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.

Association between serum chlamydial antibody levels and tubal infertility in tertiary health facility in South-East Nigeria: a case-control study

Objectives: This study evaluates the association between genital Chlamydial infection and tubal factor infertility in a tertiary health facility in South-East Nigeria.Design: This was a case-control analytical study.Setting: Gynaecology Clinic and Maternity Unit of the Department of Obstetrics and Gynaecology of the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria.Participants: Ninety-six (96) women with confirmed tubal factor infertility served as the cases, and 96 women with normal intra-uterine pregnancy matched in age served as the control.Data Collection/Intervention: A structured questionnaire was used to extract information on the sociodemographic data and the sexual history of the participants. About 2mls of blood was collected, the blood was allowed to clot, and the sera were used for the test.Statistical analysis/Main outcome measure: Pearson Chi-square, Fisher’s exact test, likelihood ratio and multivariate logistic regression were used to determine risk associations and identify factors independently related to tubal factor infertility. P-value < 0.05 was considered significant.Results: The sociodemographic characteristics of both cases and control did not differ (P = 0.975). The Chlamydial antibody seropositivity was significantly higher in the cases than the control 78(81.2%) versus 13(13.5%) respectively {(P < 0.001; OR (95% CI) = 27.7(12.7-60.2)}. Only lower abdominal pain {(P = 0.011); OR (95% CI) = 4.3(1.4-13.3)}; was independently associated with tubal factor infertility.Conclusion: Tubal factor infertility is strongly associated with chlamydial IgG antibodies, and a history of lower abdominal pain significantly predicted tubal factor infertility