Ih Itam

Morbidity and mortality in booked women who deliver outside orthodox health facilities in Calabar, Nigeria.

Women who booked for antenatal care at the University of Calabar Teaching Hospital (UCTH), Calabar, but delivered outside orthodox health facilities were studied. The aims were to determine the pattern of maternal morbidity and mortality in them and to compare this with the pattern in women who booked and delivered at UCTH. One hundred and eighteen of the defaulters traced (35.1%) had complications compared with 34 (10.1%) of the control. Only 32.2% of these defaulters with complications presented in orthodox health facilities for treatment. The major complications in the study group were: perineal tear (19.0%); primary postpartum haemorrhage (12.5%); and puerperal sepsis (5.4%). These were significantly higher in the study group than in the controls (P<0.001). Maternal mortality ratio of 6.0 per 1000 live births was recorded in the study group, but there was no death in the control. Health education and public enlightenment campaigns emphasising universal antenatal care along with delivery in orthodox health facilities are strongly advocated.

Haemoperitoneum following coitus with no associated vaginal injury

Postcoital haemoperitoneum resulting in shock rarely occur without evident vaginal injury. A 24 year old Para 0 ±4 women presented to the emergency unit in shock with a history of fainting attack and severe absominal pain of 6 hours duration. Pain was felt immediately after coitus and was so severe that the patient had a blackout. Ultrasound scan revealed a left adnexal mass and fluid in the peritoneal cavity. At laparatomy more than 2 litres of fresh blood was found in the peritoneal cavity. The left ovary was enlarged by a haemorrhagic cyst with 3 bleeding points. The left fallopian tube was slightly oedematous with 2 areas of haemorrhagic spots but no obvious bleedig. Left ovarian cystectomy was done. Haemostasis was secured. Mary Slessor Journal of Medicine Vol. 5(2) 2005: 70-72

Laparoscopy in the management of pelvic pain in Calabar, Nigeria

During the study period (July 1988 to June 1993), 707 laparoscopics were performed in the maternity annex of the University of Calabar Teaching Hospital. Fifty-eight (8.2%) were for pelvic pain. Some of the cases of pelvic pain were laparoscoped only after failure of other investigative procedures and medical treatment. In 45 (77.6%) definitive diagnoses were made and 37 of these became asymptomatic after definitive treatment following the laparoscopy. Of the 12 (20.69%) with no detectable abnormalities, four became asymptomatic with explanation and reassurance. All the patients with unruptured and the two with ruptured ectopic pregnancy were managed without the need for blood transfusion. Most of the diagnostic laparoscopies were performed on a day-case basis. A complication rate of 1.7% was recorded. A more liberal use of the procedure in the investigation of pelvic pain in women is advocated.