Background:Many women suffer from some degree of intrauterine adhesions (IUAs) presenting with various clinical symptoms and signs. Hysteroscopy is the mainstay of diagnosis, classification, and treatment of the IUA.Aim:This study was undertaken to review the clinical features and treatment outcome in patients diagnosed with Asherman's syndrome at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, over a 10 years period, 1997–2006.Subjects and Methods:This is a retrospective study of cases of Asherman's syndrome managed at the UMTH over a 10-year period, from January 1, 1997 to December 31, 2006. Case records of the patients were retrieved from medical records' Department. Sociodemographic and clinical information relating to clinical presentations, treatment modalities, and outcomes were collated. The data were analyzed using SPSS 16.0 Statistical Computer Package (SPSS Inc., IL, USA 2006). Chi-square and binary logistic regression were used for inferential statistics.Results:Asherman's syndrome constituted 8.1% (81/996) of all gynecological operations in UMTH during the study period. The case records retrieval rate was 96.3% (78/81 folders). Most of the patients, 59% (46/78) were in their third decade and majority 85.9% (67/78) were married. The most common risk factor was pregnancy-associated, accounting for 61.5% (48/78). Infertility and hypomenorrhea were the most common mode of presentations in 55.1% (43/78) and 32.1% (25/78) of cases, respectively. Most of the patients 85.9% (67/78) were treated by blind dilatation and curettage (D/C), Foley's catheter insertion and estrogen-progesterone combination. Correction of menses was seen in 37.2% (29/78) of the patients while the pregnancy rate was 32.1% (25/78). On binary logistic regression age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) emerged as the only respondent's related risk factors associated with the development of Asherman's syndrome.Conclusion:Asherman's syndrome is relatively common due to complications of pregnancy and delivery, and blind D/C has a relatively poor outcome. Age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) were associated with the development of Asherman's syndrome. Therefore, other methods of adhesiolysis such as hysteroscopic adhesiolysis should be explored.
Hydatidiform mole (HM), is a known cause of early pregnancy wastage and has the risk of malignant potential. This is a retrospective study of 71 patients who were managed for hydatidiform mole at the University of Maiduguri Teaching Hospital, (UMTH) Maiduguri over a 10-year period, from January 1996 to December 2005, inclusive. The objective of the study was to determine the incidence, risk factors, clinical presentations and histological types of HM. Case records of 71 histologically confirmed HM were studied. Their sociodemographic characteristics, clinical presentations and histology reports were obtained and analysed. The institutional incidence of molar pregnancy was 3.8/1,000 deliveries. Histological findings showed partial mole in 51 (71.8%) cases and complete mole in 20 (28.2%) cases. The peak age-specific incidence rate was 17.5 years. The leading presenting clinical feature was abnormal vaginal bleeding seen in 100%. No case of invasive mole was found. Maternal complications included severe haemorrhage requiring blood transfusion (30.0%) and infections (15.5%). There was no maternal death. In conclusion, the incidence of partial hydatidiform mole was found to be higher than that of complete variety in our environment and the identified risk factors were young age, low parity and previous history of HM.
In developing countries, most deliveries take place without a skilled birth attendance. This lack of skilled birthattendance could be considered as one of the major factors contributing to maternal and neonatal morbidity and mortality. The use of facility-based delivery system helps to reduce various complications during childbirth, which may be affected by social and cultural norms among several other factors. This study was to assess the proportion of pregnant women delivering at home and the role of socioeconomic and demographic factors affecting the choice of place of delivery among pregnant women attending antenatal, postnatal and Immunization clinic at Rano General Hospital, Kano. This is a cross sectional study carried out between September 2018 to November 2018 among 310 pregnant women who had at least delivered once and are attending antenatal care, post-natal or immunization clinic at the General hospital in Rano local government area of Kano state within the study period. Data was collected using interviewer administered questionnaire which was interpreted to those participants who cannot understand English language. Data obtained was entered into excel spread sheet 2018 and subsequently analyzed using SPSS 2016 version 20. Multivariateregression methods were used for measuring the associations between socio-demographic variables and place of delivery. About 310 questionnaires were distributed of which 100% retrieval rate was achieved. A total of 281 (90.6%) received antenatal services at least once during their previous pregnancy among which 183 (59.03%) of them had home delivery. The respondents were between the ages of 18-37 years with the mean age of 24.9 ± 5.1 years. Minimum age of the respondents was 18 years, while the maximum age was 37 years. The main reasons for home delivery were, previous delivery was at home and complication free, short interval between onset of labor and delivery and also husband and mother in-law's decision. This study has shown that there is still high rate of home delivery among antenatal clinic attendees. This home delivery is usually preferred to hospital delivery by their husbands and mother in-laws as they consider it to be safe and more convenient. There is therefore need to educate women on early signs of labor and address the importance of health care delivery to prevent complications which may increase the maternal mortality rate.
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