needs to be conserved, patient should be managed by experts in well equipped centres. A case of spontaneous bilateral tubal pregnancy that remained undiagnosed till laparotomy, is described

A phase three open label randomized controlled trial to compare the efficacy of oral hypoglycemic agents (OHA) with insulin in the treatment of gestational diabetes mellitus (GDM)

Background: The incidence of GDM is 1 – 14 % (5 – 8 % reported in most areas). It is globally on the rise in parallel with type 2 diabetes. The short and long term adverse maternal, fetal and neonatal outcomes in pregnancy with Diabetes are well known. Insulin therapy has been regarded as the gold standard medical intervention in pregnancy. It has limitations especially in poorly resourced, illiterate and non-compliant population. Studies have shown that some oral hypoglycemic agents (OHA) ( FDA category B:Glibenclamide and Metformin) are safe in pregnancy. Studies comparing these with insulin have found them to be as effective as insulin with comparable outcomes in pregnancy. Objectives: Primary objective:To compare efficacy of Oral Hypoglycemic Agents and Insulin in the treatment of GDM (percentage of subjects achieving target blood sugars at delivery). Secondary objective :To compare cost and acceptability to treatment in both groups. Methods: This is a collaborative study between the Department of Obstetrics and Gynaecology and the Section of Endocrinology, Department of Medicine. Results and conclusions: This clinical trial is in progress and is recruiting patients. Results will be communicated later o