Uterine rupture; An obstetric tragedy still with us. A six year review of cases in a specialist hospital, NorthWest Nigeria

Uterine rupture is a major cause of perinatal and maternal morbidity and mortality, it usually has a devastating outcome if not promptly attended to. The study determined the trends, risk factors, feto-maternal outcomes following uterine rupture as seen at ASYBSH. Method: The study was a retrospective review of cases of uterine rupture managed at the ASYBSH between March 2015 and February 2021. Records of the theatre and labour wards were searched and the folders of patients with uterine rupture were retrieved. Relevant information such as socio-demographic variables, booking status, clinical presentations were retrieved and entered into a structured profoma. Results: Deliveries in the hospital during the period were eleven thousand four hundred and twenty (11,420), out of which one hundred and fifty-six (156) were complicated by uterine rupture giving an overall incidence of 1.36 percent or one in every seventy-four (74) deliveries. Uterine rupture occurred mainly among women of low socio-economic status and high parity. The major predisposing factors were injudicious use of oxytocin (62.8%) prolonged obstructed labour (19.8%), previous caesarean section scar (8.5%), use of misoprostol (5.3%), fundal pressure (2.4%) and unexplained factors (1.2%) Conclusion: Uterine rupture remains a devastating obstetric calamity with a high incidence. Injudicious use of oxytocin, prolonged obstructed labour and previous caesarean section scar were the three leading predisposing factors identified in this study

Assessment of the prevalence of abnormal hysteroscopic findings in infertile women undergoing ART

Background: The endometrium plays an important role in implantation of good quality embryos in ART. Many studies have proved the negative impact of intra uterine pathologies on reproductive outcome whether spontaneous pregnancy or ART, because uterine anomalies may be associated with many obstetric complications such as miscarriage, preterm birth, premature rupture of membrane, malpresentation, postpartum bleeding and retained placenta. Aim of the work: This study aims to assess the prevalence of abnormal hysteroscopic findings among infertile women undergoing ART at Ain Shams Maternity University Hospital over the period from January 2007 to January 2017. Patients and Methods: This descriptive retrospective study was carried out on infertile couples planned for ART who were sent to ECDU for hysteroscopy in Early Cancer Detection Unit (ECDU), Ain Shams University Maternity Hospital. Case reports From January 2007 to January 2017 were reviewed. Results: The most prevalent congenital abnormality was endometrial polyp (18.4%) followed by uterine septum (6.9%). Conclusion: This study concluded that the most common uterine abnormality was endometrial polyp (18.4%), followed by uterine septum in 6.9% of patients. Also, thick endometrium was very common with a prevalence of 12.9%. Therefore, based on this high prevalence of abnormalities, this study is in agreement with the opinion that all women should be offered hysteroscopy, even if they have normal vaginal ultrasound and hysterosalpingography, because this is supposed to increase the detection rate of minor abnormalities, which theoretically will improve the reproductive outcome. Still, further interventional randomized controlled trials (RCT) are needed to verify the positive impact of routine use of hysteroscopy prior to ART

Morbidity of total abdominal hysterectomy at the university of maiduguri teaching hospital, maiduguri, Nigeria

Total abdominal hysterectomy is a commonly performed gyneacological procedure. Although it is safe, it can still be associated with development of complication. The aim of this study was to determine morbidity associated with total abdominal hysterectomy in our environment.METHOD:All cases of total abdominal hysterectomy done over a five-year period (January 2003-December 2006) at the University of Maiduguri Teaching Hospital (UMTH) were reviewed. Information was obtained from the patients' case notes, gynaecology ward, and theatre records. The complications of the procedure were determined. Multiple logistic regression was used to find the factors that were independently associated with development of complications.RESULTS:During the study there were 101 cases of total abdominal hysterectomy out of 729 gynaecological operations, a rate of 13.8%. In majority of the cases 56 (68.3%) the indication of the hysterectomy was uterine fibroid (symptomatic). Overall 37 (45.1%) experience some form of complication out of which 26 (70.3%) was febrile morbidity Finding enlarged uterus intraoperatively {OR (95% CI) = 14.5 (1.84-114.6), p = 0.011}, blood transfusion {OR (95% CI) = 31.1(1.35-718.8), p = 0.032}and postoperative PCV < 30% {OR (95%CI) = 9.63 (1.14-81.3) p = 0.037} were found to be significantly associated with development of complication. conclusions: Total abdominal hysterectomy was associated with development of complications and enlarged uterus, increasing parity independent risk factors for development of the complication

Endometrite du post-partum : facteurs de risque; ecosysteme bacterien a propos de 104 cas colliges au CHU de Treichville

Introduction: Malgre les progres de l'obstetrique et de l'antibiotherapie; l'endometrite du post-partum reste l'un des probleme-cle de I'Obstetricien .Objectif : Notre travail a pour but de determiner les facteurs de risque et les micro-organismes concernes dans le service de gynecologie obstetrique du CHU de Treichville. Methodologie : Au cours d'une etude transversale nous avons compare 104 cas d'endometrite colliges du 1er aout 1999 au 31 juillet 2000 a un groupe temoin de 208 femmes. Une recherche de germes ete effectuee sur des prelevements de lochies. RESULTATS : Durant cette periode; la prevalence globale de l'endometrite a ete estimee 2;23 pour cent; celle de l'endometrite post-cesarienne a 6;31 pour cent et celle de I'endometrite apres accouchement par voie basse 0;47 pour cent. Nous avons pu; au cours de notre etude; degager certains facteurs favorisant et circonscrire une population a risque : Il s'agit de femmes jeunes; de niveau socioeconomique modeste primipares; referees; febriles a l'accouchement avec de longs delais de travail et d'ouverture de l'oeuf; accouchees par cesarienne. Les bacilles a gram negatif et principalement Escherichia coli; sont le plus souvent en cause. L'ensemble des germes a ete fortement sensible aux quinolones (76;2 pour cent) et au cefatoxine (73;9 pour cent). CONCLUSION : Cette pathologie a un impact important en terme de cout de la sante. Ce travail rappelle la necessite : - de la prevention par une surveillance prenatale de bonne qualite; - de creer des structures obstetrico-chirurgicales bien equipees et decentralisees

Le role du Chlamydia trachomatis dans les infections utero-annexielles ou leurs sequelles au C.H.U. de Kamenge (Bujumbura-Burundi) : a propos de 82 cas

Les auteurs rapportent les resultats d'une etude prospective de 82 cas d'infections utero-annexielles ou de leurs sequelles; comme les sterilites; les grossesses extra uterines les douleurs pelviennes chroniques; traitees au C.H.U. de Kamenge entre Mars 1993 et Aout 1994. La moyenne d'age etait de 29;4 ans; et les nullipares representaient 28 pour cent de la serie. Chlamydia trachomatis a ete isole dans 71 pour cent des cas. Sur la base des ces resultats epidemiologiques; les auteurs recommandent une antibiotherapie a diffusion intracellulaire; active sur ce germe; en cas d'infection utero-annexielle

Aspects radiologiques de la pathologie utero-tubaire dans la sterilite feminine: a propos de 1314 hysterosalpingographies au CHU-Lome

1314 examens hysterosalpingographiques ont ete realises chez des femmes consultant pour sterilite secondaire et 25 pour cent une sterilite primaire. Les anomalies radiologiques observees sont dominees par les lesions uterines (53 pour cent) dont pres de la moitie representee par les sequelles traumatiques (27 pour cent). Les osbtructions tubaires representent 30 pour cent. 17 pour cent des femmes ont une hysterosalpingographie normale. La proportion elevee des sterilites secondaires; des lesions traumatiques uterines et des obstructions tubaires traduit la necessite de mettre en place des programmes de sante publique visant a sauvegarder la fecondite de la femme bien que les experts demographes parlent de l'Afrique en terme d'explosion demographique et de limitation des naissances