Objective: To ascertain the pattern and frequency of malignant tumours of female genital tract in North Eastern Nigeria. Design: A retrospective analysis of surgical biopsy materials. Setting: University of Maiduguri Teaching Hospital, the only teaching hospital in the North Eastern region of Nigeria. Subjects: Three hundred and eighty-two cases of female genital malignancies histologically confirmed between January 1st 1991 and December 31st 2000. Results: The age range of patients whose specimens were received during the ten year period was three to eighty years. Mean age of presentation was 44.2 years, (SD + 13). Cancer of the uterine cervix was the most common (70.5%), followed by ovarian cancer (16.3%), then cancer involving the uterus (8.5%). There was a steep rise in reported cases within the period of study especially for cancer of the cervix. Ovarian tumours were the most common tumours in the teenage group. Conclusion: The high incidence of cancer of the uterine cervix and the early mean age of presentation of all malignancies underlies the importance of screening programmes and awareness campaign in our community. The study also provides the basis for further analysis of female genital malignancies.

Objective: To look at the trends in maternal mortality in our institution over 5 years. Methods: Records of 112 maternal deaths were retrospectively reviewed to determine the trends and the likely direct cause of each death over the study period. Results: There were a total of 112 maternal deaths, while 3931 deliveries were conducted over the 5-year period. The maternal mortality ratio (MMR) was 2849/100,000 deliveries. The highest MMR of 6234/100,000 was observed in 2003, with remarkable decline to 1837/100,000 in 2007. Eclampsia consistently remained the leading cause, accounting for 46.4% of the maternal deaths, followed by sepsis and postpartum hemorrhage (PPH) contributing 17% and 14.3%, respectively. There were no statistically signifi cant differences in the corresponding percentages of maternal deaths between various age groups (χ 2 ϭ 6.68; P ϭ 0.083). Grandmultiparas accounted for a signifi cant proportion of maternal deaths as compared to low parity, with χ 2 ϭ 10.43; P ϭ 0.00054. Lack of seeking antenatal care (unbooked) and illiteracy were observed to be signifi cant determinants of maternal mortality (χ 2 ϭ 64.69, P ϭ 0.00000; and χ 2 ϭ 18.52, P ϭ 0.0000168, respectively). Conclusion:In spite of decrease in the maternal mortality ratio over the years, it still remains high, with eclampsia persistently contributing most signifi cantly. Community enlightenment on the need to avail of antenatal care and hospital delivery services, and improvement in the quality of skilled maternity care will, among other factors, drastically curtail these preventable causes of maternal death and reduce MMR.

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To investigate the knowledge and practices regarding medical abortion and postabortion care in northern Nigeria among private physicians--the principal providers of such services in the area--122 doctors operating separate clinics in five states--Bauchi, Borno, Kaduna, Niger, and Taraba--were interviewed by means of a structured questionnaire. The results showed that 22 percent of the doctors reported that they terminate unwanted pregnancies, whereas nearly all reported that they manage complications of unsafe abortion. Manual vacuum aspiration and dilatation and curettage performed singly or in combination were the most common methods of abortion and postabortion care reported by the doctors. Only one doctor reported exclusive use of medical abortion in the first trimester, and three reported its exclusive use in the second trimester. Only 35 percent of the doctors listed misoprostol as a drug that they knew could be used for abortion and postabortion care, and only 12 percent listed mifepristone. By contrast, 49 percent listed inappropriate or dangerous drugs for use in abortion provision in the first and second trimesters of pregnancy. We conclude that private practitioners in northern Nigeria have limited knowledge of medical abortion and postabortion care, and that a capacity-building program on the subject should be instituted for them.