Maternal near miss mortality: indication of maternal care

Maternal mortality is one of the important indicators used for the measurement of maternal health. To overcome this challenge, maternal near miss has been suggested as a compliment to maternal death. The prevalence of near miss is higher in developing countries and causes are similar to those of maternal mortality namely haemorrhage, hypertensive disorders, sepsis and obstructed labor. Reviewing near miss cases provide significant information about the delays in health seeking so that appropriate action is taken. It is useful in identifying health system failures and assessment of quality of maternal health-care. Certain maternal near miss indicators have been suggested to evaluate the quality of care. The near miss approach will be an important tool in evaluation and assessment of the newer strategies for improving maternal health. Here we are presenting case series of near miss mortality cases reported in Muzaffarnagar medical college.

A case report of 26 weeks of complete molar pregnancy with posterior uterine fibroid

Molar pregnancy is one of the classifications of GTD and sometimes can be associated with hyperthyroidism. The classic features are irregular vaginal bleeding, hyper emesis and large uterus for gestational age. Though incidence of uterine fibroid with pregnancy is 1% to 10% but encountered with molar pregnancy is rare. Here we reported a case of complete molar pregnancy with posterior uterine fibroid who initially presented with 3-month amenorrhea and had a complaint of spotting per vagina occasionally with ultrasonography report suggestive of molar pregnancy and post uterine fibroid with raised beta-hCG with low TSH suggestive of hyperthyroidism.

Comorbidities among infertile women at NKST hospital Mkar-Gboko, North-Central Nigeria

Background:  Infertility, a common, non-fatal ailment, is sometimes associated with substantial comorbidity that can add adverse outcomes during treatment or pregnancy and increase costs of care. This study aims to assess the magnitude and pattern of comorbidities in infertile Nigerian women.Method: This descriptive retrospective study was undertaken at NKST Hospital Mkar-Gboko, Nigeria, from 1st January 2005 to 31st July 2013. Clinic records of patients who attended the gynaecological outreach clinic were retrieved and analyzed using descriptive statistics and test of associations with Microsoft Excel 2013.  Jos University Teaching Hospital gave ethical clearance.Results: 1,926 women seen during the study period, 1030 (53.5%) presented for infertility care. 941 (91.4%) women had complete records, among them, 476 (50.5%) met the inclusion criteria, and their records were analyzed. The mean age of the women was 32.6±6.0 years with a range of 20 to 53 years, see Table1. There were 52 comorbid conditions among the 476 women. The comorbidities included uterine myoma, previous appendectomy/pelvic surgeries, genital tract infections/retroviral disease, hypertension, obesity and diabetes, among others, see Table 4. Table 2 and 3 shows there is a significant statistical association between comorbidity type, age, parity, duration of infertility and symptoms complex between infertile women and comorbidities (p<0.05).Conclusion: Comorbidities that can influence treatment and pregnancy outcomes are common among infertile women in central Nigeria. This finding strongly supports the routine assessment of women for comorbidities during infertility care for appropriate multidisciplinary management and counselling.