Post -Episiotomy Morbidity amongst Parturients at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.

Background: Episiotomy, a commonly performed obstetric operation is associated with complications following its administration and care. These complications largely go unnoticed because of the deviation of attention after a successful delivery and subsequent loss of follow up of parturients after delivery. The objective of this study is to identify the morbidities associated with episiotomies and factors associated with such morbidities.Methods: This was a cross sectional descriptive study among females who were attended to at the Obstetric Department of the st University of Port Harcourt Teaching Hospital between 1st of January and 31st of May 2010. The study population consisted of patients who had episiotomies in their previous confinements attending either the antenatal clinic or the post natal clinic in the University of Port Harcourt Teaching Hospital.Results: Majority of the subjects were in the 31-35 year age group. Post operative pain was the commonest complication and dyspareumia accounted of 70% of sexual complications. Majority of episiotomies were performed on subjects in their first confinement and repair performed by  interns.Conclusion: There is need to have a review of the pain management of patients with episiotomies and surgical techniques of interns repairing episiotomies. A restrictive use of routine episiotomy amongst  primigravidae is advised to reduce the rate of episiotomy amongst this group.Keywords: Post Episiotomy; Morbidity; Port Harcourt

Acute uterine inversion complicating mid-trimester unsafe abortion in a teenage Nigerian girl

Uterine inversion is a rare but life-threatening obstetric emergency, complicating 1 in 2,000 to 1 in 50,000 deliveries. Very rarely, this condition also complicates unsafe abortion. A case of acute complete (fourth-degree) uterine inversion, with gangrene of the uterus in an 18-year-old nulliparous girl who presented to the Gynaecologic Emergency Unit of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, in hypovolemic shock from massive haemorrhage following unsafe mid-trimester termination of unwanted pregnancy is reported. She was adequately resuscitated, and a vaginal hysterectomy was performed. The patient was discharged following an uneventful postoperative period. This case highlights the consequences of the high unmet need for family planning and the restrictive abortion laws in Nigeria, limiting access to effective contraception and safe abortion services, thereby increasing the risk of maternal mortality and morbidity from complications of unsafe abortion

Vulva Haematoma following Sexual Assault in an Adolescent Nigerian Girl: A Case Report

Non-obstetric vulva haematomas are uncommon, with an incidence of 3.7% accounting for less than 1% of gynaecologic emergencies. Non-consensual sexual intercourse constitutes the most common aetiology. A 15-year-old adolescent Nigerian girl, who presented to the Gynaecologic Emergency Unit of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, with vulva haematoma following sexual assault, is presented. She had surgical management, screening and prophylaxis for sexually transmitted infections, emergency contraception, and psychosocial therapy and was discharged after 24 hours, following an unremarkable postoperative period. This case is being reported to draw attention to the serious global public health problem of adolescent sexual abuse, highlight that though rare, vulva haematomas, which could be life-threatening, can be a complication of sexual assault, and review the literature on its management

Knowledge, Attitude and Uptake of Pap Smear among Female Healthcare Professionals in a Nigerian Teaching Hospital

Background: Despite the high prevalence of cervical cancer (CC) in Nigeria, the uptake of screening services, including Pap smear, remains poor, even amongst healthcare providers. Objective: To assess Pap smear knowledge, attitude, and uptake among female healthcare professionals (FHPs). Methods: A cross-sectional descriptive study was conducted at the University of Ilorin Teaching Hospital (UITH), Kwara State, Nigeria, using a self-administered questionnaire. Results: A majority (343, 98.6%) of the FHPs knew Pap smear. Five (26.3%) medical laboratory scientists did not know what a Pap smear was. All the nurses, doctors, pharmacists, physiotherapists and medical social workers knew Pap smear. Only a fifth (71; 20.4%) of the FHPs had ever done a Pap smear. The most common reason cited for not having done a Pap smear was lack of time (109; 31.3%). There was a relationship between age and uptake of Pap smear (p = 0.024). Only 188 (54%) of the FHPs had ever recommended Pap smear to other women. Conclusion: Despite the high level of knowledge of Pap smear amongst FHPs in Nigeria, attitude and uptake remain poor. There is a need for further training and education of FHPs on the benefits of CC screening to increase their uptake and improve their effectiveness in promoting positive attitudes towards CC screening and prevention in the general population