Case Report on Septate Uterus: An Incidental Finding in a Multiparous Woman who Had an Emergency Cesarean Section

Background: Septate uterus is caused by incomplete resorption of the Mullerian duct during embryogenesis which may alter the reproductive outcome of the patients. It is the commonest form of structural uterine anomaly and has the highest reproductive failure rate. Case Report: A 21-year-old booked G4P2 +1 woman with two living male children admitted into the Antenatal ward through the Accident and Emergency ward at 33 weeks gestation for conservative management of preterm premature rupture of membrane. She had a previous history of miscarriage, preterm delivery, and elective caesarean section due to breech presentation in her first, second, and third pregnancies in 2007, 2008, and 2009, respectively. She, however, had an emergency caesarean section due to fetal distress at 33 weeks plus 4 days with the delivery of a live female baby that weighed 2.0 kg with APGAR scores of 7 and 8 in the 1st and 5th minutes, respectively. There was intraoperative finding of septate uterus with dimple at the fundus. The other abdominal viscera were normal. Conclusion: congenital uterine anomalies especially septate uterus, though rare, should be suspected in women with positive history of miscarriage, preterm delivery and malpresentation.Keywords: Asia, fetal distress, multiparous, preterm, septate, uteru

Maternal mortality at the University of Nigeria Teaching Hospital, Enugu, 1999-2003

No Abstract. Global Journal of Medical Sciences Vol. 5(1) 2006: 13-1

Relationship between Sonographic Placental Thickness and Gestational Age in Normal Singleton Fetuses in Enugu, Southeast Nigeria

Background: The accuracy of common ultrasound parameters for the estimation of gestational age (GA) decreases as pregnancy advances in age. Hence, there is need to explore other parameters that may complement the established fetal biometric parameters in predicting GA in late pregnancy. Aim: The aim of this study is to determine the relationship between the sonographic placental thickness (PT) and GA in the second and third trimesters.Subjects and Methods: A cross‑sectional study of 627 normal pregnant women with GA between 14 and 40 weeks was conducted at the University of Nigeria Teaching Hospital Ituku‑Ozalla, Enugu from May 2013 to February 2014 by sonography. Anteroposterior diameter of the placenta was measured at the level of the umbilical cord insertion. The last menstrual period of the women, femur length, biparietal diameter, head circumference, and abdominal circumference of the fetus were measured for GA estimation. Descriptive statistics, regression analysis, and independent sample t‑test were used in statistical analysis.Results: Mean PT was 23.2 (2.8) mm in the second trimester and 36.1 (3.6) mm in the third trimester. There was a significant difference between the values in the present study and values from similar studies in other populations (P < 0.04). There was a strong relationship between GA and PT and the following mathematical relationships for the second and third trimesters were obtained in the GA = 0.982 (PT) + 3.614 and GA = 0.977 (PT) + 3.354, respectively.<Conclusion: Population‑specific charts for PT may be used to estimate GA inthe second and third trimesters.Keywords: Gestational age, Placental thickness, Second and third trimesters, Sonograph

Outcome of tubal surgeries at the University of Nigeria Teaching Hospital, Enugu, Nigeria

No Abstract. Nigrian Journal of Clinical Practice Vol.9 (1) 2006: pp.44-4

Concurrent Occurrence of Uterovaginal and Rectal Prolapse: An Uncommon Presentation

Concomitant uterovaginal and rectal prolapse is an uncommon occurrence. Where laparoscopic equipment and skills are lacking, sacrohysteropexy with synthetic mesh and rectopexy can be accomplished by laparotomy, especially in women who desire to retain their uterus for either biological or psychological reasons. A 40-year-old primipara with a history of concomitant mass protruding from both her vagina and anus following a spontaneous unsupervised delivery at home. Following pelvic examination, a diagnosis of uterovaginal and rectal prolapse was made. In view of her parity and desire to retain her reproductive function, she was offered abdominal sacrohysteropexy with synthetic mesh and rectopexy with satisfactory postoperative recovery. In resource-limited settings with concomitant uterine and rectal prolapse, open abdominal sacrohysteropexy with synthetic mesh and rectopexy is an effective and safe alternative to Manchester operation in the absence of laparoscopic equipment and skills.Keywords: Concomitant, Rectal prolapse, Utero-vaginal prolaps