Maternal death and obstetric care audits in Nigeria: A systematic review of barriers and enabling factors in the provision of emergency care.

Acknowledgements We would like to thank Yutaka Osakabe for co-ordinating the retrieval of full text articles. The John D. and Catherine T. MacArthur Foundation supported this study, grant number 12-100074-000-INPPeer reviewedPublisher PD

The prevalence of gynaecological diseases at the Imo State University Teaching Hospital, Orlu, Nigeria

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Experience with manual vacuum aspiration at the Imo State University Teaching Hospital, Orlu, Nigeria

Background: Criminal or illegal abortions and it's attendant complications contribute significantly to maternal morbidity and mortality in developing countries. Manual vacuum aspiration provides a cheap, safe and effective means of reducing this morbidity and mortality.Aim: To evaluate the usefulness of manual vacuum aspiration in the management of first trimester miscarriages in Orlu.Methods: The case notes of 324 patients with first trimester miscarriages managed with manual vacuum aspiration (MVA) over a 5-year period from June 2004 to June 2009 were retrieved. Information extracted included age, parity, gestational age at presentation, indication for MVA use and complications resulting from the procedure.Results: A total of  1672 gynaecological patients were seen during the study period out of which 324 had MVA procedure, giving a prevalence rate of 19.4% with a mean age of 24+2.3 years. The highest number of procedures were carried out on patients aged 26-30 years (23.5%). Grandmultiparous patients accounted for the highest number of cases (53.1%). Most of the procedures (46.3%) were carried out in patients whose miscarriages occurred between 9-10 weeks of gestation. Incomplete miscarriage (75.6%) was the commonest indication for the use of MVA while genital tract bleeding (46.4%) was the commonest complication encountered. Majority of the procedures (86.4%) were carried out on out patient basis. There was no maternal death or blood transfusion.Conclusions: Abortion and it's attendant complications with a prevalence  rate of 22.1% appears to be fairly common in our environment. MVA is very effective in the management of first trimester miscarriages in our centre. Keywords: Manual vacuum aspiration, Miscarriage, Experience, Orl

The use of cervical smear in the diagnosis of gemital tract infections at a University Teaching Hospital

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