A six year review of hysterectomy for benign gynaecological conditions at the Federal Medical Centre, Owerri

Background: Hysterectomy is one of the commonest major gynaecological surgeries performed for both benign and malignant conditions. Hysterectomy for benign gynaecological conditions is usually done to improve the quality of life of women who suffer from these disorders. Aim of current study was to analyze hysterectomies performed in the centre for benign gynaecological conditions during the period of the study.Methods: This was a retrospective descriptive study of all cases of hysterectomy (for benign gynaecological disorders over a 6 year period (January 1, 2006 - December 31, 2011) at Federal Medical Centre, Owerri. Information on socio-demographic characteristics, clinical presentation, indication for surgery, type of hysterectomy, operative findings, and postoperative complications during admission were retrieved and analyzed.Results: Hysterectomy for benign gynecological conditions accounted for 14.1% of all major gynecological surgeries. The leading indications for hysterectomy were uterovaginal prolapse (47.3%), uterine fibroid (33.6%), and dysfunctional uterine bleeding (DUB) (9.1%). Abdominal hysterectomy accounted for 55.0% while vaginal hysterectomy accounted for 45.0% of hysterectomies performed for benign gynecological conditions. A post-operative morbidity rate of 23.7% was found. Post-operative fever, requiring investigation and treatment, was the leading complication. No mortality associated with hysterectomy was recorded.Conclusions: Hysterectomy for benign gynaecological conditions is relatively common and safe in our centre, but there is need for improvement on the high post-operative morbidity rate

Outcome of single breech term deliveries at the Federal Medical Centre, Owerri, South Eastern Nigeria: a five year review

Background: The best mode of delivery of breech presentation for optimum neonatal outcome has been a subject of controversy over the years. Aim of current study was to determine the pattern of distribution, incidence, mode of delivery and outcome of singleton breech presentations at term among parturients at this centre.Methods: This was a retrospective study of singleton breech term delivery at the federal medical centre, Owerri between January 1, 2007 and December 31, 2011. Singleton breech term deliveries were identified from the labor ward register and the hospital numbers extracted to retrieve the case notes from the medical records department of the hospital. Some data were collected and analysed.Results: There were a total of 9624 deliveries during the study period, out of which 328 (3.4%) were singleton breech presentation at term. Term singleton breech was commoner in multiparous 200 (61%) than in primiparous 128 (39%) women. Extended (Frank) breech was the commonest type of breech presentation (60.4%) followed by flexed (complete) breech (36.0%) and footling breech (3.6%) was the least common. Assisted vaginal breech delivery was conducted in 66.2% of cases while 27.4% were delivered by emergency caesarean section and 6.4% of cases were delivered through elective caesarean section. There were one maternal and 24 perinatal death. Twenty one (87.5%) of perinatal deaths those occurred in unbooked mothers.Conclusion: Although assisted vaginal breech delivery for singleton breech term delivery was commonly performed in our centre, elective caesarean delivery gives the better neonatal outcome for fetuses presenting breech.