Complications associated with intrauterine contraceptive devices at the Imo State University Teaching Hospital, Orlu, Nigeria

Background: Intrauterine contraceptive device (IUCD) is one of the reversible methods of contraception. Its use has increased steadily worldwide. However, some women reject it based on presumed  complications associated with its use.Aim: To determine the complications reported by women, action taken on the complications and other associated factors in Orlu, Nigeria.Method: This is a cross-sectional study of 130 women who had IUCD insertions at the family planning clinics of Imo State University Teaching Hospital as well as its urban and rural practice centres (namely Anara Health Centre and Ogbaku Comprehensive Health Centre) both in Orlu Senatorial district between May 2008 and August 2008. Structured questionnaires were administered to consecutive women on follow-up visits at the Family Planning Clinics who are on IUCD. Information regarding age, parity, complications, reported action taken after the complication, clients' awareness of the availability of intrauterine device and duration of IUCD use were included in the questionnaires.Result: A total of 130 users were available for study. Heavy menstruation was reported by 50 (35.2%) women which was the commonest in this study; 65 (50%) did not do anything about whatever complication reported. The age range was 21-45years with a peak age group of 26-30 years. Majority of the clients 85 (65.4%) knew about IUCD from the hospital. More than half (46.2%) of the patients had between 2-5 children. The distribution of the duration of IUCD use showed that most of the clients had the IUCD for one year and less.Conclusions: IUCD is well accepted among users who still consider the benefit of reversible contraception more than the reported complication.Keywords: IUCD, Complications, Orlu Senatorial district

Uterovaginal prolapse at a University Teaching Hospital in South-East Nigeria

Background: Uterovaginal Prolapse is a common gynaecological problem particularly in the grandmultipara. It is of considerable importance to the practising gynaecologist in the tropics because of its strong association with repeated child birth and poor conduct of labour.Objective: To determine the hospitalprevalence and management pattern of this condition in Imo State University Teaching Hospital, Orlu and the attendant problems associated with the management.Methodology: This was a retrospective study of all patients presenting with uterovaginal prolapse between 1st January, 2004 and 31st December, 2007. There were 1,075 gynaecological admissions during the period and 43 patients had genital prolapse out of which 42 (97.7%) case notes were retrieved from the medical records department. Relevant data were obtained from the case notes, which included age, parity, presenting symptoms, number of living children, types of delivery, types of surgical management and associated operative morbidity and mortality. The data were presented as simple percentages.Results: The prevalence of uterovaginal prolapse in this study was 39.1 per 1000 gynaecological admissions making it 3.9% of total gynaecological admissions. The mean age of presentation was 51.4± 3.3 years. The mean parity was 4.2± 1.6. Grandmultiparity accounted for 81% of the cases. The most common symptom at presentation was the sensation of a protrusion down the vagina in 32 (76.2%) of the patients. Difficult labour was found to be the most common associated factor in 32 (76.2%) of the patients. The most common form of treatment offered was vaginal hysterectomy with pelvic floor repair, 37 (88.1%).Conclusion: There is need to educate women on the importance of accessing skilled antenatal, delivery and postnatal services as these might reduce the prevalence of uterovaginal prolapse in our environment.Keywords: Difficult labour, genital, hysterectomy, multiparit