Adenomyosis and uterine rupture during labour in a primigravida: an unusual obstetric emergency in Nigeria.

The primigravid uterus is believed to be immune to rupture during labour. This may not be true for those who have had prior adenomyomectomy, hence this report. The patient was a 28-year-old nullipara who became pregnant 11 months after an adenomyomectomy. Twelve hours after vaginal delivery at term, she developed haemoperitoneum of unclear cause. Emergency laparotomy and subsequent histology showed a fundal complete uterine rupture through the adenomyomectomy site, which was repaired. It is concluded that adenomyomectomy predisposes a pregnant uterus to rupture during labour. Therefore, such women should be offered elective caesarean delivery at term.

An unmet cancer screening need of HIV-positive women in southeastern Nigeria.

CONTEXT: HIV infection and cervical cancer are common in Nigeria. HIV-positive women have a higher risk for cervical neoplasm; therefore, counseling and regular cervical cancer screening are recommended. After post-HIV testing counseling, HIV-positive women should be aware of the Papanicolaou (Pap) smear. OBJECTIVE: To determine the coverage of cervical cancer screening information for HIV-positive women by the post-HIV testing counseling. METHODS: Questionnaires were administered to 150 HIV-positive women and 150 HIV-negative controls after post-HIV testing counseling at the voluntary counseling and testing clinic of University of Nigeria Teaching Hospital, Enugu, Nigeria. Proportions of responses were compared by using a chi-square test at a 95% confidence level. RESULTS: Thirty-three (22.0%) HIV-positive women and 57 (38%) HIV-negative women were aware of cervical cancer. The awareness of the Pap smear among HIV-positive women (4.0%) was lower than that of HIV-negative women (21.3%) (P < .001). However, this finding became insignificant after adjustment for educational status groups (P > .05). No respondent agreed to being informed of Pap smears during post-HIV testing counseling. After counseling on cervical cancer, 96.0% of the HIV-positive group and 98.7% of the HIV-negative group expressed willingness to undergo routine Pap screening. CONCLUSIONS: Cervical cancer screening information is not part of post-HIV testing counseling for women in Enugu, southeastern Nigeria.