Transverse lie in labor: A study from Kaduna, Northern Nigeria

Context: Transverse lie of the fetus in labor is an emergency that could be potentially live threatening and clinically tasking to the Obstetrician.Objective: To determine the incidence and clinical outcome in transverse lie.Study design, setting, and subjects: A-12 ½ year retrospective study of all women who presented with fetuses in the transverse lie during labor at a tertiary institution.Results: During the period there were 16633 deliveries and 30 women with transversely lying fetuses, giving an incidence of 1 in 554 deliveries. Forty percent of the cases were neglected transverse lies. The para 4 and above group had the highest incidence of 2.69/1000. Northern minorities ethnic group had the highest incidence of 2.35% and the Ibos the lowest incidence of 0.48/1000. The highest incidence of transverse lie was among women that were not registered for prenatal care, 3.89/1000 as against those registered, 1.46/1000. Eighty percent of the women were delivered abdominally; and 63.33% of these were cesarean deliveries. Vaginaldelivery was achieved in 13.33% of the women, vaginal route destructive operations and delivery in conduplicatio corpore on two occasions each. Anencephaly was the only gross congenital malformation seen among the infants. Sixteen perinatal and six maternal deaths were recorded. Two women died undelivered. Transverse lie was associated with uterine fibroids, abdominal pregnancy, second twin with ruptured membranes andpendulous abdomen.Conclusion: Transverse lie in labor is associated with high perinatal and maternal mortality.Keywords: Transverse lie incidence delivery outcom

Heterotopic gestation with subsequent live birth in a Jehovah's witness: A case report

No Abstract

Cesarean section in Ahmadu Bello University Teaching Hospital Zaria, Nigeria: A five‑year appraisal

Objective: In 1985, the WHO recommended an optimum Cesarean section (CS) rate of 10–15% and stated that there was no justification for any region to have higher rates. The global increase in CS rate is causing concern and it is a major public health issue. Our objective is to appraise the CS intervention, observe trend, and proffer solutions.Materials and Methods: All relevant clinical data from the patients delivery records in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria over the period 2010–2014 were pooled and used to analyze the clinical information.Results: There were a total of 9,388 deliveries during the period out of which 2,254 were CS, giving a rate of 24.5%. The mean age and parity of the study groups were 30.6 ± 4.8 years and 1.9 ± 1.6, respectively. A total of 288 (12%) of them were done as elective. Most of the CS was done due to previous scar, pre‑eclamsia/eclampsia. The maternal mortality rate (MMR) during this period was 870/100000 live births, the CS‑related mortality was 339/100,000, and the perinatal mortality (PM) was 43.9/1000 live births.Conclusion: The CS rate, the MMR, and PM are all high and the indications show that alternative interventions can be used to reverse the ugly trend but there is a need for training.Key words: Cesarean section; rate; maternal mortality; perinatal mortality; indications; trend and training

Umbilical Cord Prolapse In Kaduna, Northern Nigeria: A Study Of Incidence

Prolapse of theumbilical cord is a live threatening obstetric emergency for the fetus-infant. To determine, the incidence of cord prolapse in the hospital. A-12½year retrospective study of all women who presented with cord prolapse in labour at a university teaching hospital. During the period therewere16633 deliveries and 34women presentedwith cord prolapse, giving an incidence of 2.0 per 1000 (1 in 504 deliveries). Highest incidence occurred in women of 35 years and above (5.0 per 1000); in the 25-29 years group 2.3 per 1000 and in those less than 20 years old 1.3 per 1000. The highest incidence of cord prolapse was in the para 5 and over, 2.4 per 1000; para 0, 2.0 per1000 and paras 1 4, 1.9 per 1000.The incidence of cord prolapse in the unregisteredwomenwas 5.2 per 1000, and in the registered 1.5 per 1000. The highest incidence was in the Hausa/ Fulani ethnic group 3.4 per 1000; the Yoruba ethnic group, 2.1 per 1000 ; the Northernminority ethnic group , 2.0 per 1000; the Ibo ethnic group, 1.0 per 1000. No case of cord prolapse was recorded among women of Southern minority ethnic group. The incidence of cord prolapse among preterm births was, 62.7 per 1000, breech, 32.5 per 1000; shoulder, 133.3 per 1000 , twin births.16.8 per 1000 and cesarean births, 11.4 per 1000. Cord prolapse is an uncommon obstetric complication, the incidence of which is determined by the influence of various factors acting individually or in synergy. Keywords: Cord Prolapse, incidence,Kaduna,Nigeria. Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 316-31

Childbirth in Germany and Nigeria compared

No Abstract. Nigerian Journal of Medicine Vol 15 (4) October-December: 387-39

Perinatal mortality associated with eclampsia in Kaduna, northern Nigeria

No Abstract. Nigerian Journal of Medicine Vol. 15 (4) October-December 2006: 397-40

Anterior Abdominal wall Rhabdomyoma mimicking fibroid: A Case Report

We report a case of a 27 year old Para 1+O house wife who presented with a four months history of a rapidly increasing tumor of the anterior abdominal wall. The abdomen was swollen to the size of a 16 weeks gravid uterus. At laparatomy a tumor measured 15cm by 10cm attached to the posterior aspect of the rectus sheath. The resected mass proved on histology to be Rhabdomyoma of the anterior abdominal wall. Rhabdomyoma is an exceedingly rare tumor in females and when it does occur, it is found in the genitalia (Genital Rhabdomyoma). The origin in the anterior rectus is extremely rare

Routine screening for Trichomonas vaginalis among human immunodeficiency virus-seropositive antenatal clients in Zaria: A necessity or option?

Background: Trichomonas vaginalis infection is the most common curable sexually transmitted infection worldwide with about 160–180 million people affected annually. Pregnant women with trichomoniasis are at a risk of adverse pregnancy outcomes such as premature rupture of membranes, preterm labor, low birth weight as well as neonatal infection with human immunodeficiency virus (HIV), and T. vaginalis. There is a paucity of knowledge of prevalence of T. vaginalis infection among HIV-seropositive antenatal clinic attendees in northwestern Nigeria. Objectives: The objective of this study was to determine the prevalence of T. vaginalis vaginitis among HIV-seropositive antenatal clinic clients in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Design: The study was a descriptive cross-sectional study. Setting: The study was conducted at the Antenatal/Prevention of Mother to Child Transmission clinic of ABUTH, Zaria, between May 6 and September 5, 2013. Materials and Methods: One hundred and two HIV-seropositive pregnant women were recruited into the study. Sociodemographic, clinical, and obstetric information were obtained using a pro forma. Vaginal swabs were collected from each woman and examined using wet mount microscopy for T. vaginalis and cultivated in Trichomonas OXOID culture media enriched with horse sera. Results were analyzed with SPSS software Version 16. Results: The mean age of the participants was 31 years with a standard deviation of 4.9 years. Out of the 102 participants examined for T. vaginalis, 6 were positive using both wet mount microscopy and culture giving a prevalence rate of 5.9% and about 60% of the positive clients were symptomatic. Conclusion: The prevalence of T. vaginalis vaginitis among HIV antenatal clinic attendees in ABUTH, Zaria, was 5.9%. About 40% of the trichomonad-positive participants were asymptomatic. Routine screening of HIV-seropositive antenatal clients for T. vaginalis is cost-effective