by Emmanuel C. Egwuatu, Chigozie G. Okafor, George U. Eleje, Osita S. Umeononihu, Chukwuemeka C. Okoro, Jonhnbosco E. Mamah, Tobechi K. Njoku, Charlotte B. Oguejiofor, Chidinma C. Okafor, Chukwunwendu F. Okeke, Chukwudi A. Ogabido, Hillary I. Obiagwu, Chito P. Ilika, Obinna K. Nnabuchi, Nnaedozie P. Obiegbu, Chiemezie M. Agbanu, Ebube B. Akosa, Stanley C. Egbogu, Chinedu L. Olisa and Chukwunonso I. Enechukwu
Original Research
Background: Maternal morbidity and death have been linked to ectopic pregnancy, particularly in sub-Saharan Africa. Because of early presentation, diagnosis, and treatment, the death rate from it has decreased in high-income countries, but this is not the case in low- and middle-income countries. Given this, it is crucial that we periodically review it in our setting. Objectives: To determine the prevalence, associated risk factors, and treatment modalities of ectopic pregnancy during the study period. Materials and Methods: This is a retrospective cross-sectional study of all cases of ectopic pregnancy at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, between January 1, 2012, and December 31, 2021. The case files of patients who had ectopic pregnancy during the study period were retrieved from the medical records department of the hospital to extract relevant information. A structured proforma was used to collect socio-demographic and clinical data on the subjects. Ethical approval was obtained from the NAUTH Ethics Committee. The data were analysed using Statistical Package for Social Sciences (SPSS) version 25. Results: There were a total of 8194 deliveries, 5892 gynaecological admissions, and 113 ectopic pregnancies. However, only 98 case files of ectopic pregnancies were available with complete information for the study (retrieval rate of 86.7%) and were used for further analysis. This gave a prevalence of 1.38% of total deliveries and 1.92% of gynaecological admissions. The mean age of the patients was 29.07 ± 5.20 years. The average gestational age of the patients at the time of presentation was 7.6 weeks. The most common associated risk factors included previous pelvic inflammatory disease (29.6%), multiple sexual partners (25.5%), and previous termination of pregnancy (23.5%). The treatment modality for all cases in the study was surgical, with total salpingectomy (75.5%) being the most commonly performed surgery. There were 3 (3.1%) maternal deaths due to late presentation and delayed intervention. Conclusion: Ectopic pregnancy remains a major gynaecological problem associated with significant mortality and morbidity. A high prevalence of pelvic inflammatory disease and unsafe abortions result in a high incidence of ectopic pregnancy in our environment. Laparotomy and total salpingectomy also remain the main treatment modality in our environment. Therefore, early diagnosis and timely intervention will go a long way in reducing the morbidity and mortality associated with ectopic pregnancy.
American Journal of Clinical Medicine Research. 2023, 11(2), 35-40. DOI: 10.12691/ajcmr-11-2-3
Pub. Date: January 01, 2024
by Justina Omoikhefe Alegbeleye and Olusegun Abayomi Biyi-Olutunde
Original Research
Introduction: Anaemia is a common but avoidable negative prognostic factor in newly diagnosed patients with gynecological malignancy. However, there is little information regarding the prevalence of anaemia among newly diagnosed gynaecological cancer patients in developing countries like Nigeria. Objectives: To evaluate the prevalence, pattern, and associated factors of pre-operative anaemia in gynaecological cancer patients at the University of Port Harcourt Teaching Hospital. Materials and Methods: A cross-sectional study of 146 women diagnosed and managed for gynaecological cancers at the University of Port Harcourt Teaching Hospital between January 1, 2019, and December 31, 2022. A structured interviewer-administered questionnaire was used to obtain socio-demographic and clinical characteristics. Data was entered into a spreadsheet and analyzed with SPSS 25. The 95% confidence interval was used, and a p value of ≤ 0.05 was considered statistically significant. The Chi square test and Pearson's correlation were used to determine the relationship between anaemia and variables. Results: The mean age was 53.3 ± 13 years, 96 (65.8%) were married while 49 (33.6%) had tertiary education. One-fifth of the women 30 (20.5%) were traders and skilled workers/farmers 30 (20.5%). The median parity and age at menarche were 4 (4) and 13 (1) years respectively. Majority of the women 75 (52%) were diagnosed with stage III gynaecological cancer. The prevalence of anaemia was 113 (90 %). The highest prevalence was among patients with cervical cancer 42 (75%). There was a significant statistical relationship between anaemia and type of gynaecological cancer (X2 = 47.539, p-value <0.001). In addition, there was a significant statistical relationship between level of education (X2 = 28.633, p-value <0.001), occupation (X2 = 42.096, p-value = 0.001), and anaemia. Conclusion: There is a high prevalence of anaemia in patients with cervical cancer and advanced disease. Early presentation, prompt diagnosis, and in severe cases, blood transfusion may be beneficial, and reduce morbidity.
American Journal of Clinical Medicine Research. 2023, 11(2), 29-34. DOI: 10.12691/ajcmr-11-2-2
Pub. Date: October 23, 2023
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by Johnbosco Emmanuel Mamah, Chigozie Geoffrey Okafor, Chichetaram Ruth Otu and Chidinma Charity Okafor
Review Article
Obstetric pubic diastasis is a rare but significant complication that can occur during childbirth. This literature review explores the existing body of knowledge on obstetric pubic diastasis, including its incidence, risk factors, aetiopathogenesis, clinical presentation, diagnostic methods, management strategies, and outcomes. By examining the available literature, we aim to enhance our understanding of this condition and provide insights into its optimal management. During pregnancy and childbirth, there is a physiologic widening of the pubic symphysis; these changes are often reversible postpartum. Abnormal separation of the pubic symphysis (pubic symphysis diastasis- PSD) due to ligamentous rupture is an infrequent complication of labor and delivery that may impair the parturient general health and lead to a problematic puerperium. Postpartum pelvic pain is often ascribed to labor and childbirth; hence the diagnosis of pubic diastasis might be delayed and sometimes missed altogether. In this article, we discuss the presenting features, aetiopathogenesis, the management of the condition, and outcomes of obstetric pubic diastasis. Awareness of this condition is crucial for early recognition and appropriate treatment to ensure optimal patient outcomes. Ultimately, conservative management, including analgesics, physical therapy, and activity modification, is generally effective in achieving favorable outcomes.
American Journal of Clinical Medicine Research. 2023, 11(2), 25-28. DOI: 10.12691/ajcmr-11-2-1
Pub. Date: October 11, 2023
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