The Incidence; Pattern and Management Outcomes of Early Pregnancy Losses at the Ebony State University Teaching Hospital; Abakaliki

Background: Early pregnancy losses are a source of deep emotional trauma to any woman; her family and the attending Gynaecologist. This study evaluated the prevalence; pattern and management outcomes of such losses at a tertiary Health Institution. Methods: Data of all women who suffered early pregnancy losses between 1st January; 2002 and 31st December; 2004; were reviewed in a descriptive study. Information obtained from their case notes which related to the early pregnancy event; their socio demographics; obstetric history and management outcomes were collated. Univariate analysis was performed and frequency tables and figures were constructed where appropriate. Results: Early pregnancy losses comprised miscarriages; molar pregnancy and ectopic gestations accounted for 32.1of all gynaecological admissions during the period. Miscarriages were the commonest diagnosis and incomplete abortion constituted the bulk of this. Women of all parities were involved but rate of loss increased down the socio economic class strata. Majority were unbooked. A maternal mortality rate of 1.8attended all forms of early pregnancy losses during the period. Conclusion: Early pregnancy loss constitutes a major gynaecological problem in our centre. Health care providers must institute prompt and appropriate clinical management for a good clinical outcome

Evaluation of ultrasonographic examination prediction of spontaneous first trimester abortion

This study was carried out on 445 patients in the first trimester of pregnancy. They had one or more risk factors for abortion. History and clinical examination were done and abdominal ultrasonographic examination was carried out on day 43 to 56, 57 to 70 and 71 to 84 of the estimated gestational age [EGA]. At the end of the first trimester, the results showed that the total incidence of abortion was 17.5%. The three ultrasonic examinations showed that the incidence of abortion was very high when the shape of gestational sac [GS] was irregular, followed by the dumbbell shape and when the average diameter of GS or crown-rump length [CRL] was shorter or longer than that of equal to EGA. Measurement of CRL on day 71 to 84 was accurate in prediction of first trimester abortion. It is concluded that ultrasound examination is accurate in predicting first trimester abortion. If EHM is not seen by day 71 to 84 of EGA, missed abortion should be considered. For patient at risk of abortion, ultrasound examination is recommended to be carried out as early in pregnancy as possible and to be repeated-within two weeks for three times

Avortement a' re'pe'tition et endome'trite tuberculeuse [a propos d'un cas

Tuberculous endometritis is always associated with tuberculous salpingitis and the sterility is the consequence. The pregnancy results in abortion in the few cases where the nidation is happened.We report the case of a young woman aged of 25 years old, mother of one child of 7 years old. After the abolition of his intrauterine device, she has one spontaneous abortion of 12 weeks of amenorrhea and another similar episode after an interval of 7 month

Uterine factor in repeated abortion, hysteroscopic, hysterographic and ultrasonographic study

Recurrent abortion is a frustrating problem due to the despair of being unproductive in spite of conception. Uterine factor represents a contributing element in that problem. This work comprised 120 patients presenting with history of recurrent abortion. All patients were subjected to careful history taking and clinical examination. Hysterography, ultrasonography and hysteroscopy were performed for all cases. It was revealed that hysteroscopy and hysterography were nearly equal in diagnosing uterine anomalies and both methods were superior to ultrasonogrphy. However, hysterography can not precisely differentiate bicornuate from septate uterus, whereas hysteroscopy was more informative about extent and thickness of the septum. As regard fibroid uterus, both hysteroscopy and hysterography were equal in diagnosing submucos myomata, whereas ultrasonography was much more superior in diagnosing intra-mural and subserous myomata. Operative hysteroscopy resulted in successful division of uterine septum in 89% of cases and incomplete procedure in 11% of cases. Hysteroscopic adhesiolysis of synechiae resulted in successful procedure in 55% of cases, incomplete procedure in 13% and failed procedure in 32% of cases

significance of anticardiolipin antibodies in recurrent abortion

The levels of anticardiolipin antibodies were investigated in the sera of 40 women with recurrent spontaneous unexplained abortion, coming for antenatal care. The difference in AC values between patients and control was statistically insignificant. Also, no difference of significance was observed between primary and secondary aborters. However, the incidence of AC positivity rose as the number of abortions increased, a finding of statistical significance [r = 309, P < 02]. Platelet counts tended to be lower in the patients group irrespectively to category, yet without statistical significance. AC positivity was exclusive to the GPL fraction of anticardiolipins. The significance of AC antibodies in recurrent unexplained abortion is further confirmed, with assertion of the importance of GPL over MPL