Ruptured uterus in a primigravida: a case report.

Maternal mortality and morbidity have remained very high in the developing countries and one of its commonest causes is ruptured uterus, which in a primigravida is rather unusual. The patient reported was a primigravida with no previous uterine scar who had prenatal care and delivery of a live male infant at a private clinic in Ibadan. The identifiable aetiological factors in this case are pitocin augmentation and manual removal of the placenta. Fortunately, a timely exploratory laparatomy averted another mortality. This is not usually the case in the majority of high-risk patients labouring outside a proper hospital setting consequent upon a declining economy and the rising influence of religion. Methods to reduce this obstetric catastrophy are discussed.

Total ovulating period: any contribution to ovarian carcinogenesis?

The etiology of ovarian cancer has many postulates including that of incessant ovulation. Women of high parity especially those that breastfeed in addition are supposed to be protected. Ovarian cancer patients in the developing world are of higher parity than their Caucasian counterparts. Our study compared the length of reproductive career (LRC), the physiological ovulation free period (PFP) and the total ovulating period (TOP) amongst histologically proven ovarian cancer patients and age - matched controls. This is a questionnaire survey of 21 ovarian cancer patients managed by us between 1st December 1998 and 31st July 2002 and 42 gynaecological patients not known to have ovarian cancer. The mean age among the patients was 45.7+16.9 years while among the controls it was 45.4 +/- 16.1 years. The mean parity of the patients was 3.6 +/- 2.2 compared to 3.4 +/- 2.9 in the controls. The patients had a mean LRC of 23.8 +/- 11.2 years while in the controls it was 25.7+10.8 years. The mean PFP of the patients was 7.4 +/- 5.6 years and for the controls 7.1 +/- 6.5 years. The patients had a mean TOP of 15.8 +/- 8.8 years while this was 18.6 +/- 8.1 years for the controls. None of these differences was statistically significant. Our study revealed no statistically significant differences in the total ovulating periods between ovarian cancer patients and age-matched controls. Further studies will be necessary.