Introduction: Gas gangrene in pregnancy, perinatal periods, or after an abortion has a poor prognosis. This study aims to present risk factors for the disease as reported worldwide and to discuss current concepts of its aetiopathogenesis. Materials and Methods: Using search terms, a bibliographical search was done in PubMed/ Medline and PubMed Central databases for publications on gas gangrene in pregnancy, abortions, and delivery published within the study period. Risk factors for the disease were identified by studying each of the reports. Results were presented with a discussion of the aetiopathogenesis of the disease. Results: Eighty-one (81) studies reporting on 67 patients and aetiopathogenesis of the disease were studied. The most common causes of the disease were clostridia which infected 63 (94.03%) of the patients. Identified risk factors were abortions, prolonged labor, prolonged obstructed labor, standard spontaneous vaginal delivery, Cesarean sections, episiotomy, amniocentesis, cordocentesis, ruptured uterus with fetal death, perforated appendix, pelvic tumors, trauma, foreign bodies in living tissues, accumulation of hematoma and devitalized tissues in pelvic tissues. Lethal effects of the pathogens were reported to be mediated by exotoxins produced by clostridia. Conclusion and Recommendations: Common risk factors are standard diagnostic and therapeutic procedures in pregnancy and its outcome. Local policies need to be developed for the extended use of antibiotics in normal labor and when carrying out procedures in pregnancy, delivery, and abortions. Attractive points in the aetiopathogenesis for the prevention of the disease are (i) prevention of attachment of clostridia to tissue cells and (ii) pre-pregnancy immunization of women of childbearing age.

Introduction: New and emerging trends in the causation of urogenital and rectovaginal lesions, and changing patterns of behavior of female patients with the diseases were observed. The aim of this study is to determine the risk factors and etiology of these diseases. Methods: This was a cross-sectional observational study of records of consecutive female patients operated on at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria, with major urogenital and rectovaginal lesions from 01/01/2018 to 31/12/2022. Each patient’s records, sociodemographic data, clinical assessment, laboratory investigations, diagnosis, and intraoperative findings were studied and recorded. Data obtained were analyzed with simple statistics, and presented in charts prose, and tables. Results: Twelve major cases were found and studied. Their age statistics (in years) were as follows: mean age, 38.6±11.5; median, 34; and age range of 25 to 68. Ten of them were within the childbearing age (15-45 years). One patient had a uterocutaneous fistula with subcutaneous endometriosis. Another had anorectal carcinoma with rectovesical and rectouterine fistulas. One had uterovesical fistulas with menouria (Youssef’s syndrome), and the fourth had uterovesical fistula with a perineal tear. Four patients had uterovaginal prolapse, and 4 had vesicovaginal fistulas. Obstetric and gynecological trauma and sexual battery accounted for nine of 12 cases. The patients had high-risk pregnancies but had antenatal care and labor managed by either traditional birth attendants or primary healthcare staff at peripheral institutions. Conclusion: Most of the risk and etiological factors of the lesions were found modifiable. Appropriate measures have been suggested for the management and prevention of the lesions.

Objectives: To determine the factors that are associated with good prognosis in the management of patients with urogenital fistulas in our tertiary hospital in Port Harcourt, Nigeria. Materials and Methods: We retrospectively identified all patients managed fully for urogenital fistula at the University of Port Harcourt Teaching hospital from January 2018 to December 2022. From the case files, we collected data on age, parity, etiology and type of fistula, investigation findings, management, including perioperative findings and use of drugs, and outcome of treatment. Results: Of the six patients with urogenital fistulas managed, four had vesicovaginal fistulas. Obstetric fistulas were the most common, accounting for five fistulas. Four had surgical repairs, and two were resolved entirely following bladder catheterization. Of those who had a surgical repair, multidisciplinary management involving urologists and gynecologists via the abdominal approach was done in two patients. Two patients had transvaginal fistula repairs performed by only gynecologists (with no urologists). All primary fistula repairs were successful. Conclusion: Most of the urogenital fistulas in this study had obstetric origins. The patients had delayed presentation for treatment. Good patient selection with individualization of patient treatment, adequate history-taking, basic evaluation under anesthesia with three swab testing, experience, and good surgical skills as well as optimal post-treatment care were vital for a good prognosis of fistula repairs