Social demographic characteristics of women with pelvic organ prolapse at the Tamale Teaching Hospital, Ghana

Objective: To determine the prevalence, social demographic characteristics and types of pelvic organ prolapse that patients present with at the Tamale Teaching Hospital (TTH).Methods: A descriptive study of pelvic organ prolapses at the Tamale Teaching Hospital from 1st January 2010 to 31st December 2011.Results: The 118 pelvic organ prolapse cases constituted (2.68%) of the 4403 gynaecological out-patient cases seen during the two year study period. The mean age and standard deviation was (45.9± 15.1) and themodal age group was 30-39 years with 32 (27.1%) of cases. There were 112 (94.9%) cases of uterine prolapse, 95 (80.5%) had cystocele, 16 (13.5%) patients had rectoceles and 3 (2.5%) had enterocele. Their main occupations were trading 66 (55.9%) and farming 44 (37.3%), seventy (62.5%) of the patients with uterine prolapse were premenopausal while (10) 14.3% of the premenopausal cases had an ongoing pregnancy. The parity ranged from zero to 13 with mean and standard deviation of (4.4±1.7). Fifty five (46.6%) were from the Tamale metropolis and only 12(10.5%) had all their deliveries in hospital. The commonest complication was decubitus ulcer present in 20 (16.9%) patients, 16(80%) of it in patients with procedentia.Conclusion: Pelvic organ prolapse is not a rare gynaecological condition at the Tamale Teaching Hospital. The patients are relatively young and are from various districts in the northern region. Some occupational, socio-cultural practices and reproductive characteristics may be contributory to severity of pelvic organ prolapse.Keywords: Pelvic organ prolapse, uterine prolapse, Tamale Teaching  Hospital, Social demographic characteristics

Trends in Maternal Morlility in Tamale Teaching Hospital, Ghana

Objective: To determine the yearly maternal mortality ratio over the period 2006-2010 and trends in the causes of 139 audited maternal deaths from 2008-2010 at the Tamale Teaching Hospital in Ghana Study Design: Retrospective descriptive review of maternal deaths Setting: Department of Obstetrics and Gynaecology, Tamale Teaching Hospital Methods: Data on maternal deaths that occurred over the review period were obtained from the patient folders, departmental monthly reports, midwifery monthly returns, audit reports, theatre, intensive care unit, maternity, gynaecology and the labour ward records. Results: There were 280 maternal deaths from 1st January 2006 to 31st December 2010. The maternal mortality ratio dropped from 1870 per 100,000 live births in 2006 to 493 per 100,000 live births in 2010, a fall of nearly 74%. Using 2008 as the baseline, maternal mortality ratio dropped from 842 per 100,000 live births in 2008 to 493 per 100,000 live births in 2010, a fall of 41.4%. The main causes of 139 audited maternal deaths from 2008 to 2010 were sepsis (19.8%) hypertensive disorders(18.6%), haemorrhage (15.8%), unsafe abortion (11.5%), obstructed labour (5.7%), anaemia (8.7%), sickle cell disease (5.7%) and malaria (5.0%). The ages of the 139 audited maternal deaths ranged from 14-48 years; with mean age of 26.5±4.6years. Nearly 50% of the maternal deaths were aged 20-29 years and about 10% were 14-19 years. Eighteen(13%) of the maternal deaths were from towns over 150km from Tamale. Conclusion: There has been significant reduction in maternal mortality at the Tamale Teaching Hospital, it is however still unacceptably high. Keywords: Maternal Mortality Ratio, Maternal Mortality Trends, Millennium Development Goals, GhanaGhana Medical Journal, September 2011, Volume 45, Number