Background:Abdominal myomectomy is a common modality of treatment for large and symptomatic uterine fibroid in women who wish to retain their fertility. Though frequently performed the procedure may still be associated with complications.Materials and Methods:A retrospective review of all patients who had abdominal myomectomy from January 1999 to December 2008 at the University of Maiduguri Teaching Hospital. Information on the Sociodemographic characteristics, indication for the myomectomy, uterine size, pre and post operative packed cell volume (PCV), intraoperative findings, cadre of surgeon, duration of hospital stay and complications were obtained.Results:The rate of abdominal myomectomy was 3.34%. Majority of the patients (79.8%) aged 30–49 years, and most (58.9%) were nulliparas. Abdominal mass (63.7%), menorrhagia (57.7%), and subfertility 55.2% were the leading indications for abdominal myomectomy. Complications were seen in 10.9% of the cases, 55.5 % of which were wound infections. Clinical and intra operative factors associated with complications included menorrhagia (P=0.003), estimated blood loss (EBL) ≥500mls (P=0.005) and post operative PCV of <30% (P=0.081).Conclusion:Complication rate after myomectomy was low with menorrhagia and EBL ≥ 500 mls being significantly associated with development of complication.

A 40-year-old woman presented with subcutaneous masses on her chest wall, abnormal vaginal bleeding and an enlarged uterus. Chest X-ray and liver ultrasound revealed metastatic disease to these sites, respectively. A urine human chorionic gonadotrophin assay was positive. A biopsy of the chest wall lesion and endometrium revealed choriocarcinoma. Treatment with methotrexate, actinomycin-D and cyclophosphamide led to complete resolution of the disease on examination, X-ray and ultrasound scans. The urinary pregnancy test became negative.

For HIV-infected people, prevention of transmission of the virus to their spouses and other sexual partners can only be achieved through abstinence and safer sex practices using condoms. New drugs and technologies are now available that can prevent vertical transmission of the virus. A total of 262 people living with HIV/AIDS (PLWHA) were interviewed to explore their sexual and reproductive desires and practices. About 75.6% of them were sexually active and 62.2% never used condoms. Although only 26.3% had no living child, the majority of these (71.4%) wanted to have children. Their knowledge of mother-to-child transmission of HIV and how to prevent it was good. PLWHA engage in unprotected sexual intercourse with the desire to have more children. It is expected that more paediatric HIV infections will be seen in the future in a poor-resource setting like ours.

The human immunodeficiency virus (HIV) infection has been shown to be a risk factor for premalignant and malignant conditions of the cervix. Patients attending the gynaecological clinic of the University of Maiduguri Teaching Hospital received voluntary counselling and testing (VCT) for HIV. All patients who were screened for HIV also had their pap smear taken. Cervical dysplasia was significantly commoner among HIV infected women than those that were HIV negative (31.3% vs 7.8%, respectively). The incidence of cervical dysplasia was also proportional to the degree of immunosuppression as women with low CD4 count had higher incidence of cervical dysplasia. The population studied was generally promiscuous irrespective of their HIV status, with over 90% of them having multiple sexual partners. It is recommended that health education in this population should be aimed at discouraging multiple sexual partners. Gynaecologists should be co-care providers to all HIV+ women in view of the menace of cervical dysplasia.

The human immunodeficiency virus (HIV) can be transmitted vertically through the placenta in utero, during labour and delivery and through breast milk. In Nigeria, about 5.8% of women attending antenatal clinics were HIV infected as of December 2002. It was projected that by the end of the year 2002, there were about 849,000 orphans resulting from AIDS and about 755,000 established paediatric AIDS in this country. Interventions to prevent mother-to-child transmission of HIV include voluntary counselling and testing (VCT), administration of antiretroviral drugs (ARV), modification of obstetric practices and infant feeding options in HIV infection. Over the period July 2002-June 2003, 262 pregnant women received VCT at the antenatal clinic of the University of Maiduguri Teaching Hospital, and 207 (79%) agreed to be tested. Thirty-one (11.8%) were HIV positive. The majority of the HIV positive mothers received nevirapine in labour while 35% had combination ARV drugs in pregnancy. All the infants received nevirapine suspension within 72 hours of delivery. Expensive and slow testing facilities, insufficient and inconsistent counsellors, lack of ARV drugs for both mother and baby as well as unaffordable caesarean delivery were some of the constraints being faced at this centre. It is recommended that the governments at various levels should show more commitment to the programme of preventing mother-to-child transmission of HIV.