Elective hysterectomy: a clinicopathological review from Abha catchment area of Saudi Arabia.

OBJECTIVE: To review the major indications, types and clinicopathological features of elective hysterectomy managed in our locality. MATERIAL AND METHODS: A retrospective study of 317 consecutive patients who had elective hysterectomy performed for various indications during the study period from January 1994-December 2001,(96 months) was conducted. The patients were divided into 3 groups: Group 1, total abdominal hysterectomy(TAH) 165 (52%); Group 2: subtotal abdominal hysterectomy(STAH) 59(18.6%) and Group 3: vaginal hysterectomy (VH),93 (28.4%). Data extracted from the case files included age, parity, presenting symptoms and indication for hysterectomy. Others included relevant investigation results, type of hysterectomy, and histopathological diagnosis of the specimens SETTING: Abha Maternity Hospital, Abha, Saudi Arabia. RESULTS: No statistically significant trend was found in the annual number of hysterectomies performed during the study period (p > 0.05). There was statistically significant difference in the mean age in the 3 groups of patients (p < 0.05), but none in the parity (p > 0.05). Menorrhagia and abnormal vaginal bleeding was the indication for hysterectomy in 123(38.8%) patients, followed by uterine prolapse in 91(28.7%), abdominopelvic mass, 48 (15.1%) and pelvic mass in 46 (14.8%). Histopathology of hysterectomy specimens and appendages were reported as abnormal in 179 (56.4%), with uterine fibroids the most common pathology in 82 specimens (25.8%) followed by adenomyosis in 72 specimens(22.7%). CONCLUSION: Uterine fibroids and adenomyosis were the most common benign conditions in hysterectomy specimens in our community with peak incidence at 41-50 years, while endometrial and ovarian cancers peaked at the same age group. At the same time, vaginal hysterectomy was performed exclusively for utero-vaginal prolapse.

Nutrient composition of milk produced by mothers of preterm infants in Nigeria.

Nutrient composition was determined in breast milk obtained by manual expression from 12 mothers who delivered prematurely (mean 32 weeks) and 15 mothers who delivered at term (mean 39.4 weeks), on days 3, 7, 14, 21 and 28 postpartum. Complete 24-hour milk expressed by five term mothers and seven preterm mothers on days 7, 14, 21 and 28 lactational ages was also recorded. In both preterm and term mothers' milk, lactose and fact concentrations increased with lactational age, while protein and mineral concentrations decreased. The preterm mothers' milk contained higher concentrations of protein, fat and minerals and lower concentrations of lactose than term mothers's milk. The fat and caloric density of milk of the mothers in this study, who were mostly of low social class, was lower than that reported from Western countries. The implication of this finding for feeding premature infants in developing countries is discussed.

Alpha subunit and human chorionic gonadotropin in normal pregnancy and gestational trophoblastic disease.

The reported incidence of gestational trophoblastic disease is an order of magnitude higher in Nigeria than in the United States. Sera from a total of 283 pregnant black patients, 138 United States and 148 Nigerian pregnant patients, were analyzed for their serum levels of alpha subunit and human chorionic gonadotropin (hCG). The patterns of hCG secretion were similar in the two populations during normal pregnancy. However, the level of alpha subunit was persistently higher in Nigerian women than in comparable pregnant United States patients. A statistically significantly higher alpha subunit level in the Nigerian patients was found only in the ten- to 13-week gestational period (P less than .005). The higher level of alpha subunit in pregnancy in Nigerian women may signal a population of trophoblastic cells which may be at higher risk for malignancy development in the Nigerian woman.

Epidemiology of group B streptococcal carriage among pregnant women and their neonates: an African experience.

A prospective study of group B streptococcal vaginal carriage among 225 Nigerian pregnant women in labour at UCH, Ibadan during a 3 month period in 1980 revealed a vaginal carriage rate of 19.5%; 8.9% of the 224 infants of the 218 infant-mother pair studied were colonized at birth. A significant proportion of the colonized mothers were primigravidas but no significant association was found between vaginal colonization and premature onset of labour, prolonged rupture of membranes, prolonged labour, stillbirth rate or puerperal infection. None of the twenty colonized infants developed "early" or "late" group B streptococcal disease on 3 months follow up. These results suggest the incidence of group B streptococcal disease in the newborn in Nigeria may be low despite high vaginal carriage rate.