Fertility Following Myomectomy at Aba; Southeastern Nigeria

Background: While hysterectomy remains the gold standard treatment for fibroids; it is an unacceptable treatment option for women who wish to conserve their fertility. The actual effects of myomectomy on fertility remain uncertain though. Objective: The objective was to ascertain pregnancy and live birth rates among a small group of women undergoing abdominal myomectomy. Methods: The study population consisted of women of reproductive age intending to conceive soon after undergoing abdominal myomectomy. A total of 40 women who met the inclusion criteria were recruited for the study and followed-up for 4 years. Women who achieved pregnancy within the study period were analyzed in terms of their demographics and intra-operative findings. Results: The mean age of the women was 28 years (range 24-35) married for about 3 years. Majority of the women (50%) had more than 11 fibroid nodules; and the largest nodule was bigger than 5 cm in 35 women (87.5%). Cumulative pregnancy rate was 60% (24/40) while live birth rate was 22/40 (55%) following myomectomy and majority 19/22 achieved this within 2 years of myomectomy. Conclusion: Myomectomy for fibroid-associated infertility increase pregnancy rates such that approximately 60% of women undergoing the procedure subsequently conceive

Trichomoniasis as an Indicator for Existing Sexually Transmitted Infections in Women in Aba; Nigeria

"Background:Trichomoniasis is a common clinical problem. Many young women in Aba indulge in high-risk sexual behaviours. A large number of these young women are illiterates; and are in the habit of indiscriminate use of antibacterial agents at the slightest symptoms of a lower genital tract infection. Evaluation of bacterial agents associated with lower genital tract infections is therefore met with much frustration. The diagnosis of Trichomoniasis from lower genital tract is simple and its routine screening among women attending clinics would serve as an indicator for serious sexually transmitted infections in Aba. Methods:This study was undertaken among women attending a women hospital in Aba; Abia State; Nigeria (PrincessMaryHospital; Aba). In the study; 360 women who were attending the family and antenatal clinics were selected. Also; those with gynaecological problems; obvious symptoms of lower genital tract infections and those who visited the hospital for ""well women examination"" were included in the study population. High vaginal swabs collected from these women were examined microscopically by wet mount preparations and bacteriologically by cultures. Results: Out of 360 women screened for Trichomonas vaginalis through wet mount preparation; and other organisms by culture; 40 (11.1) werepositive for Trichomonas vaginalis; 6(1.7); 48(13.3) and 140(38.9) were positive for Neisseria gonorrhoeae ; Gadnerella vaginalis ; and Candida albicans respectively. The difference in age specific distribution of Trichomoniasis was statistically significant using the chi-square (P0.01). Conclusion: The finding of co-infections of T. vaginalis with G. vaginalis (0.6); N. gonorrhoeae (0.6); and C. albicans (2.8) in this study suggests its role in predisposing the carriers to other serious sexually transmitted infections; including HIV infection. There is therefore the need for routine examination of sexually active women for the screening of Trichomonas vaginalis in order to effect increased control efforts. Also; the isolation of T. vaginalis in the genital secretions should lead to a search for other sexually transmitted organisms."