Objective: To evaluate the efficacy of tranexamic acid for prevention of postpartum haemorrhage among women undergoing cesarean section who were at high risk of postpartum hemorrhage. Materials and Method: This was a double blind randomized controlled trial conducted at the Alex Ekwueme Federal University Teaching Hospital Abakaliki from January 2016 to December 2017. One hundred and sixty-eight parturients at high risk of postpartum haemorrhage who underwent caesarean section were randomly assigned to receive either tranexamic acid or placebo prior to skin incision. Results: The result of the study showed that the need for additional uterotonic was higher in women in the placebo arm when compared with women in the tranexamic arm of the study (7.4% versus 33.3%, respectively). The incidence of primary post-partum hemorrhage (blood loss > 1000 ml) was significantly lower in the tranexamic acid group compared to placebo group (11.9% versus 50%, respectively, P-value < 0.0001). Conclusion: Intravenous tranexamic acid given prior to skin incision at caesarean section reduced the need for additional uterotonics and incidence of primary postpartum among high risk women.

Background: Pregnancies complicated by diabetes are associated with significant increase in maternal and perinatal morbidity and mortality. The management of diabetes in pregnancy is a great challenge in a low resource setting because of limited resources and facilities to care for these women.

Background: Gestational trophoblastic diseases (GTD) are potentially curable with retention of reproductive function once the correct diagnosis is made and treatment is commenced early with adequate follow up. Objective: The objective of this study was to determine the incidence, clinical presentation, management and treatment outcomes of gestational trophoblastic diseases in a tertiary hospital in Abakaliki, Southeast Nigeria. Materials and Methods: This was a retrospective descriptive study of gestational trophoblastic diseases managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) over a 6-year period. The statistical analysis was done using SPSS version 22. Results: The incidence of GTD was 4.6 per 1000 deliveries. Women who were less than 20 years and more than 40 years of age accounted for 5.9% and 23.5% of cases of GTD respectively. Women who were para 5 and above accounted for 76.5% of those who presented with GTD. All the patients presented with vaginal bleeding. Suction evacuation (76.5%) was the commonest form of treatment offered to women with GTD. The commonest complication was anaemia (94.1%). Maternal death due to GTD was 8.8%. Most (58.8%) of the patients did not turn up for follow-up. Conclusion: Gestational trophoblastic diseases has remained an important cause of maternal morbidity and mortality in our hospital due to poor compliance with follow-up. Call and recall system should be introduced in the management of patients with GTD to improve compliance to management standard.