Successful pregnancy in Takayasu's arteritis type III with complete infrarenal aortic block.

A Gravida 2 Para 1 Live 1 in her late 20s and of South Asian ethnicity with previous lower segment caesarean section (LSCS) was hospitalised for confinement at 37 weeks for chronic hypertension with superimposed pre-eclampsia.The patient was diagnosed with type III Takayasu's arteritis following a previous uncomplicated pregnancy. A year after her first childbirth, she presented with headache, recurrent scleritis, hypertension, bilateral absent lower limb pulses and right femoral bruit. CT angiogram revealed concentric thickening of the aorta and complete occlusion of the infrarenal aorta, with a saccular aneurysm 18 mm in diameter in the distal thoracic aorta at the T10 level. She was started on immunosuppressants and antihypertensives. During the current pregnancy, she received multidisciplinary care and underwent an elective LSCS with intrauterine contraceptive device (IUCD) placement at term under spinal anaesthesia. Postoperatively, nitroglycerine infusion followed by oral labetalol was administered for hypertension. She was discharged on day 10 with regular follow-up.

Pregnancy outcome in subclinical hypothyroidism with and without thyroid peroxidase antibodies-a prospective cohort study.

BACKGROUND: Subclinical hypothyroidism (SCH) in pregnancy is associated with adverse foetomaternal outcomes. The literature is scarce with respect to maternal and perinatal outcomes in women with mild SCH (TSH levels between 2.5-4 mIU/L). OBJECTIVES: The primary objective of the study was to compare the pregnancy outcome between SCH and euthyroid women. The secondary objectives were to find out the proportion of women with SCH having thyroid peroxidase antibodies (TPOAb) and to see the effect of TPOAb positivity on foetomaternal outcomes. MATERIALS AND METHODS: A total of 178 pregnant women were recruited in the first trimester, and those with TSH between 0.1 and 2.4 mIU/L were considered as euthyroid and 2.5-4mIU/L were labelled as SCH. Women with SCH underwent testing for TPOAb. All women were followed until delivery, and foetomaternal outcomes were assessed. RESULTS: Amongst SCH group, there was a significantly higher proportion of overweight and obese women (76/91 (83.51%) vs 59/87 (68%), p = 0.031). The neonatal intensive care unit (NICU) admission was higher with adjusted odds ratio of 3.24 (1.41-7.43) in women with SCH as compared to euthyroid women. Otherwise, there was no difference in foetomaternal outcomes between the two groups. The proportion of gestational diabetes mellitus, intrauterine growth retardation and still birth were higher in SCH women with TPOAb as compared to euthyroid. Amongst SCH women, the proportion of induced labour was lower (aOR:0.27 (0.08-0.93) whereas the proportion of stillbirth and low APGAR scores were higher in TPOAb-positive women with a statistically significant difference and adjusted odds ratio (aOR:20.18 (1.84-220.83)) and (aOR:4.77 (1.06-21.3)), respectively, when compared to TPOAb-negative women. CONCLUSION: There appears to be no difference in pregnancy outcomes between women with SCH and euthyroid women except higher NICU admission in SCH group. Future multi-centre large prospective studies are required to understand better about the pregnancy outcomes in these women.

Third-Stage Complications Among In Vitro Fertilization Pregnancies: An Observational Study.

OBJECTIVE: This study aimed to determine the third-stage complications and their risk factors in in vitro fertilization (IVF) pregnancies. METHODS: This prospective observational study was conducted from March 2022 to November 2023 at a tertiary care university hospital in South India. We included a total of 217 women following IVF conception, and details of the third-stage labor complications were documented and expressed as the frequency with percentage. The risk factors were analyzed using a logistic regression model. RESULTS: Among 217 participants, 51 (23.5%) had third-stage complications. Postpartum hemorrhage (PPH) was the most common, complicating 20% of the deliveries. Multiple gestations (adjusted odds ratio (aOR) 2.7, 95% confidence interval (CI) 1.03-7.46, p = 0.04), operative vaginal delivery (aOR 57, 95% CI 4.2-770, p = 0.002), and emergency cesarean section (aOR 14.8, 95% CI 1.3-160.5, p = 0.026) were the risk factors for PPH. Intrapartum infection was found to be associated with a risk for the retained placenta (aOR 8, 95% CI 1.37-46.4, p = 0.02) and adherent placenta (aOR 6.06, 95% CI 1.07-34.3, p = 0.04). Assisted reproductive technology (ART)-related factors were not found to be significantly associated with third-stage complications. CONCLUSION: There is a risk of third-stage complications, especially postpartum hemorrhage, among IVF pregnancies. The type of embryo transfer was not associated with third-stage complications.

Insulin Sensitivity, Islet Cell Function, and Incretin Axis in Pregnant Women With and Without Gestational Diabetes Mellitus.

Introduction: The aim of this study was to compare insulin sensitivity, islet cell function, and incretin axes in pregnant subjects with GDM and normal healthy controls. Methods: Pregnant women at 24 to 28 weeks of gestation were subjected to a 75 g oral glucose tolerance test (OGTT). Samples for glucose, insulin, glucagon, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) were collected at 0, 30, 60, and 120 min during the OGTT. The Matsuda index (MI) and insulin secretion and sensitivity index-2 (ISSI-2) were assessed. The glucagon suppression index (GSI) was calculated along with the area under the curve (AUC) for glucose, insulin, glucagon, GLP-1, and GIP. Results: A total of 48 pregnant women (25 GDM and 23 controls) were finally analysed. The MI and ISSI-2 were low in the GDM group [4.31 vs. 5.42; P = 0.04], [1.99 vs. 3.18, P ≤ 0.01] respectively). Total AUCglucagon was higher in the GDM group (7411.7 vs. 6320.1, P = 0.02). GSI30 was significantly lower in the GDM group (-62.6 vs. -24.7, P = 0.03). Fasting GLP-1 levels were low in GDM women (17.3 vs. 22.2, P = 0.04). The total AUCGLP-1 positively correlated with total GSI in the GDM group. Conclusion: Asian-Indian GDM women have high insulin insensitivity, islet cell dysfunction, and low fasting GLP-1. Incretin axis dysfunction plays a potential role in their islet cell dysfunction.

Vaginal mesh erosion - a challenging entity.

Pelvic reconstructive surgery with mesh for pelvic organ prolapse (POP) has been reported to have a superior anatomical cure rate compared with traditional repair methods. Mesh-related adverse events are increasing worldwide. We describe a case of excision of mesh erosion following vaginal hysterectomy. A 45yr old lady presented with 3 × 2 cm infected mesh erosion on the anterior vaginal wall following a vaginal hysterectomy a year earlier in a camp setting. Cystoscopy was normal. Under anesthesia, the mesh was dissected from the vagina and excised. The vaginal edges were freshened, and approximated Postoperative period was uneventful, and she was discharged home the next day. Surgical revision is indicated for large or multiple erosions. Mesh excision can be a challenging procedure with difficulty in gaining access and increased risk of surgical bleeding. A multidisciplinary approach in conjunction with a urologist will help optimise outcomes.

Efficacy of combination of transcervical Foley catheter and sublingual misoprostol versus sublingual misoprostol for labor induction in pre-eclampsia at 28-34 weeks.

OBJECTIVE: To compare the efficacy of using a combination of transcervical Foley catheter and sublingual misoprostol with sublingual misoprostol alone for induction of labor (IOL) in women with pre-eclampsia between 28 and 34 weeks of pregnancy. METHODS: This randomized controlled trial was conducted on women with pre-eclampsia at 28-34 weeks of pregnancy, with unfavorable cervix, admitted to a tertiary hospital in south India. They were randomized to receive either a combination of transcervical Foley catheter and sublingual misoprostol, or sublingual misoprostol alone. Vaginal birth within 24 h of induction, induction to delivery interval, and neonatal morbidity/mortality were the main outcome measures. RESULTS: Vaginal birth within 24 h was higher with the combination of Foley catheter and sublingual misoprostol compared with sublingual misoprostol alone (60% versus 41.4%, P = 0.028). Overall vaginal delivery rates were comparable between the groups (90% versus 80%, P = 0.051). There was no difference in number of doses of misoprostol, and induction to delivery interval between groups. After excluding those with lower likelihood of neonatal survival, live birth rates, mean birth weight, and neonatal intensive care unit admission rates were similar in both groups. CONCLUSIONS: Combination of transcervical Foley catheter and sublingual misoprostol was found to be more effective in achieving vaginal birth within 24 h compared with sublingual misoprostol for IOL in pre-eclampsia between 28 and 34 weeks of pregnancy. TRIAL REGISTRATION NUMBER: CTRI/2018/09/015766; http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=27984.

Impact of the Covid-19 Pandemic on the Prevalence of MTP Cases and Their Clinicodemographic Profile in India: A Retrospective Multicentric Study.

Background: During the Covid-19 pandemic, reproductive health of women was disproportionately affected due to difficult access to safe abortion and contraceptive services. This study aims to assess the impact of the Covid-19 pandemic on the prevalence of MTP cases and to find out the clinicodemographic profiles of women undergoing MTP during three Covid-waves in different hospitals-Government and private sectors in India. Methods: This retrospective multicentric cohort study was conducted during three Covid-19 pandemic waves. The records were retrieved from the centers' medical record section and the MTP register from the Department of Obstetrics and Gynaecology. Results: On an average, 1.1 women/day underwent MTP during covid waves compared to 1.9 women/day during the pre-covid 2019. The first Covid wave's average MTP/day was very low (0.71) compared to the third (2.88) and second wave (1.12), respectively. These differences were statistically significant (p<0.0001). The most common indication for MTP was contraceptive failure 245(50.9%), followed by eugenic/congenital anomalies 88(18.9%). A total of 244 cases (50.6%) reported for MTP ≤ seven weeks and 114(23.6%) presented between 7 and 12 weeks. More than half (54%) of the women underwent surgical methods for abortion as the unavailability of medical abortion (MA) drugs. IUCD and sterilization were severely affected during the first and second Covid waves. Conclusion: Safe abortions are essential services for reproductive-age women. With the uncertainty of future Covid-like an emergency, we should strengthen our telemedicine network so that women can reach out early and MMA can be initiated to reduce the number of surgical abortions and unwanted pregnancies.

Spontaneous Hemoperitoneum in Third Trimester of Pregnancy-an Enigma.

Spontaneous hemoperitoneum in pregnancy is a rare and challenging obstetric emergency. It can present as acute abdomen with features of hypovolemic shock and requires high index of suspicion for diagnosis as various obstetric and non-obstetric causes have similar presenting features. Here we present a case of primigravida at 33 weeks of gestation who presented with acute abdomen, signs of shock and a pathological trace on cardiotocogram. She underwent laparotomy and cesarean section in view of suspicion of abruption placentae. Intraoperatively there was hemoperitoneum of 600 ml with 750 g clots and a small venous bleeder on the posterior surface of the uterus which was secured with hemostatic sutures. Patient got discharged along with the baby on seventh postoperative day. Timely intervention is paramount in reducing maternal morbidity and mortality.

Outcomes of teleconsultation services and patient satisfaction among pregnant women delivering at a tertiary care center in South India during coronavirus disease 2019 pandemic.

Coronavirus disease 2019 pandemic has disrupted the antenatal care in low- and middle-income countries such as India. Telemedicine was introduced for the first time in India for continuing antenatal care. Hence, a questionnaire-based descriptive cross-sectional study is done to assess the outcomes of teleconsultation services, factors influencing it, and patient's perceived satisfaction. Three hundred and fifty-five women who delivered the following teleconsultation from July 2020 to October 2020 were included in the study. Thirty-two percent were high-risk pregnancies and 15% of the babies required neonatal intensive care unit admission. Ninety-eight percent could convey their health concerns, 18% had a referral to other departments, and 25% had visited casualty. Sixty-three percent procured medicine through e-prescription. Seventy-six percent were happy with teleconsultation overcrowded clinic, 82% were happy about saving travel expenditure, whereas overall satisfaction was 50%. Fourteen percent did not have access to smartphone and 9% did not receive the call at scheduled time. Telemedicine has a vital role in managing pregnancy concerns during this pandemic.

Association of VDBP (rs4588 and rs7041) gene polymorphisms with susceptibility to postpartum depression in South Indian population: A cross-sectional study.

Low vitamin D levels have been implicated in postpartum depressive disorders (PPD). Our study aimed to demonstrate the association of Vitamin D Binding Protein (VDBP) genetic variants rs7041 and rs4588 with susceptibility to PPD and to investigate their possible relationship with serum vitamin D and VDBP levels in Indian women with PPD. A cross-sectional study involved 330 cases and 330 controls. Depressive symptoms were assessed using Edinburg Postnatal Depression Scale. Genotyping of SNPs was done by Taqman 5'allelic discrimination assay. Estimation of serum 25 hydroxyvitamin D [25(OH) D] and VDBP levels were done by ELISA. Serum total, free and bioavailable 25(OH) D levels were significantly lower in cases compared to controls, with similar levels of VDBP between the two groups. The study results showed that the VDBP rs4588 variant genotype AA was significantly associated with lower circulating levels of total 25(OH) D in cases. Also, the VDBP rs7041 variant TT genotype demonstrated significantly lower levels of total, free and bioavailable 25(OH) D levels in controls. However, VDBP rs7041 and rs4588 variants were not associated with PPD susceptibility. Also, VDBP haplotypes showed no association with PPD susceptibility. Our results demonstrated that VDBP polymorphisms rs4588 and rs7041 and their haplotypes are not associated with PPD susceptibility in the South Indian population. However, vitamin D levels were found to be influenced by the risk genotypes of VDBP SNPs rs4588 and rs7041.

Managing pregnancy in women with Sturge-Weber syndrome: case report and review of the literature.

Sturge-Weber syndrome (SWS) is a sporadic congenital neuro-cutaneous anomaly with capillary-venous malformation involving the brain, eye, and the ophthalmic division of the trigeminal nerve. In these cases, physiological changes in pregnancy, including hormonal and hemodynamic changes, may predispose to increased seizure frequency and even a life-threatening intracranial haemorrhage. There are only few case reports available about the management of women with pregnancy and SWS. We report two patients with SWS diagnosed in childhood and managed during pregnancy and reviewed the outcomes and complications during pregnancy in women with this disorder.

Maternal & perinatal outcome of fever in pregnancy in the context of dengue - A retrospective observational study.

Background & objectives: Pregnant women with dengue infection may be at increased risk of adverse maternal-foetal outcomes. This study was conducted to assess the maternal and perinatal outcomes in women who presented with fever and diagnosed to have dengue infection during pregnancy. Methods: A retrospective observational study was conducted on pregnant women admitted with fever, in a tertiary referral centre in South India, during January 2015 to December 2018. We compared outcomes of women diagnosed with dengue with that of women without dengue. The study outcomes included pre-term birth, stillbirth, low-birth weight (LBW), maternal mortality and thrombocytopenia. Results: During the study period, there were six maternal deaths following complications from dengue infection. Higher rates of thrombocytopenia (24.7% vs. 14.6%, P=0.02) were noted among those with recent dengue infection. The risk of still birth was 2.67 [95% confidence interval (CI) 1.09, 6.57], LBW [risk ratio (RR) 1.13, 95% CI 0.87, 1.45] and pre-term birth (RR 1.33, 95% CI 0.89, 1.97) among the cases. Interpretation & conclusions: Occurrence of adverse maternal and foetal outcomes was increased in pregnant women with fever diagnosed with dengue infection. Future studies are needed to formulate the optimum monitoring and treatment strategies in pregnant women, where dengue can have additive adverse effects to other obstetric complications.

Relationship between advanced glycated end products and maternal cognition in gestational diabetes: a case control study.

OBJECTIVE: Gestational diabetes (GDM) is a form of glucose intolerance which manifests during pregnancy. There is lack of literature regarding the study of cognitive functions in GDM. Recent evidences suggests an increase in accumulation of serum Advanced glycated end products (AGE'S) during GDM. Accumulation of AGE's in brain can induce changes in permeability of blood brain barrier and creates oxidative stress and inflammation that can alter cognitive functions. In this study we hypothesize that diagnosis of GDM in pregnancy is related to lower cognitive scores which is correlated to increased serum AGE's level. METHOD: This was a cross sectional case control study which recruited 60 participants in total consisting of two groups with 30 participants in each - diagnosed cases of GDM and healthy pregnant controls. Subjects were recruited from OPD of Obstetrics & Gynecology department in a tertiary care hospital in South India at gestational age of 32-36 weeks. On the first appointment, biochemical parameters of Fasting plasma glucose (FPG) & HbA1C was measured in both groups. Serum was obtained for testing levels of N Carboxy methyl lysine (N-CML) (a form of AGE). On second appointment, pen and paper neurocognitive tests including Montreal cognitive tests (MOCA) and Trail making test (TMT A & B) was presented. Event related potentials (ERP's) are time locked EEG wave signals produced in response to a sensory, motor or cognitive event. P300 is an "endogenous" ERP produced by cognitive processing in response to a stimuli presented to subject. P300 wave Latency and amplitude was recorded in both the groups as an objective marker of cognitive processing. Above mentioned biochemical and neurocognitive parameters were compared between both the groups and correlation analysis between serum AGE levels and neurocognitive parameters was performed using SPSS software. RESULTS: Biochemical parameters of HbAIC & N-CML(A form of AGE) levels were increased in GDM group (HbA1C 6.01±0.30 and N CML 236.25 ± 68.9) vs Control group (HbA1C 4.11 ± 0.68 and NCML 198.42 ± 44.2). Scores in MOCA were significantly lower in GDM (28 (27-29)) group as compared to controls (24 (23-25)). GDM subjects took significantly greater time to perform TMT A (24.59 ± 2.60 s) test than controls (29.7 ± 1.72 s). Significant changes were not found in P300 Latency & amplitude in GDM group. Decreased MOCA scores and increased duration of TMT A attempt were correlated with increased serum AGE concentration in GDM group. CONCLUSIONS: Our study indicates the vulnerability of women suffering from GDM to cognitive impairment during pregnancy. Lower scores in cognitive tests were correlated to AGE accumulation in GDM women.

A Rare Type of Uterine Rupture Following Over-the-Counter Use of Misoprostol in Second Trimester Abortion.

The use of misoprostol in the second trimester by a woman with a uterine scar may lead to severe contractions and uterine rupture. We report a 24-year-old pregnant female patient who presented at the Emergency Department at a tertiary care hospital in Puducherry, India, in 2020 with haemorrhagic shock. She was at 16 weeks of gestation and had taken over the counter misoprostol for inducing an abortion. A quick initial resuscitation and urgent laparotomy were performed. An irreparable circumferentially avulsed uterus suspended only by round ligaments was noted. Haemostasis required internal artery ligation and immediate total hysterectomy. The patient was doing well upon follow-up six months after the surgery. Proper and supervised use of misoprostol in the appropriate dosage can avoid life-threatening consequences of uterine rupture.

Serum Irisin Levels and its Association with Blood Glucose and Insulin Indices in Diagnosing Insulin Resistance in Adolescents with Polycystic Ovarian Syndrome.

CONTEXT: Irisin, a new myokine, has been found to be a biological marker of insulin resistance (IR). There is conflicting evidence on serum irisin level in adult women with polycystic ovarian syndrome (PCOS), and data are lacking in adolescents with PCOS. AIMS: We aimed to evaluate serum Irisin levels and study its association with indices using blood glucose and insulin levels in adolescents with PCOS. SETTINGS AND DESIGN: This case-control study was conducted in the gynecology outpatient department. MATERIALS AND METHODS: This study was carried out from August 2015 to June 2017. Eighty-two adolescent girls aged 15-19 years were included in the study. Fasting irisin, insulin,blood glucose; 2nd-h insulin (HOMA2-IR), and Quantitative Insulin Sensitivity Check Index (QUICKI) for all participants with addition of 2nd-h blood glucose for cases. STATISTICAL ANALYSIS: A correlation between serum irisin level and various biochemical parameters was done using Pearson's correlation. RESULTS: Fasting serum irisin was significantly higher among PCOS cases (8.43 [5.84, 13.11]) when compared to controls 4.90 (2.37, 9.09), median (interquartile range) (P = 0.002). Serum irisin was found to have a significant moderate positive correlation with 2nd-h blood glucose, fasting/2nd-h insulin, and HOMA2-IR. A significant moderate negative correlation was observed between irisin and QUICKI. CONCLUSIONS: Serum irisin levels were significantly elevated in adolescents with PCOS when compared to the controls. A significant correlation of serum irisin with blood glucose and insulin indices indicates that serum irisin could serve as a marker of IR and may help in its diagnosis in adolescents with PCOS.

Labial adhesions in a pre-pubertal girl: The importance of awareness.

Labial adhesion affects up to 0.6-5% of pre-pubertal girls. They may be congenital or acquired. Patients usually are asymptomatic, and thus, labial adhesions are found incidentally on routine examination. If the patient is indeed truly asymptomatic, there is no need for any treatment, and reassurance only is needed. When treatment is indicated, topical application of oestrogen cream is advised, but when this fails, surgical intervention is recommended. Recurrence is common regardless of the treatment. We present the case of a three-year-old girl managed by release of adhesions under topical anaesthesia and topical application of oestrogen cream.

Association of osteoprotegerin gene T950C polymorphism with cardiometabolic risk factors in gestational diabetes mellitus in South Indian Tamilian women.

BACKGROUND & AIMS: This study was designed to explore the relevance of Osteoprotegerin (OPG) and its polymorphism in the cardiometabolic risk in gestational diabetes mellitus patients before diet-therapy (GDMA1). METHODS: South Indian Tamilian pregnant women were screened and 145 were grouped as GDMA1 (n = 73) and normal pregnancy (n = 72). Serum OPG, TNF α, lipid profile, insulin and blood pressure was compared. Genomic DNA was analysed for rs2073617 T950C polymorphism. Chi square test was done to analyze the frequency distribution of alleles. Multiple regression analysis was done to assess the association among cardiometabolic parameters. RESULTS: TNF α (p < 0.01), Osteoprotegerin (p < 0.01), lipid profile (p < 0.01), atherogenic indices (p < 0.01), systolic and diastolic and blood pressure (<0.001) levels were higher in GDMA1 patients. TNF α (p < 0.01) and osteoprotegerin (p < 0.01) were higher in women with CT allele. Osteoprotegerin was independently contributed by BMI in all GDMA1 cases and diastolic blood pressure (DBP) in CT allele cases. There was significantly higher odd (OR = 3.63) in the distribution of CT genotype among the multiparous women. CONCLUSIONS: Osteoprotegerin, atherogenic lipid risk factor and inflammation are higher in GDMA1 women. Rise in OPG is contributed by high BMI in GDMA1 women. Higher odds of CT allele distribution in multiparous women suggests that TT allele women are at higher risk of developing GDM in their first pregnancy. Further analysis of T950C polymorphism in a larger cohort is warranted to confirm its role.

Pseudoaneurysm of uterine artery complicating caesarean section: a rare cause of intractable secondary postpartum haemorrhage managed with uterine artery embolisation.

A 27-year-old woman presented 6 weeks after an uncomplicated lower segment caesarean section with excessive bleeding per vagina. On examination, she had mild pallor with a pulse rate of 86 beats per minute and blood pressure of 116/80 mm Hg, uterus well involuted with closed cervical os and bleeding demonstrated through the cervix. A transvaginal ultrasonography with colour Doppler revealed a normal size uterus with an empty cavity and a hypoechoic area with blood flow within it in the left side of the uterus with a prominent arterial feeder vessel. A CT angiogram confirmed the diagnosis of a 1.3×0.7 cm pseudoaneurysm of the uterine artery near the left cornua of the uterus. After failed attempts to control the bleeding with antifibrinolytics, bilateral uterine arteries were embolised using gel foam. Post procedure, bleeding resolved immediately. A follow-up transvaginal ultrasound after a year revealed no evidence of the pseudoaneurysm and her fertility was preserved.

Imaging as an alternate diagnostic modality in a presumptive case of abdominopelvic TB in a COVID-19 patient.

A 30-year-old, multiparous widow, with postpolio residual paralysis, presented with complaints of dull aching abdominal pain for 15 days. Ultrasound showed a mixed echogenic right adnexal mass with free fluid in the pelvis and abdomen. CT abdomen and pelvis revealed partially defined peripherally enhancing collection in lower abdomen and right adnexa suggestive of tubo-ovarian abscess. There was mild ileal wall thickening and few enlarged mesenteric lymph nodes. Ascitic fluid did not show acid fast bacilli and cultures were sterile. Extensive diagnostic laboratory work was done which was inconclusive. Diagnostic laparoscopy could not be performed due to non-availability of elective operation theatre in the COVID-19 pandemic. Presumptive extrapulmonary tuberculosis was clinically and radiologically diagnosed. She was started on daily anti tuberculosis treatment. This case shows us the importance of imaging as a diagnostic tool and as an alternative for laparoscopy in COVID-19 pandemic to diagnose abdomino-pelvic tuberculosis.