Abdominal pregnancy in Usmanu Dan-Fodiyo university teaching hospital, Sokoto: A 10-year review

Background: Abdominal pregnancy, a rare condition with high maternal mortality (up to 50%), and even higher perinatal mortality (40 ­ 95%), is often associated with diagnostic difficulties. Objectives: To determine the mode of presentation and management of abdominal pregnancy, from cases in the Usmanu Dan-Fodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A retrospective review of the case records of all abdominal pregnancies managed in UDUTH, Sokoto, between January 2000 and December 2010. Results: During the 10-year study period, there were eight cases of abdominal pregnancies, 285 extrauterine pregnancies, and 25,506 total deliveries. All the patients were not booked for antenatal care and their ages ranged between 20 and 39 years (mean=28.1±3.4 years). The majority (88%) were grand multipara. The main presenting symptoms were persistent abdominal pain, vaginal bleeding, and prolonged pregnancy. Seven cases (87.5%) were diagnosed accurately by an ultrasound scan. There were seven perinatal deaths (87.5%) and one live birth. There was one maternal death (12.5%), which occurred in the patient whose placenta was left in-situ. Conclusion: Presence of persistent lower abdominal pain, vaginal bleeding, and prolonged pregnancy should raise the suspicion of abdominal pregnancy. Removal of the placenta, where feasible, improves the outcome of maternal health

Carcinoma of the Cervix in Sokoto, Northern Nigeria

Background: Cancer of the cervix, a preventable disease, is the second most common cause of cancer-related morbidity and mortality in women in the developing world. Experience of the disease in Sokoto is lacking in the literature. The aim of this study is to determine the demographic characteristics, clinical features, stage of the disease at presentation and outcome in cases of carcinoma of the cervix in the Usmanu Danfodiyo University Teaching Hospital(UDUTH), Sokoto. Materials and Methods: A descriptive retrospective study of all patients diagnosed with carcinoma of the cervix between January 1998 and December 2003 at UDUTH, Sokoto. Results: There were 100 cases of carcinoma of the cervix during the 6-year study period. The peak age incidence was in the 50-59 year age group(30), and mean age was 48 years. Parity ranged from 0 to 13. Sixty-seven percent(67) of patients were Para 5 and above. The main clinical features were irregular vaginal bleeding, postmenopausal bleeding, offensive vaginal discharge and abdominal/pelvic pain. Eighty-nine percent (89) of patients presented in advanced stages of the disease(Stage IIb to IV). Most patients were not able to receive radiotherapy and were lost to follow-up. Conclusions: Carcinoma of the cervix in Sokoto is a disease of grandmultiparous women who usually present at the advanced stages. Prognosis is poor due to late presentation and inability to afford the cost of radiotherapy. It is recommended that measures to prevent carcinoma of the cervix must be put in place, chief amongst which is the implementation of a population-based screening programme