ABSTRACT
We encountered a 47-year-old woman, at 35 weeks of gestation, carrying triplets, who attended the hospital with severe pre-eclampsia and at admission had eclamptic fit followed by cardiac arrest. Cardiopulmonary resuscitation was started when she did not respond to initial measures; resuscitative hysterotomy was started on the site of collapse immediately, within 4 min postarrest, to deliver the triplets within 5 min postmaternal cardiac arrest. Timely decision of resuscitative hysterotomy done primarily to restore maternal cardiac output due to a grossly gravid uterus saved the mother and the triplets. With increasing maternal age and use of in vitro fertilisation resulting in multiple pregnancies, maternal comorbidities are more likely. These could result in maternal collapse in which case timely resorting to resuscitative hysterotomy can make survival of mother and feti more likely.
Subject(s)
Cesarean Section , Heart Arrest/therapy , Hysterotomy , Pregnancy Complications, Cardiovascular/therapy , Female , Heart Arrest/diagnosis , Heart Arrest/etiology , Humans , Pregnancy , Pregnancy Complications, Cardiovascular/diagnosis , Pregnancy Complications, Cardiovascular/etiology , Pregnancy, TripletABSTRACT
Smooth muscle neoplasms of the vulva are rare, and when localized in the Bartholin's gland, it can be mistaken as a benign lesion leading to a delay in diagnosis. We report a case of leiomyosarcoma of the Bartholin's gland in a 63-year-old postmenopausal woman, which clinically mimicked a chronic Bartholin's gland cyst. This case report emphasizes the importance of suspecting malignancy in any vulvar lesion in women of postmenopausal age, despite its location and asymptomatic appearance. A prompt, careful evaluation with adequate clinical judgment will help to manage such cases efficiently.