Background:There have been several publications from different countries on the relationship between the placental weight and birth weight of the neonate. However, such reports from Nigeria are lacking in literature. The objective of this study was to determine the relationship between the placental weight and birth weight of the neonate at term pregnancy in a Nigerian hospital.Materials and Methods:It was a cross-sectional study conducted at Usmanu Danfodiyo University Teaching Hospital Sokoto between 1st October 2008 and 31st March 2009. Data gestational age at delivery (in weeks), parity, mode of delivery, fetal birth weight, placental weight, fetal gender, presence or absence of maternal medical diseases were obtained from 1009 singleton term deliveries who met the inclusion criteria for the study. The data was processed using EPI-INFO version 2005 and statistical analysis performed using one-way analysis of variance. A probability of 0.05 was set for statistical significance.Results:The placental birth weight ranged from 300 to 890 g with a mean of 590±82 g while the birth weight of the neonate ranged from 2030 to 5020 g with an average of 3275±469 g. The mean gestational age at delivery was 38.8±1.1 weeks while the mean placental birth weight ratio was 18.2±2.4 Increase in birth weight of the neonate was associated with corresponding increase in placental weight. However, as the gestational age at term advances the proportion of increase in the former was greater than that of the latter.Conclusions:There is a positive correlation between placental weight and birth weight of the neonate. However, the ratio of the placental and neonatal birth weights at term decreases with advancing gestational age. Thus, prolongation of pregnancy at term may adversely affect the fetus.

Background:Emergency obstetric hysterectomy (EOH) is a life-saving procedure which is often performed to treat some obstetric complications, as a last resort, to prevent maternal mortality.Objectives:This study was designed to determine the rate, indications, and complications of the EOH procedure at Usmanu Danfodito University Teaching Hospital (UDUTH), Sokoto.Materials and Methods:This retrospective study involved all the patients who had EOH at UDUTH, Sokoto, Nigeria, between January 2005 and December 2010. The case records of these patients were retrieved from the medical record library and information relating to age, parity, booking status, indications, type of hysterectomy, cadre of the surgeon, type of anesthesia, and complications of the procedure were extracted. The data were processed via SPSS version 11.5 and the χ2 test was used to analyze some of the results with the confidence limit set at 95%.Results:During the 6-year period, 83 EOH were performed out of 16,249 deliveries giving the rate of the former as 0.51%, i.e. 1 in 196 deliveries. However, the case records of only 74 patients (82.9%) were available for the study. The rate of EOH increased with advancing maternal age and increasing parity. The majority of the patients (89.2%) were unbooked for antenatal care, and the rate of the procedure among these patients (1.82%) was significantly higher than 0.07% observed amongst booked subjects (P<0.001). The main indication for the procedure was ruptured uterus (93.2%) and the majority of the patients (95.9%) had subtotal hysterectomy. Anemia (66.2%), excessive hemorrhage (35.5%), septicemia (18.9%), and wound infection (16.2%) were the leading complications. Excessive hemorrhage was significantly higher in the procedure performed by the senior registrars (51.2%) compared to those undertaken by consultants (16.2%); P=0.03. The case fatality rate of the EOH procedure was 12.1%. However, the case fatality rates in the procedure performed by consultants and senior registrars were 6.5% and 16.3%, respectively.Conclusion:The rate of EOH in the centre is relatively high and ruptured uterus is responsible for the majority of the procedure. Prevention of prolonged obstructed labor, and therefore uterine rupture, through antenatal care and supervision of labor will reduce the rate of EOH whereas performance of the procedure by the most experienced surgeon will minimize the maternal morbidity and mortality.

Background:Elective caesarean sections have been considered safer for both mother and the fetus compared to their emergency counterpart. However, emergency caesarean sections have continued to form bulk of caesarean deliveries in our facility.Objective:The objective of this study was to determine the caesarean section rate together with the trend, indications, and maternal mortality associated with elective caesarean operation.Materials and Methods:A retrospective analysis of clinical records of all the patients that had caesarean section between January 2002 and December 2010 (9 years) at Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, Nigeria was conducted.Results:During the 9 year study period, 2284 caesarean sections were performed out of 22,985 total deliveries at UDUTH Sokoto, thus giving a caesarean section rate of 9.9%. Emergency and elective operations accounted for 1784 (78.2%) and 498 (21.8%) of the cases respectively. The rate of elective caesarean section increased from 1.7% in 2002 to 3.2% in 2007. Thereafter it declined gradually to 1.8% in 2010. Repeat caesarean section (30.7%) and malpresentation (17.1%) were the most common indications for elective caesarean operation. There were 18 maternal deaths from caesarean section and only one from the elective caesarean procedure.Conclusion:The rising trend in the elective caesarean section rate in this study underscores the need for better and improved patient selection together with counseling on its benefits and risks. This is because despite the fact that it is safer than emergency caesarean operation, it is not entirely devoid of complications. Routine use of spinal anesthesia in performing the procedure should be encouraged.

This is a case report of an abdominal pregnancy that was carried to term with live fetus. Illiteracy, poverty and lack of antenatal care had resulted in her late presentation. Bleeding per vagina, persistence abdominal pain, weight loss and pallor were the main clinical features. She had laparotomy and delivery of a live fetus. Key words: abdominal pregnancy, term, live fetus RésuméCe cas clinique se rapporte à une grosses abdominale qui s'est déroulée jusqu'à terme avec un fétus vivant. L'ignorance, la pauvreté et l'absence de consultation prénatale ont abouti à une consultation tardive. Un saignement par voie vaginale, une douleur abdominale persistante, une perte de poids et une pâleur étaient les éléments caractéristiques au plan clinique. Elle a bénéficié d'une laparotomie avec accouchement d'un foetus vivant.

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Background: PCOS is a condition with significant decrease in antioxidant with an increased risk of oxidative stress. Antioxidant supplementation has been shown to improve insulin sensitivity in PCOS and may improve outcome of management of PCOS. Objectives of this study were to determine the oxidative stress level of PCOS patients, to assess the effect of antioxidant supplementation on the outcome of management of PCOS and to compare with a control group.Methods: The study was a single blind randomised control trial involving 200 patients with PCOS. The study was conducted at Usmanu Danfodiyo University Teaching Hospital Sokoto. They were randomly divided into intervention and control groups and base line serum levels of oxidative stress marker, antioxidant enzymes, vitamins and minerals were determined. Antioxidant supplementation and placebo were given to the intervention and control groups respectively. All the patients had ovulation induction with clomiphene citrate and were followed up for 6 months. Outcome measures were clinical pregnancy or menstrual regularisation. Level of significance was <0.05.Results: There was statistical significance in the serum levels of oxidative stress marker, antioxidant enzymes, vitamins and minerals between the two groups (post intervention). Glutathione peroxidase (p = 0.001), superoxide dismutase (p = 0.0001), catalase (p= 0.0369), melondialdehyde (p= 0.007), Vitamin A, Vitamin C, Vitamin E (p = 0.0001), zinc and copper (p = 0.0001). The clinical pregnancy outcomes were 22 (22%) versus 2 (2%); live births 18 (18%) versus 2 (2%) and menstrual regularisation 48 (48%) versus 46 (46%) in the intervention and control groups respectively.Conclusions: Antioxidant supplementation in this study significantly affected pregnancy rate in patients with PCOS. Larger studies are suggested to revisit the conclusion of the Cochrane review that antioxidants supplementation had no significant role in female infertility.

Background: Cervical cancer is the most common gynecological cancer among women in Nigeria. The incidence is on the increase and poses a public health problem. The etiological agent is the human papilloma virus that is sexual transmitted. The cervical cancer incidence is related to lifestyle, poverty and sexual practices. Fortunately, it is a preventable disease as it is preceded by a pre-invasive phase that can be detected and treated. There is paucity of report in literature on cervical cancer screening in Sokoto NorthWest Nigeria. Aim: To determine the uptake, indications and results of cervical cancer screening in Usmanu Dan-fodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A 3-year descriptive study of the results of cervical cytology among women who attended the gynaecological outpatient clinic of UDUTH, Sokoto. Results: During the period of study, 126 cervical smears were taken and 96% (121/126) of them were considered adequate for cytological evaluation thus constituting the subjects of the study. The average annual uptake of cervical smear was 1.29%. The main indications for cytologic smears were abnormal uterine bleeding 33.9% (41/121) and suspected carcinoma of the cervix 28.1% (34/121). Cytologic study was positive for dysplastic cells in 7% (25/121) of cases. Ten percent (12/121) of them were high grade squamous intra-epithelial lesions while invasive carcinoma was seen in 3.3% (4/121) of the smears. Conclusion: Presence of abnormal cervical smear in 20% of the study subjects underscores the need for routine screening for cervical cancer. While organized national screening policy is awaited, opportunistic screening should be maximized.