Bode-Law Faleyimu

Fertility after ectopic pregnancy in an African population

Cases of ectopic pregnancy were studied retrospectively at the Obafemi Awolowo University Teaching Hospitals Complex, Ile‐Ife, Nigeria, for the period from January 1, 1977 to June 30, 1987. The records of 108 patients who had at least 1 year of follow‐up were reviewed to determine their subsequent reproductive performance. Thirty‐eight patients (35.9%) subsequently conceived, 15 (13.9%) had recurrent ectopic pregnancy, 21 (19.4%) delivered at term, and 40 (37%) remained secondarily infertile. Thirty patients were sterilized or using contraception.

Ovarian pregnancy causing obstructed labor at term in a heterotopic gestation

A case of advanced heterotopic pregnancy in which an ovarian pregnancy caused obstructed labour with incomplete uterine rupture is presented. A live baby that weighed 3.25 kg was delivered at caesarean section. Total abdominal hysterectomy with bilateral salpingo‐oophorectomy was performed. The left ovarian mass contained a fetus papyraceus of about 24 weeks gestation.

Retained second twin: management and outcome in 108 cases.

In this review we present our experience of retained second twin, at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The data are based on a review of all records of twin deliveries that occurred between 1 January 1979 and 31 December 1987. Retained second twin was defined as a birth in which the interval between the deliveries of the first and second twin exceeded 30 min. There are 787 twin deliveries during the 9 years of the study. In 108 (14070) of these, there was retained second twin. Among the 108 cases of retained second twin, 101 (94070) were unbooked patients admitted as emergencies. Ninety-three (86070) mothers were 20-39 years old and 73 (68070) were para 1-4, while 14 (13070) were nullipara. The gestational age at delivery was at term (37 + weeks) in 60 (56070) cases while 48 (44070) were preterm. The birth weight of the babies ranged from 600 to 3750 g. Twelve (11070) babies weighed less than 1500g, 43 (40070) weighed 1500-2499 g and 53 (49070) weighed 2500 g or more. The mode of deliverywas by spontaneous vaginal delivery in 46 (43070) cases, caesarian section in 40 (37070), breech extraction in 10 (9070), assisted breech delivery in eight (7070), forceps in three and vacuum extraction in one. The indications for caesarian sectionweretransverselie(18); shoulder presentation/ hand prolapse (18); ruptured uterus (2); breech presentation (1) and cord presentation (1). The intrapartum complications associated with retained second twin included intrauterine fetal death (38070), malpresentation (34070), fetal distress (13070), abruptio placentae (8070), compound presentation (5070) and cord prolapse (4070). There were 52 Tropical Doctor, October 1990

Reproductive Performance in Grand Multiparae in a Suburban Teaching Centre in Nigeria—the Ile-Ife Experience

SummarySummaryThree hundred and fifty consecutive grand multiparae (19·6 per cent of 1789 deliveries in 1987–1989) in lie State Hospital were reviewed. The incidence of placenta praevia. abruptio placentae, preterm rupture of the membranes and ruptured uterus were greater (P<0·05) than those for women of lower parity. The perinatal mortality rate was lower and the maternal mortality rate comparable to that of women of lower parity. The grand multipara may be at a higher risk of complications but adequate care in pregnancy, labour and puerperium can reduce serious consequences.