Unruptured Second Trimester Tubal Pregnancy-A Case Report

Ectopic pregnancy is a major health risk for women of reproductive age group and is a major cause of death in the first trimester. While most cases of tubal pregnancy will present in the first trimester, advanced tubal pregnancy is rare and may be associated with diagnostic difficulty. We present the case of a 30 year-old primigravida who had total salpingectomy for unruptured mid-trimester tubal pregnancy with favorable outcome at 20 weeks gestation

The changing pattern of obstructed labour in Lagos

Background: Obstructed labour is still a major cause of maternal mortality and morbidity and of adverse perinatal outcome in developing countries.Objectives: To determine the incidence, pattern of presentation, source of referral, complications, maternal and perinatal mortality and morbidity from obstructed labour as seen in a university teaching hospital.Methods: A longitudinal descriptive study of all cases of obstructed labour managed at Ayinke House; the Obstetric and Gynecology unit of the Lagos State University Teaching Hospital (LASUTH) Ikeja, between January 2007 and December 2008 was carried outResults: There were 7,470 deliveries during the study period and 316 of these were complicated by obstructed labour giving an incidence of 4.2%. Of the 316 women, 189 (59.8%) were nullipara. One hundred and eleven cases (35.1%) with obstructed labour were booked in LASUTH, while the remainder were unbooked. Cephalopelvic disproportion was the commonest cause of obstruction and accounted for 69.6% of cases and lower segment cesarean section was the most common intervention. Most of the women (42.4%) were in occupational social class IV. The leading complication of obstructed labour was wound infection/ puerperal sepsis accounting for 18.7% of cases There were 15(4.7%) maternal deaths giving a maternal mortality ratio of 1,415 /100,000 and perinatal mortality was 19.9%.Conclusion: Obstructed labour remains one of the leading causes of maternal mortality in this centre with majority being booked for antenatal care.Keywords: obstructed labour, new trend, maternal morbidity and mortalit

Prevalence of malaria parasitaemia in the booking antenatal (ANC) patients at the Lagos state university teaching hospital

We studied 270 patients attending the booking antenatal clinic recruited for three months in the Lagos State University Teaching Hospital (LASUTH), Nigeria. Each patient was screened for malaria parasites using Giemsa’s stain of thick and thin blood films on 2 ml venous blood. Parameters on the age, parity, gestation at booking, booking weight, haemoglobin status among others were obtained. Most of the booked patients are primigravida (55%) with 58.4% of the cases between 14 - 26 weeks gestation. 48 and 65% of patients were of blood group O positive and genotype AA. The prevalence rate for malarial parasitaemia was 34% and mostly Plasmodium falciparum were isolated. However, a negative correlation exist between malaria parasitaemia and age of patient (r = - 0.02), parity (r = - 0.02) and gestation at booking (r = -0.08). Malarial parasite load was high especially in primigravida and in second trimester of pregnancies. Since most of the fetal losses associated with malarial parasitaemia in pregnancies occurred during this period, greater attention be paid to this vulnerable group