A ten year review of female sterilization at the university of Maiduguri teaching hospital, Maiduguri, Nigeria

Background: In most developing countries like Nigeria, female sterilization is not a popular method of contraception. Objective: The objective of this study was to determine the prevalence of female sterilization and socio-demographic characteristics of women who had sterilization in our setting.Methodology: This was a retrospective study carried out between 1st January 1997 and 31 December 2006.A total of two hundred and one female sterilisation operations were performed but ten case notes were incomplete and therefore, one hundred and ninety one 191 were analyzed. Information retrieved from the case notes included the age, parity, religion, literacy, and type of bilateral tubal ligation. The data collected were analyzed using SPSS Version 16.0 statistical package and the results represented in simple tables and percentages.Results: There were 16,319 deliveries during the study period and 201women had bilateral tubal ligation (BTL), giving a prevalence of 1.2%. The mean age at BTL was 30.18, while the mean parity was 4±0.6. Women between the ages of 30-39 constituted majority of the patients. In most of the women 138 (72.3%) bilateral tubal ligation was performed during caesarean section, while few women 16 (8.4%) had the procedure at laparotomy. The rest, 37(19.4%) women opted for interval BTL. Significantly more literate women (73%) sought for interval tubal ligation compared to non literate (23%) ones. A large number of the Muslims (87.5%) had BTL at laparotomy compared to the Christians (12.5%). P=0.002.Conclusion: The prevalence of bilateral tubal ligation in this study is low. There is need to encourage the uptake of female sterilization in our environment

A 10-year Review of the Clinical Presentation and Treatment Outcome of Asherman's Syndrome at a Center with Limited Resources.

BACKGROUND: Many women suffer from some degree of intrauterine adhesions (IUAs) presenting with various clinical symptoms and signs. Hysteroscopy is the mainstay of diagnosis, classification, and treatment of the IUA. AIM: This study was undertaken to review the clinical features and treatment outcome in patients diagnosed with Asherman's syndrome at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, over a 10 years period, 1997-2006. SUBJECTS AND METHODS: This is a retrospective study of cases of Asherman's syndrome managed at the UMTH over a 10-year period, from January 1, 1997 to December 31, 2006. Case records of the patients were retrieved from medical records' Department. Sociodemographic and clinical information relating to clinical presentations, treatment modalities, and outcomes were collated. The data were analyzed using SPSS 16.0 Statistical Computer Package (SPSS Inc., IL, USA 2006). Chi-square and binary logistic regression were used for inferential statistics. RESULTS: Asherman's syndrome constituted 8.1% (81/996) of all gynecological operations in UMTH during the study period. The case records retrieval rate was 96.3% (78/81 folders). Most of the patients, 59% (46/78) were in their third decade and majority 85.9% (67/78) were married. The most common risk factor was pregnancy-associated, accounting for 61.5% (48/78). Infertility and hypomenorrhea were the most common mode of presentations in 55.1% (43/78) and 32.1% (25/78) of cases, respectively. Most of the patients 85.9% (67/78) were treated by blind dilatation and curettage (D/C), Foley's catheter insertion and estrogen-progesterone combination. Correction of menses was seen in 37.2% (29/78) of the patients while the pregnancy rate was 32.1% (25/78). On binary logistic regression age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) emerged as the only respondent's related risk factors associated with the development of Asherman's syndrome. CONCLUSION: Asherman's syndrome is relatively common due to complications of pregnancy and delivery, and blind D/C has a relatively poor outcome. Age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) were associated with the development of Asherman's syndrome. Therefore, other methods of adhesiolysis such as hysteroscopic adhesiolysis should be explored.

Awareness and perception of human papilloma virus vaccine among healthcare professionals in Nigeria.

Human papilloma virus (HPV) is a necessary cause of cervical cancer and cervical cancer is largely a vaccine-preventable disease. The aim of the study was to document the knowledge of healthcare professionals of the HPV vaccine and its acceptability. It was a cross-sectional study in three of the six geo-political zones of Nigeria, carried out between June 2010 and January 2011. The 602 adult Nigerian respondents were made up of 147 (24.4%) males and 455 (75.6%) females aged 20-57 years, with a mean of 34.3 ± 7.9 years; most were under 40 years (70.1%) and married (n = 394; 65.5%). In total, 548 (91%) were aware of HPV; 83.4% knew HPV as an STI; 78.2% knew HPV can cause cervical cancer but only 265 (44.0%) were aware of the HPV vaccine. Among the healthcare professionals studied, nurses were the least aware of the existence of the HPV vaccine (χ(2) = 1.54, p = 0.001). A total of 489 (81.0%) would approve HPV vaccine for their teenage daughters. The men were more likely to accept the vaccination of their daughters than the women (χ(2) = 14.76, p = 0.002). The unmarried were more favourably disposed to vaccination of teenagers than the married (χ(2) = 27.37, p = 0.001). Safety concerns were the commonest reasons expressed by the 7% who were reluctant to accept the vaccination of their teenage daughters. In conclusion, healthcare providers are the custodians of health in a community, yet have low knowledge of a vaccine that can prevent the commonest cancer in women in sub-Saharan Africa.

Prevalence of bacterial vaginosis in pregnant women in Maiduguri, North-Eastern Nigeria.

OBJECTIVE: This study determined the prevalence and socio-demographic characteristics of bacterial vaginosis (BV) among pregnant women with abnormal vaginal discharge. STUDY DESIGN: Descriptive cross-sectional study. SETTING: University of Maiduguri Teaching Hospital. MATERIALS AND METHODS: Vaginal swab samples and data on epidemiological risk factors were collected from 400 consecutive pregnant women with complaints of abnormal vaginal discharge. The data was analyzed using the SPSS 16.0 statistical software. Association between variables was compared by using the Chi-square (χ2 ) and Fisher's exact tests while P < 0.05 was considered significant at 95.0% confidence level. RESULT: The prevalence of BV among pregnant women with abnormal vaginal discharge was 17.3%. Age 20-24 years, multigravidity, lack of western education and unemployment were associated with increased prevalence of BV. Yellowish, watery vaginal discharge (P = 0.001) was associated with BV. Dysuria, dyspareunia and lower abdominal tenderness were associated with BV (P = 0.001). Fifty three (77%) of patients had BV during the second trimester compared to 6 (9%) who had it in the 1 st trimester of pregnancy (P = 0.012). CONCLUSION: The high prevalence of BV in this study may necessitate adequate screening of pregnant women with abnormal vaginal discharge in order to give appropriate treatment and avoid complications associated with it.

Twin fetuses papyraeci in a spontaneous triplet pregnancy presenting with unexplained preterm contractions.

Fetus papyracie in a triplet pregnancy is indeed rare and can pose serious management challenges. These challenges are more pronounced where facilities for monitoring are either inadequate or nonexistent. A 39-year-old, grand multipara multipara was referred to the University of Maiduguri Teaching Hospital at 27 weeks gestation with preterm contractions. Materno fetal monitoring did not reveal the cause of the preterm contractions. She was delivered via caesarean section, at 36 weeks of gestation, on account of decreased fetal movement and the products were a live female fetus weighing 2.3 kg and two male papyraceous fetuses weighing 150 g and 130 g, respectively.

Prevalence of vaginal candidiasis among pregnant women with abnormal vaginal discharge in Maiduguri.

BACKGROUND: Pregnancy represents a risk factor in the occurrence of vaginal candidiasis. OBJECTIVES: To determine the prevalence and clinical features associated with abnormal vaginal discharge and C. albicans infection in pregnant women. METHODS: High vaginal swab samples and data on epidemiological characteristics were collected from 400 pregnant women with complaints of abnormal vaginal discharge at booking clinic of University of Maiduguri Teaching Hospital. The data was analysed using SPSS 16.0 statistical software. RESULTS: The prevalence of abnormal vaginal discharge in pregnancy was 31.5%. The frequency of abnormal vaginal discharge was 183 (45.8%) among those aged 20-24 years, 291 (72.8%) in multipara, 223 (55.8%) in those with Primary education and 293 (73.2%) in unemployed. Vulval pruritus 300 (75.0%) was significantly related to abnormal vaginal discharge (P < 0.001). The prevalence of C. albicans was 41%. The frequencies of Vulval itching, Dyspareunia and vulval excoriation among those with candidiasis were 151 (50.3%), 14 (56.0%) and 75 (75.0%) respectively (P < 0.001). CONCLUSION: The prevalence of abnormal vaginal discharge in pregnancy was high in this study and C. albicans was the commonest cause. It is recommended that a pregnant woman complaining of abnormal vaginal discharge be assessed and Laboratory diagnosis done in order to give appropriate treatment.

Home births and postnatal practices in Madagali, north-eastern Nigeria.

BACKGROUND: Home births are common in resource poor countries and postnatal practices vary from one community to the other. OBJECTIVE: To determine the proportion of home births, reasons for home delivery, and evaluate postnatal practices in Madagali, north-eastern Nigeria. MATERIALS AND METHODS: This was a cross-sectional descriptive study of 400 women of reproductive age, who had put to birth in the past 1 year. The study was carried out over a period of 8 weeks from April to June 2010. The multistage method of sampling was used to select respondents. In the first stage, four of the five health districts were chosen randomly, namely, Gulak, Madagali, Sukur, and Duhu. The questionnaires were evenly distributed among the four health districts. In the second stage, from each district, two villages were chosen by simple random sample. In the third stage, two wards were selected in each village by simple random sampling. RESULT: Of the 400 respondents interviewed, 289 (72.2%) were aged between 20 and 39 years, and most, 374 (93.5%) were married. Only 14 (3.5%) had tertiary education. Most respondents, 224 (56.0%) were farmers and grandmultiparae, 187 (46.7%). A total of 196 (49.0%) women delivered at home, whereas 204 (51.0%) delivered at the hospital. Of the 196 respondents who delivered at home, the bedroom 142 (72.4%), was the preferred place of birth. The most common reason for home birth was short duration of labor in 71 (36.3%) cases. Delivery was conducted by untrained persons in 50, (25.4%), whereas 99 (50.8%) and 31 (15.5%) deliveries were supervised by Traditional Birth Attendants (TBAs) and Midwives/Nurses, respectively. Postpartum, the majority, 235 (58.7%) respondents used sanitary pads to stanch lochia, whereas 140 (35%) used rags. CONCLUSION: A significant number of births take place in the home and supervised by unskilled persons. Against the backdrop of poor education and low socio-economic status of respondents, perineal hygiene can be adjudged satisfactory. There is the need to increase on the number of hospital birth and also trained TBA who conduct most of home deliveries.

Knowledge of symptoms and signs of puerperal sepsis in a community in north-eastern Nigeria: a cross-sectional study.

Puerperal sepsis is a leading cause of mortality in developing countries. The objective of this study is to determine the knowledge of symptoms and signs of puerperal sepsis. It was a cross-sectional community-based study. Of the 400 respondents interviewed, 289 (72.2%) were between the ages of 20 and 39 years, and most, 374 (93.5%), were married. Only 14 (3.5%) had tertiary education. Most respondents, 224 (56.0%) were farmers and grandmultiparae accounted for 187 (46.7%). A reassuring number of respondents, 265 (66.3%), knew that fever with abnormal vaginal discharge; 252 (63%) fever with foul smelling lochia; 346 (86.4%) fever occurring with lower abdominal pain and 182 (45.5%) knew that fever occurring with prolonged flow of lochia, are all indicators of puerperal sepsis. A total of 53% of respondents were not aware of the causes of puerperal sepsis; 10% believed it is caused by evil spirits. The knowledge of the causes of puerperal sepsis is poor. There is the need to put more emphasis on the causes of puerperal sepsis during antenatal health talks. This could help reduce morbidity and mortality associated with puerperal sepsis.

Gender attitude to the empowerment of women: an independent right to contraceptive acceptance, choice and practice.

Multiple factors influence the acceptance, choice and utilisation of contraceptive. The objective of the study is to identify individual attitude towards the empowerment of women to an independent right to accept, choose and utilise a contraceptive method of their choice without recourse to their male partners. This is a cross sectional study of men and women of different socio-cultural background working or utilising the services of the Federal Medical Centre Gombe, Nigeria. There were 554 respondents. Only 187 (34.4%) respondents thought that all women, irrespective of marital status, should have an independent right to contraceptive acceptance, choice and practice. Significantly more men (85.4%) than women (61.8%) rejected that women should have an independent right to contraceptive acceptance, choice and practice. Majority of both gender favoured male influence in the acceptance and choice of method of contraception. Our study has re-echoed the importance of male involvement in contraception decision-making.

Maternal mortality at federal medical centre yola, adamawa state: a five-year review.

BACKGROUND: The North Eastern region of Nigeria has one of the highest maternal mortality ratios (MMRs) in the world, and most of these deaths are preventable. Culture, religion and customs that prevent access to care contribute immensely to these deaths. AIM: To review and document the MMR. MATERIALS AND METHODS: This was a retrospective study of all maternal deaths recorded at the Federal Medical Centre Yola (FMCY). The case notes of all cases of maternal deaths from January 2007 to December 2011 were retrieved and relevant data obtained and analyzed. The age, parity, literacy level, booking status, causes of maternal deaths, were analysed. Data were presented in tables and percentages, using SPSS version 16(Chicago, USA 2006). RESULTS: There were 54 maternal deaths among the 8497 deliveries, giving an overall MMR of 636 per 100,000 deliveries. Thirty three folders (33) folders were retrieved and 28 had complete information for analysis. The mean (SD) age and parity were 28.2 (6.2) and 3.4 (2.0), respectively. Most deaths (9/28; 32.1%) were in the age group of 20-24 years. Multiparae (14/28; 50%) constituted the largest parity group. Majority (16/28; 57.1) were non-literates, 16/28 (57.1%) were of Hausa/Fulani extraction and 12/28 (42.9%) were unbooked. The leading causes of maternal mortality were preeclampsia/eclampsia (9/28; 32.1%), obstetric hemorrhage (8/28; 28.6%) and severe anemia (3/28; 10.7%). All those who died of preeclampsia/eclampsia were Hausa/Fulani. Most (14/28; 50%) deaths occurred within 24 h of admission. Majority of the deaths were Muslims (χ(2) = 15.108, P = <0.001). Ethnicity had no significant influence on maternal death (χ(2) = 15.550, P = 0.21). CONCLUSION: In conclusion, the MMR in FMCY is higher than the national average. The fact that most deaths occurred within 24 h of admission suggests that many of the patients delayed reaching the referring center for a variety of reasons. Preventive measures should focus on this delay, which is usually beyond the reach of the hospital. Measures to reduce preventable hospital deaths should also be put in place.

Home Births and Postnatal Practices in Madagali; North-Eastern Nigeria

Background: Home births are common in resource poor countries and postnatal practices vary from one community to the other. Objective: To determine the proportion of home births; reasons for home delivery; and evaluate postnatal practices in Madagali; north-eastern Nigeria. Materials and Methods: This was a cross-sectional descriptive study of 400 women of reproductive age; who had put to birth in the past 1 year. The study was carried out over a period of 8 weeks from April to June 2010. The multistage method of sampling was used to select respondents. In the first stage; four of the five health districts were chosen randomly; namely; Gulak; Madagali; Sukur; and Duhu. The questionnaires were evenly distributed among the four health districts. In the second stage; from each district; two villages were chosen by simple random sample. In the third stage; two wards were selected in each village by simple random sampling. Result: Of the 400 respondents interviewed; 289 (72.2) were aged between 20 and 39 years; and most; 374 (93.5) were married. Only 14 (3.5) had tertiary education. Most respondents; 224 (56.0) were farmers and grandmultiparae; 187 (46.7). A total of 196 (49.0) women delivered at home; whereas 204 (51.0) delivered at the hospital. Of the 196 respondents who delivered at home; the bedroom 142 (72.4); was the preferred place of birth. The most common reason for home birth was short duration of labor in 71 (36.3) cases. Delivery was conducted by untrained persons in 50; (25.4); whereas 99 (50.8) and 31 (15.5) deliveries were supervised by Traditional Birth Attendants (TBAs) and Midwives/Nurses; respectively. Postpartum; the majority; 235 (58.7) respondents used sanitary pads to stanch lochia; whereas 140 (35) used rags. Conclusion: A significant number of births take place in the home and supervised by unskilled persons. Against the backdrop of poor education and low socio-economic status of respondents; perineal hygiene can be adjudged satisfactory. There is the need to increase on the number of hospital birth and also trained TBA who conduct most of home deliveries

Determinants of utilization of papanicolaou smear among outpatient clinic attendees in north-eastern Nigeria.

BACKGROUND: The utilization of cervical cancer screening services is very poor in developing countries. OBJECTIVE: The study was aimed at establishing the determinants of the awareness of cervical cancer, Papanicolaou smear and its utilization among outpatient clinic attendees in north-eastern Nigeria. METHODOLOGY: Cross sectional study among outpatient clinic attendees in two tertiary institutions in north-eastern Nigeria. RESULTS: A total of 235 women of reproductive age were interviewed during the study period. Sixty two (62%) were aware of cervical cancer, while 44.3% were aware of screening with Pap smear. However, overall, only 11.5% had ever been screened for cervical cancer before our study. More than half (54%) of the respondents did not state any reason for not doing the test. Compared with women who were not screened, screened women were aged 30 years and above with a mean age of 29.7 +/- 7.6 years (p = 0.021), better educated (p = 0.046), multiparous and employed outside home (p = 0.000). Determinants of awareness of cervical cancer and Pap smear were higher level of education (O.R. 7.80, 95% CI: 7.2-9.4; O.R. 5.12, 95%; CI: 5.0-6.4) and being civil servants (O.R. 2.01, 95% CI: 2.5-3.0; O.R. 3.23, 95%; CI: 2.9-4.7) respectively, while utilization of Pap smear depended on the age (O.R. 3.25, 95%; CI: 2.7-4.0) and higher educational status (O.R. 2.87, 95%; CI: 2.9-3.2). CONCLUSION: The utilization of Pap smear among women studied is very low. But the reasons advanced for poor utilization are modifiable. Efforts at addressing these reasons might improve the take up rate of cervical cancer screening in North-eastern Nigeria.

Oral health practices among pregnant women in North Eastern Nigeria.

OBJECTIVE: The objective of this study was to document oral health practices of pregnant women in two tertiary institutions in North-eastern Nigeria. MATERIALS AND METHODS: This was a cross-sectional study of pregnant women seen at the antenatal clinics of the University of Maiduguri Teaching Hospital and Federal Medical Centre Yola from May 1, 2009 to July 1, 2009. RESULTS: A total of 294 women were interviewed. They were aged 15-46 with a mean of 27.42 ± 5.97 years. The parity ranged from 1 to 9 with a mean of 2.23 ± 1.65. Twelve (4.1%) women gave a history of symptomatic oral lesion in index pregnancy. Forty-four (15%) had had previous encounter with a dentist, while the highest frequency of oral care was twice a day in 164 (55.8%) of respondents. The majority, 264 (89.9%), used toothbrush/toothpaste as a form of oral care while 2 (0.7%) used charcoal. Women of low parity tended to have better oral care than those of high parity (P = 0.002). Women who are employed had better oral care than housewives (x2 = 27.749, P = 0.001). There was no significant relationship between oral complaints and trimester of pregnancy (x2 = 4.271, P = 0.118). CONCLUSION: Oral healthcare among the respondents was encouraging but involvement of the dental surgeon in preventive oral care in pregnancy is rather dismal.

Hysterosalpingographic findings in infertile women: a seven year review.

OBJECTIVES: To review the hysterosalpingographic (HSG) findings in women investigated for infertility in a tertiary center in north eastern Nigeria. MATERIALS AND METHODS: A retrospective review of HSG films of 272 women investigated for infertility between January 2000 and December 2006 were reviewed. RESULTS: One hundred and thirty (47.8%) were investigated for primary infertility, while 142 (52.2%) were investigated for secondary infertility. Most of the women investigated for infertility by HSG had abnormal findings 192(70.6%). The most common pathology revealed among the infertile women was tuboperitoneal factor in 196 (72.1%) followed by uterine synechia in 35(12.9%). Seventeen (6.3%) had bilateral tubal block and 5 (1.8%) had bicornuate uterus. CONCLUSION: HSG is helpful in the investigation of infertile women.

Anaesthesia for caesarean delivery: choice of technique among antenatal attendees in North-eastern Nigeria.

The objective of this study is to document the anaesthetic preference of pregnant women in two tertiary institutions in North-eastern Nigeria. This was a cross-sectional study of pregnant women seen at the antenatal clinics of the university of Maiduguri teaching hospital and Federal Medical Centre, Yola, from August to October 2009. A total of 254 women were interviewed. They were aged 18-43 with a mean of 28.56 ± 5.602 years. The parity ranged from 1-9 with a mean of 2.71 ± 1.956. Most (178, 70.1%) respondents preferred general anaesthesia and the commonest reason for the preference was various forms of fear 128 (71.9 %). The commonest reason for preference for regional anaesthesia was to watch the procedure live 50 (65.8%). Age (χ(2) = 52.364, p = 0.000), education (χ(2) = 8.780, p = 0.032), occupation (χ(2) = 18.555, p = 0.002) and religion (χ(2) = 4.936, p = 0.026) were significantly associated with preference for general anaesthesia. Only age (p = 0.000, OR 8.17, CI = 0.000-1.00) retained significance after multivariate analysis. Considering the fact that the global trend is towards regional anaesthesia due to lower morbidity and mortality, the high preference for general anaesthesia in our survey is worrisome. Health education during antenatal clinics should highlight the superiority of regional over general anaesthesia for caesarean delivery.

Postpartum hypocalcaemia in Maiduguri, North-eastern Nigeria: a 10-year review.

The aim of maternal calcium homeostasis is to provide adequate calcium flux across the placenta during pregnancy and into breast milk during lactation, to ensure normal fetal and neonatal skeletal mineralisation. The objective of this study was to document the characteristics and outcome of patients who had postpartum hypocalcaemia. Cases of symptomatic postpartum hypocalcaemia managed over a 10-year period (1 January 1998 to 31 December 2007) at the University of Maiduguri Teaching Hospital, were retrospectively reviewed. A total of 34 cases were identified. The sociodemographic characteristics, corrected calcium level, duration of treatment, mode of delivery and the packed cell volume (PCV) were analysed using the EPI-INFO Version 3.4.3 statistical package. The mean age and parity were 24.29 ± 5.88 and 3.39 ± 2.32, respectively. All the patients presented with carpopedal spasm with or without associated symptoms. There was a direct relationship (R² linear = 0.292, p = 0.001) between PCV and serum calcium. Multiparous women were significantly more affected than primiparae (χ² = 15.08; p = 0.0005). Half of the patients presented within 1 week of onset of symptoms. In conclusion, the association between anaemia and postpartum hypocalcaemia needs further study to determine the cause and effect relationship.

Effect of sugars on characteristics of Boer goat semen after cryopreservation.

In order to improve Boer goat semen quality during cryopreservation process, the influence of sugar supplementation on semen characteristics of sperm were investigated. Three experiments were carried out to investigate the effect of (a) addition of two monosaccharides (fructose and glucose) and two disaccharides sugars (trehalose and sucrose) (b) sugar combination (fructose and trehalose, sucrose and trehalose, glucose and trehalose), and control (glucose without trehalose) (c) different concentrations of trehalose on cryopreservation using Tris based extender. The total motility, forward motility, viability, normal spermatozoa, acrosome integrity and membrane integrity were assessed subjectively. Differences were not detected among monosaccharides, but glucose increased (P<0.05) sperm forward motility in post-thaw goat semen compared to trehalose or sucrose supplementation. Semen quality did not differ (P>0.05) among disaccharide sugar supplementation. Combination of glucose and trehalose significantly improved the characteristics of Boer spermatozoa after cryopreservation (P<0.05). Supplementation of trehalose (198.24mM) into the glucose extender significantly increased total motility, forward motility, live spermatozoa, acrosome integrity and membrane integrity following cryopreservation (P<0.05). In conclusion, glucose had the better ability to support Boer sperm motility and movement patterns. Combination of monosaccharide (glucose) and disaccharide (trehalose) improved semen quality following cryopreservation. Trehalose supplementation at the concentration of 198.24mM to the glucose extender conferred the greater improvement of semen quality for Boer semen cryopreservation.

Pelvic types as seen in a tropical setting.

BACKGROUND: Cephalo pelvic disproportion is still the leading indication for caesarean section in many developing countries and the contribution of pelvic typology may play some role in this regard. Our objective is to determine the proportion of pelvic types as seen in a tropical setting. METHOD: A retrospective review of preliminary films of hysterosalpingography of 400 women who underwent the study between January 2000 and December 2007 was reviewed to determine the pelvic typology. RESULT: Of the 400 films reviewed, 361 (90.3%) were gynaecoid, 36 (9%) were androidc and 3 (0.8%) were andropoid. There was no platypelloid pelvis seen in the films reviewed and a mixed type pattern was not observed in this study. CONCLUSION: The proportion of pure gynaecoid pelvis seen in this review is about the highest reported in the literature.

Morbidity of total abdominal hysterectomy at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.

BACKGROUND: Total abdominal hysterectomy is a commonly performed gyneacological procedure. Although it is safe, it can still be associated with development of complication. The aim of this study was to determine morbidity associated with total abdominal hysterectomy in our environment. METHOD: All cases of total abdominal hysterectomy done over a five-year period (January 2003-December 2006) at the University of Maiduguri Teaching Hospital (UMTH) were reviewed. Information was obtained from the patients' case notes, gynaecology ward, and theatre records. The complications of the procedure were determined. Multiple logistic regression was used to find the factors that were independently associated with development of complications. RESULTS: During the study there were 101 cases of total abdominal hysterectomy out of 729 gynaecological operations, a rate of 13.8%. In majority of the cases 56 (68.3%) the indication of the hysterectomy was uterine fibroid (symptomatic). Overall 37 (45.1%) experience some form of complication out of which 26 (70.3%) was febrile morbidity Finding enlarged uterus intraoperatively {OR (95% CI) = 14.5 (1.84-114.6), p = 0.011}, blood transfusion {OR (95% CI) = 31.1(1.35-718.8), p = 0.032}and postoperative PCV < 30% {OR (95%CI) = 9.63 (1.14-81.3) p = 0.037} were found to be significantly associated with development of complication. conclusions: Total abdominal hysterectomy was associated with development of complications and enlarged uterus, increasing parity independent risk factors for development of the complication.