An appraisal of retained placentae in Ibadan: a five year review

Objectives: To determine the frequency of retained placenta at the University College Hospital Ibadan (UCH). and to describe the socio-demographic characteristics of the patients and examine the risk factors predisposing to retained placenta.Methods: This is a descriptive study covering a period of 5 years from January 1st 2002 to December 31st 2006. During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births.Results: During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were available for analysis. The mean age was 29.37 ± 4.99 years. First and second Para accounted for 52 per cent of the patients. Majority of the patient were unbooked for antenatal care in UCH with booked patients accounting for 27.8 per cent of the cases. The mean gestational age at delivery was 34.29 ± 6.02. Three patients presented to the hospital in shock of which 2 died on account ofsevere haemorrhagic shock. Fifty-eight patients (64.8%) presented with anaemia (packed cell volume less than 30 per cent) and 35 patients (38.8%) had blood transfusion ranging between 1-4 pints. 1 patient required hysterectomy on account of morbidly adherent placenta. Eleven patients (12.2%) had placenta retention in the past, 28 patients (31%) had a previous dilatation and curettage, 14 patients (15.5%) had previous caesarean sections and 47 patients (41.3%) had no known predisposing factorsConclusion: Retained placenta still remains a potentially life threatening condition in the tropics due to the associated haemorrhage, and other complications related to its removal. The incidence and severity may be decreased by health education, women empowerment and the provision of facilities for essential obstetric services by high skilled health care providers in ensuring a properly conducted delivery with active management of the third stage of labour

Routine saline infusion sonohysterography prior to assisted conception: a review of our initial experience

Saline infusion sonohysterography has been employed to evaluate the uterine cavity prior to commencement of assisted conception.Intra-uterine lesions play an important role in the outcome of assisted conception procedures. A descriptive retrospective study of 760 patients who had saline infusion sonohysterography prior to assisted conception, between January 2008 and December, 2010. Forty-six percent of the patients had intra-uterine pathologies. Submucous fibroids accounted for almost half (48.57%) of the pathologies, followed by adhesions (28.57%) and endometrial polyps (22.86%). Complications arising from the procedure were minor and occurred in 26 patients (3.42%). Abdominal cramps, vaginal bleeding and vaginal discharge occurred in 14 (53.85%), 8 (30.77%) and 4 (15.38%) respectively. The average duration of the procedure was 6 minutes with a range of 4-9 minutes. Saline infusion sonohysterography is a reliable, cost effective and safe diagnostic tool in the evaluation of the uterine cavity prior to assisted conception.Keywords: Routine, Saline infusion sonohysterography, Assisted conception, Experience

A case report of premenarchial transverse vaginal septum at the University College hospital, Ibadan

Premenarchial Transverse vaginal septum is a benign condition. The septum may be found in the upper, middle or lower vagina. A case report of a premenarchial girl with transverse vaginal septum managed at the university college hospital, Ibadan, in January 2009. Diagnosis was made following a history of primary amenorrhea, cyclical low abdominal pain and pelvic examination which revealed a vaginal septum. She had surgical resection of the vaginal septum and a vaginal stent was left in-situ to keep the vagina patent during the healing process. The procedure was uneventful and she was able to achieve menstrual flow following surgery. Follow up visits were essentially unremarkable.Keywords: Premenarchial, Transverse vaginal septu

Endometriotic ascites: A very rare presentation of pelvic endometriosis

A 30 year-old P0+1 lady who was referred to the gynaecology clinic on account of inability to conceive for 8 years duration and progressive  abdominal distension of 2 years duration. She had a history of severe cyclical dysmenorrhoea warranting occasional hospitalization. An abdomino-pelvic ultrasound revealed marked intra-abdominal collection. The uterus and ovaries appeared normal. She subsequently had laparoscopy and drainage of  6 litres of endometriotic ascites. Both fallopian tubes were diseased. She was followed up on an out-patient basis with sub-cutaneous goserelin injections and referred for assisted reproduction. Keywords: Endometriosis, Ascites, Infertility, Laparoscop

Experience with three-dimensional computed tomographic angiography in Ibadan, Nigeria

No Abstract

Symptomatology of menopause among suburban Nigerian women

Background: It is believed that the perception and attitude of women to menopause are strongly influenced by several variables which are largely social, cultural, and economic and may reflect in the differences in the mode of treatment. The objective of this study is to determine the age of attainment of menopause and the perception of the symptomatology of menopause among Nigerian women of different backgrounds.Materials and Methods: Information was obtained with the aid of a structured questionnaire from 543 women who had attained natural menopause. Data were analyzed using SPSS version 21. Data analysis was descriptive and inferential at 95% confidence interval, and P < 0.05 was considered statistically significant.Results: The mean menopausal age was 49.1 ± 4.54 years. The commonest early symptom of menopause was hot flushes (45.8%). The commonest late symptom of menopause was pain in the joints (57%). A majority of the women (82.4%) did not think that any of the symptoms may have been associated with cessation of their menses. However, the better educated the women were, the more knowledgeable they were about the symptoms of menopause P < 0.01.Conclusion: The age at which Nigerian women attain menopause is comparable to that of other populations. The manifestation of menopausal symptoms in our women may constitute a significant health burden and it is imperative that healthcare providers should be knowledgeable about the manner in which these groups of women perceive menopausal symptoms. Education improves perception and may be the link to promoting better health‑seeking behavior among menopausal women.Keywords: Menopause; suburban; symptomatolog

A 5-year review of ultrasonographic evaluation of ocular diseases at the University College Hospital IBADAN, south-west, Nigeria

Background: Orbito-ocular diseases are a major public health issue, often causing visual impairment with serious socioeconomic  implications on individual lives. Ocular ultrasonography is an invaluable diagnostic tool when clinical examination of the ocular fundus is difficult.Objectives: To describe the indications, sonographic findings, and contribution of orbito-ocular ultrasonography to the management of orbito-ocular diseases in the University College Hospital, Ibadan.Materials and Methods: A retrospective review of B-mode ocular ultrasound findings and hospital data of all patients referred to the Radiology department of the University College Hospital, Ibadan for ocular Ultrasound between January 2014 - December 2018.Results: There were 142 patients, aged 1-85 years, (median age =28 years). 72 (50.7%) patients were under 30 years of age, and 50 (35.2%) were pediatric cases. Male to female ratio was 1.84:1. The commonest presenting complaint was blurred vision in 97 (68.3%) cases,  followed by eye trauma in 54 (38.0%). B-mode Ultrasound, demonstrated cataract in 63 (44.4%,) cases, vitreous hemorrhage in 42 (29.6%), retinal detachment in 27 (19.0%), vitreous detachment in 19 (13.4%), normal findings in 17 (12%) and orbital tumors in 13 (9.2%) patients.B-mode ultrasound scan and clinical diagnosis demonstrated good agreement in 91 /142 cases (64.1%), partial agreement in 23/142  (16.2%) cases, and no agreement in 28 (19.7%). Kappa agreement scores, K were 74.3% and 70.9%, for ruptured globe and cataract respectively.Conclusion: Orbito-ocular ultrasonography contributes significantly to the diagnosis of orbito-ocular disease and shows good correlation with clinical diagnoses. However, a future study with larger numbers is required