Nifedipine and hydralazine could both be used effectively to control blood pressure in severe preeclampsia in our subregion. While hydralazine is administered intravenously and needs strict monitoring, nifedipine is more effective, is easy to administer orally, less demanding on hospital staff, convenient and more predictable.

Short women with heights up to 150 cm are at risk of failing spontaneous vaginal delivery and should be referred to hospitals where labor could be closely monitored and cesarean section performed if necessary.

Repair of vesicovaginal fistulas resulting from obstetric trauma remains a major challenge to surgeons worldwide. Large defects that result in partial or total urethral loss are especially difficult to repair. Even when closure of such fistulas is accomplished, return of normal urogenital function is often impaired, underscoring the need to improve existing surgical procedures. Transvaginal urethral and bladder neck reconstruction using mobilized anterior bladder wall was helpful in closing 18 of 20 vesicovaginal fistulas with urethral involvement caused by obstetric trauma. This method involves advancement of an anterior bladder wall flap into the vagina, where it is rolled into a neo-urethra or connected to whatever remnant of urethral tissue exists. Complications included stress incontinence requiring further surgery (four), small bladder capacity with detrusor instability (two), urethral stenosis requiring dilatation (two), postoperative hemorrhage (one), and vaginal stenosis (one). Continued modification of this procedure holds promise for many patients considered inoperable in the past.