Rupture of a Pregnant Uterus in a Primigravida: A Case Report

Uterine rupture is a common obstetric complication in developing countries. Primigravidity is now commonly associated with uterine rupture. We present a case of uterine rupture in an unbooked primigravida who had induction of labor with oxytocin and was given 50ug of misoprostol about 3 hours after commencing oxytocin when it was adjudged patient was not contracting well. Operative findings include a female fresh stillbirth weighing 3.4kg partly in the peritoneal cavity, a transverse uterine rupture at the lower segment, hemoperitoneum of approximately 2 liters. The peritoneum was lavaged and repair was done without bilateral tubal ligation

The Trend of Twin Pregnancy Over a 5-year Period in a University Teaching Hospital in Lagos, Nigeria

Twin pregnancy is associated with increased perinatal mortality, preterm deliveries and maternal complications, especially in developing countries. The obstetrics result of twin deliveries at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria between January 2002 and December 2006 were reviewed. Within the 5-year period, there were 314 twin deliveries out of 13,351 total deliveries giving an incidence of 1 in 42.6 or 23.5/1000. Perinatal death was over one and a half times greater than that in singleton deliveries (149.7 and 89.7/1000 deliveries respectively). Majority (61.8%) of the patients was booked and there was no relationship with parity. There was no particular trend in the incidence over the 5-year period. Preterm delivery occurred in 25% of the twins and prematurity accounted for about one-quarter of all perinatal deaths which was the highest. The perinatal mortality ratio between the booked (67/1000) and the unbooked (308/1000) cases was 1 in 5. There was no change in the trend of twinning rate. The antenatal booking and delivery in a specialist centre will reduce the morbidity and perinatal mortality associated with twin pregnancies. Keywords: Trend, perinatal mortality, twins

Unplanned Vaginal Birth after Two Previous Caesarian Sections. The Case of a Booked Patient

Caesarean Section is one of the most common operative procedures in Obstetrics. It is carried out for the benefit of both mother and baby. Most Obstetricians will permit vaginal birth after a previous Caesarean section. We report the case of a 33-year old teacher, Gavida 3 Para 2+ 0, both alive with two previous Caesarean Sections came in active phase of labor at term. She had an unplanned successful vaginal birth. This case highlights the fact that vaginal delivery is possible after two previous Caesarean Sections if a careful selection of the patient is made