Is There an Association Between Early Pregnancy Losses and Low 25-Hydroxy Vitamin D Levels?

Objective: Since the etiology of pregnancy losses during first trimester has not still been clear, we aim to analyze the relationship between vitamin D deficiency and early pregnancy losses. Patients and Methods: The study was conducted on 200 women. Plasma was collected from 100 nulliparous women with singleton at 7-10 weeks of gestation (50 with viable gestation and 50 with pregnancy loss) and 100 non-gravid reproductive age women (50 with a successful pregnancy history and 50 with one or more spontaneous first trimester pregnancy loss history). Serum 25 (OH) D and calcium levels were compared between groups. Results: The serum 25(OH) D levels for the groups turned out to be 47.64 ± 3.2 (95% CI: 44.4-50.8 ng/ml) for normal pregnancy group, 27.3 ± 1.2 (95% CI: 26.1-28.5 ng/ml) for the group of early pregnancy loss, 38.5 ± 5.1 (95% CI: 33.4-43.6 ng/ml) for the non gravid women with healthy pregnancy history and 11.6 ± 4.2 (95% CI: 7.9 - 15.6 ng/ml) for the non-gravid women with history of 1 or more first trimester pregnancy loss. There was a strong correlation between low 25(OH) D levels and early pregnancy loss (odds ratio (OR): 1.70, 95% CI: 1.2-2.3, p <0.001). The calcium levels were significantly lower in pregnancy loss group than normal pregnancy and non-gravid groups (p=0.005, p=0.033 respectively). Conclusions: Although our study is emphasized on role of vitamin D in early pregnancy it is not possible to recommend screening and supplementation of vitamin D in early pregnancy, as prognosis of pregnancies receiving supplementation and the incidence of pregnancy related complications in follow-up are not known. Well designed studies with long term follow up results needed. Keywords: 25 hydroxy vitamin D, Pregnancy loss, 25 (OH) D vitamin

Supernumerary Ovary: A Case Report

Supernumerary Ovary is a rare incidental diagnosis, which is on the rise due to modern imaging modalities and advent of laparoscopy in Gynecology. It has various clinical implications. It can present like Endometrioma, Fibroma or as papillary serous cystadenocarcinoma. Removal of this additional ovary tends to stay in dilemma, because its follicles can be used in the treatment of infertility and it has malignant potential. Hence, correct diagnosis and prompt decision making is necessary based on the patient age and parity. As in our case, a nulligravida presented with torsion of the ovarian cyst. During Laparoscopic procedure, we noticed that this pathology was from the third ovary as in this case Supernumerary ovary. The removal of the ovary was not done as this patient was undergoing treatment for infertility. Weighing the benefits over risks, patient was counselled for proper follow-up and removal of this Supernumerary ovary following completion of family. All gynecologists should be aware of this rare condition due to its clinical implications and its appropriate management. Keywords: Supernumerary Ovary, Ovarian Torsion, Malignant potential, Fertility, Incidental diagnosis

Dengue Fever Haemorrhage in Pregnancy

Dengue fever is considered as one of the most common diseases in Vietnam, previously dengue fever rarely happened in adults, but currently it has become more common in adults and especially more dangerous for pregnant women due to its complications. Prognosis depends on the extent of disease, gestational age, placental circulatory failure during labor and bleeding after birth or after surgery. Most cases of Dengue fever in pregnancy is managed by conservative treatment, the complications are rare and include: blood clotting disorders, respiratory distress, mother-child transmission. Mortality rates is up to 10-20% when dengue haemorrhagic fever or dengue shock syndrome occurs. Prevention is the most useful in the community, however dengue fever vaccine is just in testing phase of clinical trial. One case of Dengue fever haemorrhage happened in Hung vuong hospital, Ho Chi Minh city, Vietnam reported. 26- year old woman with gestation of 37 weeks had serious Dengue fever haemorrhage. The Obstetricians and midwives followed up carefully and decided appropriate management such as platelets transfusion, vaginal delivery... saved both mother and child. Both of them discharged in the happiness of their family as well as hospital staffs after 10 days of treatment. Keywords: Dengue fever, Dengue hemorrhagic fever, Dengue Shock Syndrome, Severe thrombocytopenia