The overall goal of obstetric practice is to deliver a healthy baby to a healthy mother. Attaining this goal sometimes may require the ultimate weapon at the disposal of the obstetrician, which is intervention. Intervention becomes necessary when on critical assessment of the obstetric balance, the risk of continuing the pregnancy far outweighs the risk of interrupting it. The intervention at the disposal of the obstetrician is either of induction of labour or Caesarean section. This study aims to determine the incidence, indications and the maternal and neonatal outcome of induction of labour at the Niger Delta University teaching Hospital, okolobiri, Bayelsa State, Nigeria. This is a cross-sectional, prospective study conducted between 1 st January 2010 to 31 st December 2011.The incidence of induction of labour in this study was 6.5% and the three commonest indications were; prolonged pregnancy31 (51.7%), followed by prelabour rupture of foetal membranes 19 (31.7%) and hypertensive disorders of pregnancy 10(10.0 %). Most of the patients had induction of labour with vaginal misoprostol 33(55.0%). Majority of the women had spontaneous vaginal delivery51 (85.0%), while 9(15.0%) had emergency Caesarean section. The commonest indication for the Caesarean section is cephalopelvic disproportion 5(8.3%). The most common complication seen in the mothers is hyper stimulation 4(6.7%), while 7 (11.7%) of the babies were admitted into the special care baby unit (SCBU).

This study determined the obstetric benefits and compared the obstetric indices and pregnancy outcome of enrollees and non-enrollees of the national health insurance scheme (NHIS). A prospective cohort study of enrollees and non-enrollees of NHIS was conducted over 2 years. Data was analysed with Epi-info statistical software. Malaria (25.3% versus 8.0%, p value ≤0.001), anaemia (11.3% versus 3.3%, p value ≤0.0001), preterm delivery (8.0% versus 2.7% p value = 0.00001), antenatal default rate (22.7% versus 6.7%, p value = 0.0001) and maternal death (2.7% versus 0.7%, p value = 0.00001) were higher in the non-insured. Singleton low birth weight (9.3% versus 2.7%, p value = 0.00001) and new born admission (10.7% versus 4.7%, p value = 0.00001) were also more in non-enrollee, with higher perinatal deaths (6.7% versus 2.0%, p value = 0.00001). Women managed under the Nigerian NHIS scheme had better maternal and perinatal indices, therefore, effort should be scaled up to ensure universal health insurance coverage for all parturient and their newborn.

Aim: This study examined the fertility performance of women after combined hysterolaparoscopic surgical management of endometriosis. Design: This study is a hospital-based retrospective review. Materials and Methods: Data collected from the records of all patients presented with endometriosis-related infertility using a checklist designed for the purpose. Result: A total of 81.3% (370/455) of women who have had the desire to have children became pregnant during the study period after the surgery. Of those who became pregnant, all three-hundred-forty-seven patients were followed to the end of their pregnancies. A successful live birth occurred in 94.2% (327/347) of individuals, and pregnancy loss occurred in 5.8% (20/347). The mean patient age was 34.1 ± 4.1 years, and the average duration of infertility was 3.4 ± 3.3 years. Pregnancy occurred spontaneously in 39.5% (146/370) of patients, after artificial insemination (AIH) in 3.8% (14/370) of women, and after in vitro fertilization-embryo transfer (IVF-ET) in 56.8% (210/370) of cases. Patients aged ≤ 35 years had a higher chance of conception post-surgery—84% versus 77%, respectively (p = 0.039). Based on the modes of pregnancy, the timely introduction of an assisted reproductive technique (ART) demonstrated a significant effect on fertility performance postsurgery. Comparatively, this effect was 91.3% vs. 74.1% among the ≤35- and >35-year-old age groups, respectively. There was no significant difference in reproductive performance based on stages of endometriosis, nor in the other parameters evaluated. Conclusion: Our data are consistent with previous clinical studies regarding the management options of endometriosis-related infertility. Overall, the combined hysterolaparoscopy treatment is a very effective and reliable procedure, and is even more effective when combined with ART. It enhances women’s wellbeing and quality of life, and significantly improves reproductive performance.

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