Anjana Annal

Abstract

Leiomyomas are the most common benign gynaecological tumour and contribute to 40-60% of hysterectomies performed all over the world. Despite proven benefits of GnRH analogues in reducing the size of myoma, it is used mostly as a temporary preoperative drug, as it has not shown to be associated with complete mass regression. We present a case of an abnormal uterine bleeding in a perimenopausal woman with history of multiple caesarean sections and incisional hernia repair. The patient was diagnosed with leiomyoma and was severely symptomatic due to anaemia. She responded to GnRH analogues and the mass regressed completely after 6 months. A favourable outcome in this patient establishes the role of medical treatment in symptomatic uterine fibroids in perimenopausal woman with previous abdominal surgeries where the risks of surgical intervention may be higher. Keywords: Fibroid uterus, Perimenopausal woman, Abnormal uterine bleeding, Medical management of fibroid, Gonadotrophin releasing hormone agonist.

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Abstract

India has one of the highest number of snakebites in the world with annual mortality rate of 2.4 per 100, 000 due to severe envenomation. However, the incidence of snake bite in pregnancy is rare. Diagnosis and management of snake bite in pregnancy poses challenges to an obstetrician due to its rarity. This case report presents such a scenario of a snake bite in a surrogate mother with twin pregnancy at 32 weeks with premature rupture of membranes complicated by coagulopathy. The surrogacy added to the complexity of the case. This case report addresses the early detection and multidisciplinary management of the above case preventing grave consequences for fetus and mother. Keywords: Snake bite, Pregnancy, Surrogate, Antisnake venom.

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