Anaemia in pregnancy is a major health problem and an important cause of adverse foetomaternal outcomes in developing countries. Iron deficiency is the cause of the overwhelming majority of the cases of anaemia in pregnancy. Iron deficiency anaemia (IDA) has been linked with adverse foetal and maternal outcomes. This study investigated the prevalence of IDA and evaluated its effects on foetomaternal outcomes among parturients in Lagos, Nigeria. This was a cross-sectional study that enrolled 220 women aged 15-49 years with singleton gestation at term, between May 1, 2016, and March 31, 2017. Participants were selected by systematic sampling and baseline data were collected through interviews. Venous blood samples were obtained to measure haemoglobin and serum ferritin concentrations, and the associations between IDA (defined as anaemia and iron deficiency) and pregnancy outcomes were examined. A P-value <0.05 was considered as statistically significant. The prevalence of IDA was 12.3%. Routine antenatal iron supplementation (adjusted odds ratio 0.18, 95% confidence interval 0.07-0.46; P = 0.001) and interpregnancy interval of at least 2 years (adjusted odds ratio 0.20, 95% confidence interval 0.05-0.97; P = 0.021) have significant association with IDA. Iron deficiency anaemia was not significantly associated with adverse perinatal outcomes but there were significant associations with increased risk of blood transfusion (P = 0.001) and maternal infectious morbidities such as puerperal pyrexia (P = 0.041) and wound infection (P = 0.020). IDA is still a fairly common condition among parturients in Lagos and it's mostly associated with maternal peripartum morbidities. Adequate pregnancy spacing through the use of effective contraception and routine antenatal iron supplementations in pregnancy is a recommended preventive measure against IDA and its adverse sequelae. Future studies should adopt the use of transferrin saturation (TSAT) in compliment with serum ferritin assay as a more sensitive marker of iron deficiency.
Results We reviewed the data of 1137 patients with ovarian tumors. Ovarian metastases from a breast cancer were found in 13 cases. Mean age was 59 years. 46% of patients received CT-scan and only in 15% of cases a PET-CT scan was performed. The mean interval time between the primary diagnosis of breast cancer and the occurrence of ovarian metastasis was 52 months. The most common histologic type found was invasive lobular carcinoma (60% of cases). Extraovarian metastases were found in 69% of cases (9 out 13 patients). The extraovarian metastases concerned the following organs: uterus (3 cases), bone marrow (5 cases), liver (5 cases), lungs (3 cases), brain (3 cases), stomach (1 case), and adrenal gland (2 cases). All cases were treated surgically and received adjuvant chemotherapy. A cytoreductive surgery was performed in five cases. A unilateral or bilateral adnexectomy was done in one and seven cases respectively. Mean survival was 60 months. Recurrence was noted in 46% of cases (6 out 13 patients). Mean time to recurrence was 38 months. Conclusions Ovarian metastases from a breast cancer occur rarely and are associated with worse prognosis. Despite surgical and adjuvant therapy recurrence rate is very high.
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