Pregnancy in a noncommunicating rudimentary horn of a unicornuate uterus: a case report

Pregnancy in the rudimentary horn is rare and carries grave consequences for the mother and fetus. A case report is presented of a 26 year old single gravida 3 para 0+2 lady with rupture of a rudimentary horn pregnancy at a gestational age of 20 weeks. Laparotomy was done and the rudimentary horn excised. Post-operative recovery was uneventful. The need for a high index of suspicion and the role of ultrasonography in the accurate diagnosis is highlighted

Adolescent Sexual and Reproductive Health in the Niger Delta Region of Nigeria-Issues and Challenges

There has been an increasing awareness of the need to pay special focus on the adolescent and their sexual and reproductive health. This article reviews the sexual and reproductive health of adolescents in the Niger Delta region (NDR) of Nigeria. The objective is to bring to focus these important issues in the region. Adolescents in the NDR engage in unhealthy sexual behaviour characterized by early age at sexual initiation, unsafe sex and multiple sexual partners. The local socio-economic condition exerts extra pressure on the adolescent with negative reproductive health consequences. There is urgent need to develop a time bound strategic framework and plan to redress this situation. This will require the participation of all stake holders.La santé sexuelle et de reproduction de l'adolescent dans la région du Niger Delta au Nigéria: Questions et défis Il y a eu une conscience croissante de la nécessité de prêter une attention particulière aux adolescents et à leur santé sexuelle et de reproduction. Cet article passe en revue la santé sexuelle et de reproduction des adolescents dans la région du Niger Delta du Nigéria (RND). L'objectif est de tirer l'attention aux questions importantes concernant la région. Les adolescents dans la RND s'engagent dans des comportements sexuels malsains caractérisés par l'initiation sexuelle précose, l'acte sexuel dangereux et des multiples partenaires sexuels. La condition socio-économique locale exerce une pression supplémentaire sur l'adolescent, aboutissant à des consequences de la santé de reproduction negatives. Il y a une nécessité urgente d'élaborer un cadre stratégique et un plan qui seront liés au temps afin de corriger la situation. Ceci exigera la participation de tous les partis-prenant

Huge Benign Ovarian Cystic Teratoma in a Patient with a History of Hansen’s Disease

Mature ovarian cystic teratomas are common benign ovarian neoplasm derived from germ cells. With increasing availability of ultrasound services even in developing countries, the diagnosis of benign ovarian tumour is made earlier and the size of the ovarian tumour at diagnosis is relatively small. It is unusual to find an ovarian cystic teratoma larger than 10 cm. We report a huge mature ovarian cystic teratoma in a multipara with a history of Hansen’s disease. We conclude that, in circumstances where women have restricted access to health care, the unusual finding of mature ovarian cystic teratoma larger than 10 cm is possible due to delayed presentation for diagnosis and treatment

Caesarean Section at the University of Benin Teaching Hospital Revisited

Context: Regular auditing of caesarean sections is necessary to establish trend, review indications, associated complications and proffer possible solutions to improve outcome. Objective: To audit caesarean sections done over a 5-year period from January 1996 to December 2000 and to compare such with those from the same hospital 20 years ago. Materials and Methods: A review of the clinical records of all mothers who had caesarean sections from January 1996 – December 2000 was made. Data on the indications, and on maternal and fetal outcome were extracted and analysed. Results: The caesarean section (CS) rate was 22.2%. Dystocia (28.2%) was the commonest indications for CS. There were a total of 351 (39.3%) patients with complications, with anaemia being the commonest form of morbidity. Eight CS-related deaths were recorded – Maternal Mortality Ratio: 7.8 per 1000. The perinatal mortality rate (PNMR) was 128.3 per 1000 births. Being unbooked was associated with poor maternal and fetal outcome. Compared with 20 years ago, there was an increase in the CS rate from 10.1% to 23%. The indications remained essentially the same. There was a lowering of the maternal morbidity rate from 54.1 to 39.3%, but an increase in the PNMR from 88 to 128.3 per 1000 births. Conclusion: The CS rate has more than doubled in the two decades since the last audit. Booking of high-risk cases in tertiary institutions and early referral of complicated cases to these institutions should be encouraged. The neonatal care services should be improved to cope with complications in neonates. Key Words: Caesarean Section, Maternal Morbidity, Perinatal Audit [Trop J Obstet Gynaecol, 2003, 20: 63-66

Ethical Issues in the Practice of Assisted Reproductive Technologies in Nigeria: Empirical Data from Fertility Practitioners

The need to formulate practice guidelines and ethical framework to guide the practice of assisted conception in Nigeria has been highlighted severally. The Association for Fertility and Reproductive Health (AFRH) ethics committee is charged with the objective of producing ethical guidelines that would govern the practice of assisted conception in Nigeria. This study was a survey of attendees at the AFRH international conference that held in Abuja in September 2017. The aim of the study was to generate empirical data that would form the drafting of ethical practice guidelines in Nigeria. Ninety-seven (50%) of the respondents were of the view that performing IVF for unmarried couples was ethical while about 70 (36%) were of the contrary opinion. Respondents were equally divided (45.26% versus 44.21%) on the ethical standing of performing IVF for single ladies. About 128 (70.33%) of respondents agree that egg donors should be paid more in compensation besides reimbursement for personal expenditure incurred during the process of egg donation and that they should be an upper age limit for clients requesting ART with donor eggs. Several unethical practices ongoing in Nigeria were highlighted including inadequate provision of information and counselling and exploitation of egg donors. Majority agreed on the need for a regulatory framework to govern the practice of ART in Nigeria. The diverse range of views and ethical issues concerning ART practice in Nigeria obtained from this study demonstrates the need to recognise the local context in Nigeria when applying universal principles of ethics.Keywords: Ethics, Assisted Reproductive Technology, Nigeri