Pub Date : 2020-01-01DOI: 10.4103/tjog.tjog_109_19
G. Akunna, O. Olabiyi, O. Adenike, L. Enye, Segun Ajeleti
Context: Menstruation is a natural event that occurs throughout the reproductive years of every woman. Most women during their menstrual period experience pain and discomfort called dysmenorrhea which is the most common gynecological complaint in young women and may result in absences from school, work, and social engagement. Aims: To study the relationship between BMI, hip circumference, menarcheal age, and management on the severity of dysmenorrhea among undergraduates. Methods and Materials: A self-administered structured questionnaire having four (4) sections including information on the sociodemographic data, data related to menstrual characteristics, information related to menstrual symptoms, and information on management attitudes of these students were used for data collection. Statistical Analysis Used: A non-probability convenient method was used to select 400 participants. A self-administered structured questionnaire was used for data collection and data were analyzed with SPSS software version 23.0. Results: The prevalence of dysmenorrhea was 87.1%, with most commonly felt symptoms being tiredness (72.5%) and mood swings (67.8%). Symptoms lead to decreased social activities (55.8%), low confidence (55.5%), and increased absenteeism (49.5%) from lectures. Although dysmenorrhea has no significant relationship with BMI, it was significantly (P < 0.05) higher (197) in participants with smaller hip circumference (0.80–1.00 m) and late (13–14 years) menarche (47.8%). There was a low rate (4.2%) of consultation with the majority (63%) opting for self-medication as previously advised by a relative (23.4%), self (21.1%), and friends (18.9%). Conclusions: Smaller hip circumference, late age at menarche, and increased BMI can increase the severity of dysmenorrhea which can further affect the quality of life.
{"title":"Correlation between primary dysmenorrhea characteristics, age at menarche, anthropometric variables, gynecological history, management attitudes, and quality of life among undergraduates in Nigeria","authors":"G. Akunna, O. Olabiyi, O. Adenike, L. Enye, Segun Ajeleti","doi":"10.4103/tjog.tjog_109_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_109_19","url":null,"abstract":"Context: Menstruation is a natural event that occurs throughout the reproductive years of every woman. Most women during their menstrual period experience pain and discomfort called dysmenorrhea which is the most common gynecological complaint in young women and may result in absences from school, work, and social engagement. Aims: To study the relationship between BMI, hip circumference, menarcheal age, and management on the severity of dysmenorrhea among undergraduates. Methods and Materials: A self-administered structured questionnaire having four (4) sections including information on the sociodemographic data, data related to menstrual characteristics, information related to menstrual symptoms, and information on management attitudes of these students were used for data collection. Statistical Analysis Used: A non-probability convenient method was used to select 400 participants. A self-administered structured questionnaire was used for data collection and data were analyzed with SPSS software version 23.0. Results: The prevalence of dysmenorrhea was 87.1%, with most commonly felt symptoms being tiredness (72.5%) and mood swings (67.8%). Symptoms lead to decreased social activities (55.8%), low confidence (55.5%), and increased absenteeism (49.5%) from lectures. Although dysmenorrhea has no significant relationship with BMI, it was significantly (P < 0.05) higher (197) in participants with smaller hip circumference (0.80–1.00 m) and late (13–14 years) menarche (47.8%). There was a low rate (4.2%) of consultation with the majority (63%) opting for self-medication as previously advised by a relative (23.4%), self (21.1%), and friends (18.9%). Conclusions: Smaller hip circumference, late age at menarche, and increased BMI can increase the severity of dysmenorrhea which can further affect the quality of life.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"140 - 150"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48562406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Gynecological cancers have been shown to contribute overwhelmingly to gynecological mortality worldwide, particularly in developing countries. An in-depth study of the patterns of the distribution will help to elucidate the estimates of the disease burden in University of Abuja Teaching Hospital (UATH). Objectives: The aim of this study was to determine the pattern and relative frequencies of gynecological cancers at UATH. Materials and Methods: Case notes of patients managed for gynecological cancers at UATH over a 5-year period from January 1, 2014 to December 31, 2018 were retrieved. Relevant data on age, parity, and type of cancer, clinical, surgical, and histopathological diagnosis were collated using a proforma and analyzed using Statistical Package for the Social Sciences (SPSS). Result: A total of 167 gynecological cancer cases of 3030 gynecological admissions were seen during the period putting its to prevalence at 5.5%. The most common gynecologic cancer was cervical cancer that constituted (88) 52.7% of the cases; ovarian 47 (28.1%), endometrial 17 (10.2%), choriocarcinoma 11 (6.6%), and vulva cancers 4 (2.40%) are not so common. The mean age and parity at presentation are cervical cancer (55.50 ± 12.71 and 4.41 ± 2.05), ovary (42.34 ± 14.91 and 2.94 ± 2.11), uterus (50.54 ± 15.18 and 3.39 ± 2.25), and vulva (63.50 ± 15.09 and 5.50 ± 2.38), respectively. The overall mean age for all cancers is 51.16 ± 14.95 and overall parity is 3.85 ± 2.21. Majority presented in advanced stage of the disease; the most common cause of death is renal failure. Conclusion: The burden of gynecological cancers is high, although cervical cancer is on downward trend in our environment and most cancer cases came as late presentations.
{"title":"Pattern and relative frequencies of gynecological malignancies at the University of Abuja Teaching Hospital, Abuja","authors":"H. Abdullahi, M. Ayogu","doi":"10.4103/tjog.tjog_99_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_99_19","url":null,"abstract":"Background: Gynecological cancers have been shown to contribute overwhelmingly to gynecological mortality worldwide, particularly in developing countries. An in-depth study of the patterns of the distribution will help to elucidate the estimates of the disease burden in University of Abuja Teaching Hospital (UATH). Objectives: The aim of this study was to determine the pattern and relative frequencies of gynecological cancers at UATH. Materials and Methods: Case notes of patients managed for gynecological cancers at UATH over a 5-year period from January 1, 2014 to December 31, 2018 were retrieved. Relevant data on age, parity, and type of cancer, clinical, surgical, and histopathological diagnosis were collated using a proforma and analyzed using Statistical Package for the Social Sciences (SPSS). Result: A total of 167 gynecological cancer cases of 3030 gynecological admissions were seen during the period putting its to prevalence at 5.5%. The most common gynecologic cancer was cervical cancer that constituted (88) 52.7% of the cases; ovarian 47 (28.1%), endometrial 17 (10.2%), choriocarcinoma 11 (6.6%), and vulva cancers 4 (2.40%) are not so common. The mean age and parity at presentation are cervical cancer (55.50 ± 12.71 and 4.41 ± 2.05), ovary (42.34 ± 14.91 and 2.94 ± 2.11), uterus (50.54 ± 15.18 and 3.39 ± 2.25), and vulva (63.50 ± 15.09 and 5.50 ± 2.38), respectively. The overall mean age for all cancers is 51.16 ± 14.95 and overall parity is 3.85 ± 2.21. Majority presented in advanced stage of the disease; the most common cause of death is renal failure. Conclusion: The burden of gynecological cancers is high, although cervical cancer is on downward trend in our environment and most cancer cases came as late presentations.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"177 - 181"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49302710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Salawu, Adedamola Salawu, T. Ogunfunmilayo, V. Nwadike, A. Adebayo
Introduction: Soil-transmitted helminth infection is a major contributor to anemia which is associated with morbidity and mortality during pregnancy in endemic regions like Nigeria. This study assessed the predictors of helminthic infections among pregnant women attending Antenatal clinics in the Federal Medical Center (FMC), Abeokuta, Ogun State. Methodology: A cross-sectional study was conducted among pregnant women attending the Antenatal (ANC) of the Department of Obstetrics and Gynecology, FMC, Abeokuta. Systematic random sampling was used for selecting study participants and semi-structured self-administered questionnaire was employed for data collection. Stool samples were collected from the participants and formol-ether concentration technique was used for stool examination. Besides, eggs of helminths were identified and quantified. Data were analyzed using statistical package for social sciences (SPSS) version 22. Associations were tested using the Chi-square test. Predictors of helminths infection were determined using the logistic regression analysis. Level of significance was set at 5%. Result: One hundred and seventy-four (174) women participated in the study. The mean age (SD) of the pregnant women was 30.44 (4.87) years. The majority (81.6%) had a tertiary level of education. The prevalence of intestinal helminth infection among the respondents was 21.8%. Ascaris lumbricoides (9.2%) was the most prevalent helminth, followed by hookworm infestation (7.5%) and Trichuris trichuria infestation (3.4%). The predictors for helminthic infestation among the respondents were aged 30 years and below (1.000; 0.23–1.20), pregnant women who had primary education and below (1.74; 0.72–3.06), and use of pit latrine and bush as waste disposal method (2.31; 0.86–6.21. Respondents who practiced handwash were less likely to have a helminthic infection (0.98; 0.11–9.08). Conclusion:Ascaris lumbricoides is the most commonly found helminth among the study population. Low education and poor hygiene were significant risk factors for helminthic infection among pregnant women.
{"title":"Predictors of soil-transmitted helminthic infection among pregnant women attending antenatal clinic at the Federal Medical Center, Abeokuta, Nigeria","authors":"M. Salawu, Adedamola Salawu, T. Ogunfunmilayo, V. Nwadike, A. Adebayo","doi":"10.4103/tjog.tjog_40_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_40_19","url":null,"abstract":"Introduction: Soil-transmitted helminth infection is a major contributor to anemia which is associated with morbidity and mortality during pregnancy in endemic regions like Nigeria. This study assessed the predictors of helminthic infections among pregnant women attending Antenatal clinics in the Federal Medical Center (FMC), Abeokuta, Ogun State. Methodology: A cross-sectional study was conducted among pregnant women attending the Antenatal (ANC) of the Department of Obstetrics and Gynecology, FMC, Abeokuta. Systematic random sampling was used for selecting study participants and semi-structured self-administered questionnaire was employed for data collection. Stool samples were collected from the participants and formol-ether concentration technique was used for stool examination. Besides, eggs of helminths were identified and quantified. Data were analyzed using statistical package for social sciences (SPSS) version 22. Associations were tested using the Chi-square test. Predictors of helminths infection were determined using the logistic regression analysis. Level of significance was set at 5%. Result: One hundred and seventy-four (174) women participated in the study. The mean age (SD) of the pregnant women was 30.44 (4.87) years. The majority (81.6%) had a tertiary level of education. The prevalence of intestinal helminth infection among the respondents was 21.8%. Ascaris lumbricoides (9.2%) was the most prevalent helminth, followed by hookworm infestation (7.5%) and Trichuris trichuria infestation (3.4%). The predictors for helminthic infestation among the respondents were aged 30 years and below (1.000; 0.23–1.20), pregnant women who had primary education and below (1.74; 0.72–3.06), and use of pit latrine and bush as waste disposal method (2.31; 0.86–6.21. Respondents who practiced handwash were less likely to have a helminthic infection (0.98; 0.11–9.08). Conclusion:Ascaris lumbricoides is the most commonly found helminth among the study population. Low education and poor hygiene were significant risk factors for helminthic infection among pregnant women.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"27 - 32"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46966701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Methyldopa and labetalol are the drugs that frequently used for the management of pregnancy-induced hypertension. But fewer data available for the efficacy and safety of their use. So, here we are doing a systemic review for the safety and efficacy of methyldopa in comparison to labetalol. Objectives: Assessment of efficacy and safety of methyldopa versus labetalol in pregnancy-induced hypertension. Method: A total of 10 randomized controlled trials (RCTs) following PRISMA guidelines (2015) and have included pregnant women who developed hypertension after the 20th week of gestation and receiving methyldopa (100–400 mg/day) or labetalol (250–1000 mg/day). All RCTs with changes in mean arterial pressure (MAP) before and after drug administration was collected. The adverse effects of the respective drugs were also noted. RevMan 5.3 software was used for the calculation of standardized mean difference (SMD). P value less than 0.05 will be considered significant. Result: Data of 1,200 patients were included in our study. Both the drug decreases MAP statistically significantly. In the labetalol group, P value was statistically significant (random effect model P < 0.005 and in the fixed-effect model <0.001). In methyldopa group, P < 0.001, significant in fixed effect. In the majority of the studies, the difference in the reduction of MAP was higher in labetalol than methyldopa. In labetalol vs methyldopa study using random-effect model SMD was 1.568 (95% CI, 0.735 to 2.401, P < 0.001). Drowsiness, headache, nausea, vomiting, weakness, and myalgia were associated with drugs. Out of the six adverse effects, there was a significant difference found in drowsiness (P = 0.023) which was seen more in patients receiving methyldopa. There was no significant difference in the prevalence of the other maternal side effects. Conclusions: Labetalol is more efficacious and safer as compared to methyldopa.
{"title":"Comparative evaluation of efficacy and safety of methyldopa and labetalol in pregnancy-induced hypertension: A meta-analysis","authors":"R. Patel, R. Shah, D. Lad, D. Rana, S. Malhotra","doi":"10.4103/tjog.tjog_87_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_87_19","url":null,"abstract":"Introduction: Methyldopa and labetalol are the drugs that frequently used for the management of pregnancy-induced hypertension. But fewer data available for the efficacy and safety of their use. So, here we are doing a systemic review for the safety and efficacy of methyldopa in comparison to labetalol. Objectives: Assessment of efficacy and safety of methyldopa versus labetalol in pregnancy-induced hypertension. Method: A total of 10 randomized controlled trials (RCTs) following PRISMA guidelines (2015) and have included pregnant women who developed hypertension after the 20th week of gestation and receiving methyldopa (100–400 mg/day) or labetalol (250–1000 mg/day). All RCTs with changes in mean arterial pressure (MAP) before and after drug administration was collected. The adverse effects of the respective drugs were also noted. RevMan 5.3 software was used for the calculation of standardized mean difference (SMD). P value less than 0.05 will be considered significant. Result: Data of 1,200 patients were included in our study. Both the drug decreases MAP statistically significantly. In the labetalol group, P value was statistically significant (random effect model P < 0.005 and in the fixed-effect model <0.001). In methyldopa group, P < 0.001, significant in fixed effect. In the majority of the studies, the difference in the reduction of MAP was higher in labetalol than methyldopa. In labetalol vs methyldopa study using random-effect model SMD was 1.568 (95% CI, 0.735 to 2.401, P < 0.001). Drowsiness, headache, nausea, vomiting, weakness, and myalgia were associated with drugs. Out of the six adverse effects, there was a significant difference found in drowsiness (P = 0.023) which was seen more in patients receiving methyldopa. There was no significant difference in the prevalence of the other maternal side effects. Conclusions: Labetalol is more efficacious and safer as compared to methyldopa.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"119 - 125"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46314139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The introduction of highly active antiretroviral therapy has so far led to a comparable reduction in disease progression and restoration of normal functioning of reproductive system in female living with HIV infection. The main objective of this study was to find out the magnitude of pregnant and its determinants among ART-registered clients in Simiyu region, Tanzania. Methods: We used a retrospective cohort study of HIV/AIDS women initiated ART in Simiyu region from 2005 up to 2018. Kaplan–Meier survival graphics were used to explain the difference pregnancies experiences among different groups. Cox proportion hazard was used for model building to determine the predictors of pregnancy. Results: A total number of 525 women became pregnant, giving an overall incidence rate of 3.1/100 person year at risk (PYAR) (95% CI 2.84–3.37). The incidence of pregnant was higher between the age 15 and 29 years (5.86/100 PYAR, 95% CI: 5.23–6.55). Cohabited and those who are married were associated with high incident rate of pregnant (5.62/100 PYAR, 95% CI: 1.81–17.43 and 4.16/100 PYAR, 95% CI: 3.79–4.57). Weight >55 kg were associated with high incidence of pregnant (5.03 PYAR, 95% CI: 4.54–5.57), and WHO stage one have high incidence of pregnant (11.14/100 PYAR, 95% CI: 9.95–12.47). Conclusion: Young age and being healthier were the main predictors of pregnancy after ART initiation in this population. Policy for integration of family planning services into HIV care and treatment clinics should be strengthened but focused to young women. More follow-up is needed for pregnant and newborn outcome.
{"title":"Incidence and determinants of pregnancy among women receiving HAART in Simiyu region: 14-year retrospective follow-up","authors":"Kihulya Mageda, M. Mohamed, Khamis Kulemba","doi":"10.4103/tjog.tjog_92_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_92_19","url":null,"abstract":"Introduction: The introduction of highly active antiretroviral therapy has so far led to a comparable reduction in disease progression and restoration of normal functioning of reproductive system in female living with HIV infection. The main objective of this study was to find out the magnitude of pregnant and its determinants among ART-registered clients in Simiyu region, Tanzania. Methods: We used a retrospective cohort study of HIV/AIDS women initiated ART in Simiyu region from 2005 up to 2018. Kaplan–Meier survival graphics were used to explain the difference pregnancies experiences among different groups. Cox proportion hazard was used for model building to determine the predictors of pregnancy. Results: A total number of 525 women became pregnant, giving an overall incidence rate of 3.1/100 person year at risk (PYAR) (95% CI 2.84–3.37). The incidence of pregnant was higher between the age 15 and 29 years (5.86/100 PYAR, 95% CI: 5.23–6.55). Cohabited and those who are married were associated with high incident rate of pregnant (5.62/100 PYAR, 95% CI: 1.81–17.43 and 4.16/100 PYAR, 95% CI: 3.79–4.57). Weight >55 kg were associated with high incidence of pregnant (5.03 PYAR, 95% CI: 4.54–5.57), and WHO stage one have high incidence of pregnant (11.14/100 PYAR, 95% CI: 9.95–12.47). Conclusion: Young age and being healthier were the main predictors of pregnancy after ART initiation in this population. Policy for integration of family planning services into HIV care and treatment clinics should be strengthened but focused to young women. More follow-up is needed for pregnant and newborn outcome.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"38 - 45"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41844547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: The study was undertaken to assess the efficacy of the International Ovarian Tumor Analysis (IOTA) ultrasound rules and the IOTA- Assessment of Different NEoplasias in the adneXa (ADNEX) model risk calculator in the investigation of ovarian masses in a semi-rural Indian population. Methods and Material: The study was a retrospective study. The pre-operative ultrasound images of all patients who had surgery for an adnexal mass over a two year period were looked at and classified according to the IOTA-ADNEX model calculator. Results: There were 45 patients who had surgery for an adnexal mass of which 78% had benign findings, 15% were malignant, and 6% were borderline on the final histological diagnosis. After retrospectively applying the ADNEX calculator, the study confirmed the low false positive (4%) and false negative (2%) rates, and this was despite not having cancer antigen 125(CA125) in hand at the time of the scan. There was one case where an adnexal lesion was classified benign on ultrasound, but was proven to be malignant on histology and as per the ADNEX model risk calculator. Conclusions: The study results showed vast potential in the management of adnexal masses in countries where costs, healthcare providers, infrastructure, and patient follow-up can be limited. The use of a predictive algorithm like the ADNEX model can help reduce anxiety, provide reassurance, and importantly avoid unwarranted surgery in patients with benign pathologies.
{"title":"Relevance of International Ovarian Tumor Analysis (IOTA) ultrasound rules and ADNEX risk calculator in the investigation of ovarian masses in a semi-rural Indian population","authors":"Archna Tolani, N. Anandan, N. Bhuskute, P. Kapoor","doi":"10.4103/tjog.tjog_33_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_33_19","url":null,"abstract":"Aims: The study was undertaken to assess the efficacy of the International Ovarian Tumor Analysis (IOTA) ultrasound rules and the IOTA- Assessment of Different NEoplasias in the adneXa (ADNEX) model risk calculator in the investigation of ovarian masses in a semi-rural Indian population. Methods and Material: The study was a retrospective study. The pre-operative ultrasound images of all patients who had surgery for an adnexal mass over a two year period were looked at and classified according to the IOTA-ADNEX model calculator. Results: There were 45 patients who had surgery for an adnexal mass of which 78% had benign findings, 15% were malignant, and 6% were borderline on the final histological diagnosis. After retrospectively applying the ADNEX calculator, the study confirmed the low false positive (4%) and false negative (2%) rates, and this was despite not having cancer antigen 125(CA125) in hand at the time of the scan. There was one case where an adnexal lesion was classified benign on ultrasound, but was proven to be malignant on histology and as per the ADNEX model risk calculator. Conclusions: The study results showed vast potential in the management of adnexal masses in countries where costs, healthcare providers, infrastructure, and patient follow-up can be limited. The use of a predictive algorithm like the ADNEX model can help reduce anxiety, provide reassurance, and importantly avoid unwarranted surgery in patients with benign pathologies.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"23 - 26"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45844506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Egbe, Theophile Nana-Njamen, Henri Esome, G. Enow-Orock
Heterotopic pregnancy is the simultaneous presence of an intrauterine and ectopic pregnancy. The prevalence of the condition is unknown in Cameroon. We report a case of heterotopic pregnancy managed by laparoscopy. MS a 33-year-old G2P0010 woman was admitted to our department because of 7 2/7 weeks' amenorrhea, mild vaginal bleeding, and severe lower abdominal pain. She has a 6 years' history of secondary infertility, one induced abortion, and chlamydia infection treated with doxycycline. Furthermore, she has a history of left laparoscopic salpingotomy for tubo-ovarian abscess. She became pregnant after receiving clomiphene citrate and timed intercourse. Her beta hCG assay was 97000 mIU/mL and transvaginal sonography confirmed ruptured heterotopic pregnancy. She underwent laparoscopic left salpingectomy and the intrauterine pregnancy evolved normally and she gave birth to a healthy female that weighed 3050 g at 38 5/7 weeks gestation. The diagnosis of heterotopic pregnancy needs a high index of suspicion. Laparoscopic treatment of heterotopic pregnancy needs to become widespread in Cameroon.
{"title":"Vaginal birth after laparoscopic management of heterotopic pregnancy at the Douala general hospital, Cameroon: A case report","authors":"T. Egbe, Theophile Nana-Njamen, Henri Esome, G. Enow-Orock","doi":"10.4103/tjog.tjog_97_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_97_19","url":null,"abstract":"Heterotopic pregnancy is the simultaneous presence of an intrauterine and ectopic pregnancy. The prevalence of the condition is unknown in Cameroon. We report a case of heterotopic pregnancy managed by laparoscopy. MS a 33-year-old G2P0010 woman was admitted to our department because of 7 2/7 weeks' amenorrhea, mild vaginal bleeding, and severe lower abdominal pain. She has a 6 years' history of secondary infertility, one induced abortion, and chlamydia infection treated with doxycycline. Furthermore, she has a history of left laparoscopic salpingotomy for tubo-ovarian abscess. She became pregnant after receiving clomiphene citrate and timed intercourse. Her beta hCG assay was 97000 mIU/mL and transvaginal sonography confirmed ruptured heterotopic pregnancy. She underwent laparoscopic left salpingectomy and the intrauterine pregnancy evolved normally and she gave birth to a healthy female that weighed 3050 g at 38 5/7 weeks gestation. The diagnosis of heterotopic pregnancy needs a high index of suspicion. Laparoscopic treatment of heterotopic pregnancy needs to become widespread in Cameroon.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"49 1","pages":"207 - 209"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70848260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To compare the effectiveness and side effect of two different dosage regimes of oral Nifedipine in the treatment of preterm labour Methods: A double blinded randomized controlled trial in which 86 pregnant women with preterm labour were randomized to receive either the low or high dose regimen of Nifedipine for tocolysis. Low dose of 10 mg of oral Nifedipine then 5mg every 15min for 1hr 10mg 6hly for 48hrs, while the high dose was 20 mg of oral Nifedipine followed by 10 mg every 15 minutes for 1hr then 20mg 6hourly for 48 hours. The primary outcome was defined by mean uterine quiescence time and fetomaternal side effect were compared between the groups. Results: The mean uterine quiescence time for the low dose and high dose regime were comparable 13.60±11.69 hours versus 12.16±8.90 hours (P = 0.747) respectively, there was no statistical significance difference. None of the patients in both groups needed rescue treatment. Forty patients (93%) versus 41 patients (95%) (P = 0.506) of low and high dose respectively where able to achieve uterine quiescence within 48hours, there was no statistical significant difference. Maternal headache was higher in the high dose compared to the low dose but not statistically significant {19% vs 5% (p = 0.08)} None of the women in both groups had fetal heart rate abnormality. Discussion: The high dose regimen of oral Nifedipine for tocolysis does not have any advantage over the low dose regime in terms of effectiveness for tocolysis and infact low dose had a lower maternal side effect.
{"title":"Comparing the effectiveness of two different dosage regimes of oral nifedipine in the treatment of preterm labour","authors":"A. Adegoke, O. Fasubaa","doi":"10.4103/tjog.tjog_15_20","DOIUrl":"https://doi.org/10.4103/tjog.tjog_15_20","url":null,"abstract":"Objective: To compare the effectiveness and side effect of two different dosage regimes of oral Nifedipine in the treatment of preterm labour Methods: A double blinded randomized controlled trial in which 86 pregnant women with preterm labour were randomized to receive either the low or high dose regimen of Nifedipine for tocolysis. Low dose of 10 mg of oral Nifedipine then 5mg every 15min for 1hr 10mg 6hly for 48hrs, while the high dose was 20 mg of oral Nifedipine followed by 10 mg every 15 minutes for 1hr then 20mg 6hourly for 48 hours. The primary outcome was defined by mean uterine quiescence time and fetomaternal side effect were compared between the groups. Results: The mean uterine quiescence time for the low dose and high dose regime were comparable 13.60±11.69 hours versus 12.16±8.90 hours (P = 0.747) respectively, there was no statistical significance difference. None of the patients in both groups needed rescue treatment. Forty patients (93%) versus 41 patients (95%) (P = 0.506) of low and high dose respectively where able to achieve uterine quiescence within 48hours, there was no statistical significant difference. Maternal headache was higher in the high dose compared to the low dose but not statistically significant {19% vs 5% (p = 0.08)} None of the women in both groups had fetal heart rate abnormality. Discussion: The high dose regimen of oral Nifedipine for tocolysis does not have any advantage over the low dose regime in terms of effectiveness for tocolysis and infact low dose had a lower maternal side effect.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"67 - 71"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44175477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Ogunlaja, G. Ano-Edward, I. Ogunlaja, M. Lasisi
Carvenous hemangioma of the uterine cervix is a rare clinical condition which has the potential of being life threatening. This rare clinical condition can manifest with patients presenting with abnormal uterine bleeding, menorrhagia with eventual anaemia. The case report here is that of a 27 year old Para o+o lady who was admitted to the Accident and Emergency Unit of our hospital with a day history of a huge mass protruding per vagina and a history of significant bleeding per vagina. Packed cell volume was 16% on admission and she had 4 units of blood transfused. She subsequently had examination under anaesthesia and excision of the prolapsed mass done via the vaginal route. Histology of the excised mass was in keeping with cavernous hemangioma of the uterus. Her Postoperative clinical state was satisfactory.
{"title":"Carvenous hemangioma of the uterine cervix: A case report","authors":"O. Ogunlaja, G. Ano-Edward, I. Ogunlaja, M. Lasisi","doi":"10.4103/tjog.tjog_23_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_23_19","url":null,"abstract":"Carvenous hemangioma of the uterine cervix is a rare clinical condition which has the potential of being life threatening. This rare clinical condition can manifest with patients presenting with abnormal uterine bleeding, menorrhagia with eventual anaemia. The case report here is that of a 27 year old Para o+o lady who was admitted to the Accident and Emergency Unit of our hospital with a day history of a huge mass protruding per vagina and a history of significant bleeding per vagina. Packed cell volume was 16% on admission and she had 4 units of blood transfused. She subsequently had examination under anaesthesia and excision of the prolapsed mass done via the vaginal route. Histology of the excised mass was in keeping with cavernous hemangioma of the uterus. Her Postoperative clinical state was satisfactory.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"210 - 212"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42073796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Onset of spontaneous labor occurs on completion of fetal functional maturity at amniotic fluid optical density (AFOD) value 0.98 ± 0.27 (Mean ± SD). All three events occurring together at any time from 35 to 42 weeks indicate individual term for each fetus. Babies born with AFOD ≤0.40 are functionally premature and develop varying degrees of respiratory distress syndrome (RDS). In this study, we tested the hypothesis, labors with AFOD 0.98 ± 0.27 are functionally mature with well-established labor cascades and may respond well t o induction. On the other hand, labors with AFOD ≤0.40 are functionally premature with poorly established labor cascades and may not respond well t o induction. Methods: In this gestational age and parity-matched case control study, cases consisted of 36 uncomplicated singleton laboring women who delivered normally with premature (≤0.40) AFOD values. Controls consisted of 36 similar laboring women who delivered normally with mature AFOD (0.98 ± 0.27) values. Uncentrifuged fresh AF samples collected at amniotomy were used for OD measurement with colorimeter at 650 nm. Women were assigned to groups based on AFOD values. In both groups, labor was induced with vaginal T. Misoprostol 25 mcg 6 hourly up to 4 doses. Labor outcome measures; Bishop score at induction, induction- delivery intervals (IDI), induction failures, number of T. Misoprostol required, presence of fetal distress, RDS, and NICU admission days were recorded in both groups and compared. Results: Median Bishop scores at induction in cases and controls were 5.0 (IQR 4.25--6), 7.0 (IQR 6--8), respectively. Median IDI in cases and controls were 18 h (IQR 12.25--21.5 h) and 7.0 h (IQR 5--9.5 h), respectively. Number of induction failures in cases and controls were 8 and 0, respectively. Outcomes of Induction of labor with…. Statistically significant differences observed in all these outcomes between groups (P = 0.00) favoring inductions with mature AFOD. Conclusion: Labor induction with mature AFOD value was successful in all women with shorter IDI and with better perinatal outcomes.
{"title":"Outcomes of induction of labor with mature and premature amniotic fluid optical density (AFOD): A preliminary case control study","authors":"H. Ram, I. Samyuktha, Vasudeva Nagasree","doi":"10.4103/TJOG.TJOG_90_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_90_18","url":null,"abstract":"Background: Onset of spontaneous labor occurs on completion of fetal functional maturity at amniotic fluid optical density (AFOD) value 0.98 ± 0.27 (Mean ± SD). All three events occurring together at any time from 35 to 42 weeks indicate individual term for each fetus. Babies born with AFOD ≤0.40 are functionally premature and develop varying degrees of respiratory distress syndrome (RDS). In this study, we tested the hypothesis, labors with AFOD 0.98 ± 0.27 are functionally mature with well-established labor cascades and may respond well t o induction. On the other hand, labors with AFOD ≤0.40 are functionally premature with poorly established labor cascades and may not respond well t o induction. Methods: In this gestational age and parity-matched case control study, cases consisted of 36 uncomplicated singleton laboring women who delivered normally with premature (≤0.40) AFOD values. Controls consisted of 36 similar laboring women who delivered normally with mature AFOD (0.98 ± 0.27) values. Uncentrifuged fresh AF samples collected at amniotomy were used for OD measurement with colorimeter at 650 nm. Women were assigned to groups based on AFOD values. In both groups, labor was induced with vaginal T. Misoprostol 25 mcg 6 hourly up to 4 doses. Labor outcome measures; Bishop score at induction, induction- delivery intervals (IDI), induction failures, number of T. Misoprostol required, presence of fetal distress, RDS, and NICU admission days were recorded in both groups and compared. Results: Median Bishop scores at induction in cases and controls were 5.0 (IQR 4.25--6), 7.0 (IQR 6--8), respectively. Median IDI in cases and controls were 18 h (IQR 12.25--21.5 h) and 7.0 h (IQR 5--9.5 h), respectively. Number of induction failures in cases and controls were 8 and 0, respectively. Outcomes of Induction of labor with…. Statistically significant differences observed in all these outcomes between groups (P = 0.00) favoring inductions with mature AFOD. Conclusion: Labor induction with mature AFOD value was successful in all women with shorter IDI and with better perinatal outcomes.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"206 - 211"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42034879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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