Preeclampsia: a review of the evidence.

Preeclampsia is a common complication of pregnancy associated with high maternal and perinatal morbidity and mortality especially in developing countries. There is considerable progress in the understanding of the pathophysiology and the management of the diseases, although the aetiology and primary pathology remained elusive. Integration of current evidence in the clinical management of the condition has witnessed improved maternal and fetal outcomes in many societies. In developing countries variations in management often not based on current evidence accounts for comparatively higher morbidity and mortality. This article aims to provide an overview of our present understanding of preeclampsia help care providers and our managers focus practice and policy to reflect existing evidence.

Surgical-Site Infection Following Cesarean Section in Kano; Nigeria

Objectives: To determine the prevalence, risk factors and common bacterial pathogens for surgical site infection (SSI), following cesarean section (CS). Materials and Methods: A retrospective case-control study of patients delivered by CS in Aminu Kano Teaching Hospital, Kano, Nigeria. The cases were the patients whose CS was complicated by SSI; they were matched by other patients delivered by CS who had had no SSI as controls. Hospital records of cases and controls were compared.Results: Four hundred and eighty five hospital records were available for review, 44 (9.1%) had SSI. Statistically significant determinants of infection are: Long duration of labor before CS (P<0.001), Long operation time (P=0.009), heavy intraoperative blood loss and blood transfusion (P<0.001). Eleven (25%) of the cases had CS due to obstructed labor compared to 15.3% of controls. Staphylococcus aureus was isolated in 31.8% of the cases. Cephalosporins and quinolones were the most sensitive antibiotics.Conclusion: The incidence of SSI following CS in our unit was 9.1%. Most cases followed prolonged obstructed labor, with long operation time and heavy blood loss. Staphylococcus aureus sensitive to cephalosporins was the most frequently isolated pathogen. Strategies for preventing prolonged obstructed labor and appropriate antibiotic prophylaxis may prove effective

Disseminated intravascular coagulation following induction of labour with misoprostol: a case report.

BACKGROUND: Disseminated Intravascular coagulopathy (DIC) has been reported following use of Misoprostol which is an old drug with new indications in Obstetrics and Gynecology. Its effectiveness, low cost, stability in tropical conditions and ease of administration as well as side effects like gastrointestinal effect, uterine rupture and post partum haemorrhage (PPH) have been documented. METHOD: This is to report a case of disseminated intravascular coagulopathy (DIC) associated with use of misoprostol for induction of labour and to call for extra vigilance in its use. RESULT: This was a case of 22-year old gravida 2 para 1 at 42 weeks gestation that was induced with 100 microg of misoprostol and delivered a live female baby with good Apgar score. She subsequently developed PPH and epistaxis simultaneously, then conjunctival haemorrhage 30 minutes later. She was managed with fresh whole blood and had a satisfactory recovery. CONCLUSION: Life threatening complication could result from use of Misoprostol. More research and high index of suspicion are needed to establish the association of prostaglandins with DIC.

Maternal mortality in rural northern Nigeria.

We presented a study of maternal mortality over a 4-year period in a tertiary health facility in northern Nigeria. Increased effort is needed in order to meet the millennium development goals.

Gigantomastia complicating pregnancy: a case report.

BACKGROUND: Mammary gigantism is a rare, cosmetically embarrassing complication of pregnancy that may ulcerate and have potentially fatal bleeding. METHODS: A case report of a 20-year old primigravida with bilateral massive breast enlargement is presented to highlight the clinical presentation and management challenges of the condition. RESULTS: She was treated with local debridement, bromocriptine, antibiotics and blood transfusion with good results. The pregnancy however terminated at 27 weeks of gestation. CONCLUSION: Gigantomastia is a rare complication of pregnancy, which may pose a major management challenge. A favorable outcome may be achieved with prompt recognition of the condition and conservative management in selected cases.