Background: Gestational trophoblastic disease (GTD) is an uncommon complication of pregnancy. It is of clinical and epidemiological interest partly because of its good prognosis if detected and managed early. Objective: This study was to determine the prevalence, clinical presentation, management outcome and histologic types of GTDs at University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methodology: A five-year retrospective study of histologically confirmed cases of GTDs managed in UMTH was undertaken. Folders of patient treated for GTD during the study period served as source of data. Statistical analysis was done using Statistical Package for the Social Sciences. Results: There were a total of 47 (38 molar and 9 choriocarcinoma) cases of GTDs that were diagnosed and managed at UMTH. However, only 40[31(77.5%)] molar and [9(22.5%) choriocarcinoma] case files were retrieved. 55% of the GTDs were complete hydatidiform mole, 22.5% partial hydatidiform mole and 22.5% choriocarcinoma. There was no case of invasive mole or placental site trophoblastic tumour noted. There were 15,426 deliveries in UMTH during this period giving the incidence of GTDs as 3.0 per 1000 deliveries or 1 in 328deliveries. The mean (SD) age of the patients was 30.5 ± 5.6years. Only 3(7.5%) of the patients were below 20 years of age and those who were at least 40 years of age constituted 8(20%). Low parity constituted 62.5% of the patients while 12.5% and 2.5% were nullipara and primipara respectively. The mean gestational age (SD) at presentation was 16.5±6.2 weeks. The common clinical presentations were amenorrhoea (100.0%), abnormal vaginal bleeding (97.5%), lower abdominal pain (90%) and passage of grape-like vesicles (45.0%). Only 6(15.0%) complied with the follow-up protocol for one year, while 25(62.5%) of the patients did not observe the follow-up protocol. Anaemia was the commonest complication observed. Conclusion: Gestational trophoblastic disease is relatively common in our center with an incidence of 3.0 per 1000 deliveries and 1.48% of our gynaecological admissions. Adequate patient counseling and compliance to follow-up are recommend for good outcome. Keywords: Prevalence, gestational trophoblastic disease, Hydatidiform mole, Choriocarcinoma, Maiduguri.
Background: Preterm birth (PTB) is an important cause of perinatal morbidity and mortality in developing societies like Nigeria. It poses huge long-term medical and financial burdens for the affected children, their families, the health care system and society at large. Objective: The objective of this study was to determine the prevalence, risk factors and birth outcome of PTB at UMTH, Nigeria. Methodology: A two-year case-control study of cases of preterm births at the UMTH, from 1st January, 2016 to 31st December, 2017 was undertaken. For each PTB, the next term delivery was taken as control. Information on socio-demographic characteristics, risk factors, gestational ages at presentation and delivery, and birth outcome were obtained from the women’s case files with proforma and compared with that of the control. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software Version 23. The statistical significance was set at P<0.05. Results: During the period under review, there were 6,171 deliveries and preterm births constituted 291 births giving a prevalence rate of 4.7% or 47 per 1000 deliveries. The mean ages for the cases and controls were similar 26.4± 6.1 vs 26.5± 5.3 with (F=0.15, P=0.7) while the mean parity were 3.0±2.6 and 3.2±2.5 with (F=4.6, P=0.03). Nulliparity was commoner among the cases 61(24.6%) compared to the controls 34(13..7%) with X2 = 9.69, P=0.001. Similarly, 96(38.7%) of the cases were unbooked compared to 44(17.7%) among the conrols X2 = 26.9, P=0.000. About 20% of the cases had no formal education compared to 13% of the control. Preterm birth was associated with unbooking status (OR=1.82, CI: 1.40-2.36), nulliparity (OR = 2.05, CI: 1.29-3.26), previous preterm delivery (OR = 95.2, CI: 13.10-691.99) and pregnancy induced hypertension (OR = 25.45, CI: 9.13-70.92). Antepartum haemorrhage (OR = 13.89, CI: 4.92-39.25), twin gestation (OR = 18.18, CI: 2.40-137.68), Polyhydramnios (OR = 2.02, CI: 1.85-2.22) and PROM (OR = 5.39, CI: 2.87-10.15) were other risk factors independently associated with PTB. The perinatal mortality in PTB was 43(16.2%). Conclusion: The prevalence rate of PTB at the UMTH is 4.7% and is associated with previous PTB, unbooked status, twin gestation, polyhydramnious, APH and PIH. Efforts should be intensified on educating women of reproductive age group on the benefits of antenatal booking in pregnancy and quality antenatal care as this would provide ample opportunity for early detection and proper management of women at risk. Keywords: Preterm birth, Risk factors, Neonatal outcome, Maiduguri.
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