Background: The pregnancy outcome following cervical cerclage for women with cervical incompetence is generally favourable. However, the outcome for emergency cerclage is less favourable. Methodology: A retrospective analysis of the case notes of pregnant women who underwent emergency cervical cerclage from January 2007 until December 2010 at Garkuwa Hospital and Sheehan Hospital was performed. Results: There were a total of 56 cases of cervical cerclage comprising 46 elective and 10 emergency cervical cerclage respectively. The procedure prolonged pregnancy in all the patients with the mean duration of 38 days. The outcome for emergency cerclage was 3 stillbirths (IUFD) and 7 live births (6 survived with 1 early neonatal death). Neonatal outcome was good if the initial cervical dilatation was 4 cm or less. Conclusion: Favourable outcomes should be expected in carefully selected cases and all patients should be informed of the survival rates before undergoing this procedure.

Episiotomy is an incision on the introitus and the perineum to increase pelvic outlet to facilitate childbirth and prevent trauma to fetal and maternal tissues. Episiotomy and perineal laceration may predispose the woman to short and long term complications. The objective of this study was to determine the prevalence of episiotomy and perineal lacerations and their associated risks factors at Benue State University Teaching Hospital, Makurdi, Nigeria. Retrospective data of all women who had spontaneous vagina delivery over a 3 year period with perineal laceration/episiotomy were reviewed. Data was obtained from the records and information on the socio-demographic variables, episiotomies, lacerations and the birth weight of infants. The associated risk factors were recorded using Statistical Package for Social Sciences version 22.Of the 636 vaginal deliveries, 85(13.4%) had lacerations with 65(10.2%) first degree, 19(3.0%) second degree and 1(0.2%) major laceration. Episiotomy rate was 132(20.8%). The mean parity and birth weight of infants were 2.62(SD= ± 1.83) and 3.1 kg (SD= ± 0.767) respectively. The highest number of perineal tears 69(10.8%) were in the lower age group (≤ 30 years). A similar observation was noted in respect of episiotomies which rate however decreased with parity. The relationship between maternal age, parity, booking status, fetal weight and the perineal status at delivery was statistically significant (P≤ 0.05). Episiotomy and perineal laceration rates in our institution were low. The major risk factors were low parity, young maternal age and increasing fetal weight at birth and their presence should be an early warning sign. We advise perineal support for all women during delivery.

Objective: Ureteric injuries following pelvic surgeries have been widely reported. It often causes severe morbidity and even mortality. It is generally agreed that the true incidence is difficult to determine as only patients who become symptomatic may present for intervention. The aim of this article was to document our 5-year experience in managing patients with post-hysterectomy ureteric injury. Materials and Methods: A retrospective review of all patients with ureteric injuries following hysterectomy managed at public and private hospitals between 2008 and 2013 was undertaken. Results: Seventeen injuries occurred in nine patients within the study period; eight patients sustained bilateral injuries. Ureteric ligation and transections were the most common. The left ureter was more commonly injured (58.8%) than the right. Ureteroneocystostomy was the most common method for treating injuries in the distal 2.5 cm of the ureter in this study. A mortality rate of 33.3% was recorded while all the other six patients had a favorable outcome. Conclusion: Early recognition and treatment guarantee a good outcome in the management of ureteric injuries.

Abdominal pregnancies are rare; however, they are still frequently missed pre-operatively. This presents diagnostic and treatment dilemma especially in resource-constrained settings where CT-scan and MRI are not readily available for accurate diagnosis. Five cases of abdominal pregnancies were managed over an eighteen-year period. In 2 cases, the condition was diagnosed preoperatively. The age range of the patients was from 32 to 36 years with a mean of 32.4 years. All 5 patients recovered fully; 4 required at least 2 units of blood transfusion; the placenta was left behind in 1 case; 1 required methotrexate to enhance placental resorption. One patient had recurrent intestinal obstruction and eventually had laparotomy and release of thick bands of adhesion. Two patients had conceived at least once each following treatment. Abdominal pregnancies present serious diagnostic and management dilemma especially in low resource settings. A high index of suspicion and prompt laparotomy can be life-saving. There is little information known about future fertility after abdominal pregnancy.

No abstract