Background: Caesarean section (CS) is one of the most common surgical procedure in obstetrics. It involves a surgical incision made through the abdominal and uterine walls to deliver the foetus and placenta after the period of foetal viability.Methods: This was a cross-sectional study aimed at reviewing emergency caesarean section in Rivers State University Teaching Hospital (RSUTH) over a 5-year period, to determine the prevalence and sequelae. Data were analysed using IBM Statistical Product and Service Solution (SPSS) version 25.0 (Armonk, NY).Results: During the review period, there were 13516 deliveries and 3699 cases of emergency CS, giving the prevalence of emergency CS as 27.4% or 274 per 1000 deliveries. Majority (90%) of the parturient were unbooked. The most common complication in women that had emergency caesarean section was fever (56.4%), followed by endometritis (14.7%), absconding from hospital (8.8%), urinary tract infection (7.1%) and wound infection (6.1%). There was a statistically significant association between types of CS and their sequelae, χ2=1153.9, p<0.001, (95% CI: 0.000, 0.000). Women that had emergency CS were 101 times more likely to have a complication compared to those that had planned CS.Conclusions: The rate of emergency caesarean section is high in RSUTH and with more complications compared to planned caesarean section. Booking for antenatal care, early presentation for delivery, birth preparedness and complication readiness will enhance improved maternal and perinatal outcome.

Background: Caesarean section (CS) is a major obstetric surgery done for pregnant women and is lifesaving.  Aim: The study was aimed at reviewing CS at the Rivers State University Teaching Hospital (RSUTH), to determine the prevalence, trend and indications, for improved management outcomes. Methods: In this cross-sectional study, we reviewed five thousand, five hundred and ninety-eight (5598) cases of caesarean sections (3699 emergency, 1899 planned) managed at the RSUTH from 1st January, 2015 to 31st December, 2019.  Data collected were analysed using IBM, Statistical Product and Service Solutions (SPSS), version 25.0 Armonk, New York. Results: There were 13,516 deliveries and 5,598 cases of CS over the review period, giving the prevalence of CS as 41.4% or 414 per 1000 deliveries.  Emergency and planned CS cases accounted for 66.1% and 33.9% respectively. An increasing trend of CS was observed over the review period. The mean age ± SD of the participants was 32.30±1.04 years (95% CI:30.26,34.34). Modal age group was 35-39 years, accounting for 33.2% followed by those aged 30-34 years (26.2%). Majority of the patients were multipara [3396 (60.7%)], married [4890 (87.4%)], Christians [5540 (99%)] and had tertiary level education [2800 (50%)]. The commonest indication for CS in RSUTH was previous caesarean section [1925(34%)], followed by cephalopelvic disproportion [757(13.4%)], foetal distress [418(7.4%)], preeclampsia [390(6.9%)] and multiple gestation [252 (4.5%)]. Conclusion: The rate of caesarean section is high in RSUTH with an increasing trend.  Although CS is lifesaving, efforts should be made to reduce the rate to the level recommended by WHO, especially in Low-middle-income countries (LMICs), where there is high aversion to CS.

Leiomyoma is a benign tumor of the uterus. It typically does not present with weight loss, massive ascites, gastrointestinal symptoms, elevated CA125, and elevated alpha fetoprotein. This was a rare case of a 48-year-old nullipara, emaciated with grossly distended abdomen, huge abdominal mass corresponding to 36 weeks' gestation, associated anorexia, easy satiety, constipation and vomiting that had TAH and BSO for suspected ovarian malignancy, which histology report revealed leiomyoma. Abdominal ultrasound scan done noted huge right ovarian mass, possibly malignant, with massive ascites. Findings at surgery, revealed a large, firm mass with necrotic patches, attached to the uterine fundus by a thin stalk 5 x 3 cm thick and to the omentum by large dilated blood vessels and adhesions. Mass weighed 5.8 kg. Eleven (11) liters of ascitic fluid was aspirated, sent for cytology and report showed no malignant cells. Histology confirmed a degenerated leiomyoma with no evidence of malignancy. Atypical presentation of leiomyoma can mimic that of malignancy. This knowledge will help Clinicians and Gynaecologists to have a high index of suspicion with such clinical features, in making prompt diagnosis and instituting appropriate management.

Background: Oral Contraceptive Pills (OCPs) are the most widely prescribed form of hormonal contraception both in developed and developing countries. They are also the most popular non-surgical method of contraception. Objective: To determine the prevalence rate and socio-demographic characteristics of oral contraceptive pills acceptors at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt. Methods: A 10 year review of all clients who accepted oral contraceptive pills in the family planning clinic of the hospital from 1st January, 2008 to 31st December, 2017. Data was extracted, coded and analyzed using the Statistical Package for Social Sciences (SPSS) IBM version 25.0 (Armonk, NY). Results: There were 1893 contraceptive acceptors during the study period, out of which 86 (4.5%) accepted the oral pills. Majority of the clients 66 (76.8%) were between the age range of 20 to 34, married 82 (95.3%), multiparous 48 (55.8%), Christians 82 (95.3%) and 82 (95.3%) had formal education. Clinical personnel were the commonest source of information on the use of oral contraceptive pills, accounting for 36 (41.8%). Conclusion: Oral contraceptive pills are methods of contraception used by young, multiparous and educated women. Only 4.5% of the women accepted OCPs during the study period therefore concerted efforts should be made to improve its uptake in the family planning clinic.