Case Report on Septate Uterus: An Incidental Finding in a Multiparous Woman who Had an Emergency Cesarean Section

Background: Septate uterus is caused by incomplete resorption of the Mullerian duct during embryogenesis which may alter the reproductive outcome of the patients. It is the commonest form of structural uterine anomaly and has the highest reproductive failure rate. Case Report: A 21-year-old booked G4P2 +1 woman with two living male children admitted into the Antenatal ward through the Accident and Emergency ward at 33 weeks gestation for conservative management of preterm premature rupture of membrane. She had a previous history of miscarriage, preterm delivery, and elective caesarean section due to breech presentation in her first, second, and third pregnancies in 2007, 2008, and 2009, respectively. She, however, had an emergency caesarean section due to fetal distress at 33 weeks plus 4 days with the delivery of a live female baby that weighed 2.0 kg with APGAR scores of 7 and 8 in the 1st and 5th minutes, respectively. There was intraoperative finding of septate uterus with dimple at the fundus. The other abdominal viscera were normal. Conclusion: congenital uterine anomalies especially septate uterus, though rare, should be suspected in women with positive history of miscarriage, preterm delivery and malpresentation.Keywords: Asia, fetal distress, multiparous, preterm, septate, uteru

Attitude of Nigerian gynaecologists to bilateral oophorectomy during hysterectomy for benigh diseases

No Abstract

The contribution of severe pre-eclampsia to maternal death on the operating table (D.O.T.) in Enugu: a five years review, problems proffered solutions

Background: Maternal death on operating table is a most distressing situating in obstetric practice.Methods: A review of records of maternal deaths on table January 1995 and December 1999 at the NAUTH Enugu.Results: There were 18 maternal deaths following caesarean section at the University of Nigeria teaching Hospital (N.A.U.T.H), Enugu. Nine (50%) of the these maternal deaths occurred on the operating table (DOT). Severe pre-eclampsia was responsible for 66.7% (6 out of 9). Intraoperative surgical difficulty in the form of uncontrollable hemorrhage occurred in one of the nine cases. Discussion and conclusion: The difficulty of intubations and other problems of general anaesthesia posed by these patients thought to be contributory factors are analyzed. Suggestion is made as to alternative methods of an aesthesia for this risky group of patients especially in the setting of a developing nation where skilled anesthetists are in short supply.Keywords: maternal death on the table, pre-eclampsiaTropical Journal of Medical ResearchVol. 9(1) 2005: 18-2

Pattern and Outcome of Infertility in Enugu: The Need to Improve Diagnostic

No Abstract

Trends and Determinants of Episiotomy at The University of Nigeria Teaching Hospital (Unth), Enugu, Nigeria

BACKGROUND: Episiotomy is the most commonly performed obstetric procedure. The indications and efficacy are poorly established and its practice has remained controversial. OBJECTIVE: To determine the rate and the determinants of episiotomy in the parturients at the UNTH, Enugu.METHODS: A five year retrospective review of stepisiotomy at UNTH Enugu between 1 January ,2000 stand 31 December,2004 .RESULTS: Out of 3032 vaginal deliveries, 1201 women had episiotomy during vaginal delivery, giving a rate of 39.6%. The rate fluctuated between 38.7% in 2000 to 32.7% in 2004.The risk of receiving episiotomy is significantly higher among primigravidae than multigravidae [OR=10.92,(95%CI=8.98,13.28]. Similarly, macrosomia(birth weight>4kg) significantly increases the risk of episiotomy[OR=0.096, (95%CI=0.06,0.15]. Women who had instrumental or destructive vaginal delivery are significantly more likely to receive episiotomy than those who had spontaneous vaginal delivery[OR=0.13 (95%CI=0.07,0.26]. The postpartum blood loss is significantly higher among women that received episiotomy than those who did not[t=42.161, P>0.0001]. CONCLUSIONS: The rate of episiotomy in UNTH, Enugu is high. Primigravidity, macrosomia and instrumental deliveries are factors associated with increased risk of episiotomy. Knowledge of these risk factors will guide in predicting episiotomy among paturients in labour ward.KEYWORDS: Episiotomy, Trends, determinants, Enugu-Nigeria

Antihyperglycemic and antihyperlipidemic properties of aqueous root extract of Icacina senegalensis in alloxan induced diabetic rats

Objective: To evaluate the antidiabetic and hypolipidemic activity of aqueous root extract of Icacina senegalensis (I. senegalensis) in alloxan-induced diabetic rats. Method: Blood glucose levels of alloxan-induced diabetic rats were monitored after the administration of I. senegalensis extract (100, 200 and 400 mg/kg) to diabetic rats for 14 d. Different biochemical parameters, serum cholesterol, serum triglyceride, high density lipoprotein, low density lipoprotein and very low density lipoprotein were also examined. Results: Treatment of alloxan diabetic rats with the extract showed significant (P<0.05) activity. The activity of the extract was comparable to that of the standard drug, glinbeclamide. Conclusions: The results suggest that the root extract of I. senegalensis possesses antidiabetic and hypolipidemic properties, which might be a potential source for isolation of new orally active agent in the treatment of diabetes and its associated complications

Trends of Myomectomy at the University of Nigeria Teaching Hospital (UNTH) Enugu Nigeria

No Abstrac

Patter of Gynaecological Cancers in University of Nigeria Teaching Hospital, Enugu, South Eastern Nigeria

No Abstrac

Anti‑malaria prescription in pregnancy among general practitioners in Enugu state, south east Nigeria

Background: The national policy on malaria control recommends use of intermittent preventive treatment with sulfadoxine/pyrimethamine (IPT‑SP) for chemoprophylaxis against malaria in pregnancy; and use of quinine and arthemisinin‑based combination therapy (ACT) for acute treatment of malaria in the first, and second/third trimesters, respectively. In Nigeria, a large proportion of pregnant women are seen by the general practitioners (GPs). Objective: To determine the pattern of anti‑malaria prescription in pregnancy among GPs in Enugu state, and access the level of conformity with the national policy on malaria control. Materials and Methods: Questionnaires were administered to a cross‑section of 147 GPs that attended the 2010 Enugu state branch of the Nigeria Medical Association Scientific Conference/Annual General Meeting/Election. Results: The mean age of the GPs was 37 ± 3.6 (range 27-70) years. Quinine was the commonly (45.6% (n = 67)) prescribed anti‑malaria drug in the first trimester while in the second/third trimester ACT was commonly (48.3% (n = 71)) prescribed. Seventy‑six (51.7%) practitioners prescribed IPT‑SP for chemoprophylaxis against malaria while the rest (48.3%) prescribed other drugs. GPs who obtained MBBS qualification less than or equal to 5 years prior to the survey were more likely to comply with the national policy on malaria control in their prescriptions (P &lt; 0.05). Conclusion: The pattern of anti‑malaria prescription among GPs in Enugu state is varied, and conformed poorly to the evidence‑based national policy on malaria control. There is need for continuing professional development to keep the GPs abreast with current trends in malaria treatment during pregnancy.Keywords: Anti‑malaria prescription, Enugu state, general practitioners, pregnancyNigerian Medical Journal | Vol. 54 | Issue 2 | March-April | 201

Coinfection with Hepatitis B and C Viruses among HIV Positive Pregnant Women in Enugu South East, Nigeria

Background: Hepatitis B and C viruses coinfection in HIV positive pregnant women is a common public health problem and recognized worldwide. The consequences of this problem in our poor resource setting with the risk of mother to child transmission is obvious with increased morbidity and mortality in our environment. Objective: To determine the prevalence of coinfection patterns of HBV and HCV among HIV positive pregnant women in Enugu Nigeria.Methods: A retrospective survey conducted on 401 Nigeria HIV positive pregnant women seen at Prevention of Mother To Child Transmission (PMTCT) clinic at the UNTH Enugu Nigeria over a 3 year period between 1st January 2007 and 31st December 2009. Results: The prevalence of hepatitis B and C viruses coinfection among HIV positive pregnant women in Enugu is 6.5%. HIV/HBV coinfection was commoner than HIV/HCV coinfection. There was no significant association between hepatitis B and C viruses coinfection and the age, ethnic group, marital or educational status of the women (P&gt;0.05).Conclusion: There is high prevalence of hepatitis B and C coinfection among HIV positive pregnant women in Enugu. This high burden of these hepatotropic virus coinfection calls for continued need to screen for these infections and vaccinate the affected babies for hepatitis B and/or C where appropriate.Keywords: HIV, Hepatitis B, Hepatitis C, PMTCT, pregnant women, Enugu Nigeri