Abstract Utero‐vaginal prolapse can be caused by traction on to the cervix by heavy myoma. Here we present a unique case of huge, compressed, pedunculated fibromyoma of the cervix, which led to cervical elongation and third‐degree utero‐vaginal prolapse.
Chronic vaginal discharge in children and adolescents is a common gynaecological complaint which is often resistant to antibiotic treatment. We present a 14 years old, premenarcheal girl who presented to us with the complaints of recurrent, foul smelling purulent occasionally blood stained vaginal discharge for eight years, where a foreign body in the upper vagina was found after releasing a dense adhesion of the lower vagina which was unable to detect by pelvic ultrasound.
Abstract Objectives Thyroid dysfunction carries large burden during pregnancy and untreated thyroid dysfunction is associated with poor maternal and foetal outcome. The exact burden of thyroid dysfunction during pregnancy in Nepal is not well established. This is descriptive cross‐sectional study done in tertiary care centre of Nepal to know burden of thyroid dysfunction and establish possible need of universal thyroid function screening during pregnancy. Methods A descriptive cross‐sectional study was conducted from 4 September 2020 to 3 September 2021 on pregnant women attending to ANC clinic during their first trimester after obtaining ethical approval. Among eligible patients, after taking informed consent, a total of 385 pregnant women were included in the study. Thyroid function status was assessed by measuring serum levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri‐iodothyronine (FT3). Women with pre‐existing thyroid disorders were excluded. Serum thyroid function was used to detect thyroid disorder based on American Thyroid Association 2011 criteria. A convenience sampling method was used. Point estimate and 95% confidence interval (CI) were calculated. Results Among 385 pregnant women, 152 (39.48%) (39.20–39.70, 95% CI) had thyroid disorders. Among thyroid disorders ( n = 152), 111 (28.83%) had subclinical hypothyroidism, 37 (9.61%) overt hypothyroidism, 3 (0.78%) subclinical hyperthyroidism and 1 (0.26%) had overt hyperthyroidism. Conclusion Around four in every 10 pregnant women had thyroid disorder. Thyroid dysfunction is easily detectable and can be effectively, inexpensively treated, which can prevent adverse maternal and foetal outcome. Thus, we should consider universal screening of pregnant women for thyroid disorder especially in a country like Nepal where there is a high prevalence of undiagnosed thyroid disorder.
An imperforate hymen may exist at the lower end of the vagina. This is due to failure in breakdown of the partition between the mullerian and sinovaginal bulb, contributing to the formation of vagina. We are presenting a case of a fourteen-year girl who was diagnosed as haematocolpus with imperforate hymen from history and clinical examination. Diagnosis was reconfirmed with abdominal ultrasonogram after evacuation of bladder, who had urgent surgical treatment (incision and excision) and relief of symptoms of lower abdominal pain and inability to pass urine.
Leiomyoma is considered the most common benign tumor of genital tract with variable presentation and diverse operative findings. We are presenting a case of asymptomatic huge subserosal pedunculated leiomyoma in a 37 years unmarried nullipara lady diagnosed as highly vascular abdominopelvic mass preoperatively as suggested by imaging studies but of uncertain origin, imposing surgical challenge due to diagnostic dilemma and its vascularity. Laparotomy revealed solid mass of 26 x 24 cm occupying whole abdomen covered with torturous dilated serpentine vessels derived from omentum. The mass was arising from the fundus of bulky uterus with small pedicle suggesting suserosal pedunculated leiomyoma. Myomectomy with infracolic omentectomy with round ligament plication was done and her post operative recovery was smooth. Histological examination confirmed it as leiomyoma. Keywords: Omentum, Pedunculated Leiomyoma, Serpentine
How the largest of the large (> 10 x 8 cms) sub mucous myoma arising from the fundus uteri successively promotes the occurrence of non puerperal uterine inversion over the years as depicted through 3 different illustrations imitating a gradual process; first by forming an indentation in the uterine fundus then progressively causing more dimpling in the verge of uterine inversion until finally giving rise to a full blown picture of complete uterine inversion where the uterine fundus is driven beyond the level of introitus with the consequences of prolapsed incarcerated myoma in a post menopausal woman. A total abdominal hysterectomy and bilateral salpingoophorectomy were performed on all of these 3 women 2 perimenopausal and a postmenopausal; the latter was first facilitated by vaginal myomectomy further supplemented by division of the inversion ring posteriorly as described by Haultain. Key words: Non puerperal uterine inversion, submucous fundal myoma, vaginal myomectomy. doi:10.3126/njog.v1i2.2398 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 51-54 Nov-Dec 2006
Abstract We report a case of hematometra and bilateral hematosalphinx in a 15‐year‐old mentally handicapped adolescent girl, complicated by vaginal agenesis over cervical atresia in the presence of an ovarian adenoma. The case was managed by abdominal hysterectomy and bilateral salphingectomy of the hematosalphinx, which had formed a tubo‐ovarian mass. One ovary was preserved. This case also considers the management of the mentally handicapped patient unable to comprehend pain arising from cryptomenorrhea.
A woman with a history of laparotomy and corrective abdominal surgery for acute puerperal uterine inversion reverted by division of the inversion ring anteriorly "Dobbins's operation" subsequently was successful to undergo assisted vaginal breech delivery arriving at second stage of labor warranting, manual removal of placenta which was complied with the management of PPH. This case is reported because of the rarity of uterine inversion itself in the first place. Next because of the conception taking place spontaneously after morbid puerperal period and then the pregnancy advancing to term: all the management beginning from correction of uterine inversion to retained placenta being handled in the same facility a rare event too in our set up. Key words: Uterine inversion and subsequent birth, manual removal of the placenta. doi:10.3126/njog.v2i2.1462 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 78 - 80
 scale(5.56106)'%3e%3ccircle r='1'/%3e%3cg id='d'%3e%3cg id='c'%3e%3cpath id='b' d='M.195-.98 0-1.39l-.195.408' transform='rotate(11.25)'/%3e%3cuse xlink:href='%23b' transform='rotate(22.5)'/%3e%3cuse xlink:href='%23b' transform='rotate(45)'/%3e%3c/g%3e%3cuse xlink:href='%23c' transform='rotate(67.5)'/%3e%3c/g%3e%3cuse xlink:href='%23d' transform='scale(-1 1)'/%3e%3c/g%3e%3cg transform='translate(0 58.787) scale(8.1434)'%3e%3ccircle r='1'/%3e%3cg id='g'%3e%3cg id='f'%3e%3cpath id='e' d='M.259.966 0 1.576l-.259-.61'/%3e%3cuse xlink:href='%23e' transform='rotate(180)'/%3e%3c/g%3e%3cuse xlink:href='%23f' transform='rotate(90)'/%3e%3c/g%3e%3cuse xlink:href='%23g' transform='rotate(30)'/%3e%3cuse xlink:href='%23g' transform='rotate(60)'/%3e%3c/g%3e%3c/g%3e%3c/svg%3e)
