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: In spite of a high contribution of 26.7% to 35.0% of sepsis to maternal mortality in our hospital, there is little or no documentation about pyogaseous infections in pregnancy in the area. We present here a series of cases of different forms and presentations of pyogaseous infections managed at designated hospitals in Port Harcourt and its environs. Materials and Methods: Using a common proforma containing clinical and relevant laboratory tests, consecutive patients that presented to designated hospitals in Port Harcourt and its environs with normal and complicated pregnancies, deliveries and abortions were evaluated. Those with diagnosis of gas gangrene were treated and enlisted in this study. Socio-demographic and clinical data including outcome of all investigative and therapeutic procedures in pregnancy, puerperium and abortions were recorded. Results were presented. Results: One thousand five hundred and eighty-three (n=1583) patients were evaluated. Five (5) patients (aged 19-35years) had features of gas gangrene. One patient had gas gangrene in the mid-trimester of pregnancy. In three the disease complicated abortions; one after Cesarean section done for complicated term pregnancy. Two patients survived. Three died in spite of treatment. Conclusion/ Recommendations: High index of suspicion, early diagnosis, complete surgical excision of affected tissues, antibiotic therapy, maintenance of homeostasis and team work were needed for successful treatment. Intraoperative findings in one patient agree with observations of others that gastrointestinal etiology should be sought for gas gangrene of anterior abdominal wall. Recommendations are given on improvement of treatment of the lesion in affected rural areas.

Introduction:The natural history of prostate cancer varies among patients. The aim of this study is to detect any variations in clinical and pathological characteristics of the tumor in patients from different ethnic groups in Southern Nigeria.Patients and Methods:Consecutive patients who presented with features of prostatic diseases at the Urology Units of University of Port Harcourt Teaching Hospital, Port Harcourt and Nnamdi Azikiwe University Teaching Hospital, Nnewi, were evaluated prospectively with history, physical examination, and relevant investigations using a proforma. Data obtained were collated and analyzed statistically using the Chi-square test and Microsoft Excel.Results:Of 187 patients studied, 169 were analyzed. Eighty-six were Ibos, 31 Ijaws, 25 Ikwerres, and 12 Ogonis. Two were from each Etche, Urhobo, Opobo, and Effik; 4 from Andoni, and 3 Ibibio. Fifty-seven (66.3%) Ibos presented with the disease at higher ages (70–80 years) than 19 (61.3%) Ijaws and 11 (91.7%) Ogonis. These age differences were statistically significant with 95% and 99.9% confidence, respectively. All cases were adenocarcinomas. Clinical features, pattern of serum prostate-specific antigen levels, grades of the tumors, tumor metastases, and complications were similar for all ethnic groups. Although more Ibos had tumors with relatively more aggressive metastatic features, there was no statistical significance.Conclusion:Clinical and pathological features of adenocarcinoma of the prostate in Ibos, Ikwerres, Ijaws, and Ogonis were found to be similar. However, Ibos presented with the disease at older ages than Ijaws and Ogonis.

Introduction: Gas gangrene in pregnancy and its outcome has a poor prognosis. The aim of this study is to determine the patterns of its occurrence worldwide, and the evolution of its treatment within the last 6 decades. Materials and methods: The study was done at the University of Port Harcourt Teaching Hospital, Nigeria. Using search terms, a bibliographical search was made in the PubMed/ Medline and PubMed Central computerized databases for articles published on the subject from 01/01/1966 to 31/12/2022. Details of each publication, including the date and location of the study, number and socio-demographic information on affected patient(s), clinical features of the disease, laboratory investigations, types, and outcome of treatments were recorded. Results obtained were collated with simple statistics and presented. Results: Ninety-five (95) study reports on 153 patients were seen and studied. The disease has global distribution. The number of study reports significantly correlated positively with the number of treated patients. There was no significant increase in the number of study reports, and the number of cases during the study period, P>0.50. The pattern of treatment was focused on aggressive life-saving surgical excision of all involved tissues. In some cases, these ablative procedures either had fatal complications, or left many patients with loss of vital organs and body parts, with poor functional and cosmetic outcomes. Conclusion: The dearth of records suggests that, generally worldwide, experience with the disease may be limited. A program of development of conservative treatment of the disease, and pre-pregnancy immunization of women of childbearing age is advocated.

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.