Ushadevi Gopalan

Abstract

Background: Postpartum Haemorrhage (PPH) is an important cause of maternal death and severe maternal morbidity. Compared to vaginal delivery, women undergoing caesarean delivery incur the highest risk of PPH and haemorrhage related morbidity. Furthermore, evidence suggests that PPH during caesarean delivery is occurring more frequently. Objective: To study the effect of low dose intravenous tranexamic acid in reducing blood loss during Caesarean section. Materials and Methods: This randomized control trial among 50 antenatal women aged >18 years undergoing Lower segment caesarean section in tertiary care centre. They were divided into Study group and control group. Study group received 1gm iv tranexamic acid and the Control group did not receive tranexamic acid. Data was entered in Microsoft Excel data sheet (MS-Excel) and analysed using commercially available SPSS 23 software package. MS Excel and MS word was used to obtain various types of graphs such as bar diagram. Results:  Among the study population who underwent Lower section caesarean section in our study, we found that the requirement of additional oxytocin was nil with tranexamic acid group (p value Conclusion: Tranexamic acid significantly reduces the amount of blood loss during and after lower segment caesarean section. It was not associated with any significant side effects and complications. It can be used effectively in all women undergoing caesarean section to reduce the postpartum Haemorrhage thereby reducing the maternal morbidity and mortality.   Keywords: Lower segment caesarean section, Postpartum haemorrhage, Blood loss, Tranexamic acid.

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Abstract

Endometrial Stromal Tumor is a rare malignant tumor seen in perimenopausal women. This is a case of Endometrial stromal tumour in a in a young nulliparous woman around her early thirties mimicking Fibroid uterus. She presented with a 34 weeks size mass abdomen with six months duration without any menstrual irregularities. The mass was diagnosed to be a huge sub serous fibroid by both clinical and ultrasonographic examination. MRI revealed a well demarcated, pedunculated mass in the uterine cavity. After the pre operative work up, she was planned for myomectomy where intraoperatively a huge mushroom shaped firm mass was seen arising from the fundus of the uterus with a pedicle which was deep rooted into the uterus. Histopathological examination of mass confirmed as a Low grade endometrial stromal sarcoma. CT scan was done and revealed no metastatic lesion.   Keywords: Endometrial stromal sarcomas (ESSs), Leiomyoma uterus.

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