We studied prospectively the effect of antenatal care on the obstetric performance of teenagers seen at a university teaching hospital over a 14-month period. When the obstetric complications among the teenagers were compared to their older counterpart, there were significantly higher complication rates, especially anaemia, preterm delivery, low birth weight and neonatal admission. After controlling for utilisation of antenatal care, significant differences were observed only in the incidence of low birth weight babies. In conclusion, this study has shown that the poor obstetric outcome of teenage pregnancy is related to non-utilisation of prenatal care rather than their biological age.

We set out to compare a policy of two-layered postpartum perineal repair leaving the skin unsutured with a policy of three-layered repair, which involved skin closure. Parturients who sustained a second-degree tear or an episiotomy in four Nigerian centers were randomised to have either a two-layered repair (417 women) or a three-layered repair (406 women). Fewer women in the two-layered group reported perineal pain at 48 hours (57% vs. 65%, relative risk [RR] 0.87, 95% confidence interval [CI] 0.78-0.97) and 14 days postpartum (22% vs. 28%, RR 0.77, CI 0.61-0.98). The two-layered repair was also associated with reduced risk of suture removal (6% vs. 10%, RR 0.62, CI 0.39-0.99), and less superficial dyspareunia at 3 months (6% vs. 12%, RR 0.52, CI 0.33-0.81). The rates of wound healing were similar between the two groups. Leaving the skin unsutured during postpartum perineal repair reduces perineal pain and dyspareunia.

Obstructed labour is a common obstetric complication in Nigeria associated with poor fetal and maternal outcome. Delivery of the fetus at caesarean section is always difficult, especially if the fetal head is impacted in the pelvis. The mode of delivery at caesarean section may occasionally compound the morbidity associated with obstructed labour. The purpose of this study was to examine and compare the morbidity and mortality associated with two methods of delivery of the impacted fetal head at caesarean section for obstructed labour (the push method and the pull (reverse breech) method). This study is a prospective study of cases of obstructed labour admitted into the labour ward of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife between 1 June 1998 and May 31 2000. One hundred and eight women with obstructed labour at term with live fetus undergoing caesarean section were assigned randomly to either of the methods of admission. The maternal and fetal outcomes were analysed and compared between groups. Patients in the push group had statistically significant higher rates of maternal morbidity (longer operation time, more blood loss, extension of uterine incision, endometritis, longer hospital stay and higher hospital bills) than the pull method (P < 0.05). Also the fetal morbidity was worse in the push group. The 'pull' method of delivery of impacted fetal head at caesarean section for obstruction is safer and faster than the 'push' method.

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Most studies on the use of misoprostol for induction of labour have been carried out in well-endowed hospitals in developed countries with state-of-the-art monitoring equipment. There is need for more studies to be conducted in facilities with limited resources, if more patients are to benefit from the low cost and effectiveness of the drug. Following Ethical Committee approval, 152 women had labour induced in our maternity unit using intravaginal misoprostol. The patients were monitored clinically using the WHO model partograph with digital palpation of uterine contractions and intermittent auscultation of fetal heart with a pinard stethoscope. One hundred and thirty-five (88.8%) of the women had a vaginal delivery, while nine (5.9%) had a caesarean section for various obstetric indications. Eight cases of uterine hyperstimulation were noted but none of uterine rupture. We conclude that misoprostol can be used safely for induction of labour in less endowed hospital settings such as in developing countries, using basic clinical tools for monitoring.