ARDS – AN UNCOMMON LIFE-THREATENING OBSTETRIC EMERGENCY

Dr Anita Matai, Dr Nitin Rathi, Dr Neera Agarwal, Dr Ritu Goyal

ARDS is a form of hypoxaemic respiratory failure characterised by severe impairment of gas exchange and lung mechanics, with a high case fatality rate. The incidence of this clinical syndrome has been on the rise with the rising levels of pollution in our city. Respiratory failure complicates relatively a small number of pregnancies, but causes significant potential risks for both mother and foetus. The mortality rate is high at 38.5% and has not significantly improved for the past several decades. Here we present a patient at 35 week’s pregnancy, presented with respiratory failure and was managed successfully, with the mother and baby being discharged in a good condition. A high index of suspicion is needed for diagnosis and subsequent management for a good maternal and foetal outcome.

Keywords: ARDS; Pregnancy; Respiratory failure


TO COMPARE THE BUCCAL AND VAGINAL MISOPROSTOL ADMINISTRATION FOR LABOUR INDUCTION AT TERM

Dr Ruchika Garg, Dr Vishy Agarwal, Dr Saroj Singh, Dr Rekha Rani, Dr Meenal Jain

The study was aimed to compare the buccal and the vaginal administration of the misoprostol at term . The randomized prospective study was done on 100 pregnant women. Out of which 50 cases are induced by buccal misoprost and the remaining 50 cases are induced by the vaginal misoprost. In the study it was found that about 36% of the patients in the buccal group were induced after a single dose but it is only 32% in vaginal misoprost group but the tachysystole develops in the buccal group was higher than that of in vaginal group. Thus, it was contemplated in our study that buccal misoprost was more effective than vaginal misoprost in inducing labour but it is associated with more side effects.

Keywords: Induction of labour; Buccal misoprost; Vaginal misoprost


MALLORY-WEISS SYNDROME IN A PATIENT WITH HYPEREMESIS GRAVIDARUM: A CASE REPORT

Dr Suman Lata Mendiratta, Dr Rekha Yadav, Dr Rajni Mittal, Dr Haripriya Bajwa, Dr SK Mishra

Mallory Weiss syndrome refers to mucosal laceration or tear at gastro oesophageal junction resulting due to violent coughing or vomitting and causes upper gastro intestinal bleeding. In pregnant women it can occur in patients of hyperemesis gravidarum.

Keywords: Mallory Weiss Syndrome; Hyperemesis gravidarum


GIANT UTERINE LEIOMYOMA MIMICKING MALIGNANCY: A DIAGNOSTIC AND THERAPEUTIC CHALLENGE

Dr Shivali Bhalla, Dr Seema Grover Bhatti, Dr Parveen Rajora, Dr Ashwani Kumar, Dr Rashmeet Kaur, Dr Roopam Goyal

To report an extremely rare benign tumour variant of leiomyoma, the giant leiomyoma mimicking malignancy. Giant leiomyomas are the exceedingly rare variants of leiomyoma uterus, that weigh >11.4 kg posing a great diagnostic and therapeutic challenge to the gynaecologists. 40 years old nulliparous female presented with a huge abdomino-pelvic mass. The clinical features mimicked that of a malignant lesion. Ovarian malignancy, leiomyosarcoma and mesenchymal tumor were among our most probable diagnosis. Exploratory laprotomy, however, revealed a giant leiomyoma measuring 30 cm X 25 cm X 16 cm and weighing 12 kg. Giant uterine leiomyomas have an atypical presentation, requiring multi–disciplinary and individualized approach in every patient. The treatment is usually surgical. They need to be differentiated from malignant lesions of uterus and adnexa.

Keywords: Giant uterine fibroid; Hysterectomy