Indian Journal of Obstetrics and Gynecology

  Abnormal uterine bleeding is a common gynecological clinical problem. In premenopausal age uterine leiomyomata are the common cause and among the postmenopausal women the concern is endometrial carcinoma. Ovarian steroidal hormones do stimulate cell proliferation and extracellular matrix accumulation initiating or promoting growth of leiomyocyte. It is known that ovarian hormones are dependent on receptors for exerting their action. Leiomyoma grow even in patients with no increased estrogen. Whereas, endometrial carcinoma is an ovarian hormone dependent tumor with a subtype more often attributed to an unopposed estrogenic stimulation of endometrium. Reported are 4 cases in premenopausal age that were detected to have developed endometrial carcinoma in short time after the myomectomy.

Keywords: Leiomyoma; Endometrial Carcinoma; Premenopausal Women; Nulligravida; Abnormal Uterine Bleeding

Neurofibromatosis type 2 in pregnancy is an extremely rare condition. Central nervous system involvement with shwannomas and spinal tumours is very common. This condition is very challenging for obstetricians especially when the neurological complications starts manifesting. Close obstetric care, timely interventions and Multidisciplinary approach is the key to successful outcome in cases of Neurofibromatosis 2 in pregnancy.

Keywords: Neurofibromatosis Type 2; Pregnancy; Schwannomas; Paraparesis.

Abdominal pregnancy is a rare variety of ectopic pregnancy with high maternal and perinatal mortality. Persistent abdominal pain, mal-presentation, extreme displacement of cervix and lack of myometrial response to oxytocin stimulation are the important clinical diagnostic features of abdominal pregnancy. Diagnosis is missed in about 50% of cases on ultrasound. We are reporting a case of term abdominal pregnancy following tubal ligation, which was clinically suspected to be abdominal pregnancy but was reported as intrauterine pregnancy on ultrasound done thrice, Which led to confusion and the diagnosis was confirmed preoperatively only after incising through the uterus. MRI and CT scan should be done along with ultrasonography to confirm the diagnosis of secondary abdominal pregnancy for better surgical planning.

  The health care offered before conception in order to optimize the outcome of a given pregnancy is preconception care. Preconception counselling is a part of preventive medicine. It includes risk assessment and education every reproductively capable women create reproductive health plan. Optimizing women’s health before and between pregnancies is an ongoing process that requires access to and the fall participation of all segments of the health care system. Maternal nutrition plays an important role for pregnancy outcomes and for the health of newborn. Providing simple nutritional interventions before pregnancy can reduce maternal and neonatal mortality and morbidity women of childbearing age should achieve and maintain good nutritional status prior to conception.

Keywords: Preconception Care; Interventions; Nutrition; Counselling.

  Context: original. Aims and Objectives: To study the relationship between bacterial vaginosis in third trimester and preterm labor. To study the relationship between periodontal infection in third trimester and preterm labor. To find out the incidence of bacterial vaginosis and periodontal infection in antenatal patients at PGIMSR, New Delhi. Settings and Design: The prospective case control study. Methods and Material: A total of 500 patients were enrolled for the study. The incidence of Bacterial vaginosis and periodontal infection was calculated for the hospital. Out of these 500 patients, 200 patients were randomly selected and divided into 4 groups. Group 1(n = 50): Patients with no evidence of bacterial vaginosis and periodontal infection. Group 2(n = 50): Patients positive for periodontal infection. Group 3 (n = 50): Patients positive for bacterial vaginosis Group 4(n = 50): Patients positive for periodontal infection and bacterial vaginosis. Group 1 was the control group with sample size of 50 patients. Groups 2, 3, 4 were compared with the control group and correlated to the preterm birth and perinatal outcomes. Results: 14(29.2%) patients in group 1 had PROM, 29(59.2%) patients in group 2 had PROM, 15(31.3%) patients in group 3 had PROM and 19(40.4%) patients in group 4 had PROM. The difference in all the groups was statistically significant (p<0.05) (Table 6, Figure 6). Conclusion: Significant correlation is seen between periodontal infection and preterm labor & preterm premature rupture of membranes. Bacterial vaginosis is not found to be associated with preterm labor. Both of them have no significant correlation with perinatal outcomes. 

Keywords: Bacterial Vaginosis; Periodontal Infection and Preterm Labour.

  Context: cross-sectional study. Aims: Estimation of the relationship of Serum levels of Inhibin A, Activin A and leptin in intrauterine growth retardation and appropriate for gestational age pregnancy Settings and Design:Cross-sectional study Total numbers of 100 pregnant women, were studied in department of Gynecology and Obstetrics in Postgraduate Institute of Medical Sciences and Research. Employee State Insurance Corporation, New Delhi. Methods: Hundred pregnant women, 50 with IUGR pregnancy were matched with 50 women with Appropriate for gestatational age (AGA ) pregnancy. Inhibin A, activin A and leptin levels were measured in two samples. First sample was obtained by venous blood drawn from maternal peripheral circulation, which was collected before delivery, and second sample was taken from the umbilical vein after delivery. Data relating to delivery (e.g. mode, birth weight, signs of intrapartum fetal distress, and Apgar scores) were recorded. Statistical Analysis Used: Karl Pearson’s correlation coefficient were calculated. Mann–Whitney U test was used for comparison between cases and controls.The data were entered into a multivariable linear regression model to allow a comparison between cases and controls subjects. Paired-Samples tTest used to compare Ultrasound (USG ) findings in cases and controls. The level of significance was set as p-value - 0.05. Results: Mean maternal inhibin A and activin A (0.57±1.50–0.08±0.04 ng/ml and 1.57±0.39– .24±0.60 ng/ml respectively) and mean fetal inhibin A and activin A (1.304±2.92–0.13±0.06 and 1.43±0.58– 1.31±0.36ng/ml respectively) concentrations were significantly higher in cases. However, a statistically significant correlation was not found between fetal leptin concentrations per kilogram of fetal weight and fetal activin A concentrations in cases (r=0.120; P>0.05). Conclusions: Inhibin A, activin A and leptin as serum markers in routine screening can detect IUGR 

Keywords: Intrauterine Growth Restriction; Appropriate for Gestational Age; Inhibin A; Activin A; Leptin.

  Objectives: 1. Estimation of lipid profile parameters including triglycerides, total cholesterol, HDL cholesterol, LDL cholesterol and apolipoprotein A in both cases of carcinoma cervix and healthy controls. 2. Estimation of association of lipid parameters in cases with carcinoma cervix of various clinical stages. Materials and Methods: A total number of 60 women were recruited in our study. Out of these 60 women, 30 were cases and 30 were healthy controls. The 30 cases were clinically and histologically confined cases of carcinoma cervix of various stages. The 30 controls were matched with cases for age and BMI. The present comparative case control study was conducted at R. L. Jalappa Hospital and Research Centre attached to Sri Devaraj Urs Academy of Higher Education,Tamaka, Kolar between January 2014 to June 2015. Lipid parameters were analyzed using Vitros 250 dry chemistry auto analyzer from Johnson and Johnson. Serum apolipoprotein A was analyzed by immunoturbidimetry. Results: The mean age for cases was 56.5± 12.03 and mean age for controls was 55.8± 10.16.Majority of patients 14(46.7%) presented with three main symptoms i.e. offensive vaginal discharge, loss of appetite, weight loss. Majority of the cases, 18(60%) were postmenopausal women..Out of these 30 women who undergone biopsy, 28(96.7%) had squamous cell carcinoma and 2 (3.3%) had adenocarcinoma. Amongst 30 cases, 9 patients (30%) had well differentiated, 19 had moderately differentiated and 2 had poorly differentiated carcinoma. Majority of patients 17(56.7%) presented with stage IIIB. The mean serum HDL, LDL, triglycerides, total cholesterol were 35.67± 8.16, 79.47±14.97, 107.77±28.11,131.7±20.32 in cases respectively. The mean serumHDL, LDL, Triglycerides, total cholesterol were 50.47±7.04, 117.57±22.89, 183.57±32.93, 176.3±24.24 in controls respectively. The mean serum apolipoprotein A levels in cases (169.19 ± 24.60) were increased when compared to controls. Conclusion: The mean serum HDL cholesterol, LDL cholesterol, triglycerides and total cholesterol were found to be significantly lower in patients with cervical cancer when compared to health controls. The mean serum Apolipoprotein A was found to be significantly elevated in cases when compared to healthy controls. 

Keywords: Lipid Profile; Cancer Cervix; Apolipoprotein A.

  Introduction: Bleeding that occurs between menstrual periods or excessive menstrual bleeding is considered to be abnormal uterine bleeding. Once a woman who is not taking hormone therapy enters menopause and the menstrual cycles have ended, any uterine bleeding is considered abnormal. Methodology: All patients in the perimenopausal age group (45+ 5 years) with symptoms of abnormal uterine bleeding presenting at hospital were included in the study. Totally 100 study subjects were included in the study. Results: The most common bleeding pattern was menorrhagia (64%) followed by polymenorrhea (28%), metrorrhagia (18%) and menometrorrhagia (8%) Conclusion: Accurate diagnosis of the causative factor of abnormal uterine bleeding in any age group is of importance so that appropriate management can be initiated 

Keywords: Abnormal Uterine Bleeding; Polymenorrhea; Clinical Evaluation.

  Objective: Elevated LDH levels can be used to help in decision­making and management to improve the maternal and fetal outcome, as elevated LDH levels are indicative cellular damage and dysfunction. Elevated LDH levels indirectly reflect severity of preeclampsia. Materials and Methods: This retrospective observational study was conducted in a tertiary referral hospital of
Northern India (Banaras Hindu University), which has a wide catchment area. We wanted to find out the role of LDH levels in explaining prognosis to the mother and also in prediction of adverse outcome of feto­maternal outcomes. Results: Total 46 women. 31(67.39%) were nonsevere gestational hypertension (NSGH) and 15 (32.60%) were severe gestational hypertension (SGH). There were 3women out of the SGH category who had eclampsia. LDH levels were >800 in all three eclamptic women. LDH was 600­800 in 83.33% of severe gestational hypertension group (SGH). In nonsevere gestational hypertension (NSGH) LDH level was <600 in 64.51%. In the group with LDH levels of 600­ 800 one case of Abruptio placentae was diagnosed. The group with LDH>800, they all had eclampsia, there was thrombocytopaenia/ HELLP in all 3 cases and oliguria found in 2 pregnant women. Fetal growth restriction was found in 2 cases. Conclusion: he study concludes that LDH levels have significant association with increasing maternal and fetal morbidities in patients with severe gestational hypertension. 

Keywords: Lactic Dehydrogenase; Severe Preeclampsia; Eclampsia; Severe Gestational Hypertension, Nonsevere Gestational Hypertension.

  Objectives: To compare oral, buccal and vaginal administration of Misoprostol following oral Mifepristone, in terms of Safety, Efficacy (completion of abortion) and Patient acceptability of route of administration(Acceptance may be defined as whether the patient was satisfied with the route of administration of misoprostol after termination of pregnancy). Study Design: A prospective open label randomized study. Materials and Methods: All pregnant women with less than 9 weeks who presented to R. L. Jalappa Hospital for Medical Termination of Pregnancy between March 2014 and June 2015 were included in this study. Total number of 90 patients included in this study. Patients were divided into 3 groups by computerized randomization plan 17213 and each group comprised 30 patients. Results: Majority of the women were multi gravida(71.1%). Age distribution was similar in all 3 groups, majority of whom belonged to the age group between 21 and 25 years. Most common indication for termination of pregnancy was unplanned pregnancy. Patients in oral (4.3 ± 2.88 hours) and buccal (4.325 ± 2.17 hours) group had shorter induction to expulsion duration compared to vaginal group (5.79 ± 2.42 hours) which was statistically significant. Induction to expulsion duration was reduced with lesser gestational age in all the three groups. Success of complete expulsion was more with buccal route (93.3%). However, this was not significant statistically (P value­0.69). Side effects were similar in all the groups except diarrhoea which was significantly more in oral group (P value <0.001). However vaginal group had comparatively least side effects, but not significant statistically. Patient acceptance was similar in all the groups. However in oral and buccal groups, they are able to self administer the drug avoiding the vaginal route of administration. conclusion: The induction to expulsion interval was similar in oral and buccal routes but vaginal route had significantly prolonged duration. Vaginal route had comparatively least side effects while oral route had highest. Buccal route had shorter induction to expulsion interval, minimal side effects and better acceptance of the route of administration. 

Keywords: Mifepristone; Misoprostol; Abortion.

Objective: Adolescence is the period of rapid growth, connecting childhood to reproductivity. Because of improper diet and increased demand, there is a deficiency of nutrients, most commonly iron reflecting as iron deficiency anemia. One more important milestone is onset of menses in adolescence, which further adds to anemia. The age of menarche, cycle length, duration of flow, association of dysmenorrhea and PMS varies in every girl. Our aim of study is to know the age of menarche, the cycle pattern, and association of menorrhagia with anemia and overall prevalence of anemia in adolescent age group. Material and Method: We conducted our study in various schools of Udaipur city. Girls from 7th to 10th standard were included in the study with an age group of 10 to 16 years. The girls were given proforma to fill and Hb estimation was done by Sahli’s method. Conclusion: Mean age of menarche came out to be 13.5 years.

Introduction: Thyroid diseases are the commonest endocrine disorders affecting women of reproductive age group and hence constitute the commonest endocrine disorder in pregnancy also. Hyperthyroidism or hypothyroidism can influence the outcome for mother and fetus at all the stages of pregnancy. The aim of this study is to establish the prevalence and effect of thyroid disorder on pregnancy outcome. Materials and Methods: This study was a prospective study carried on 920 women coming for antenatal check­up in Adichunchunangiri Institute of Medical Sciences, B.G. Nagar, from October 2014 to September 2015. All women who were included in this study were followed up from 11­14 weeks of pregnancy up to delivery for thyroid disorders and their outcome on pregnancy. Results: Totally about 8.69 % (80) of 920 antenatal patients were diagnosed as thyroid disorders. The most common thyroid disorder was subclinical hypothyroidism accounting to 4.13% and patients having overt hypothyroidism the most common complication was preeclampsia 30.76% (8/26), 38.46% (10/26) babies developed jaundice. Conclusion: TSH is the hallmark in detection of hypothyroid as well hyperthyroid, so TSH should be routine investigations done in all antenatal women in first trimester. If TSH values are abnormal then FT3, FT4 and TPOAb need to be checked. Gestational age specific reference intervals are of utmost importance for monitoring thyroxine replacement therapy in pregnant women. 

Keywords: Thyroid Disease; Pregnancy; Feto­Maternal Outcome; Prevalence .

Objective: The incidence of infertility is quite increasing in India. One in every six couples is having infertility. Due to work culture, couples are planning pregnancy in their fourties. A retrospective study was conducted to analyze the etiopathology management and outcome in perimenopausal age group i.e. 44 to 55 years [1].Method: This was a retrospective study conducted among 384 patients during their infertility workup, IVF, antenatal period. We reviewed the data of patients attending our clinic from Jan 2014 to Dec 2014. This was an observational study and not compared with. Results: The perimenopausal age group patients were 40% to 60% of the total patients. They were benefited wit IVF/ICSI with success rate of 50% to 60%. Success rate increased with donor egg upto 50% as compared to self egg (20%). 90% were caesarean  deliveries. Conclusion: Perimenopausal age groups are a high risk group attending an infertility clinic. They are a challenge to manage, which grows as the period of gestation.  

Keywords: Perimenopausal Age Group; High Risk Groups; Ageing and Infertility.

  Introduction: Meconium stained amniotic fluid has been considered a sign of fetal distress in presentation other than breech and associated with poor fetal outcome but others considered meconium passage by fetus is physiological phenomena and produce environmental hazards to fetus before birth. Methods: 200 women in labour with meconium stained amniotic fluid considering the inclusion and exclusion criteria at Teaching & General Hospital. Effect of thin and thick meconium on fetus was studied. Fetal monitoring, mode of delivery, Apgar score, birth weight, resuscitation of baby noted.All babies followed­up up to 1st week of neonatal life. result: Major complications were birth asphyxia, meconium aspiration syndrome, early neonatal death seen in 5.5% (11 cases), morbidity in 20.5%, 4.5% in thin and 16% in thick MSAF. Causes of death were meconium aspiration syndrome in 7 cases, sepsis in 2 cases, pneumonia in 1 case and birth asphyxia in 1 case. Conclusion: From our study we conclude that MSAF adversely affect fetal outcome mostly by thick meconium.  

Keywords: Meconium Stained Amniotic Fluid; Meconium Aspiration Syndrome; Birth Asphyxia.

  Context: Grand multiparas were considered as high risk because of their complications during pregnancy and labour. Maternal as well as perinatal mortality and morbidity are closely related with grand multiparity. Aims: The aim of this study was to find out various maternal and fetal complications associated with grand multiparity. Methods: A retrospective study was conducted from January 2013 to December 2013 in our tertiary care centre. All women who were with five or more pregnancies admitted to our hospital were included. Results: A total of 133 cases were seen out of 15267 live births showing an incidence of 0.8%. The common complications seen were hypertensive disorders(12%), malpresentations (10%),intrauterine deaths (15%), preterm labour(9.8%), congenital anomalies(2%) and abortions (9%). Out of 103 live births 12 babies required NICU admissions for LBW and low APGAR. Six of those babies died due to sepsis. onclusion: Grand multiparity is one of the cause for maternal, fetal and neonatal mortality and morbidity, low socioeconomic status, illiteracy and religion are key factors. Health education , proper contraceptives for prevention and good antenatal care to avoid complications are essential.

Keywords: Grand Multiparity; Great Grand Multiparity; Pregnancy Outcome.

 Introduction: Meconium is likely to cause both mechanical obstruction of the airways and chemical pneumonitis. The free fatty acids in meconium will strip away alveolar surfactant. Atelectasis, consolidation, pneumothorax and pneumomediastinum may occur that would prove to be fatal. Methodology: During study cases were selected with pregnant women at term gestation with cephalic presentation with meconium stained amniotic fluid, keeping in mind the inclusion and exclusion criteria. Results: 75 patients with thin meconium stained amniotic fluid, 34 (45.33%) had normal vaginal delivery, while in thick meconium stained amniotic fluid out of 125 only 36 (28.8%) delivered normally. Conclusion: Incidence of LSCS was more in thick meconium stained amniotic fluid as compared to with thin Meconium stained amniotic fluid.

Keywords:Meconium; Amniotic Fluid; Mode of Delivery.

 Introduction: The characteristics of placenta praevia is painless, apparently cause less bleeding from abnormally situated placenta. Often bleeding occurs when the woman is at rest in bed, although it may follow straining, during defaecation, sneezing or coitus. Methodology: A thorough history of vaginal bleeding (warning haemorrhage) was taken. Cases with confirmed diagnosis of placenta praevia on ultrasonography were included in the study. If patients had come in emergency without USG, diagnosis of placenta praevia was confirmed by per vaginal examination or examination of the placenta after the delivery, were included in the study. Results: Out of 72 cases (85.72 percent) of C/D, 46(54.76 percent) were live babies. 16(19.06 percent) were dead, 7(8.33 percent) were still born and 3(3.57 percent) were deeply asphyxiated and died within few hours after delivery. Conclusion: Perinatal outcome mainly depends on gestational age, birth weight and mode of delivery.  

Keywords: Placenta Praevia; Perinatal Mortality; Foetal Outcome.

  Introduction: Post partum haemorrhage ( PPH) is an important cause of maternal morbidity and mortality especially in the developing countries. Compared to expectant management, active management decreases the incidence of PPH. Objective of study is to compare the effectiveness of rectal Misoprostol against Intramuscular Oxytocin in prevention of postpartum haemorrhage. Material and Methods: This is a prospective, randomized and analytical study at department of obstetrics and gynecology, katihar medical college and hospital , katihar. A total of 25 women were included to receive 800 micrograms rectal misoprostol tablets and another 25 women received 10 units of oxytocin intramuscularly. Primary outcome measures were incidence of postpartum hemorrhage or a change in hemoglobin from admission to day two post delivery. Secondary outcome measures including duration of third stage of labor and side effects of both drugs were recorded. Results: With Misoprostol there was reduced blood loss as compared to oxytocin however there was no significant difference among groups in drop of hemoglobin.Secondary outcome measure – duration of third stage of labor was similar in both groups. However the side effects were less in the misoprostol group. Conclusion: Rectal misoprostol is as effective as intramuscular oxytocin in preventing postpartum hemorrhage but with lesser side effects and is worth while to be used as a ureteronic agent for the routine management of third stage of labor.  

Keywords: Misoprostol; Postpartum Hemorrhage; Oxytocin.

  Introduction: The management of women with bleeding from a placenta praeviawill depend on 2 main factors, the degree of haemorrhage and the fetal maturity at the time of hemorrhage. Absolute indications for delivery include, bleeding of any type at fetal maturity, fetal distress at viable gestations and persistant hemorrhage causing maternal hemodynamic instability at any
stage in pregnancy. Methodology: Those cases that came with history of painless bleeding per vagina or warning hemorrhage after 28 weeks of gestation were admitted in the hospital. USG was done, if found to be placenta praevia, with live premature fetus, hemodynamically stable, with no or minimal bleeding and not in established labour were managed expectantly with tocolytics, antibiotics, steroids and bed rest. Results: table shows 33 (39.29 percent) cases had type II placenta praevia out of which 18 (21.43 percent) cases had type II anterior placenta praevia and 15 (17.86 percent) had type II posterior placenta praevia. 20 (23.80 percent) cases had grade III placenta praevia, 18 (21.43 percent) cases had type I placenta praevia, remaining 13 (15.48 percent) cases had central placenta praevia. Conclusion: Majority of patients with major degree placenta praevia were managed withC/S except 1 case which delivered vaginally. 

Keywords: Placenta Praevia; Management; Bleeding Per Vagina.

To determine and compare the efficacy and safety of transcervical foley catheter and 50µg intravaginal misoprostol for induction of labor after 37 completed weeks of gestation and to determine the maternal and fetal outcome. Materials and Methods: This was a prospective study conducted from March 2014 to August 2015 in R.L Jalappa Hospital and Research centre, Tamaka, Kolar. A total of 200 cases were included in the study. Each group was alternatively induced with transcervical foley catheter and 50µg of intravaginal misoprostol. The two groups were comparable with respect to maternal age, parity, gestational age and pre induction modified bishop score. Post induction bishop score after 6hours, induction delivery interval, mode of delivery, maternal and fetal outcomes were recorded. The collected data was analyzed using student ‘t’ test and chi square test. Results: The groups were comparable with respect to maternal age, parity, gestational age and pre induction modified bishop score. The mean induction to active stage was significantly less in misoprostol group (7.46±4.82hrs) when compared to foley catheter group (9.7±4.47hrs) with p=0.01**. Mean induction to delivery interval was less in misoprostol group (14.59±5.57) when compared to foley catheter group (15.67±4.91) with p   value of 0.005** .The requirement of oxytocin augmentation was significantly more in foley catheter group with p<0.001**. The cesarean section rate was high in foley catheter group (40%) when compared to misoprostol group (29%) with p=0.223 which was not statistically significant. Apgar scores, birth weight, neonatal intensive care unit admissions and maternal side effects showed no difference between two groups. Conclusion: Misoprostol as a method of induction of labor intravaginally in dosage of 50µg is more efficacious than transcervical foley catheter in terms of shorter induction delivery interval and less oxytocin augmentation. Maternal and perinatal outcomes were similar in both the methods of induction confirming the safety of both methods. 

Keywords: Foley Catheter; Induction of Labor; Misoprostol.

Objectives: To compare oral misoprostol 600 microgram with 10 IU oxytocin intramuscularly in controlling PPH. Materials and Method: A total of 200 women of 37 weeks to 42 weeks of gestation delivering vaginally in the Adichunchanagiri Institute of medical Sciences, Mandya Karnataka. After randomization 200 women received oral misoprostol 600 microgram and 100 women received 10 IU intramuscularly oxytocin immediately after delivery of baby but before the delivery of placenta. Results: In the oxytocin group mean blood loss was 235 ml. Mean duration of third stage 4.58 minutes. In the misoprostol group mean duration of third stage of labour was 4.72min. Mean blood loss was 252 ml. No significant difference was observed in respect of above factors. 3 cases required additional uterotonic in misoprostolgroup, 2 patient required additional uterotonic in oxytocin group. Pyrexia was found in 1 patient in misoprostol group. Abdominal pain was seen in 4 patients in oxytocin group. Diarrhea was found in 2 patients of misoprostol group. Conclusion: Oral misoprostol is very effective in controlling PPH and it is comparable to oxytocin 10 IU intramuscularly. It can therefore be used in places, where facilities of storage and parenteral administration of oxytocin is limited. 

Keywords: Postpartum Haemorrhage (PPH); Misoprostol; Oxytocin.

  Rarely, corpus luteum hemorrhage may produce a life threatening emergency or may be fetal if not diagnosed or treated. 15 cases of ruptured corpusluteum cysts in the duration of three years presented at PIMS (pacific institute of medical sciences) Umarda, Udaipur, Rajasthan. The presentation was mimicking ruptured ectopic pregnancy and in three cases (20%) the patient just passed out suddenly while at home or at market place They were brought to the hospital in unconscious state. In other cases (80%) the presentation was less dramatic and chronic. There had been no history of amenorrhoea nausea and vomiting. Urine pregnancy test was negative. Refractory hypotension could not be improved by intravenous therapy and were referred to gynaecologist. Ultrasonography of abdomen showed fluid and clots in pouch of douglas and ascites. Keeping ruptured ectopic in mind laparotomy was performed which revealed haemoperitoneum. However both side fallopian tubes were intact. Ovary on one side revealed ruptured corpus luteum cyst with fresh oozing from the site of rupture. Ovary was repaired and haemostasisensured and the patients made an uneventful recovery. To Conclude Ruptured corpus luteum cyst should be kept in mind while treating gynae emergencies with haemoperitoneum and acute abdominal pain.

Keywords: Corpus Luteum Cyst Ruptured Corpus Luteum Cyst Hypotensive Shock Ruptured Ectopic Gestation Emergency Laparotomy Haemoperitoneum.

 Not Provided.