ABSTRACT
Cost effectiveness of managing 107 incomplete abortions by manual vacuum aspiration (MVA) is compared with management of 92 incomplete abortions by evacuation by curettage (E by C) at Muhimbili Medical Centre (September-November 1992). Pre-evacuation waiting times, duration of procedures and duration of hospital stay were less for MVA as compared to E by C. The total pre-evacuation waiting time, the durations of the procedure and hospital stay were 15.59 days (55.11%), 10.96 (46.41%) hours and 21.23 (40.53%) days less for MVA as compared to E by C. The direct costs revealed a cost differential of MVA over E by C of Tshs 776.9 (US$2.6). MVA is more cost effective than contemporary E by C and its introduction on a wider scale in our health care delivery system is recommended.
Subject(s)
Abortion, Incomplete/therapy , Dilatation and Curettage/economics , Vacuum Curettage/economics , Adult , Cost-Benefit Analysis , Female , Humans , Length of Stay , Pregnancy , Time FactorsABSTRACT
This is a case report on phantom pregnancy at Muhimbili. Relevant factors pertaining to personality of the patient, the experienced psycho-social stresses, the medical history and possible causes of symptom formation culminating in pseudocyesis are looked into and discussed.
Subject(s)
Pseudopregnancy/diagnosis , Adult , Female , Humans , Pseudopregnancy/etiology , Pseudopregnancy/psychologyABSTRACT
Between 1 June 1986 and 31 August 1987 all 47 pregnant diabetic Tanzanian women attending Muhimbili Medical Centre, Dar es Salaam were seen and managed by a small team of interested physicians and obstetricians. Of the 50 pregnancies there were 44 (88%) live births, five (10%) perinatal deaths, and one (2%) spontaneous abortion. One child was born with a serious congenital abnormality. All five perinatal deaths were seen in women who presented late in pregnancy (three) or had poor blood glucose control (two). In 10 (36%) of the 28 pregnancies in the 25 patients with insulin-requiring diabetes, insulin requirements decreased greater than 8 U during the course of pregnancy. The present study suggests that with close supervision of the pregnant diabetic patient in Africa perinatal mortality rates approaching those seen in developed countries can be achieved, despite the lack of home blood glucose monitoring. Rates could be further reduced if medical services were more widely available, and if all patients were educated on the importance of early presentation in pregnancy.
