Obstructed labour is an important cause of maternal death in developing countries. Obstructed labour also causes significant maternal morbidity mainly due to infection and hemorrhage and foetal death from asphyxia is also common. Objectives are to reduce maternal and newborn complications by early detection and rapid interventions and to reduce maternal and perinatal morbidity and mortality. This Hospital-based prospective cross-sectional study was conducted from June 2013 to June 2014 in Sylhet, MAG Osmani Medical College Hospital. 100 obstructed labour cases were selected those who were admitted in Inpatient department of Obstetrics and Gynaecology, SOMCH. 100 obstructed labour cases were recorded. The majority (80%) were residents of rural areas in which transportation were difficult, the occupation of the women were housewives mostly (90%) and remaining (10%) were tea-garden worker.75% of the obstructed labour cases did not have any antenatal follow-up. Most of the cases (70%) were visited Osmani Medical College Hospital by their attendant. 70% Visited at 12-24 hours of labour, (80%) came from a distance of 10-50 kilometers. Cepholo-pelvic disproportion was the major cause of obstructed labour (78%) and cesarean section was the main way of delivery (95%). PPH (4%), puerperal sepsis (4%), rupture uterus (2%), VVF (2%), rupture uterus with shock (1%), were the main complications and maternal death (1%). Obstructed labour was the major causes of poor perinatal outcome and perinatal death (7%). This study revealed high incidence of maternal morbidity and perinatal morbidity and mortality.
This study was carried out in two medical facilities in Enugu, Nigeria, from September to November 2007. An interviewer-administered questionnaire was used to collect data from HIV-positive pregnant women accessing PMTCT (prevention of maternal-to-child transmission) services at the two centres. Ninety-two women were interviewed: 89 (96.7%) had disclosed their status, while 3 (3.3%) had not. Of the 89 women who had disclosed, 84 (94.4%) had disclosed to partners, 82 (92.1%) to husbands, 2 (2.2%) to fiancés, 18 (20.2%) to sisters, 13 (14.6%) to mothers, 10 (11.2%) to brothers, 10 (11.2%) to fathers and 10 (11.2%) to priests. Fifty-two (58.4%) gave emotional support as the reason for disclosure and 46 (51.7%) gave economic and financial support as reasons. Fifty-six (62.9%) reported understanding from partner as a positive outcome and 44 (49.4%) reported financial support. Forty-six (51.7%) reported no negative outcome. Serostatus disclosure rate in this study was high with most women disclosing to their partners.
Our objective was to determine the trend of rupture of the gravid uterus at Enugu, Nigeria and to determine any change in pattern of presentation, management and outcome of such patients. The birth register of 4,333 deliveries at the University of Nigeria Teaching Hospital Enugu from January 1997 and December 2000 were reviewed. Forty-one cases of ruptured uterus were identified and analysed. The incidence of uterine rupture was 1 in 106 deliveries with a mean maternal age of 31.2 years. The majority (75.6%) of the patients were multiparous and had some form of antenatal care (61%) with 19.5% of the total booked at the Teaching Hospital. Many (78.1%) of the patients were in labour for 24?hours or less and 22.0% had oxytocin to augment or induce labour. The majority (68.3%) had a previously scarred uterus and many (53.6%) had lower segment ruptures. At laparotomy 31.7% had repair alone, 29.2% had repair with tubal ligation, 22.0% subtotal hysterectomy and 17.1% total hysterectomy. Perinatal mortality was high (87.8%) and maternal mortality rate 48.8 per 1,000 deliveries. Labour in a previously scarred uterus was the most common aetiological factor followed by obstructed labour in a multiparous woman. The incidence of ruptured uterus is still rising at Enugu, Nigeria but maternal mortality, due to uterine rupture continues to fall. The most commonly performed surgery is repair with or without sterilisation rather than hysterectomy.
High copper levels indicate that supplementation should not be undertaken during normal pregnancy. Dietary intake should be modified to ensure optimal selenium levels during pregnancy.
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