Perforation of the Rectum by a Copper-T Intrauterine Contraceptive Device with Retrieval per Rectum: A Case Report

Intrauterine contraceptive devices are among the most effective forms of contraceptives available. They provide long term reversible protection from pregnancy and are currently the most popular and widely use reversible contraceptive method. Though they are associated with few side effects, perforation of the uterus remains the most serious. We report the case of a grandmultiparous lady whose copper-IUCD perforated her rectum 8 years after its insertion. We advocate the inclusion of rectal examination in theevaluation of patients for missing IUCDs and removal of the devices per rectum if partially embedded rather than resorting to surgery.Key Words: Rectum, Perforation, IUC

Seminal Fluid Indices Of Male Partners Of Infertile Couples In Uyo, Nigeria

This retrospective study analyzes the seminal fluid indices of 633 male partners of infertile couples at the University of Uyo Teaching Hospital over a four year period. All the laboratory records on seminal fluid analysis between 1st January 2003 and 31st December 2006 were reviewed. The seminal fluid characteristics of the patients were determined and the abnormalities classified according to the World health organisation guidelines. Five hundred (79.0%) of the men had abnormal seminal fluid parameters. About 56.0% of the subjects were asthenozoospermic, 38.9% were oligozoospermic, 2.8% had teratozoospermia while 7.0% had azoospermia. The significant contribution of the male factor to infertility in our environment is highlighted. The need for the encouragement of male partners of infertile couples to avail themselves for proper infertility evaluation and the advantages of early detection and treatment of sexually transmitted infections in men is stressed. KEY WORDS: Male infertility, seminal fluid indices, Uy

Emergency peripartum hysterectomy in a tertiary hospital in southern Nigeria

Introduction: Emergency peripartum hysterectomy, a maker of severe maternal morbidity and near miss mortality is an inevitable surgical intervention to save a woman’s life when uncontrollable obstetric haemorrhage complicates delivery. This study was conducted in order to determine the incidence, types, indications and maternal complications of emergency peripartum hysterectomy at the University of Uyo Teaching Hospital, Uyo, Nigeria. Methods: The case records of all women who underwent emergency peripartum hysterectomy between 1st January 2004 and 31st December 2011 were studied. Results: There were 12,298 deliveries during the study period and 28 emergency peripartum hysterectomies were performed resulting in a rate of 0.2% or 1 in 439 deliveries. The modal age group of the patients was 26-30 years (35.7%), majority were of low parity (64.4%), while 17.9% attained tertiary level education. Half of the patients (50.0%) were  unbooked while 14.3% were antenatal clinic defaulters. Extensive uterine rupture (67.8%) was the most common indication for emergency hysterectomy distantly followed by uterine atony with uncontrollable haemorrhage (17.9%). Subtotal abdominal hysterectomy was performed in 92.8% of the cases. The case fatality rate was 14.3% while the perinatal mortality rate was 64.3%. Conclusion: Emergency peripartum hysterectomy is not uncommonly performed in our centre and extensive uterine rupture from prolonged obstructed labour is the most common indication. In addition, it is associated with significant maternal and perinatal mortality. There is need to enlighten women in our communities on the benefits of ANC and hospital delivery as well as the dangers of delivering without skilled attendance. Government should consider enacting legislation to discourage people or organisations who operate unlicensed maternity homes in our environment.Key words: Emergency peripartum hysterectomy, extensive uterine rupture, uncontrollable haemorrhage, Uy

Prevalence Of HIV Infection Among Antenatal Attendees At Uyo Teaching Hospital, Akwa Ibom State, South-South Nigeria

This retrospective study was conducted at the maternity unit of the University of Uyo Teaching Hospital Uyo. The aim was to determine the prevalence of HIV infection among pregnant women receiving antenatal care in the center. The voluntary counselling and testing register, the partner notification and antenatal clinic registers of all patients that booked for antenatal care between 1st July 2005 and 31st December 2007 were reviewed. There were 5,635 new antenatal clients during the study period out of which 464 were confirmed HIV positive resulting in a prevalence of 8.2%. Most of the patients were between 21-30 years (70.0%). About 59.4% of the patients were multiparous while 49.4% booked for antenatal care in the third trimester of pregnancy. HIV was diagnosed in the antenatal clinic in 408 (87.9%) of the patients and 182 (39.2%) received antiretroviral drugs during pregnancy. Only 38.8% of the patients accepted to notify their partners. One hundred and eighty eight patients delivered in the hospital. One hundred and twenty (63.8%) had spontaneous vaginal delivery, 63 (33.5%) were delivered by caesarean section, 3 (1.7%) had assisted vaginal breech delivery and 2 (1.1%) had ventouse delivery. The high prevalence of HIV infection among women pregnant women who have antenatal care in our hospital is highlighted. The intensification of strategies aimed at primary prevention of HIV infection in the community, encouraging all pregnant women to avail themselves of orthodox antenatal care, and the need to emphasize the advantages of self disclosure of serostatus to partners during counselling sessions in the antenatal clinic are advocated. KEY WORDS: HIV Positive women, antenatal attendees, Uy

Fetal interlocking complicating twin pregnancy: A case report

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Profile of women with ectopic pregnancy in Eket, South-South geo-political zone of Nigeria

One hundred and forty two patients who had ectopic pregnancy at the Immanuel General hospital, Eket between 1st January 1998 and 31st December 2002 were studied. The aim was to establish the incidence of ectopic pregnancy and identify socio-demographic factors that may be useful in predicting its diagnosis. The incidence of ectopic pregnancy was 1.7%. It was most common among young women of low parity (51.3%) and petty traders (59.9%). Lower abdominal pain was the commonest presenting symptom (93.0%) and 98.6%) of the patients had had pelvic inflammatory disease. The need for proper counseling and health education of our women on safe sexual practices and general improvement in their socio-economic status are advocated. Keywords: pregnancy, pelvic inflammatory disease, traders, home delivery, Eket Mary Slessor Journal of Medicine Vol. 5(2) 2005: 35-3

Mothers' Perception of The Need for Social Companionship During Labour in The University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.

The perception of women on the need for social companionship during labour and childbirth is essential in order to ascertain the acceptability of this parctice to the women being served. Pre-tested, pre-coded questionnaires were used to interview subjects at the antenatal clinic. Most (95.8%) of the 288 respondents interviewed expressed the need for social companionship during labour. Forty-six (51.7%) multiparous respondents had delivered with a social companion during previous deliveries either at a private maternity unit or at their homes. Most (93.5%) of such respondents reported that, with a social companion during childbirth, they felt less pain, less fear and that they had a more satisfying experience of the childbirth process. Women that were 30 years of age or younger were significantly more likely to prefer a social companion during labour than older women (p = 0.0083). Educational status and parity did not influence women's perception of the need for social companionship during labour in the study population (p= 0.31 and p<0.01 respectively). Married women were significantly more likely to prefer social companionship during labour than sinlge women (p<0.005). Majority (46.0%) of such respondents preferred their husbands as companions during labour. Most women in our environment would want to have a social companion during labour and delivery. Such companionship during labour is associated with a more satisfying of the childbirth process by the women.Keywords: perception, social companionship, childbirth, maternal satisfactio

Elective Hysterectomy at the University of Uyo Teaching Hospital: A 3-Year Review

A 3-year review of elective hysterectomies performed at the University of Uyo Teaching Hospital was carried out. The aim was to determine the indications and outcome of elective hysterectomies performed in the center. Elective hysterectomy made up 10.5% of all gynaecological operations and 24.9% of all major gynaecological surgeries. An abdominal mass (34.1%) and the protrusion of a mass from the vagina (24.4%) were the most common presenting complaints, while uterine fibroids (39.0%) and utero-vaginal prolapse (24.4%) were the most common indications. Total abdominal hysterectomy with conservation of both ovaries (41.1%) and vaginal hysterectomy with pelvic floor repair (24.4%) were the most common procedures performed. The morbidity rate was 39.0% which was mainly from postoperative pyrexia (12.2%) and abnormal vaginal discharge (7.3%). All post-operative complications were more common in patients who underwent abdominal hysterectomy (34.1%) when compared to those following vaginal hysterectomy (4.9%). Hysterectomy is a relatively safe procedure in our center and uterine fibroids and utero-vaginal prolapse are its most common indications. With its increasing safety, more women in our environment would be encouraged to accept hysterectomy.Key words: Elective hysterectomy, incidence, Uy

The Burden of Psychological Symptoms in Gynaecological Conditions among Women in Uyo, Akwa Ibom State, Nigeria.

Background: There is an increasing evidence of significant psychological symptoms (anxiety and depression) among a large percentage of women with gynaecological conditions. These symptoms are often neglected in the course of management of physical problems, thus leading to an increased morbidity and unresolved primary presenting complaints in the clinics. Aim: The objectives of the study were: 1. To screen the women attending gynaecological clinic for anxiety and depression. 2. To determine the sociodemographic characteristics of the women. 3. To compare the findings with previous studies. Methods: Three hundred and sixty eight women with gynaecological conditions were randomly screened for psychological symptoms (anxiety and depression) at the gynaecological outpatient clinic of the University of Uyo Teaching Hospital, using the Hospital Anxiety and Depression Scale (HADS), between May and July 2006. Results: Data from 321 (87.2%) women who completed the questionnaires were analyzed. Majority of the women were aged between 20-39 years, with a mean age of 29.9± 10.3 years; 46.7% of them were either separated, divorced or widowed, while 15.5% were single. Ninety seven (30.2%) and fifty five (17.1%) of them scored high on the anxiety and depression subscales respectively. Forty five (46.4%) of the 97 women had mild anxiety, 33 (34.0%) had moderate anxiety while 19 (19.6%) had severe anxiety. Similarly, 28 (50.9%) of 55 women had mild depression, 19 (34.5%) had moderate depression while 8 (14.6%) had severe depression. Conclusion: The results of this study show that women with gynaecological conditions suffer additional psychological symptoms of anxiety and depression. Therefore, a multidisciplinary approach aimed at detecting and treating these conditions is necessary for the management of women with physical symptoms. Keywords: Burden; Psychological Symptoms; Women; Gynaecological condition Nigerian Journal of Psychiatry Vol. 6 (1) 2008: pp. 21-2