Indian Journal of Obstetrics and Gynecology

Background and Objectives: Thyroid hormones play one of the most vital roles in functioning of body including reproductive function. Thyroid dysfunctions are becoming more prevalent worldwide. Thyroid disorders are more common in women than men. Women after menopause are at enhanced risk of developing thyroid disorders. Aim of the study was to compare thyroid profile of postmenopausal women with those in reproductive age group. Methods: The present study consists of total 500 women out of whom 250 women were of reproductive age group aged between 15-49 years and 250 post menopausal women aged 50-75 years. Thyroid status was assessed by estimating the serum levels of T3, T4, TSH in both the groups. Results: Thyroid profile was compared between women of reproductive age group and postmenopausal women. Serum TSH levels were slightly high in postmenopausal women compared to reproductive women, whereas Serum levels of tri iodothyronine and thyroxine are slightly higher in reproductive age group compared to postmenopausal women. But both are statistically not significant (p-value >0.05). Conclusion: Thyroid screening may be advisable as routine investigation for all women at least once in 3-4 months for early detection of thyroid dysfunction.

As the survival rate of children, Adolescents and young adults improve following cancer therapy, it also creates an urgent demand in studying and progressing in the field of oncofertility. Options for fertility preservation include : medical treatment, surgical treatment, oocyte or embryo cryopreservation and expectant management. Treatment is individualised based on age, ovarian reserve, partner status, number of future children desired and time to cancer treatment. It is important to understand that oncofertility includes preservation of fertility as well as endocrine functions, helping them to have a better quality of life, post cancer therapy.

Background: Posterior reversible encephalopathy syndrome (PRES) is a rare but serious clinical neuroradiological entity characterized by headache, visual disturbances, vomiting, seizures, altered mental status and unconsciousness with characteristic imaging findings including sub-cortical vasogenic edema at the bilateral parietal and occipital lobes. Objective 1. To identify potential risk factors, signs and symptoms that can lead to PRES syndrome. 2. To promptly diagnose this condition with the help of imaging modalities so that timely treatment can be started. 3. This condition is to be kept in mind as a differential diagnosis in comatose patient of pregnancy with uncontrolled hypertension or history of convulsions (severe preeclampsia and eclampsia). 4. Explain importance of knowledge and communication among interprofessional team to enhance patient care and management with patient of PRES. Method: In this case study, we describe a case of 21 year old PRES patient with post partum eclampsia. The diagnosis of PRES was reached after report of CT brain. Conclusion: Inspite of treatment, the patient could not survive.Early diagnosis and aggressive treatment should be kept in mind for such patients.

Background: Large uterine fibroids during pregnancy are associated with increased maternal and fetal complications. It can be a cause for arrest of labor and the need for cesarean delivery. Prior to the late 2000s, the reported prevalence ranged from 0.1 to 3.9%, with more recent data suggesting rates closer to 11%.1,2 The majority of these fibroids do not significantly change during pregnancy and frequently remain asymptomatic but if the fibroids grow in isthmic localization, vaginal delivery can be very difficult or impossible and many complications might also occur. Objectives: Uterine fibroids greater than 5 cm in diameter are more likely to grow during pregnancy and cause obstetrical complications. In this case,we report a case of a large 10 cm lower uterine fibroid presented to our hospital with obstructed labour and antepartum eclampsia resulting in cesarean delivery. Myomectomy was also done simultaneously. Methods: A 38 year-old gravida 3, para 2, pregnant woman was referred to our obstetrics emergency at SNMMCH, Dhanbad at 37 week gestation with diagnosis of antepartum eclampsia. Her pregnancy was further complicated by a presence of enlarged lower uterine segment fibroid with largest measuring 10.3 cm. Conclusion: Uterine fibroids are associated with an increased risk of caesarean delivery. The main factors for deciding the mode of delivery depends on the location, size and number of fibroids. Fibroids which are located in lower uterine segment present as case of obstructed labor and in these case caesarean delivery is preferred. Also caesarean myomectomy has been increasingly done now a days in order to avoid risk of reoperation in future.

Introduction: Metastatic breast cancer to the uterine cervix is a rare and unusual occurrence. Here, we present a case of metastatic lobular breast carcinoma to the uterine cervix in a 51-year-old postmenopausal woman. Objectives: The objectives of this case report are to highlight the importance of comprehensive diagnostic workup in identifying rare and atypical metastatic patterns and to emphasize the need for clinicians to consider uncommon sources of metastasis in the evaluation of postmenopausal women. Materials & Methods: A 51-year-old postmenopausal woman presented with postmenopausal white discharge per vaginum. A cervical biopsy was performed, and histopathological examination was conducted. Immunohistochemical analysis was subsequently performed to confirm the diagnosis. Results: Histopathological examination of the cervical biopsy revealed a discordant morphology. Immunohistochemical analysis confirmed the presence of metastatic lobular breast carcinoma cells in the uterine cervix. Conclusion: This case highlights the importance of comprehensive diagnostic workup, including histopathological and immunohistochemical evaluation, in identifying rare and atypical metastatic patterns. Accurate diagnosis is crucial, as primary genital tract carcinoma and metastatic lobular carcinoma require distinct management strategies. Clinicians should consider uncommon sources of metastasis in the evaluation of postmenopausal women presenting with unusual symptoms.

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