Mature cystic teratoma (MCT) is a benign and unilateral ovarian neoplasm usually seen in premenopausal women. Its most common complication, torsion, is a well-known cause of acute abdominal pain. However, it is rare in the early postpartum period. In this paper, we present a case of ovarian torsion due to MCT, which was diagnosed radiologically in the early postnatal period and surgically confirmed. A 25-year-old woman vaginally delivered a healthy baby on time and without any problems. She presented with acute abdominal pain in the right lower quadrant on the postpartum 5th day. Abdominal ultrasound (US) and computed tomography (CT) demonstrated an ovarian mass containing fat and calcification in the right adnexa and non-enhancing ovarian parenchyma. The patient was discharged on the 5th day after the salpingo-oophorectomy operation without any complications. US and CT provided crucial information to make an accurate and rapid management decision in ovarian torsion due to MCT.

Background: While the prevalence of human immunodeficiency virus shows a decreasing trend globally, it is reported that the frequency of the infection and the associated mortality has increased in Somalia. HIV infection also plays an important role in maternal mortality and morbidity. Objective: It is aimed to determine the HIV prevalence in pregnant women by observing the general population. Methods: It was a quantitative, retrospective study conducted to examine the records of anti-HIV antibody test results of all patients. The sample size was calculated as 664 with a 99% confidence interval (CI) and a 5% margin of error. Anti-HIV results of selected patients in the electronic database were obtained. Mean, standard deviation, minimum and maximum values were calculated for the age. Percentages were calculated for prevalence. Results: A total of 7959 pregnant were tested and 17 pregnants were found to be positive (0.2%). The results of 199,936 patients were analyzed. A total of 699 patients were found to be positive (0.3%). Of the 699 positive cases, 293 (41.9) were female and 406 (58.1%) were male. HIV seroprevalence in men and women was 0.3% and 0.4%, respectively. Conclusion: Within the scope of WHO's global HIV elimination goal, Somalia needs effective national and international initiatives.

Introduction and importance Quintuplets conceived spontaneously are a rare occurrence. As compared with singleton pregnancies, quintuplets are associated with high rates of obstetric complications and significant prenatal morbidity and mortality. To our knowledge, here we reported the first case of spontaneous quintuplet pregnancy faced by a practicing clinician in an underdeveloped country (Somalia) with a Successful outcome. Case presentation A 32-year-old woman presented in her third trimester of gestation at 30 weeks feeling pain and uterine contractions. Clinical findings and investigations Ultrasound examination showed multiple pregnancies with four alive intrauterine pregnancies, but quintuplets could not be ruled out. Fetal heart activities were present, and the amniotic fluid was normal in amount. Interventions and outcome Extensive preparations made included four sets of ventilators. We did an emergency cesarean section under spinal anesthesia: five alive infants, three boys and two girls delivered in cephalic and breech presentations. Conclusions Quintuplet pregnancy is rare but poses relevant clinical problems to both the obstetrician and the neonatologist. Relevance and impact The takeaway lesson from this case would be that Pregnancy with multiples is considered a high-risk pregnancy; with more complications observed as the number of fetuses increases, their effective follow-up requires early diagnosis with regular monitoring. Through this case, we would like to highlight the urgent need to focus on the delivery of women's health care services in Somalia, along with the need to recognize the importance of receiving antenatal care in the community so that the burden of thousands of lives that are lost each year could be reduced. This case report has been reported according to the SCARE Criteria (Agha et al., 2020).

Background: Gynecological malignancies are prevalent, with a high mortality rate. The present is the first report from Somalia regarding the epidemiological and histopathological characteristics of gynecological cancers. Methods: This study reviewed all pathology results obtained from gynecologic patients who underwent various procedures and biopsies over seven years. The investigated parameters were sociodemographic features, histopathological characteristics, and management options, including surgical interventions. Results: The prevalence of gynecological cancers in our study was 7.1%. Among 225 cases with histopathologically confirmed primary gynecological malignancies, cervical and endometrial cancers were the most common (n= 137 and 42, 61% and 18.6%), respectively. Squamous cell carcinoma was the most common histologic type in cervical, vaginal and vulvar cancers. All patients diagnosed with cervical cancer had no history of cervical screening. Approximately 70% of the patients presented in the late stages of the disease. More than half (n=28, 67%) of patients with Endometrioid adenocarcinoma have been found to have other comorbidities, including diabetic Mellitus (n=17, 60.7%) and hypertension (n=11, 39.3%). Total abdominal hysterectomy and bilateral salpingo-oophorectomy without pelvic lymphadenectomy were performed in 35/42 patients with endometrial cancer. Conclusions: Cervical carcinoma was the most frequently observed gynecological malignancy during the study period. Majority of our patients presented in the late stages of advanced disease. Lack of adequate knowledge of the disease, poor socioeconomic status, limited resources, and inadequate expertise is believed to be the causes of the late presentation of the patients. Since cervical cancer is a preventable disease, national screening and awareness programs are necessary to reduce the burden of cancer and improve women's health in Somalia.

Background and Importance Spontaneous uterine rupture, especially in an unscarred uterus, is a rare pregnancy complication that can cause severe morbidity and mortality in both the mother and the fetus. The vast majority of uterine ruptures occur in the presence of a previous uterine scar, most commonly from a previous cesarean delivery. To our knowledge, here we reported the first case of spontaneous rupture of unscarred uterus in a term primigravida secondary to lethal skeletal dysplasia fetus (Type 1 Thanatophoric dysplasia) faced by a practicing clinician in an underdeveloped country (Somalia) with a successful outcome. Case Presentation The patient was 24 yrs. Old Primagravida, at 40 weeks gestation by LMP, presented with abdominal pain and active vaginal bleeding; she did not receive antenatal care during pregnancy; after initial abdominal ultrasonography and vaginal examination, laparotomy was performed due to high suspicion of uterine rupture. After dead fresh fetal extraction, the uterine defect was repaired successfully, and the patient was discharged home in good condition after several days. Conclusion Through this case, we would like to highlight the urgent need to focus on and recognize the importance of receiving antenatal care in the community so that the burden of thousands of lives lost each year can be reduced.