Vaidyanathan Gowri

Cervical pregnancies (CPs) are dangerous due to associated life-threatening haemorrhage requiring massive blood transfusions and a possible need for hysterectomy. The main aim in the management is to prevent hysterectomy especially in young women who desire fertility. If diagnosed early, conservative management of an asymptomatic CP using systemic or local medical treatment seems superior to the surgical intervention. Surgical intervention as a primary mode of treatment may cause severe haemorrhage. The optimum therapeutic option for symptomatic CP is still unclear. We report a case of cervical pregnancy initially misdiagnosed as threatened miscarriage- in a woman with previous multiple cesarean sections.

Coiling of umbilical cord is a normal process during development. Abnormal umbilical coiling is associated with adverse pregnancy outcomes. Hyper coiling of umbilical cord may be associated with increased rate of miscarriage, fetal growth restriction, fetal heart decelerations, cord stenosis and intrauterine fetal death. The difference in coiling has been described as an antenatal marker for fetuses at risk. We describe a patient where hypercoiling in a pre term pregnancy contributed to fetal death in a woman with multiple previous caesarean sections. Routine investigations for fetal death were negative in the postpartum period.