Uterine fibroid is the commonest benign tumour of the female reproductive tract. It occurs in 20–40% of women, whereas the estimated incidence in pregnancy is 0.1–3.9%. Uterine fibroid in pregnancy is usually asymptomatic with complications occurring in 10–30% of cases. The first line of management is conservative with counselling for myomectomy after delivery. However, in the presence of intractable symptoms, both antepartum myomectomy and caesarean myomectomy have been reported to be successfully performed in carefully selected cases. We report a case of large subserous uterine fibroid in pregnancy that was referred to our centre at 14 weeks of gestation. She developed generalized body weakness, backache, and breathlessness at 27 weeks gestation. Thus, she was admitted and managed conservatively for eight weeks with significant relief of symptoms. She eventually had a caesarean myomectomy at 35 weeks of gestation; the outcome was a live female baby with a birth weight of 2.3 kg and a large subserous fibroid weighing 9.5 kg. We can therefore say that caesarean myomectomy can be safely performed in carefully selected cases.

Eighty women undergoing induction of labor at the University of Calabar Teaching Hospital were recruited and randomly allocated into two treatment groups (40 each), to receive either serial 50 µg doses of misoprostol or intracervical Foley catheter. Vaginal blood loss was collected and measured using an under buttocks plastic collection bag and by perineal pad weighing up to 6 hours postpartum. ere were no signi cant di erences between the two groups with respect to sociodemographic and obstetric characteristics. Comparison of blood loss in vaginal deliveries between the two groups revealed that subjects in the misoprostol group had signi cantly higher blood loss than subjects in the Foley catheter group (488 ± 222 versus 326 ± 106, p < 0.05). In both groups, there was strong and statistically signi cant positive correlation between postpartum blood loss and induction delivery interval (r � 0.75, p < 0.0001; r � 0.77, p < 0.0001). ere were no signi cant di erences in maternal outcomes. In view of this, further study is required to ascertain if lower doses of misoprostol for induction of labor may result in lesser blood loss. is trial is registered with ISRCTN14479515.

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OBJECTIVES: To evaluate the relationship between uterine placental location and fetal growth restriction and gestational hypertension. MATERIALS AND METHOD: A prospective cross-sectional study done in the Department of Radiology of the University of Calabar Teaching Hospital (UCTH), Calabar, within a 4-month period. The study involved a total of 100 singleton pregnant women between 20 to 40 weeks of gestation who were aged 20 to 39 years. Analysis of the data was done using the statistical package for social science (SPSS) version 20 Inc. Chicago, IL. RESULTS: The frequency distribution of the placental locations were: anterior – 35%, postero-fundal – 36%, antero-fundal – 18% and posterior – 11%. The highest mean head circumference to abdominal circumference ratio (HC/AC) was seen in subjects with posterior placental location (1.03 ± 0.09), lowest mean estimated fetal weight (EFW) was seen in subjects with antero-fundal placental location (1.87 ± 0.92 kg) while the highest mean systolic and diastolic blood pressure were seen in subjects with postero-fundal placental location (113.89 ± 10.50 mmHg and 66.61 ± 7.07 mmHg) respectively. The lowest mean HC/AC was noted in subjects with anterior placental location (1.01 ± 0.08), the highest EFW was noted in subjects with postero-fundal placental location (2.26 ± 1.03 kg) while the lowest mean systolic and diastolic blood pressure were noted in subjects with posterior placental location (109.09 ± 5.39 mmHg and 61.82 ± 4.05 mmHg) respectively. There was no significant correlation between placental location and HC/AC, EFW, systolic blood pressure and diastolic blood pressure (p = 0.744, p = 0.567, p = 0.671, p = 0.936) respectively. CONCLUSION: Placental location in the uterus has no relationship with intrauterine growth restriction and the development of gestational hypertension in the second half of singleton pregnancies.

Eighty women undergoing induction of labor at the University of Calabar Teaching Hospital were recruited and randomly allocated into two treatment groups (40 each), to receive either serial 50 µg doses of misoprostol or intracervical Foley catheter. Vaginal blood loss was collected and measured using an under buttocks plastic collection bag and by perineal pad weighing up to 6 hours postpartum. There were no significant differences between the two groups with respect to sociodemographic and obstetric characteristics. Comparison of blood loss in vaginal deliveries between the two groups revealed that subjects in the misoprostol group had significantly higher blood loss than subjects in the Foley catheter group (488 ± 222 versus 326 ± 106, p<0.05). In both groups, there was strong and statistically significant positive correlation between postpartum blood loss and induction delivery interval (r=0.75, p<0.0001; r=0.77, p<0.0001). There were no significant differences in maternal outcomes. In view of this, further study is required to ascertain if lower doses of misoprostol for induction of labor may result in lesser blood loss. This trial is registered with ISRCTN14479515.