Background. Premature rupture of membranes (PROM) is a common condition in developed and developing countries and poses a serious threat to the maternal and fetal well-being if not properly managed. This study delineated the prevalence and predictors of PROM in the western part of Uganda so as to guide specific preventive measures. Methods. A cross-sectional study design was conducted in the months of September 2019 to November 2019. A total of 334 pregnant women above 28 weeks of gestation admitted at the maternity ward of KIU-TH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain the data. Descriptive statistics followed by binary logistic regression were conducted. All data analyses were conducted using STATA 14.2. Results. Of the 334 pregnant women enrolled, the prevalence of PROM was found to be 13.8%. The significant independent predictors associated with lower odds of PROM were no history of urinary tract infection (UTI) in the month preceding enrollment into the study (aOR = 0:5, 95% CI: 0.22-0.69, p = 0:038) and gestational age of 37 weeks or more (aOR = 0:3, 95% CI: 0.14-0.71, p = 0:01) while history of 3 or more abortions (aOR = 13:1, 95% CI: 1.12-153.62, p = 0:05) was associated with higher likelihood of PROM. Conclusions. Majorly urinary tract infections, low gestational age, and abortions influence premature rupture of membranes among women. There is a great need for continuous screening and prompt treatment of pregnant women for UTI especially those with history of 3 or more abortions at less than 34 weeks of gestation.

Background: Thrombocytopenia is a serious threat both to the mother and the fetus world over. We established the prevalence and associated immediate maternal complications of thrombocytopenia among women delivering at Kampala International University Teaching Hospital (KIUTH) so as to help us draw a platform for provision of appropriate interventions.Methods: A prospective cross-sectional study involving 386 women was conducted in the months of May 2019 to August 2019. Questionnaires and laboratory result forms were used to obtain the data. Data analyses were conducted using STATA version 14.2.Results: The prevalence of thrombocytopenia was 15.8%. Significant immediate maternal outcomes were placenta abruption which was higher among women with thrombocytopenia (44.3%) than those with no thrombocytopenia (2.2%; p<0.001) and postpartum haemorrhage which was higher among those with thrombocytopenia (45.9%) than those with no thrombocytopenia (6.8%; p<0.001).Conclusions: Thrombocytopenia is a serious obstetric issue worth paying extra attention at this facility.

so as to guide the health-care providers in early identification of the patients at risk for timely intervention. Patients and Methods: A three-year prospective cohort study was conducted between March 2017 and March 2020. A cohort of 178 women diagnosed with preeclampsia at the hypertension unit of Carlos Manuel de Cèspedes Teaching Hospital were recruited. Interviewer administered questionnaires and laboratory and ultrasound scan result forms were used to collect the data. Binary logistic regression was conducted to determine the predictors. All data analyses were conducted using STATA version 14.2. Results: Forty-five (27.8%) of the studied 162 patients were still hypertensive at 12 weeks postpartum. Maternal age of 35 years or more (aRR=1.14,95% CI:1.131-4.847, p=0.022), early onset preeclampsia (before 34 weeks of gestation) (aRR=7.93, 95% CI:1.812-34.684, p=0.006), and elevated serum creatinine levels of more than 0.8mg/dl (aRR=1.35, 95% CI:1.241-3.606, p=0.032) were the independent predictors of persisting hypertension at 12 weeks postpartum. Conclusion: Recognition of these predictors and close follow-up of patients with preeclampsia will improve the ability to diagnose and monitor women likely to develop persisting hypertension before its onset for timely interventions.

Background: Management decision on whether to use medical or surgical method in women diagnosed with incomplete abortion particularly in the first trimester has been a controversial topic in Uganda and the world in general with no local studies comparing effectiveness and secondary outcomes between the two approaches. This has posed a big challenge to the attending clinicians as regards making informed management options when encountered with such cases.Methods: A five months prospective open labeled randomized clinical trial involving 100 consecutively recruited participants was conducted from June 1st, 2018 to October 30th, 2018. Ethical clearance was obtained from KIUREC and UNCST. Data collection was achieved using an investigator administered questionnaire; in-depth face to face interviews as well as laboratory and ultrasound scan report forms. Baseline demographic and clinical characteristics were assessed using univariate analysis. Statistical difference was considered when p<0.05. Numerical variables were summarized using means, medians for non-normally distributed variables, and frequencies or proportions for categorical variables. All statistical analysis was carried out using IBM SPSS Statistics software version 23.0. Results: The effectiveness of surgical management was higher than that of medical management (RRR=11.7%; p=0.043). Majority in the medical arm reported mild pain (64% vs 4%; p<0.001) while most of those in surgical arm reported severe pain (78% vs 8%; p<0.001). Bleeding was prolonged in the medical arm method with majority of those in surgical arm reporting bleeding for less than six hours (94% vs 46%; p=0.0002). Although medical method had longer bleeding, it was associated with lesser symptoms of headache, dizziness, syncope and blood transfusion. 90% of those in medical arm and only 50% of those in surgical method would recommend the method assigned (p<0.001). Fever, chills and nausea were more common in medical method. Average hospital stay was longer in medical method (p=0.03). Only one participant in surgical arm developed infection while no patient had genitourinary trauma. There was no statistical significant difference between the satisfaction levels in the two arms. Conclusion: Surgical management is more effective than medical management. Although medical management has prolonged expulsion bleeding, prolonged hospital stay and increased fevers, chills and nausea that are self-limiting; it has reduced pain. Most patients are satisfied with and would recommend medical management.

Background: Conjoined twins have invariably been a subject of revulsion among many societies across the world despite the fact that they can be diagnosed early in pregnancy and optimal obstetric management instituted accordingly. Case Presentation: We present a case of a prenatally undiagnosed derodidymus (dicephalous diauchenos) twins, an extremely unusual variant of conjoined twins. The case was such a petrifying unanticipated phenomenon to both the parents and medical staff. Conclusion: Routine prenatal ultrasonograhy and careful prenatal screening must be strongly emphasized if we are to minimize such perinatal mysteries.

<p class="abstract"><strong>Background:</strong> Anemia remains a serious health burden all over the world, more so among pregnant women. A lot of morbidity and mortality has been attributed to anemia in pregnancy. The problem is even much bigger among special groups of pregnant women such as the teenagers. The common morphologic type of this obstetric complication however remains a mystery among several populations across the world.</p><p class="abstract"><strong>Methods:</strong> We carried out a cross-sectional study for three months; between August 2021 and October 2021. A total of 288 pregnant teenagers aged between 13 and 19 years attending antenatal care at Hoima Regional Referral Hospital (HRRH) in western Uganda were consecutively enrolled. Short interviewer-administered questionnaires and laboratory report forms were used to obtain data. Descriptive statistics using SPSS version 23 was applied to present the data.   </p><p class="abstract"><strong>Results:</strong> 75 (26%) out of the 288 pregnant teenagers had anemia. Majority 40 (53.3%) had microcytic anemia, followed by normocytic anemia 25 (33.3%) while 10 (13.3%) had macrocytic anemia.</p><p class="abstract"><strong>Conclusions:</strong> Microcytic anemia remains the most common morphological type affecting pregnant teenagers at HRRH, western Uganda.</p>

Background: Chronic hypertension is one of the major sequelae of preeclampsia with associated long term morbidity and mortality among previously normotensive women diagnosed with preeclampsia. We identified the predictors of developing this complication in women with preeclampsia admitted at the Carlos Manuel de Cèspedes Teaching Hospital in Cuba based on histological assessment of their placenta so as to guide the health care providers in early identification of the patients at risk for timely intervention against this vicious condition. Methods: A three-year prospective cohort study was conducted between March 2017 and March 2020. A cohort of 178 women diagnosed with preeclampsia was recruited and followed up at 12 weeks postpartum for chronic hypertension. Histological studies were done on their placenta following delivery and the respective result forms used to collect the data. Cox’s hazards regression model was applied to estimate the risk using STATA version 14.2.Results: Chorioamnionitis (HR=1.697, 95%CI: 1.443-3.416, p=0.038), villositary infarcts (HR=1.657, 95%CI: 1.264-2.848, p=0.048), intervillositary thrombus (HR=1.529, 95%CI: 1.231-3.197, p=0.020), and endarteritis (HR=1.242, 95%CI: 1.115-1.804, p=0.025) placental lesions were predictive of chronic hypertension at 12 weeks postpartum.Conclusion: Placental histology in women with preeclampsia is key towards improving the ability to diagnose and monitor those likely to develop chronic hypertension before its onset for timely intervention.

<p><strong>Background: </strong>We aimed to establish pre-pregnancy and prenatal care risk factors for spontaneous premature delivery at Kampala international university teaching hospital (KIUTH) so as to enable us draw a platform upon which specific interventions can be formulated.</p><p><strong>Methods: </strong>This was a hospital based unmatched case-control study conducted in the months of March to June 2019. A total of 110 cases and 330 controls admitted at KIUTH maternity and postnatal units were enrolled into the study. Interviewer administered questionnaires and respondent’s medical records were used to collect data. Chi square test and multiple logistic regression analysis were performed to establish the risk factors for spontaneous premature delivery at this facility. All data analyses were done using SPSS statistics version 20.</p><p><strong>Results: </strong>Nulliparity, previous premature delivery, history of premature rupture of membranes, previous cervical procedures, history of not having received preconception care, urinary tract infections during pregnancy and maternal obesity were independently associated with spontaneous premature delivery at this hospital.</p><p><strong>Conclusions: </strong>Guided by these factors, a high index of suspicion for spontaneous premature delivery among all pregnant women attending prenatal care is vital towards ameliorating this obstetric complication at KIUTH.</p>