No abstract

The management of coexisting uterine fibroid in pregnancy is controversial. There is the need to know the labour outcome of women with coexisting fibroid in pregnancy in our environment. Objective: To ascertain the labour outcome of coexisting fibroid in pregnancy and the prevalence. Materials and Method: The study is a retrospective one that reviewed 48 women with coexisting fibroid in pregnancy over a 30 month period. Result: Out of 612 women that had antenatal care and delivery in our area of study, 48 of them had coexisting fibroid in pregnancy giving a prevalence of 7.8%. The mean age of the parturients was 32.38 ± 5.22 years and most of the parturients were primiparous (56.3%). Up to 89.5% of them delivered at term and 89.6% of their babies had normal birth weight with good APGAR score in 79.2% of them. Their caesarean delivery rate was 79.2% and 2 successful caesarean myomectomies were done. Conclusion: Fibroid can coexist with pregnancy with good outcome but they are prone to high caesarean delivery rate and at risk of uterine rupture. A low prevalence was recorded in our study and caesarean myomectomy is feasible in selected cases.

Laparoscopic myomectomy is being used to surgically treat women with uterine fibroid in our environment. The effect of this treatment modality on achieving pregnancy and its outcome in women with infertility deserves evaluation. Objective: This was to assess the fetal and maternal outcome of pregnant women with prior laparoscopic myomectomy and background infertility. Materials and Method: The study is a retrospective one involving 21 out of 86 women that underwent laparoscopic myomectomy and achieved pregnancy over a period of 30 months. Result: There was pregnancy in 21 out of 86 women that had laparoscopic myomectomy, thus giving a pregnancy rate of 24.4%. The pregnancy outcome was good. The mean gestational age at delivery was 37.76 ±1.97 weeks and the babies had the mean birth weight of 3.09 ± 0.54 kg with the mean APGAR score of 7.47 ± 2.09. The vaginal delivery rate was 23.8% and the mean duration of hospital stay was 4.62 ± 1.43 days. Conclusion: Laparoscopic myomectomy improves the chances of pregnancy in young women with background infertility and is associated with good labour outcome.

Hysterosalpingography (HSG) is a diagnostic modality still commonly used to evaluate tubal occlusion in infertility management. We evaluated the treatment benefit in achieving tubal patency and spontaneous pregnancy in women with bilateral tubal occlusion in our resource poor setting using water soluble contrast medium. Objective: To assess the proportion of women that achieved tubal patency and spontaneous pregnancy following a repeat HSG in the evaluation of infertility and the associated factors. Materials and Method: This is a retrospective study of 37 out of 180 women who achieved tubal patency and pregnancy after repeat HSG in the course of infertility evaluation over a period of 18 months. Result: Out of 180 patients with bilateral tubal occlusion that had the repeat HSG, 37 achieved tubal patency (20.5%) and from which 24 became pregnant. This gave a pregnancy rate of 13.3%. The mean age of the participants was 35.76 ± 4.72 years. The age group of 36-40 years had the highest frequency while most of them were nulliparous and had left tubal occlusion at the distal portion. Conclusion: Tubal patency and spontaneous pregnancy were achieved following repeat HSG in women with bilateral tubal occlusion undergoing infertility evaluation. HSG has both diagnostic and treatment uses in infertility management and it is cost effective.

Uterine leiomyoma is common among black women of reproductive age in Africa and is associated with infertility. Its definitive means of treatment is myomectomy which can be approached by laparoscopy or laparotomy. There is a need to know if any of these two modes of treatment affects the chances of achieving pregnancy or its outcome in women with background infertility. Objective: To assess the proportion of women who achieved pregnancy after laparoscopic and laparotomic myomectomy with background infertility, their pregnancy outcome and a comparison of the two groups. Materials and Method: The study retrospectively reviewed 36 out of 188 women that had either laparoscopic (n=86) or laparotomic myomectomy (n=102) and achieved pregnancy over a period of 30 months. Result: There was pregnancy in 21 out of 86 women that had laparoscopy and 15 among the 102 women that had laparotomic myomectomy. This gave the pregnancy rates of 24.4% and 14.7% respectively. The pregnancy outcome was favourable and similar between the two groups with the laparoscopic group having a lower caesarean delivery rate of 76.2% compared to100% in the laparotomy group. The duration of hospital stay was significantly lower in the laparoscopy group. Conclusion: Laparoscopic or laparotomic myomectomy improves the chances of pregnancy in women with background infertility below 35 years. The laparoscopic group had a significantly lower caesarean section rate and a shorter duration of hospital stay than the laparotomic group, however, both groups had a similar and favourable pregnancy outcome.