Maternal and peri-natal outcomes of dengue fever with special emphasis on vertical transmission.

OBJECTIVE: To investigate the maternal and peri-natal outcomes of dengue infection and frequency of dengue immunoglobulin G positivity in pregnant women along with pregnancy outcomes. Method: The observational two-phase study was conducted from 2012 to 2015 in Lahore, Pakistan. In phase 1, pregnant women who had acute dengue fever were prospectively and retrospectively enrolled from 4 tertiary care hospitals. Demographic data, clinical/laboratory parameters and maternal/foetal outcomes were recorded for each subject. In the second phase, normal pregnant women with no current or past history of dengue fever were enrolled from Gynaecology Department of Shaikh Zayed Hospital, Lahore, to determine the frequency of dengue immunoglobulin G positivity and pregnancy outcome. Data was analysed using SPSS 20. RESULTS: Of the 12 subjects in phase 1, 10(83.3%) were prospective cases and 2(16.6%) were retrospective. The overall mean age was 26.3±5.4 years, 7(58.3%) were in 2nd and 5(41.6%) were in 3rd trimester of pregnancy. Among the 4(33.3%) women at gestational age ≥33 weeks, 3(75%) had poor foetal outcome. In the second phase, there were 127 women with a mean age of 27.4±4.3 years. Among them, 38(29.9%) women were in the 2nd and 89(70.1%) were in the 3rd trimester. Dengue immunoglobulin G positivity was found in 65(51.2%) cases, but poor maternal or foetal outcome was not found in such women. CONCLUSIONS: Acute dengue fever at late term resulted in adverse foetal outcomes. Frequency of dengue immunoglobulin G positivity was high among pregnant women, but it was not associated with adverse outcomes.

Paraurethral leiomyoma.

Vaginal leiomyoma is a rare solid tumour with a variable presentation that can lead to pre-operative misdiagnosis. Local recurrence and transformation into sarcoma are also rare and surgical excision is recommended. Here, we present the case of a 23-year-old woman with a painless vaginal mass associated with severe dyspareunia since marriage (2 months ago) and dysmenorrhoea. She underwent surgery by vaginal route and histological findings confirmed a leiomyoma. After 2 months, the patient was disease-free and symptoms disappeared.