Background: Sexual assault is a widespread crime often associated with short term and potential long term significant physical and psycho-social distress. Objective: To determine the pattern and presentation of suspected sexual assault in Aminu Kano Teaching Hospital (AKTH) from January 2008 to December 2017. Methodology: A retrospective review of patients who presented to AKTH with suspected sexual assault from 2008 to 2017 was done. Case records were retrieved and relevant information extracted on a proforma. The data obtained were analyzed using SPSS version 23 statistical software. Results: There were 102 cases of suspected sexual assault which represents 0.4% of all gynaecologic consultations. The mean age was 12.9 ± 8.8years with a range of 3-40 years. Thirty-eight (61.3%) of the survivors were children below 10 years and over a third (41.9%) of them were assaulted in their homes. Children less than 10 years were more likely to be assaulted by their neighbours (χ2=0.814, p-value 0.013). There is a statistically significant relationship between the age of the survivor and time of assault as children below 10 years were assaulted more in the afternoon (Fishers exact, p-value <0.001). More than half of the survivors presents to the hospital within 24 hours after the assault. Forty percent of the survivors had repeated sexual assault and mostly through the vagina. Thirty-four (54.8%) of the survivors had HIV screening done and 12 (19.4%) had high vaginal swab while post-exposure prophylaxis was done in 9.7%. Only 36.3% of the post-pubertal survivors were given emergency contraceptives and 28 (45.2%) of them had follow-up visits. Conclusions: The incidence of sexual assault was found to be low in this study with the survivors mostly young children below 10 years and the assailant known to them. There is delay in presentation and disclosure of the incident. Management was mostly incomplete as a lot of the victims were lost to follow up. We recommend that a proforma should be developed to capture all the necessary and relevant information from survivors and assailants with regards to the potential medico-legal pitfalls associated with it.
Background: Appropriate documentation of the timing of events in the management of women with postpartum hemorrhage (PPH) is associated with better outcome. Objective: To find out how best the Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, fares when compared with the Royal College of Obstetricians and Gynaecologists (RCOG) guidelines about appropriate documentation of the timing of events in the management of PPH. Methodology: It was a retrospective study based on findings obtained from the case folders of women who had PPH between January 2016 and December 2017. A structured pro forma was used to extract information such as personal data, type of PPH, vital signs of patients, sequence of events, administration of pharmacological agents, and timing of interventions. Results: There were 5202 patients who presented to the labor ward, and 129 of them were cases of PPH giving an incidence of 2.48%. The mean age of the patients was 20.38 ± 1.13 years, and about half of them (47.6%) were multiparas. There was appropriate documentation in terms of initial assessment, resuscitation, and investigations as the percentages of standards achieved are 85%, 78.6%, and 85.7%, respectively. Sixty-one percent of the patients had treatment within the time recommended and 56% had treatment with appropriate uterotonics. Appropriate documentation of major surgeries according to the guidelines was achieved in 12% of cases. Conclusion: There was good performance in documentation of initial management of patients with PPH when compared with the RCOG guidelines but suboptimal performance in timing of major surgical interventions.
Background: Cornual gestation is one of the most hazardous types of ectopic gestation. It carries a significant challenge and a greater maternal mortality risk than ampullary ectopic pregnancy. The diagnosis and treatment are challenging and frequently constitute a medical emergency. Traditionally, the treatment of cornual pregnancy has been hysterectomy or cornual resection at laparotomy. However endoscopic approach is a viable option and consists of conservative techniques such as laparoscopic cornual resection, laparoscopic cornuostomy, laparoscopic salpingectomy or hysteroscopic removal of interstitial ectopic tissue. Case presentation: We report a case of a 28-year-old multipara who had an unruptured left cornual ectopic gestation with moderate pelvic adhesions and concomitant partial intestinal obstruction. She was managed via laparoscopic adhesiolysis and left total salpingectomy. Conclusions: Cornual pregnancy occurs rarely, there is a need for early and prompt diagnosis to prevent potentially fatal complications.
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