Maternal death due to delayed management of sigmoid volvulus at 32 weeks pregnancy

Colonic obstruction due to sigmoid colon volvulus during pregnancy is a rare but a serious complication with significant maternal and foetal mortality. We describe a case of sigmoid volvulus in a patient with 32 weeks of gestation that developed complete necrosis of the sigmoid colon who was admitted with 6 days of abdominal distension, vomiting, and the stoppage of the passage of gases and faeces with poor clinical conditions and signs of diffuse peritonitis. Abdominal ultrasound showed single viable foetus 32 weeks. Abdominal radiography showed severe dilation of the colon with horseshoe signal suggesting a sigmoid volvulus. The patient delivered vaginally 1.8 Kg male baby admitted to the nursery and passed later on from respiratory distress syndrome. With a diagnosis of complicated sigmoid volvulus, she underwent laparotomy where we found, an enormously distended sigmoid loop with gangrenous changes the sigmoid colon was resected and Hartman's procedure was performed. Poor postoperative recovery and the patient passed day 3 postoperativelyfrom septic shock

A perspective of the epidemiology of malaria and anaemia and their impact on maternal and perinatal outcomes in Sudan

Introduction: Both malaria and anaemia have adverse effects on maternal and perinatal outcomes. Thus there is an urgent need to investigate the co-epidemiology of malaria and anaemia and their combined impact on maternal and perinatal outcomes in the different regions of Sudan.Methodology: Various cross-sectional and case control studies conducted during the years 2003-2010 to investigate the epidemiology of malaria and anaemia and their impact on maternal and perinatal outcomes in different regions of Sudan were compared. Results: While 13.7of antenatal attendants in New Halfa had peripheral microscopically detected Plasmodium falciparum malaria; placental malaria (using histological examinations) was prevalent in 32.0-40and 19.5of parturient women in New Halfa and Gadarif Hospitals; respectively. Malaria was a risk factor for anaemia in New Halfa and for stillbirths in Omdurman Maternity Hospital. Anaemia was present in 52.5; 62.6and 80.2of pregnant women in Medani; New Halfa; and Gadarif Hospitals; respectively. In Gadarif; 57.3of pregnant women had a folate deficiency; while 1had a vitamin B12; deficiency. In Medani; zinc and copper deficiencies were detected in 45.0and 4of pregnant women; respectively. Anaemia was a risk factor for low birth weight in Al-Fashir; for fetal anaemia in New Halfa; and for stillbirth in Kassala Hospital. Conclusion: More care should be taken to ensure proper nutrition and malaria prevention such as bed nets and intermittent preventive treatments to avoid these diseases and their effects on maternal and perinatal outcomes

Maternal death due to severe pulmonary edema caused by scorpion sting: a case report

A 29 years old women parar 3 in her 32 weeks gestational age died a few hours after she had been stung by a scorpion. She presented with pulmonary oedema that probably associated with the sympathetic storm induced by scorpion envenomation. This might have contributed to respiratory failure and death