No abstract

Background: Vulva haematoma is an uncommon complication of childbirth that can cause maternal death if not properly managed. We present a case of large vulva haematoma managed conservatively with good outcome in UNTH Enugu. Clinical Presentation: This was a case of an unbooked 24 years old primiparous woman referred from a private hospital to UNTH, Enugu on account of left-sided vulva swelling of four hours duration following a spontaneous vaginal delivery of a live male baby that weighed 3.6 kilogrammes. She was given episiotomy which was repaired. Vaginal examination showed a swelling involving left labia majora and minora and extending to the perineal region and vagina. It measured 12 cm × 10 cm, firm and mildly tender. She was resuscitated with intravenous fluid, transfused with two units of blood and commenced on antibiotic and analgesic. The vulva haematoma was monitored and it remained the same size for two days, and then progressively regressed. She was discharged home on the 9th day. Conclusion: Conservative management of large vulva haematoma involving good counseling, correction of anaemia, institution of antibiotics, analgesic and close monitoring leads to effective resolution, reduced cost, scarring, pain and dyspareunia.

This was a case of a 42year-old nulipara female who presented to a private specialist hospital in Enugu because of unusual but gradual abdominal distension. Her ultrasound diagnosis was of extensive intramural and subserosal myoma. Abdominal swelling was initially noticed around the lower abdomen but progressively increased in size involving the upper abdomen, that she later found it diffi cult to wear her regular clothes and move around easily. There was associated constipation, but no nausea, vomiting or loss of appetite was reported. There was weight loss but no yellowish discoloration of eyes or urinary symptoms. There were no associated leg swelling, menstrual disorders, abnormal vaginal discharge or fever. The abdomen was grossly distended with masses arising from the pelvis that was about similar size of a 46-weeks pregnant woman. The masses were fi rm, nodular, mobile and non-tender with irregular outlines. There was no demonstrable ascites. Figure 1 below shows the patient's grossly distended abdomen before the surgery. An abdominopelvic ultrasound was performed and reported multiple, large uterine masses of varying sizes and shapes. These masses had

ObjectiveAnonymous sperm donation is a common practice in Nigeria with its associated legal and ethical challenges. This study aimed to investigate infertile couples’ opinions about issues of sperm donor anonymity and to determine factors that might influence their preferences.MethodsA cross-sectional, multicentered, questionnaire-based study was conducted among infertile couples attending infertility clinics in three tertiary hospitals in the south-eastern region of Nigeria over a period of 6 months.ResultsA total of 450 infertile couples were recruited consecutively from the three study centers. However, 450 females and 352 males (total=802) participated in the study. The level of awareness of artificial insemination using donor sperm for the management of male infertility among the respondents was 69.2%, while its acceptability rate was 62.7%. The majority of the respondents indicated their preference for secrecy and anonymity in sperm donation. Approximately 84% of the respondents indicated that the mode of conception should never be disclosed to the donor-conceived child, and ~92% of them indicated that the identity of the sperm donor should never be revealed to the donor-conceived child. Fear of adverse effect of such disclosure on the child and the possible of rejection of the father in order to seek for the donor were the major reasons for their preference for anonymity.ConclusionAlthough it has been argued that every child has a right to know their genetic parents, the reasons proffered by the respondents for their preference for anonymity cannot be totally ignored. Establishing a regulatory body and enacting laws that will address both the ethical and legal issues associated with gamete donation in the developing world will go a long way in promoting openness and honest communication with donor-conceived children.

Chorioangioma is the most common non trophoblastic tumour of the placenta which can result to severe pregnancy complications with attendant maternal and fetal morbidity and mortality [1]. Most cases of chorioangiomas are small, microscopic and of no clinical important [2,3]. We present the very fi rst case of large symptomatic chorioangioma managed successfully in University of Nigeria Teaching Hospital Enugu.The patient was referred to the University of Nigeria Teaching Hospital Enugu on account of suspected symptomatic chorioangioma, at a gestational age of 32 weeks. She was managed conservatively and had elective caesarean section at 36 weeks' gestation with good outcome. There was a large solid and cystic lesion on the placenta measuring 8cm x10cm. Histological diagnosis of chorioangioma of capillary type was made.