CASE REPORT: A 20yrs old G3,P1, L1, A1 with h/o previous cesarean section with 5months of amenorr... more CASE REPORT: A 20yrs old G3,P1, L1, A1 with h/o previous cesarean section with 5months of amenorrhea presented to Government General Hospital, Kakinada, AP, India with bleeding PV and pain abdomen since 16 days. On enquiry it was found that she underwent medical termination of pregnancy 20 days back at a private hospital for five months of pregnancy followed by profuse bleeding per vagina and D&E was done for the same complaint 16days back followed by intractable bleeding on table. She was transfused with one unit of blood and referred to Government General Hospital, Kakinada. At the time of admission patient was pale with a BP 110/70mmHg, pulse 76/min and afebrile. On examination suprapubic transverse scar was present with tenderness over suprapubic region. Uterus is around 14-16 weeks size. Per vaginal examination revealed opened cervical so with bleeding through os, uterus 14-16weeks size tender, mobile, fornices are free. On Investigations her hemoglobin was 6gm%, with normal clotting profile. Sonography revealed retained products of conception and MRI showed a rent of about 2x1 cm in the lower uterine segment with a low intense are suggestive of blood clot. 3units of compatible blood transfused. As there is no bleeding patient was discharged after observing for 10 days. After 1 week patient came to hospital with bout of bleeding with pallor and BP 90/60mmHg and one unit of blood transfused. In view of recurrent bleeding episodes emergency laparotomy was planned. On opening the peritoneum bladder was drawn up and densely adherent to lower uterine segment. Uterus contracted with ballooned out lower uterine segment. A rent of 2cm found in the lower uterine segment. While dissecting the lower uterine segment bladder was injured and repaired with suprapubic cystostomy. On cut section around 500gms clots were present in lower uterine segment and cervical canal. Postoperative period was uneventful and patient discharged on 7 th post-operative day with supra pubic catheter in situ. Cut section of uterus showing blood clot over scar rupture
Background: This is a per operative study of thickened Ligamentum flavum, in lumbar canal stenosi... more Background: This is a per operative study of thickened Ligamentum flavum, in lumbar canal stenosis due to degenerative spondylosis, found to be an important compressive force on emerging nerve root, along with hypertrophy of adjacent facet joint, causing radiculopathy [neurological claudication] independent of degenerative disc disease Materials and Methods: We operated on, 98 elderly patients, suffering from degenerative lumbar spondylosis with canal stenosis with radiculopathy. The surgeries were performed over the time period from 2011 October to 2014 May. Seventy patients were males and twenty eight were females. The mean age of patient was of 62 years (range 56 to 74 years). Out of 70 male patients, Ligamentum flavum is thickened bilaterally in 62 patients and it is more thickened unilaterally in eight patients, all 28 female patients have bilateral uniform thickening of Ligamentum flavum. All the patients of lumbar canal stenosis due to degenerative spondylosis , lumbo sacral spine screened by MRI scanning, and found Ligamentum flavum is thickened in all patients. Results: Internal decompression of lumbar canal stenosis, by thorough removal of thickened Ligamentum flavum, along with partial excision of hypertrophied superior facet; make the intervertebral foramen wide, and thus creating more room for emerging nerve root. All patients were free from symptoms post operatively. Conclusion: Thickened Ligamentum flavum must be excised thoroughly, along with partial fascetectomy of adjacent superior facet and thus decompressing the spinal root in lateral canal where it is being compressed by thickened Ligamentum flavum and by hypertrophied facet joint.
INTRODUCTIONTreacher Collins syndrome (TCS) is a rare syndrome inherited as autosomal dominant. T... more INTRODUCTIONTreacher Collins syndrome (TCS) is a rare syndrome inherited as autosomal dominant. The affected children may vary in severity ranging from minimal features as slanting of palpebral fissures to major features of craniofacial development such as hypertelorism, micrognathia, maxillary hypoplasia, high arched palate, conductive hearing loss, external ear abnormalities and narrow nostrils. We report a case of Treacher Collins syndrome with term gestation with polyhydramnios and fetus with micrognathia on ultrasound examination with previous two babies and father having the same disorder. Case Report A 30 year old ,unbooked G3 P2 L1D1, postcesaerean pregnancy, term gestation with polyhydramnios with breech presentation with features of TCS admitted for institutional delivery at Government General Hospital, Kakinada, Andhra Pradesh, India. Her scan on admission revealed single fetus in breech presentation with micrognathia and AFI 25cm. she delivered a live male baby weighing 2.2kg with features of TCS through ceserean section and inspite of airway support the baby died on first postnatal day. Conclusion This case report confirms the need to identify the antenatal women with physical malformations and early ultrasound scan in women with previous H/O anomalous children, and polyhydramnios so that termination can be planned early. Key Words Polyhydramnios , Treacher Collins Syndrome, Micrognathia, Anti mongoloid slant of eyes
Sertoli-Leydig cell tumor or " Androblastoma " or " Arrhenoblastoma " is a rare virilizing tumor ... more Sertoli-Leydig cell tumor or " Androblastoma " or " Arrhenoblastoma " is a rare virilizing tumor of ovary, mostly with masculinizing features. Many but certainly not all tumors are hormonally active. Although classified under malignant tumors the degree of malignancy is less than that of ovarian carcinoma in general. Unilateral oophorectomy was done and the patient recovered well with diminution of masculinizing features. INTRODUCTION: Sertoli-Leydig cell tumor (SLCT) is a rare ovarian tumor that belongs to the group of sex-cord stromal tumors. These constitute less than 0.5% of ovarian tumors .Most tumors are unilateral, seen during the second and third decades of life and are of less well differentiated variety. Many patients have symptoms of virilization due to the presence of androgen element in tumor. The degree of differentiation is age related. 1 Intermediate differentiated tumors comprises of 54% of tumors (data reference 2).
Aim and Objective: To assess the knowledge, attitude regarding family planning methods and contra... more Aim and Objective: To assess the knowledge, attitude regarding family planning methods and contraceptive practices among reproductive age group women. Methodology: 500 women in the reproductive age group 15-45years attending Government General Hospital, Kakinada, Andhra Pradesh, India were interviewed with predesigned questionnaire after taking informed consent. Results: Most of the women interviewed fall in the age group of 21-30years (48%). 91% are married for 5years. 46% are illiterates and only 17.6% had primary education. Out of 500 women interviewed 484 (96.8%) had heard/aware of family planning method (permanent/temporary). Out of 484 women, who had knowledge and awareness of family planning methods about 328 (67.77%) got information from social circle (husband, mother/ in laws). The importance of and use of contraception has been explained by health personnel to 68 (14%) and 88 (18.18%) got it through mass media. Out of 500 women interviewed, 269 (53.8%) were practicing different contraceptive methods. Most of them 135 (50.18%), resort to tubal ligation as a contraceptive method of choice and the reason being completion of their family in 178 (66.17%). Only 66 (24.5%) women used various methods for spacing. Only 11(4%) women used OCP as a contraceptive method as against 106(21.9%) women having knowledge about them. Conclusions: Lack of knowledge regarding the various methods of contraception is the reason for not practicing family planning methods. There is need for focused awareness program based on the knowledge gaps reported among women in reproductive age group.
The aim of the present study is to find out the demographic profile, maternal and perinatal outco... more The aim of the present study is to find out the demographic profile, maternal and perinatal outcome of patients with placenta previa. It is a prospective study done at Government General Hospital, Kakinada, Andhra Pradesh during the period of July 2013 to June 2014. 61 Antenatal women with more than 28weeks of gestational age with a complaint of painless vaginal bleeding or those diagnosed as having placenta previa on routine ultrasound examination were included in this study and were evaluated with comprehensive maternal history, clinical, laboratory and ultrasound examination and demographic profile, type of placenta previa on ultrasound examination, impact of previous method of delivery and present method of delivery, maternal and perinatal complications, incidence of postpartum haemorrhage and the need of blood transfusion were noted. Total number of deliveries during this period is 10,299. The incidence of placenta previa was 0.6%. Unbooked cases (77.04%),Mean age of presentation was 29yrs. Multigravidae (65.57%), (52.45%) presented between 28-34weeks gestational age, APH(65.57%), malpresentations (18.03%), women with previous history of surgical intervention (60%), postpartum haemorrhage (27.87%), need for blood transfusion (80.32%). Perinatalmortality (6.6%) and NICU admissions (24.56%), TAH (3.27%), maternal mortality was nil. Early diagnosis of placenta previa and timely intervention with arrangement of blood transfusion, and a good anesthetic, surgical and pediatric team improves maternal and perinatal outcome.
Background: Ovary is the common site of non-neoplastic and neoplastic lesions which accounts for ... more Background: Ovary is the common site of non-neoplastic and neoplastic lesions which accounts for significant morbidity and mortality. The objective of present study was to ascertain the frequency and distribution of the various non-neoplastic and neoplastic ovarian mass lesions and to study the clinical and histopathological presentation. Methods: Observational study of cases with ovarian mass lesions subjected to surgical management from September 2009-August 2014 at our centre Government General Hospital/RMC Kakinada. Results: Incidence of ovarian masses was (n=404) 4.66% in 8,656 admissions subjected to surgical management. There were (340/404) 84.16% neoplasms and (64/404) 15.84% nonneoplastic lesions. Follicular and simple serous cysts were common non neoplastic lesions. Twisted ovarian cyst was the commonest surgical emergency. Age of the patients ranged from 9years to 82years.Mean ages of non-neoplastic, benign and malignant lesions were 34.2years, 36.8years and 44.7yrs.Most of the cases were in reproductive agegroup (p<0.001). Benign neoplasms were (248/340) 72.94%, borderline (26/340) 7.64% and malignant neoplasms were (66/340) 19.41%. Surface epithelial tumours dominated other types (78.12%) followed by germ cell tumours (12.05%) and sex cord stromal tumours (6.47%). Mucinous cystadenoma (34.11%) was the commonest benign tumour, followed by serouscystadenoma 23.53%. Commonest malignant ovarian tumour was serous cystadenocarcinoma (9.11%). Conclusion: Ovarian neoplasms were more common than non-neoplasms subjected to surgical management. Surface epithelial tumours were the commonest neoplasms with more benign neoplasms. Commonest benign neoplasm was mucinous cystadenoma and malignant was serous cystadenocarcinoma. Significant number of malignant ovarian tumors presented at an earlier age and in late stages. Keywords: Ovarian neoplasm, Non-neoplasm, Clinical evaluation, Histopathology
Background: Tubal sterilization is considered a permanent method of contraception. The risk of fa... more Background: Tubal sterilization is considered a permanent method of contraception. The risk of failure of tubectomy is only 0.1-0.3%. Most often the pregnancy following tubal sterilization is ectopic gestation. Methods: 35 cases of post sterilization ectopic gestation were evaluated during a period of January 2014 to December 2015 at Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh, India. Results: Number of post sterilization ectopic gestation were (n=35) 33%, in 105 ectopic gestations during this period. 93% were in the age group of 20-30years with a mean age of 30.5years. 82% were gravida three who underwent sterilization with two living children. 62% of women presented with 4-6 weeks of amenorrhoea. 97.14% underwent minilaparotomy and out of which 74% were performed in Government hospitals. Puerperal sterilizations constituted 85%. In all cases ectopic gestation occurred within 10years of undergoing sterilization and all cases presented with hemoperitoneum. Site of rupture is ampulla in 31.4% of cases. Length of remaining tube is 7-8cm in 60% of cases. Conclusions: History of tubal sterilization does not rule out the possibility of ectopic gestation even when many years after the tubectomy. Adopting correct technique can reduce the failure rates. Woman should be counselled about the possibility of intra and extra uterine gestation at the time of performing tubectomy. Keywords: Contraception, Ectopic gestation, Mini laparotomy, Modified Pomeroy’s method
Abstract
Objectives: To study the clinical profile of the patients presenting with neurological d... more Abstract Objectives: To study the clinical profile of the patients presenting with neurological disorders during pregnancy and puerperium. Methods: The study was carried out at Government General Hospital, Kakinada, Andhra Pradesh, India between June 2006 and May 2007. Patients in pregnancy, postabortal and postpartum period evaluated in Neurology out-patient and in-patient departments and referred to Neurology department, Government General Hospital, Kakinada during this time were included in this study. Results: A total of 55 patients presented during pregnancy and puerperium with neurological disorders. Age of the patients ranged from 17 to 31 years. The total number of deliveries in this hospital during this period was 9726. Out of 55 patients Epilepsy—27[49.09%], Eclampsia—11[20%], Cerebro vascular disorders—6[10.9%], Neuropathies —4[7.27%], Extrapyramidal disorders---2[3.64%], CNS infections—Tubercular meningitis –1[1.81%], Myelopathy—1[1.81%], Toxic/ metabolic encephalopathy—1[1.81%]. Conclusions: Epilepsy was the most common neurological condition followed by Eclampsia and Cerebrovascular diseases. Health education measures for prospective mothers regarding the appropriate, adequate and regular use of anti-epileptic drugs should be taken up. Diligent care is to be taken to watch for neurological deficit in cases of Pre-eclampsia/ Eclampsia to identify special investigation team—Obstetrician, Neurologist, Physicians and Neurologist. The treating team should have the complete knowledge of the effects of rare neurological disorders during pregnancy and puerperium. DOI: http://dx.doi.org/10.4038/sljog.v36i3.7722 Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 74-78 Keywords: Epilepsy, Eclampsia, Cerebrovascular disorders, Chorea gravidarum, Guillain-Barre syndrome How to Cite: Sarella, L.K. & Rao, D.S., (2014). Neurological disorders in pregnancy and puerperium. Sri Lanka Journal of Obstetrics and Gynaecology. 36(3), pp.74–78. DOI: http://doi.org/10.4038/sljog.v36i3.7722
CASE REPORT: A 20yrs old G3,P1, L1, A1 with h/o previous cesarean section with 5months of amenorr... more CASE REPORT: A 20yrs old G3,P1, L1, A1 with h/o previous cesarean section with 5months of amenorrhea presented to Government General Hospital, Kakinada, AP, India with bleeding PV and pain abdomen since 16 days. On enquiry it was found that she underwent medical termination of pregnancy 20 days back at a private hospital for five months of pregnancy followed by profuse bleeding per vagina and D&E was done for the same complaint 16days back followed by intractable bleeding on table. She was transfused with one unit of blood and referred to Government General Hospital, Kakinada. At the time of admission patient was pale with a BP 110/70mmHg, pulse 76/min and afebrile. On examination suprapubic transverse scar was present with tenderness over suprapubic region. Uterus is around 14-16 weeks size. Per vaginal examination revealed opened cervical so with bleeding through os, uterus 14-16weeks size tender, mobile, fornices are free. On Investigations her hemoglobin was 6gm%, with normal clotting profile. Sonography revealed retained products of conception and MRI showed a rent of about 2x1 cm in the lower uterine segment with a low intense are suggestive of blood clot. 3units of compatible blood transfused. As there is no bleeding patient was discharged after observing for 10 days. After 1 week patient came to hospital with bout of bleeding with pallor and BP 90/60mmHg and one unit of blood transfused. In view of recurrent bleeding episodes emergency laparotomy was planned. On opening the peritoneum bladder was drawn up and densely adherent to lower uterine segment. Uterus contracted with ballooned out lower uterine segment. A rent of 2cm found in the lower uterine segment. While dissecting the lower uterine segment bladder was injured and repaired with suprapubic cystostomy. On cut section around 500gms clots were present in lower uterine segment and cervical canal. Postoperative period was uneventful and patient discharged on 7 th post-operative day with supra pubic catheter in situ. Cut section of uterus showing blood clot over scar rupture
Background: This is a per operative study of thickened Ligamentum flavum, in lumbar canal stenosi... more Background: This is a per operative study of thickened Ligamentum flavum, in lumbar canal stenosis due to degenerative spondylosis, found to be an important compressive force on emerging nerve root, along with hypertrophy of adjacent facet joint, causing radiculopathy [neurological claudication] independent of degenerative disc disease Materials and Methods: We operated on, 98 elderly patients, suffering from degenerative lumbar spondylosis with canal stenosis with radiculopathy. The surgeries were performed over the time period from 2011 October to 2014 May. Seventy patients were males and twenty eight were females. The mean age of patient was of 62 years (range 56 to 74 years). Out of 70 male patients, Ligamentum flavum is thickened bilaterally in 62 patients and it is more thickened unilaterally in eight patients, all 28 female patients have bilateral uniform thickening of Ligamentum flavum. All the patients of lumbar canal stenosis due to degenerative spondylosis , lumbo sacral spine screened by MRI scanning, and found Ligamentum flavum is thickened in all patients. Results: Internal decompression of lumbar canal stenosis, by thorough removal of thickened Ligamentum flavum, along with partial excision of hypertrophied superior facet; make the intervertebral foramen wide, and thus creating more room for emerging nerve root. All patients were free from symptoms post operatively. Conclusion: Thickened Ligamentum flavum must be excised thoroughly, along with partial fascetectomy of adjacent superior facet and thus decompressing the spinal root in lateral canal where it is being compressed by thickened Ligamentum flavum and by hypertrophied facet joint.
INTRODUCTIONTreacher Collins syndrome (TCS) is a rare syndrome inherited as autosomal dominant. T... more INTRODUCTIONTreacher Collins syndrome (TCS) is a rare syndrome inherited as autosomal dominant. The affected children may vary in severity ranging from minimal features as slanting of palpebral fissures to major features of craniofacial development such as hypertelorism, micrognathia, maxillary hypoplasia, high arched palate, conductive hearing loss, external ear abnormalities and narrow nostrils. We report a case of Treacher Collins syndrome with term gestation with polyhydramnios and fetus with micrognathia on ultrasound examination with previous two babies and father having the same disorder. Case Report A 30 year old ,unbooked G3 P2 L1D1, postcesaerean pregnancy, term gestation with polyhydramnios with breech presentation with features of TCS admitted for institutional delivery at Government General Hospital, Kakinada, Andhra Pradesh, India. Her scan on admission revealed single fetus in breech presentation with micrognathia and AFI 25cm. she delivered a live male baby weighing 2.2kg with features of TCS through ceserean section and inspite of airway support the baby died on first postnatal day. Conclusion This case report confirms the need to identify the antenatal women with physical malformations and early ultrasound scan in women with previous H/O anomalous children, and polyhydramnios so that termination can be planned early. Key Words Polyhydramnios , Treacher Collins Syndrome, Micrognathia, Anti mongoloid slant of eyes
Sertoli-Leydig cell tumor or " Androblastoma " or " Arrhenoblastoma " is a rare virilizing tumor ... more Sertoli-Leydig cell tumor or " Androblastoma " or " Arrhenoblastoma " is a rare virilizing tumor of ovary, mostly with masculinizing features. Many but certainly not all tumors are hormonally active. Although classified under malignant tumors the degree of malignancy is less than that of ovarian carcinoma in general. Unilateral oophorectomy was done and the patient recovered well with diminution of masculinizing features. INTRODUCTION: Sertoli-Leydig cell tumor (SLCT) is a rare ovarian tumor that belongs to the group of sex-cord stromal tumors. These constitute less than 0.5% of ovarian tumors .Most tumors are unilateral, seen during the second and third decades of life and are of less well differentiated variety. Many patients have symptoms of virilization due to the presence of androgen element in tumor. The degree of differentiation is age related. 1 Intermediate differentiated tumors comprises of 54% of tumors (data reference 2).
Aim and Objective: To assess the knowledge, attitude regarding family planning methods and contra... more Aim and Objective: To assess the knowledge, attitude regarding family planning methods and contraceptive practices among reproductive age group women. Methodology: 500 women in the reproductive age group 15-45years attending Government General Hospital, Kakinada, Andhra Pradesh, India were interviewed with predesigned questionnaire after taking informed consent. Results: Most of the women interviewed fall in the age group of 21-30years (48%). 91% are married for 5years. 46% are illiterates and only 17.6% had primary education. Out of 500 women interviewed 484 (96.8%) had heard/aware of family planning method (permanent/temporary). Out of 484 women, who had knowledge and awareness of family planning methods about 328 (67.77%) got information from social circle (husband, mother/ in laws). The importance of and use of contraception has been explained by health personnel to 68 (14%) and 88 (18.18%) got it through mass media. Out of 500 women interviewed, 269 (53.8%) were practicing different contraceptive methods. Most of them 135 (50.18%), resort to tubal ligation as a contraceptive method of choice and the reason being completion of their family in 178 (66.17%). Only 66 (24.5%) women used various methods for spacing. Only 11(4%) women used OCP as a contraceptive method as against 106(21.9%) women having knowledge about them. Conclusions: Lack of knowledge regarding the various methods of contraception is the reason for not practicing family planning methods. There is need for focused awareness program based on the knowledge gaps reported among women in reproductive age group.
The aim of the present study is to find out the demographic profile, maternal and perinatal outco... more The aim of the present study is to find out the demographic profile, maternal and perinatal outcome of patients with placenta previa. It is a prospective study done at Government General Hospital, Kakinada, Andhra Pradesh during the period of July 2013 to June 2014. 61 Antenatal women with more than 28weeks of gestational age with a complaint of painless vaginal bleeding or those diagnosed as having placenta previa on routine ultrasound examination were included in this study and were evaluated with comprehensive maternal history, clinical, laboratory and ultrasound examination and demographic profile, type of placenta previa on ultrasound examination, impact of previous method of delivery and present method of delivery, maternal and perinatal complications, incidence of postpartum haemorrhage and the need of blood transfusion were noted. Total number of deliveries during this period is 10,299. The incidence of placenta previa was 0.6%. Unbooked cases (77.04%),Mean age of presentation was 29yrs. Multigravidae (65.57%), (52.45%) presented between 28-34weeks gestational age, APH(65.57%), malpresentations (18.03%), women with previous history of surgical intervention (60%), postpartum haemorrhage (27.87%), need for blood transfusion (80.32%). Perinatalmortality (6.6%) and NICU admissions (24.56%), TAH (3.27%), maternal mortality was nil. Early diagnosis of placenta previa and timely intervention with arrangement of blood transfusion, and a good anesthetic, surgical and pediatric team improves maternal and perinatal outcome.
Background: Ovary is the common site of non-neoplastic and neoplastic lesions which accounts for ... more Background: Ovary is the common site of non-neoplastic and neoplastic lesions which accounts for significant morbidity and mortality. The objective of present study was to ascertain the frequency and distribution of the various non-neoplastic and neoplastic ovarian mass lesions and to study the clinical and histopathological presentation. Methods: Observational study of cases with ovarian mass lesions subjected to surgical management from September 2009-August 2014 at our centre Government General Hospital/RMC Kakinada. Results: Incidence of ovarian masses was (n=404) 4.66% in 8,656 admissions subjected to surgical management. There were (340/404) 84.16% neoplasms and (64/404) 15.84% nonneoplastic lesions. Follicular and simple serous cysts were common non neoplastic lesions. Twisted ovarian cyst was the commonest surgical emergency. Age of the patients ranged from 9years to 82years.Mean ages of non-neoplastic, benign and malignant lesions were 34.2years, 36.8years and 44.7yrs.Most of the cases were in reproductive agegroup (p<0.001). Benign neoplasms were (248/340) 72.94%, borderline (26/340) 7.64% and malignant neoplasms were (66/340) 19.41%. Surface epithelial tumours dominated other types (78.12%) followed by germ cell tumours (12.05%) and sex cord stromal tumours (6.47%). Mucinous cystadenoma (34.11%) was the commonest benign tumour, followed by serouscystadenoma 23.53%. Commonest malignant ovarian tumour was serous cystadenocarcinoma (9.11%). Conclusion: Ovarian neoplasms were more common than non-neoplasms subjected to surgical management. Surface epithelial tumours were the commonest neoplasms with more benign neoplasms. Commonest benign neoplasm was mucinous cystadenoma and malignant was serous cystadenocarcinoma. Significant number of malignant ovarian tumors presented at an earlier age and in late stages. Keywords: Ovarian neoplasm, Non-neoplasm, Clinical evaluation, Histopathology
Background: Tubal sterilization is considered a permanent method of contraception. The risk of fa... more Background: Tubal sterilization is considered a permanent method of contraception. The risk of failure of tubectomy is only 0.1-0.3%. Most often the pregnancy following tubal sterilization is ectopic gestation. Methods: 35 cases of post sterilization ectopic gestation were evaluated during a period of January 2014 to December 2015 at Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh, India. Results: Number of post sterilization ectopic gestation were (n=35) 33%, in 105 ectopic gestations during this period. 93% were in the age group of 20-30years with a mean age of 30.5years. 82% were gravida three who underwent sterilization with two living children. 62% of women presented with 4-6 weeks of amenorrhoea. 97.14% underwent minilaparotomy and out of which 74% were performed in Government hospitals. Puerperal sterilizations constituted 85%. In all cases ectopic gestation occurred within 10years of undergoing sterilization and all cases presented with hemoperitoneum. Site of rupture is ampulla in 31.4% of cases. Length of remaining tube is 7-8cm in 60% of cases. Conclusions: History of tubal sterilization does not rule out the possibility of ectopic gestation even when many years after the tubectomy. Adopting correct technique can reduce the failure rates. Woman should be counselled about the possibility of intra and extra uterine gestation at the time of performing tubectomy. Keywords: Contraception, Ectopic gestation, Mini laparotomy, Modified Pomeroy’s method
Abstract
Objectives: To study the clinical profile of the patients presenting with neurological d... more Abstract Objectives: To study the clinical profile of the patients presenting with neurological disorders during pregnancy and puerperium. Methods: The study was carried out at Government General Hospital, Kakinada, Andhra Pradesh, India between June 2006 and May 2007. Patients in pregnancy, postabortal and postpartum period evaluated in Neurology out-patient and in-patient departments and referred to Neurology department, Government General Hospital, Kakinada during this time were included in this study. Results: A total of 55 patients presented during pregnancy and puerperium with neurological disorders. Age of the patients ranged from 17 to 31 years. The total number of deliveries in this hospital during this period was 9726. Out of 55 patients Epilepsy—27[49.09%], Eclampsia—11[20%], Cerebro vascular disorders—6[10.9%], Neuropathies —4[7.27%], Extrapyramidal disorders---2[3.64%], CNS infections—Tubercular meningitis –1[1.81%], Myelopathy—1[1.81%], Toxic/ metabolic encephalopathy—1[1.81%]. Conclusions: Epilepsy was the most common neurological condition followed by Eclampsia and Cerebrovascular diseases. Health education measures for prospective mothers regarding the appropriate, adequate and regular use of anti-epileptic drugs should be taken up. Diligent care is to be taken to watch for neurological deficit in cases of Pre-eclampsia/ Eclampsia to identify special investigation team—Obstetrician, Neurologist, Physicians and Neurologist. The treating team should have the complete knowledge of the effects of rare neurological disorders during pregnancy and puerperium. DOI: http://dx.doi.org/10.4038/sljog.v36i3.7722 Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 74-78 Keywords: Epilepsy, Eclampsia, Cerebrovascular disorders, Chorea gravidarum, Guillain-Barre syndrome How to Cite: Sarella, L.K. & Rao, D.S., (2014). Neurological disorders in pregnancy and puerperium. Sri Lanka Journal of Obstetrics and Gynaecology. 36(3), pp.74–78. DOI: http://doi.org/10.4038/sljog.v36i3.7722
Uploads
Papers by Sarella LK
severity ranging from minimal features as slanting of palpebral fissures to major features of craniofacial development such as
hypertelorism, micrognathia, maxillary hypoplasia, high arched palate, conductive hearing loss, external ear abnormalities and
narrow nostrils. We report a case of Treacher Collins syndrome with term gestation with polyhydramnios and fetus with
micrognathia on ultrasound examination with previous two babies and father having the same disorder.
Case Report
A 30 year old ,unbooked G3 P2 L1D1, postcesaerean pregnancy, term gestation with polyhydramnios with breech presentation
with features of TCS admitted for institutional delivery at Government General Hospital, Kakinada, Andhra Pradesh, India.
Her scan on admission revealed single fetus in breech presentation with micrognathia and AFI 25cm. she delivered a live male
baby weighing 2.2kg with features of TCS through ceserean section and inspite of airway support the baby died on first
postnatal day.
Conclusion
This case report confirms the need to identify the antenatal women with physical malformations and early ultrasound scan in
women with previous H/O anomalous children, and polyhydramnios so that termination can be planned early.
Key Words
Polyhydramnios , Treacher Collins Syndrome, Micrognathia, Anti mongoloid slant of eyes
Keywords: Ovarian neoplasm, Non-neoplasm, Clinical evaluation, Histopathology
Keywords: Contraception, Ectopic gestation, Mini laparotomy, Modified Pomeroy’s method
Objectives: To study the clinical profile of the patients presenting with neurological disorders during pregnancy and puerperium.
Methods: The study was carried out at Government General Hospital, Kakinada, Andhra Pradesh, India between June 2006 and May 2007. Patients in pregnancy, postabortal and postpartum period evaluated in Neurology out-patient and in-patient departments and referred to Neurology department, Government General Hospital, Kakinada during this time were included in this study.
Results: A total of 55 patients presented during pregnancy and puerperium with neurological disorders. Age of the patients ranged from 17 to 31 years. The total number of deliveries in this hospital during this period was 9726. Out of 55 patients Epilepsy—27[49.09%], Eclampsia—11[20%], Cerebro vascular disorders—6[10.9%], Neuropathies —4[7.27%], Extrapyramidal disorders---2[3.64%], CNS infections—Tubercular meningitis –1[1.81%], Myelopathy—1[1.81%], Toxic/ metabolic encephalopathy—1[1.81%].
Conclusions: Epilepsy was the most common neurological condition followed by Eclampsia and Cerebrovascular diseases. Health education measures for prospective mothers regarding the appropriate, adequate and regular use of anti-epileptic drugs should be taken up. Diligent care is to be taken to watch for neurological deficit in cases of Pre-eclampsia/ Eclampsia to identify special investigation team—Obstetrician, Neurologist, Physicians and Neurologist. The treating team should have the complete knowledge of the effects of rare neurological disorders during pregnancy and puerperium.
DOI: http://dx.doi.org/10.4038/sljog.v36i3.7722
Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 74-78
Keywords: Epilepsy, Eclampsia, Cerebrovascular disorders, Chorea gravidarum, Guillain-Barre syndrome
How to Cite: Sarella, L.K. & Rao, D.S., (2014). Neurological disorders in pregnancy and puerperium. Sri Lanka Journal of Obstetrics and Gynaecology. 36(3), pp.74–78. DOI: http://doi.org/10.4038/sljog.v36i3.7722
severity ranging from minimal features as slanting of palpebral fissures to major features of craniofacial development such as
hypertelorism, micrognathia, maxillary hypoplasia, high arched palate, conductive hearing loss, external ear abnormalities and
narrow nostrils. We report a case of Treacher Collins syndrome with term gestation with polyhydramnios and fetus with
micrognathia on ultrasound examination with previous two babies and father having the same disorder.
Case Report
A 30 year old ,unbooked G3 P2 L1D1, postcesaerean pregnancy, term gestation with polyhydramnios with breech presentation
with features of TCS admitted for institutional delivery at Government General Hospital, Kakinada, Andhra Pradesh, India.
Her scan on admission revealed single fetus in breech presentation with micrognathia and AFI 25cm. she delivered a live male
baby weighing 2.2kg with features of TCS through ceserean section and inspite of airway support the baby died on first
postnatal day.
Conclusion
This case report confirms the need to identify the antenatal women with physical malformations and early ultrasound scan in
women with previous H/O anomalous children, and polyhydramnios so that termination can be planned early.
Key Words
Polyhydramnios , Treacher Collins Syndrome, Micrognathia, Anti mongoloid slant of eyes
Keywords: Ovarian neoplasm, Non-neoplasm, Clinical evaluation, Histopathology
Keywords: Contraception, Ectopic gestation, Mini laparotomy, Modified Pomeroy’s method
Objectives: To study the clinical profile of the patients presenting with neurological disorders during pregnancy and puerperium.
Methods: The study was carried out at Government General Hospital, Kakinada, Andhra Pradesh, India between June 2006 and May 2007. Patients in pregnancy, postabortal and postpartum period evaluated in Neurology out-patient and in-patient departments and referred to Neurology department, Government General Hospital, Kakinada during this time were included in this study.
Results: A total of 55 patients presented during pregnancy and puerperium with neurological disorders. Age of the patients ranged from 17 to 31 years. The total number of deliveries in this hospital during this period was 9726. Out of 55 patients Epilepsy—27[49.09%], Eclampsia—11[20%], Cerebro vascular disorders—6[10.9%], Neuropathies —4[7.27%], Extrapyramidal disorders---2[3.64%], CNS infections—Tubercular meningitis –1[1.81%], Myelopathy—1[1.81%], Toxic/ metabolic encephalopathy—1[1.81%].
Conclusions: Epilepsy was the most common neurological condition followed by Eclampsia and Cerebrovascular diseases. Health education measures for prospective mothers regarding the appropriate, adequate and regular use of anti-epileptic drugs should be taken up. Diligent care is to be taken to watch for neurological deficit in cases of Pre-eclampsia/ Eclampsia to identify special investigation team—Obstetrician, Neurologist, Physicians and Neurologist. The treating team should have the complete knowledge of the effects of rare neurological disorders during pregnancy and puerperium.
DOI: http://dx.doi.org/10.4038/sljog.v36i3.7722
Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 74-78
Keywords: Epilepsy, Eclampsia, Cerebrovascular disorders, Chorea gravidarum, Guillain-Barre syndrome
How to Cite: Sarella, L.K. & Rao, D.S., (2014). Neurological disorders in pregnancy and puerperium. Sri Lanka Journal of Obstetrics and Gynaecology. 36(3), pp.74–78. DOI: http://doi.org/10.4038/sljog.v36i3.7722