Postpartum Labial Adhesion Presenting with Apareunia: A Case Report

Labial adhesion is commonly seen in the paediatric and post-menopausal age groups and treatment of this condition with oestrogen cream is effective. On the other hand, postpartum labial adhesion is an unusual complication of vaginal birth except when it associated with trauma to the perineum. In that situation, treatment with oestrogen cream is usually in-effective. A 19-year-old primipara presented 15 months after vaginal birth with difficulty in having sexual intercourse. She had sustained a perineal tear during her last childbirth at home. Pelvic examination revealed fusion of the medial aspect of the labia minora with a membrane inferior to the external urethral opening completely closing the vaginal orifice. A surgical division under anaesthesia was carried out and she resumed sexual intercourse within five days. Postpartum labial adhesion is an uncommon complication of vaginal births and surgical division of labial adhesions is the first line of management. Good postpartum perineal care for perineal laceration following vaginal births should be encouraged to prevent apareunia.&nbsp

Grand multiparity: Obstetric performance in Aminu Kano Teaching Hospital, Kano, Nigeria

No Abstract

Reported sexual violence among women and children seen at the gynaecological emergency unit of a rural tertiary health facility, northwest Nigeria

Background: Various forms of sexual violence including: Coerced marriage or wife inheritance, female genital mutilation, forced exposure to pornography, rape by intimate partner or strangers, unwanted sexual advances, and sexual abuse occurs, especially in vulnerable groups. However, most of these cases are not reported. Aim: The aim was to review reported cases in the facility, determine the prevalence and pattern of presentation. Subjects and Methods: This was a prospective longitudinal study undertaken at the Gynecological Emergency Unit of a Tertiary Health Facility in a rural setting Northwest Nigeria. A study of survivors of alleged sexual violence who presented to the hospital from the September 1, 2011 to August 31, 2013. Results: During the study period, there were 24 cases of sexual violence (22 were alleged rape and 2 were others) of 973 gynecological consultations at the emergency unit, giving a prevalence of 3% (24/973) for sexual violence and 2.3% (22/973) for alleged rape. Majority 91.7% (22/24) of the cases were children < 16 years; 45.8% (11/24) had no formal education while 33.3% (8/24) hawked homemade drinks and snacks. The assailants were known in 83.3% (20/24) of the cases; of which 45.8% (11/24) were neighbors, 29.2% (7/24) were buyers of snacks and drinks while 8.3% (2/24) were family members. Conclusion: The prevalence of reported sexual violence in this facility was low with the majority of the survivors being children and nonstranger assailants’, mostly neighbors.Keywords: Sexual abuse, Sexual assault, Sexual violenc

Scaling up Prevention of Mother to Child Transmission of HIV Infection to Primary Health Facilities in Nigeria: Findings from Two Primary Health Centres in Northwest Nigeria

Nigeria is scaling up prevention of mother-to-child transmission (PMTCT) of HIV interventions to primary health care centres (PHCs). This retrospective study of PMTCT was at two PHCs in Northwest Nigeria with the main outcome measure being HIV infection rate of exposed infants at 6 weeks of life. Of 10,289 women who had antenatal HIV test, 74 had positive results. This gave a prevalence of 0.7%. The uptake of antenatal (99.8%) and intrapartum (97.3%) tests was high at both centres. 30% of HIV infected mothers and 25% of exposed infants were lost to follow-up (LFU). Most women (85.7%) had highly active antiretroviral therapy (HAART) and vaginal delivery (98%). Perinatal mortality rate was 66/1000 births and 95.3% of exposed infants had negative HIV-DNA polymerase reaction test at 6 weeks of life. Despite a high LFU, a new vista has been opened to attaining a zero infection rate. Afr J Reprod Health 2013 (Special Edition); 17[4]: 130-137).Keywords: HIV in pregnancy, PMTCT in primary health centr