Background: Uterine rupture has continued to be an obstetric catastrophe with tragic maternal and foetal outcomes particularly in Nigeria.Methods: an institutional, cross sectional retrospective study was carried out at Jos University Teaching Hospital, North-Central Nigeria. Case files of mothers with uterine rupture managed at the hospital from 1 January 2011 to 31 December 2019 were retrieved and included in the study. Data extracted from case files included maternal age, parity, gestational age, booking status, presence of uterine scar, obstetric interventions prior to rupture, site of rupture, type of surgery, units of blood transfused, intensive care unit admission and duration of hospital stay and maternal or foetal death.Results: the incidence of uterine rupture was 1 in 497 deliveries (0.2%). The mean age of the patients was 30.1±5.1years. About 75% of the patients were para 1-4. Seventeen (70.8%) patients were unbooked while fourteen (58.3%) had unscarred uterine rupture. Eight out of 14(57.1%) patients with unscarred uterus had uterotonics for induction or augmentation of labour. Fourteen (58.3%) patients had rupture involving anterior lower uterine segment. Over half of the patients had uterine repair only (58.3%), 29.2% had uterine repair with bilateral tubal ligation while 12.5% had subtotal hysterectomy. Twenty-two (91.7%) required blood transfusion, five patients had 5 or more units of blood transfused. The perinatal mortality was 69.6%, there was no maternal death.Conclusions: the major predisposing factors to uterine rupture in our facility were lack of antenatal care, presence of previous caesarean section scar and injudicious use of uterotonics.
Background:
Female sterilization is a permanent form of contraception offered to women who have completed their family size. Other methods are all temporary and meant to be reversible. A high-quality female sterilization service was introduced in Jos with the assistance of training in counseling and minilaparotomy under local anesthesia in May 1985. After training, female sterilization became available for couples desiring it on completion of family size.
Materials and Methods:
This was a retrospective study of all clients who had female sterilization for contraception between 1985 and 2019. The clinic register was retrieved and evaluated for acceptances of all contraceptive methods within the period and trends observed.
Results:
Over the 35 years, a total of 29,167 new clients accepted modern family planning methods. Out of these, a total of 5167 were female sterilizations, constituting 17.7% of the new acceptors. The temporary methods of contraception constituted 82.3%. The other methods used were the intrauterine device 8357 (28.7%), the oral pills 5125 (17.6%), the injectables 5235 (17.9%), and the contraceptive implants 5283 (18.1%). Although female sterilization was 4
th
among the five methods studied, there was however a gradual decline in its acceptance from a peak of 36.1% in 1992 to 1.4% in the year 2018.
Conclusion:
The acceptance of female sterilization rose to a peak in 1992 and declined to the lowest level in 2018, occasioned in part by the introduction of varieties of contraceptive implants providing long acting, reversible, and cheap contraception.
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