ABSTRACT
Heterotopic pregnancy is the simultaneous occurrence of intrauterine and ectopic pregnancies. It is rare in spontaneous pregnancies, occurring only in 1 per 30,000. It is a life-threatening condition with diagnostic and therapeutic difficulties. We report a case of a 16 year old with a previous unsafe abortion with a diagnosis of a ruptured ectopic pregnancy. Meticulous Ultra sound assessment resulted in the diagnosis of Heterotopic pregnancy. She had laparatomy and manual vacuum aspiration. Spontaneous heterotopic pregnancy is a life threatening condition especially in poor resource setting like ours with paucity of diagnostic equipment. Clinicians should have a high index of suspicion for heterotopic pregnancy when evaluating young teenage girls with complaints of abdominal pain and amenorrhea. In addition, tackling the unmet need for contraception in our environment, especially emergency contraception will ameliorate the morbidity and mortality associated with this rare condition.
ABSTRACT
BACKGROUND: Stable heterosexual relationships are a major determinant of the HIV epidemic and seroprevalence rate of HIV amongst antenatal women is a reflection of what is happening in the larger society. OBJECTIVES: This study aims to determine the HIV seroprevalence rate and to identify factors responsible for this rate among pregnant women. METHOD: The study was a three-year (July 2008-June 2011) cross-sectional evaluation of cases of HIV in pregnancy. Data were collected with the aid of a closed structured self-administered questionnaire for all the positive women and randomly selected negative cases. The study was carried out at Niger Delta University Teaching Hospital in Bayelsa State, Nigeria. RESULTS: The seroprevalence rate during the study period was 4.9%. Parity, age at first coitus, educational status, marital status and occupation do not seem to increase the risk. However, partner being unemployed, hospital/clinic delivery, the route of last delivery, previous induced abortion and the number of lifetime partners were identified as risk for HIV seropositivity (all p-values < 0.005). CONCLUSION: Sex education on the dangers of sexual promiscuity, availability of barrier methods of contraception, delivery with strict adherence to the principles of universal precaution and routine screening of all pregnant women during the antenatal period will help to decrease the prevalence of HIV in our environment.
ANTECEDENTES: Las relaciones heterosexuales estables son un factor determinante importante de la epidemia de VIH, y la tasa de seroprevalencia de VIH entre las mujeres prenatales es un reflejo de lo que está sucediendo en la sociedad en general. OBJETIVOS: Este estudio persigue determinar la tasa de seroprevalencia de VIH, e identificar los factores responsables de este índice entre las mujeres embarazadas. MÉTODO: Se llevó a cabo un estudio de tres años (julio 2008 – junio 2011) consistente en una evaluación transversal de casos de VIH en el embarazo. Se recogieron datos con la ayuda de un cuestionario autoadministrado estructurado cerrado aplicado a todas las mujeres positivas así como a casos negativos seleccionados al azar. El estudio se hizo sólo en el Hospital Docente Universitario de Niger Delta, en el estado de Bayelsa, Nigeria. RESULTADOS: La tasa de seroprevalencia durante el periodo de estudio fue de 4.9%. La paridad, la edad al primer coito, la escolaridad, el estado civil, y la ocupación, no parecen aumentar el riesgo. Sin embargo, la pareja desempleada, el parto en el hospital o la clínica, el desarrollo del último parto, un aborto previo inducido, y el número de parejas durante toda la vida, fueron identificados como riesgos de seropositividad de VIH (todos los valores de p < 0.005). CONCLUSIÓN: La educación sexual acerca de los peligros de la promiscuidad sexual, la disponibilidad de métodos anticonceptivos, el parto bajo la estricta observancia de los principios de precaución universal, y el tamizaje de rutina de todas las mujeres embarazadas durante el período prenatal, ayudará a disminuir la prevalencia de VIH en nuestro medio ambiente.