Comparison of 25 and 50 Microgram of Misoprostol for Induction of Labour in Nulliparous Women with Postdate Pregnancy in Port Harcourt

Background: Induction of labor for postdate pregnancy using misoprostol is one of the most common interventions in pregnancy. However; the optimal dose of misoprostol is yet to be determined with previous reports utilizing different dosages. Objective: The main objective of this study was to compare the effectiveness and safety of 25 ?g versus 50 ?g of intravaginal misoprostol for induction of labor in nulliparous women with postdate pregnancy. Methodology: This was a prospective study in which 88 nulliparous women with postdate pregnancy were randomly selected to receive either 25 ?g or 50 ?g of misoprostol for induction of labor. Student's t-test and Chi-square test were used to compare proportions. Results: There was no significant difference between the two groups with regard to the induction-vaginal delivery interval between the two doses. The proportion of women delivering vaginally with a single dose of misoprostol (11/40 vs. 23/43; P = 0.01) and vomiting were significantly greater in the 50 ?g group. However; there was no significant difference between both groups in terms of the need for augmentation of labor; caesarean section; tachysystole and hyperstimulation syndrome. Conclusion: Intravaginal administration of 25 ?g of misoprostol appears to be as effective; but safer than 50 ?g for induction of labor in nulliparous women with postdate pregnancy

Placenta Praevia at the University of Port Harcourt Teaching Hospital: a Five Year Retrospective Study

Placenta praevia is a major cause of obstetric haemorrhage commonly encountered in clinical practice in our environment. It is a life threatening condition both to the mother and her baby.To report the incidence of placenta praevia and describe its clinical presentation; associated risk factors and maternal and perinatal outcomes over a five year period at the University of Port Harcourt Teaching Hospital; Port Harcourt. A cross-sectional study design was employed in the review of hospital records of all women who had placenta praevia and had labour/delivery services at the University of Port Harcourt Teaching Hospital between January 2002 and December 2006. Simple frequencies; cross tabulations and summary statistics were computed and analysed using SPSS version 11 soft ware. Chi-square test of significance was used to compare proportions at P-value- 0.05.One hundred and forty cases of placenta praevia were observed over five years; giving a yearly rate of 28 cases; and an incidence rate of 1.0out of 13;870. One hundred and eighteen women (93.6) had vaginal bleeding out of which 96 (76.1) were painless vaginal bleeding. The mean time from onset of vaginal bleeding to presentation in hospital was 10.98(+ 13.08) hours. The commonly identified known risk factors were induced abortion (50) and previous caesarean section (25). The average time of hospitalization was 13.83 (+ 9.76) days. One hundred and fourteen cases (90.5) had diagnosis confirmed by ultrasound scan while twelve cases (9.5) had Examination Under Anaesthesia (EUA). The mean gestational age at delivery was 37.1 weeks. Caesarean delivery was performed for 101 (80) cases; while 25 (20) had vaginal delivery. There was one maternal death. Thirty two (25.3) babies had birth asphyxia. The perinatal mortality rate was 61.5/1;000 total births. Placenta praevia is still an important obstetric problem in our environment. Despite the fact that most of our women present late; the availability of blood transfusion services; adequate manpower; ultrasound scan and neonatal intensive care facilities have contributed immensely to improve maternal and fetal outcome of this condition in our centre

Aetiological Factors for Mandibular Fractures Seen in the University of CalabarTeaching Hospital; Calabar; South-South Nigeria

The objective of this study was to determine prospectively the common aetiological factors leading to fractures of the mandible in patients seen in the University of Calabar Teaching Hospital (UCTH); Calabar; Nigeria. A total 252 patients with fractures of the facial skeleton were seen out of which 174 (69) presented with mandibular fractures over a period of two years. Road traffic accidents; both vehicular road and traffic accidents (VRTA) and Motorcycle road traffic accidents (MRTA) were the commonest cause (79.9) of mandibular fractures with MRTA accounting for 36.2of total and 45.3of all the RTS's followed by assault; sporting events; falls from heights; gun shot and industrial accidents. Majority of the patients were males 142 (81.6) with fewer females 32 (18.4) giving a male-female ratio of 4.4:1. Most of the patients were aged between 21 and 30 years. Government should ban use of motorcycle as a means of commercial transportation and make more motor vehicles available for this purpose

Civilian Gunshot injuries to the Oro-facial region in Calabar, South-South Nigeria, 2002-2006

This article reviews 16 cases of civilian gunshot injuries of the oro-facial region seen at University of Calabar Teaching Hospital, Calabar over a 5-year period and highlights the rising trend in the occurrence of gun shot injuries to the orofacial region as experienced in the south-south region of Nigeria. Records of 16 patients with different types of gunshot injuries to the oro-facial region seen and treated at the University of Calabar Teaching Hospital, Calabar between 2002 and 2006 were reviewed. The focus was on the patient's age, gender, type of weapons used, the surrounding circumstances (accidental or intentional), the time of occurrence and management. Out of 16 patients seen, 14 (87.5%) were males and 2 (12.5%) were females, giving a male to female ratio of 7:1, with the age range from 18 to 50 years. Thirteen (81.3%) of the patients were injured by low velocity missile while 3 (18.7%) by high velocity missile. Violence was responsible for 14 cases (81.7%), and 2 cases (18.3%) was due to the accidental discharge. This study has shown an increasing occurrence of gunshot injuries to the oro-facial region in our environment with males more affected than females. With the changing political situation, social advancement and urbanization, there is a need to regulate the influx of deadly weapons in the country by the relevant agencies. Maxillofacial surgeons should also brace up to the new development as this poses a new kind of challenge to our knowledge of trauma management