Severity of intrauterine adhesions and pregnancy success rates after treatment: Comparison of adhesions obtained from open myomectomy versus uterine curettage

Intrauterine adhesions (IUA) are rare. A retrospective comparative study was conducted between January 1, 2015, and December 31, 2018. Group A comprised 117 women who developed IUAs after open myomectomy, while Group B comprised 113 women who developed IUAs following uterine trauma caused by uterine instrumentation after a termination of pregnancy (TOP) or spontaneous miscarriage. The IUA grade and pregnancy rates and outcomes were compared using the March classification system. All patients underwent hysteroscopic adhesiolysis. The adhesions tended to be more severe (45/117, 38.5%) in Group A than in Group B (29/113, 25.7%); however, this difference was not statistically significant (Chi-Suare 5.047; p = .080). The period of observation was 24 months from the last hysteroscopy. The pregnancy rate in Group A (26, 22.2%) was significantly lower than in Group B (46, 40.7%) (OR: 2.403, 95% CI: 1.352­4.271; p = .003). Open myomectomy was the preceding aetiological factor in a greater proportion of women with IUA in our study. In cases where pregnancy is desired after open myomectomy, especially where the endometrial cavity is breached, postoperative hysteroscopy to exclude IUAs is recommended.

Management of Giant Cell Tumour : a Nigerian Experience

Giant cell tumours (GCT) are the commonest bone tumours worldwide. It is rarely malignant but when it does it progresses to fibrosarcoma with high mortality. Otherwise it causes poor cosmesis; disability and pathological fractures. A total of 19 cases of histologically established Giant cell tumour of the bone were reviewed prospectively in a 5 year study. 14 cases were benign; 4 malignant and one was a malignant transformation. Lesions around the knee accounted for 42.2of the cases; but the radius was the commonest single bone affected with 26.3. Eleven patients had curettage; five of them had autogenous bone grafting while the remaining six had bone grafting and plate augmentation. One patient had fore-quarter amputation while seven had tumour resection. There was no recurrence recorded among those that had currretage and autogenous bone grafting. 33of those that had curettage and bone cementing as well as 16.6of those that had resection presented with recurrence. One patient died within 3 months of surgery due to metastasis to the lungs; liver and spleen. Mean follow up was 9.2 months (range of 2 to 60 months). With early presentation; curretage and bone grafting is often effective; late presentation however has an increased risk of recurrence due to soft tissue involvement; dearth of investigative tools and financial constraints

A histological study of 3095 cases of Endometrial Curettings

From 1980 to 1991; a total of 3095 cases of endometrial curretings were brought to MMC for histological study. The results showed that endometrial curretings is the commonest pathological specimen submitted. The common reasons for seeking attention were abnormal uterine bleeding (43.2 percent) and infertility (42.0 pecent). The endometrial factors associated with abnormal uterine bleeding; infertility and abnormal menstruations found are anovulatory endometrium; hyperplasia; and insufficient luteal endometrium. The importance between the clinician and pathologist for this special field is stressed