The rate of 50% missed diagnosis in this study highlights the need for a high index of suspicion in the diagnosis of abdominal pregnancies as the clinical features are varied. It calls for vigilance on the part of the obstetrician. The maternal and fetal outcomes relate to early diagnosis and skilled management.

Introduction:Eclampsia is one of the most dreaded causes of adverse outcomes of pregnancy worldwide. It is one of the greatest causes of maternal and perinatal morbidity and mortality world over. We do not know the prevalence, management outcome, and the devastation caused by this dreaded disease in our center hence the need for this work.Materials and Methods:This is a 7-year retrospective review of all cases of eclampsia managed in Mater Misericordiae Hospital Afikpo, a rural secondary cum referral Catholic Mission Hospital in Afikpo, Ebonyi State in Southeastern Nigeria.Results:The prevalence of eclampsia in our center is 1.12% or one case of eclampsia for every 89 women that delivered in our facility. The majority of the women that had eclampsia in our center 56 (71.8%) were primigravidae. Seventeen women (21.8%) had various antenatal complications with 4 or 23.6% presenting with intrauterine fetal deaths and two (11.8%) each with intrauterine growth restriction, and domestic violence, respectively. Thirty-five or 44.9% of the women were delivered by emergency lower segment cesarean section. Fifteen or 17.9% babies were dead giving a perinatal mortality rate of 174 per 1,000After delivery, and 3 (3.8%) of the women had postpartum hemorrhage. Two women (2.6%) died giving a maternal mortality ratio of 2564 per 100,000 deliveries.Conclusion:Eclampsia is a dreaded obstetric disease with adverse fetal and maternal consequences that are not mitigating, and no effort should be spared in managing it effectively including public enlightenment.

One thousand and thirteen (1013) symphysiotomies were performed and 27,477 deliveries were conducted during the period. The symphysiotomy rate in the study period was 3.7%. Fifty-six percent (56%) of the patients who had symphysiotomy were aged 39 years and below, and the mean age was 27.94 +/- 7.16 years. Mothers with maternal age greater than 40 years were at a higher risk for symphysiotomy. Thirty-eight percent (38%) of those who had symphysiotomy were nulliparae, 35% were multiparae, while grandmultiparae accounted for 27%. Cephalopelvic disproportion was the leading indication for symphysiotomy (88%), while arrest of the after-coming head of the breech and previous caesarean section with mild cephalopelvic disproportion were other indications for symphysiotomy. Transient post-operative pelvic and leg pain was the leading maternal complication in the study, while stress incontinence, para urethra/vagina lacerations and vesico-vagina fistula were the other complications highlighted. In the study, 69% of the symphysiotomies performed were for babies with birth weight between 3.0 and 3.9 kg. The record of one maternal death was available and was from massive pulmonary embolism on the third day postpartum. There were 104 perinatal deaths with a perinatal mortality rate of 108.7 per 1000 total births.