Morbidities, concordance, and predictors of preterm premature rupture of membranes among pregnant women at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.

BACKGROUND: Preterm premature rupture of membranes (PPROM) is a challenging complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of morbidities associated with PPROM is fraught with controversy. However, women should be informed of these complications. OBJECTIVE: This article aimed to review the morbidities, concordance, and predictors of PPROM over a 10-year period. METHODS: This was a retrospective review of morbidities, concordance, and predictors of PPROM among pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria between January 1, 1999, and December 31, 2008. The morbidities, concordance, and predictors of PPROM were expressed by regression analysis output for PPROM. RESULTS: Primigravidae had the highest occurrence of PPROM. Increasing parity does not significantly influence the incidence of PPROM. The concordance and predictors of PPROM are maternal age (P < 0.000), gestational age at PROM (P < 0.000), latency period (P < 0.000), and birth weight (P < 0.001). CONCLUSION: PPROM is a major complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of these morbidities associated with PPROM poses a great challenge. However, women should be informed of these complications.

Anti-malaria prescription in pregnancy among general practitioners in Enugu state, south east Nigeria.

BACKGROUND: The national policy on malaria control recommends use of intermittent preventive treatment with sulfadoxine/pyrimethamine (IPT-SP) for chemoprophylaxis against malaria in pregnancy; and use of quinine and arthemisinin-based combination therapy (ACT) for acute treatment of malaria in the first, and second/third trimesters, respectively. In Nigeria, a large proportion of pregnant women are seen by the general practitioners (GPs). OBJECTIVE: To determine the pattern of anti-malaria prescription in pregnancy among GPs in Enugu state, and access the level of conformity with the national policy on malaria control. MATERIALS AND METHODS: Questionnaires were administered to a cross-section of 147 GPs that attended the 2010 Enugu state branch of the Nigeria Medical Association Scientific Conference/Annual General Meeting/Election. RESULTS: The mean age of the GPs was 37 ± 3.6 (range 27-70) years. Quinine was the commonly (45.6% (n = 67)) prescribed anti-malaria drug in the first trimester while in the second/third trimester ACT was commonly (48.3% (n = 71)) prescribed. Seventy-six (51.7%) practitioners prescribed IPT-SP for chemoprophylaxis against malaria while the rest (48.3%) prescribed other drugs. GPs who obtained MBBS qualification less than or equal to 5 years prior to the survey were more likely to comply with the national policy on malaria control in their prescriptions (P < 0.05). CONCLUSION: The pattern of anti-malaria prescription among GPs in Enugu state is varied, and conformed poorly to the evidence-based national policy on malaria control. There is need for continuing professional development to keep the GPs abreast with current trends in malaria treatment during pregnancy.

Pattern of gynaecological cancers in University of Nigeria Teaching Hospital, Enugu, south eastern Nigeria.

BACKGROUND: Gynaecological cancers are among the leading causes of cancer related deaths worldwide. The objective of this study was to determine the pattern and relative frequencies of gynecological cancers as seen at the University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu, Southeastern Nigeria. METHODS: An analysis of retrospective clinical data from the ward admissions and discharge books and the operating theatre record books. RESULTS: During the 10-year period under study (2000-2009), 407 cases of gynaecological cancers were admitted into the hospital. The age range of these women was 21-80years with mean age of 54.6 +/- 14.2 years. The commonest gynaecological cancers in women less than 30 years of age were choriocarcinoma (36.1%) and ovarian cancer (33.3%). After 30 years, cervical cancer became the commonest cancer. Overall, cervical cancer was by far the commonest gynecological cancer constituting 78% of all the cases, followed by ovarian cancer (8.9%), choriocarcinoma (4.3%), endometrial cancer (4.1%), vulva cancer (4.0%) and leiomyosarcoma (0.5%). There was no case of vaginal cancer during the study period. Anaemia was the commonest sequelae, complicating 55% of the cases, followed by genital fistulae (12%), infertility (3%), renal failure (3%), and pulmonary complications (2%). CONCLUSION: Cervical cancer is by far the commonest gynaecological cancer in Enugu and there is high incidence of this cancer even in young women below the age of 30 years. The commonest gynaecological cancer in women less than 30 years is choriocarcinoma, and anaemia is the commonest sequelae of all gynaecological cancers.