Massive vulval oedema in multiple pregnancies at Bugando Medical Centre: Case reports

Massive vulval oedema is not common during pregnancy, but when it develops, it often is associated with patient discomfort and management challenges. Two pregnant women presented to Bugando Medical Centre in Mwanza, Tanzania, with massive swelling of the vulva at 39 weeks and 32 weeks of gestation. Both women were found to have multiple gestations.  Despite medical management, there was no resolution of the oedema.  In both cases, vulval oedema subsided after being delivered by caesarean section. Major vulval oedema during pregnancy is a serious issue.  If not treated appropriately, it can lead to major complications of increased blood loss and poor wound healing. Abdominally delivery is the preferred mode of delivery at our institution for massive vulval oedema

Prevalence of Bacterial Vaginosis and Associated Factors among Pregnant Women Attending at Bugando Medical Centre, Mwanza, Tanzania

Bacterial vaginosis (BV) is an extremely common reproductive tract condition worldwide with reported high prevalence among African population. Factors associated with this condition include preterm labour, premature rupture of membranes, preterm delivery and possibly spontaneous abortion. Nevertheless, antenatal screening and treatment is not routinely available in most poor-resource countries including Tanzania. A cross-sectional descriptive study was conducted among delivering women at Bugando Medical Centre (BMC), Mwanza, Tanzania to determine the magnitude of the BV using the Nugent’s criteria and to document factors associated with the condition. A total of 284 women who presented for delivery at BMC labour ward from February to March 2011 were recruited into the study. For each consented women, a vaginal swab was taken, samples collected tested and a Nugent’s score of at least seven indicated bacterial vaginosis. Overall, bacterial vaginosis was diagnosed in 28.5% (n=81) of all participants. Gardnerella was the commonest morphotypes found in approximately 66.2% (n=188) of all participants while 11.6% (33 participants) had Mobilincus. There were no evidence for the association between bacterial vaginosis having formal education, (OR, 1.42[95%CI, 0.29-6.97; p=0.667]). Urban residence (OR, 1.29 [95% CI, 0.76-2.19; p=0.352]), ever delivered before (OR 0.66[95%CI, 0.39-1.12; p=0.126]), vaginal practice to enhance dry sex (OR, 1.16[95%CI, 0.43-3.17; p=0.768]) or wet sex (OR 1.31[95%CI, 0.46-3.7; p=0.613]), gestation age less than 37 weeks (OR 0.82[95%CI, 0.45-1.51; p=0.534]) and HIV infection (OR 0.90[95%CI, 0.28-2.92; p=0.863]) were not associated with bacterial vaginosis. Bacterial vaginosis is common among women delivering at Bugando Medical Centre and more studies to include antenatal clinic attendees initiating care are required to reliably document the magnitude the condition

Massive vulval oedema in multiple pregnancies at Bugando Medical Centre: Case reports

Massive vulval oedema is not common during pregnancy, but when it develops, it often is associated with patient discomfort and management challenges. Two pregnant women presented to Bugando Medical Centre in Mwanza, Tanzania, with massive swelling of the vulva at 39 weeks and 32 weeks of gestation. Both women were found to have multiple gestations. Despite medical management, there was no resolution of the oedema. In both cases, vulval oedema subsided after being delivered by caesarean section. Major vulval oedema during pregnancy is a serious issue. If not treated appropriately, it can lead to major complications of increased blood loss and poor wound healing. Abdominally delivery is the preferred mode of delivery at our institution for massive vulval oedema