Successful pregnancy following acquired gynatresia.

Acquired gynatresia is a common gynecological condition in developing countries where puerperal complications and unskilled interventions prevail. A 23-year-old primipara who had spontaneous vaginal delivery complicated by gynatresia had vaginoplasty that failed due to erectile dysfunction in the spouse. She subsequently developed secondary amenorrhea and was relieved with dilatation and evacuation. She was planned for definitive surgery, however,she incidentally conceived with q pin-hole vagina. She was delivered of a live fetus at term via an elective cesarean section. This case is peculiar as spontaneous conception occurred with a pinhole opening. There is a need to adequately evaluate cases before definitive management to maximize success.

Résumé Acquis Gynatrésie est une condition gynécologique commune dans les pays en développement où les complications puerpérale et les interventions non qualifiées Prévaloir. Un primipares de 23 ans qui avait la livraison vaginale spontanée compliquée par Gynatrésie avait vaginoplastie qui a échoué en raison de l'érection dysfonctionnement chez le conjoint. Elle a par la suite développé une aménorrhée secondaire et a été soulagée par la dilatation et l'évacuation. Elle a été travaillé pour défi nitive chirurgie quand elle accidentellement conçu avec une cavité vaginale sténopé et a été livré d'un fœtus vivant à terme à travers césarienne élective. Ce cas est particulier que la conception spontanée a eu lieu avec une ouverture sténopé. Il est nécessaire de Evaluer les cas avant la gestion défi nitive pour maximiser le succès.

Distribution of Kell phenotype among pregnant women in Sokoto, North Western Nigeria.

INTRODUCTION: Kell antigen is highly immunogenic and is the common cause of antibody production in mismatched blood transfusions, haemolytic transfusion reaction (HTR) and maternal alloimmunization, which causes severe anaemia in neonates. The aim of this study is to determine the prevalence and ethnic variation of the Kell phenotype among pregnant women in Sokoto, Nigeria. METHODS: Kell antigen status of 150 pregnant women aged 18-45 years and mean age 27.19 ±4.69 years attending antenatal clinic in UDUTH Sokoto Nigeria was determined using the conventional tube method and anti-Kell reagents (Lorne Laboratories, UK). RESULTS: Among the 150 subjects studied, 3 (2.0%) of subjects were positive and 147 (98.0) were negative for K antigen. Of the 150 pregnant subjects; 32 (21.3%) were primigravidae while 118 (78.7%) were multigravidae. Kell phenotype was more prevalent among primigravidae (3.1%) compared to multigravidae (1.7%) women. The distribution of Kell phenotype among the pregnant subjects was compared based on ethnicity. The prevalence of Kell antigen was significantly higher among the Hausa ethnic group (3.2%) compared to other ethnic groups which indicated zero prevalence (p = 0.001). Kell negative phenotype was ≥ 96.8% among all the ethnic groups. CONCLUSION: Our observed prevalence of Kell phenotype is consistent with previous studies among Blacks and Asians but significantly lower than values observed in previous studies among Caucasians. We recommend that all pregnant women should be screened for the presence clinically significant red cell antigens including Kell antigen on their first antenatal visit. Kell negative red cell should be routinely provided for all pregnant women and women with child bearing potential to reduce the risk of Kell-associated HDFN. There is need to introduce routine screening of pregnant women for clinically significant red cell antibodies to facilitate the effective management of HDFN as well as prevent HTR. There is also need for sustained health education of pregnant women in the area to encourage early booking for antenatal care.

Kidd blood group phenotypes among pregnant women in Sokoto, North Western Nigeria

OBJECTIVE@#To investigate the prevalence of Kidd antigens among pregnant women in Sokoto, North Western Nigeria.@*METHODS@#One hundred and sixty two pregnant women aged 18-45 years [mean age (27.19±4.72) years] attending antenatal clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto, were screened for the presence of Kidd blood group antigens using the conventional tube method and anti-Jka and Jkb reagents (Lorne Laboratories, UK).@*RESULTS@#Out of the 162 pregnant women tested, 82 (50.6%) were Hausa, 26 (16%) were Igbo, 23 (14.2%) were Fulani and 20 (12.3%) were Yoruba while the minority ethnic groups were 11 (6.8%). The distribution of Kidd antigen was compared based on the ethnic groups of subjects. Jka antigen was the highest among the Yoruba ethnic group (10.0%) followed by the Hausa ethnic group (7.31%). The prevalence of Jkb was highest among Hausa subjects (10.97%) followed by the Yoruba ethnic group (10.0%). Subjects were categorized based on parity. Majority of the subjects were multigravidae, 122 (75.3%) compared to primigravidae 40 (24.7%). Subjects were stratified based on trimester. A significant number of women were in the second trimester, 111 (68.5%) compared to the third trimester 38 (23.5%) and the first 13 (8.0%). The distribution of Kidd antigens among subjects studied indicated a prevalence of Jka, Jkb and Jk(a+b+) with 8 (4.9%), 13 (8.0%) and 0 (0.0%), respectively. A significant number of subject tested were negative for Kidd antigens. Of the 162 pregnant women tested, 154 (95.1%), 149 (75.3%) and 141 (87.04%) tested were negative for Jka, Jkb, and Jk(a-b-), respectively.@*CONCLUSIONS@#This study indicates that blood group antigens can be distributed differently within different nationalities. Kidd phenotypes observed among pregnant women in this study was similar to previous reports among blacks but at variance with report among Caucasians and Asians. We recommend that detailed routine phenotyping for all clinically significant red cell antigen including Kidd antigen being carried out routinely among all pregnant women in Nigeria. There is also the need to routinely screen all pregnant women for alloantibodies to facilitate the selection of antigen negative units for those with clinically significant alloantibodies who require a red cell transfusion. This can potentially optimise the obstetric management of haemolytic disease of foetus and newborn and prevent haemolytic transfusion reaction among pregnant women.

Kidd blood group phenotypes among pregnant women in Sokoto, North Western Nigeria

Objective: To investigate the prevalence of Kidd antigens among pregnant women in Sokoto, North Western Nigeria. Methods: One hundred and sixty two pregnant women aged 18-45 years [mean age (27.19±4.72) years] attending antenatal clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto, were screened for the presence of Kidd blood group antigens using the conventional tube method and anti-Jka and Jkb reagents (Lorne Laboratories, UK). Results: Out of the 162 pregnant women tested, 82 (50.6%) were Hausa, 26 (16%) were Igbo, 23 (14.2%) were Fulani and 20 (12.3%) were Yoruba while the minority ethnic groups were 11 (6.8%). The distribution of Kidd antigen was compared based on the ethnic groups of subjects. Jka antigen was the highest among the Yoruba ethnic group (10.0%) followed by the Hausa ethnic group (7.31%). The prevalence of Jkb was highest among Hausa subjects (10.97%) followed by the Yoruba ethnic group (10.0%). Subjects were categorized based on parity. Majority of the subjects were multigravidae, 122 (75.3%) compared to primigravidae 40 (24.7%). Subjects were stratified based on trimester. A significant number of women were in the second trimester, 111 (68.5%) compared to the third trimester 38 (23.5%) and the first 13 (8.0%). The distribution of Kidd antigens among subjects studied indicated a prevalence of Jka, Jkb and Jk(a+b+) with 8 (4.9%), 13 (8.0%) and 0 (0.0%), respectively. A significant number of subject tested were negative for Kidd antigens. Of the 162 pregnant women tested, 154 (95.1%), 149 (75.3%) and 141 (87.04%) tested were negative for Jka, Jkb, and Jk(a-b-), respectively. Conclusions: This study indicates that blood group antigens can be distributed differently within different nationalities. Kidd phenotypes observed among pregnant women in this study was similar to previous reports among blacks but at variance with report among Caucasians and Asians. We recommend that detailed routine phenotyping for all clinically significant red cell antigen including Kidd antigen being carried out routinely among all pregnant women in Nigeria. There is also the need to routinely screen all pregnant women for alloantibodies to facilitate the selection of antigen negative units for those with clinically significant alloantibodies who require a red cell transfusion. This can potentially optimise the obstetric management of haemolytic disease of foetus and newborn and prevent haemolytic transfusion reaction among pregnant women.

Breech Deliveries in Usmanu Danfodiyo University Teaching Hospital Sokoto; Northwestern Nigeria: a 10-Year Review

Background: Breech delivery is a major issue in obstetric practice mainly because of the high perinatal morbidity and mortality associated with it. The aims of the study are to determine the prevalence management and perinatal outcome of singleton breech deliveries in our center. Materials and Methods: A retrospective study involving 395 singleton breech deliveries out of 24;160 deliveries conducted at the Usmanu Danfodiyo University Teaching Hospital Sokoto; Sokoto; over a 10-year (2001-2010) period. Results: The prevalence rate of singleton breech delivery was 1.7. Breech deliveries occurred more in the primigravidae. Most babies (69.1) had vaginal delivery. There was a high caesarean section (CS) rate of 30.9. Babies delivered by CS had better Apgar scores than those delivered through the vagina (P 0.05). The perinatal mortality rate in breech deliveries (410/1000) was significantly higher than that (101.5/10000) in their cephalic counterparts (P 0.05). Similarly; perinatal deaths were more common in unbooked than in booked patients (P 0.05). Conclusion: Breech delivery was frequent in the study population. Singleton breech delivered by CS had better outcome than those who were delivered through the vagina

Breech Deliveries in Usmanu Danfodiyo University Teaching Hospital Sokoto; Northwestern Nigeria: A 10-Year Review

Background: Breech delivery is a major issue in obstetric practice mainly because of the high perinatal morbidity and mortality associated with it. The aims of the study are to determine the prevalence management and perinatal outcome of singleton breech deliveries in our center. Materials and Methods: A retrospective study involving 395 singleton breech deliveries out of 24;160 deliveries conducted at the Usmanu Danfodiyo University Teaching Hospital Sokoto; Sokoto; over a 10-year (2001-2010) period. Results: The prevalence rate of singleton breech delivery was 1.7. Breech deliveries occurred more in the primigravidae. Most babies (69.1) had vaginal delivery. There was a high caesarean section (CS) rate of 30.9. Babies delivered by CS had better Apgar scores than those delivered through the vagina (P 0.05). The perinatal mortality rate in breech deliveries (410/1000) was significantly higher than that (101.5/10000) in their cephalic counterparts (P 0.05). Similarly; perinatal deaths were more common in unbooked than in booked patients (P 0.05). Conclusion: Breech delivery was frequent in the study population. Singleton breech delivered by CS had better outcome than those who were delivered through the vagina