Hydatidiform mole as seen in a university teaching hospital: a 10-year review.

SUMMARY: Hydatidiform mole (HM), is a known cause of early pregnancy wastage and has the risk of malignant potential. This is a retrospective study of 71 patients who were managed for hydatidiform mole at the University of Maiduguri Teaching Hospital, (UMTH) Maiduguri over a 10-year period, from January 1996 to December 2005, inclusive. The objective of the study was to determine the incidence, risk factors, clinical presentations and histological types of HM. Case records of 71 histologically confirmed HM were studied. Their sociodemographic characteristics, clinical presentations and histology reports were obtained and analysed. The institutional incidence of molar pregnancy was 3.8/1,000 deliveries. Histological findings showed partial mole in 51 (71.8%) cases and complete mole in 20 (28.2%) cases. The peak age-specific incidence rate was 17.5 years. The leading presenting clinical feature was abnormal vaginal bleeding seen in 100%. No case of invasive mole was found. Maternal complications included severe haemorrhage requiring blood transfusion (30.0%) and infections (15.5%). There was no maternal death. In conclusion, the incidence of partial hydatidiform mole was found to be higher than that of complete variety in our environment and the identified risk factors were young age, low parity and previous history of HM.

Knowledge, perceptions and attitudes of Islamic scholars towards reproductive health programs in Borno State, Nigeria.

Some reproductive health policies and activities of international development organizations continued to be criticized by some religious groups. Such criticisms can be serious obstacles in the provision of reproductive health and rights information and services in many communities. This study was conducted to find the knowledge, perception and attitude of Islamic scholars on reproductive health programs and to get some suggestions on the scholars' role in the planning and implementation of reproductive health advocacy and programming. The data were collected by in-depth interview with representative sample of selected Muslim scholars in and around Maiduguri town in Bomo State, Nigeria. All the scholars had vague or no idea of what reproductive health is all about. When they were explaining reproductive health, most of the scholars mentioned some of the rights of women especially the need for maintaining the good health of women and their children as reproductive health. Even though they have poor knowledge, all the Muslim scholars interviewed believed that reproductive health is an essential component of healthy living and the programs of the international development organizations are mostly good, but they have reservations and concern to certain campaigns and programs. Scholars that promised their contributions in enhancing reproductive health have a common condition for their continuous support to any international development organization or reproductive health program. Conformity to Islamic norms and principles are prerequisites to their loyalties. The scholars also advised the international development organizations on the need to identify themselves clearly, so that people know from where they are coming, what are their background, and the program that they want to do and the reasons for doing the program in the community.

Socio-clinical characteristics of modern contraceptives users at the University of Maiduguri Teaching Hospital.

OBJECTIVES: To determine the incidence and socio-clinical characteristics of modern contraceptive users. And the common methods clients received their first information on family planning. DESIGN: A retrospective observational review of clients between 1st of January 1996 and 31st of December 2001. SETTING: University of Maiduguri Teaching Hospital (UMTH) Maiduguri, Nigeria. METHODS AND METHODS: Records of new family planning clients were reviewed to determine among other things, age of the patients, educational background, religion, number of living children and the methods chosen by the clients. The data extracted were analyzed by absolute values and percentages. Where necessary mean values and student t-test were calculated. RESULTS: There was a family planning consultation prevalence of 10% of total gynaecological consultations. All the clients were females, 79.7% were for child spacing and 17% for birth control. About 90% of those women who decided not to have any more children opted for temporary methods of contraception. Contraceptive use in teenagers was only 3.6% with peak age prevalence at 25 to 29 years. Almost half of the clients had 4 or more living children. Only 11.6% of clients first heard of family planning through the Radio or Television. CONCLUSION: For a family planning program to be effective in our community, strategic planning should target the males, teenagers and multiparous women. The electronic and print media should be involved more in the propagation of family planning programs. And women who have completed their family size should be encouraged to go for sterilization.

Malignant tumours of female genital tract in North Eastern Nigeria.

OBJECTIVE: To ascertain the pattern and frequency of malignant tumours of female genital tract in North Eastern Nigeria. DESIGN: A retrospective analysis of surgical biopsy materials. SETTING: University of Maiduguri Teaching Hospital, the only teaching hospital in the North Eastern region of Nigeria. SUBJECTS: Three hundred and eighty-two cases of female genital malignancies histologically confirmed between January 1st 1991 and December 31st 2000. RESULTS: The age range of patients whose specimens were received during the ten year period was three to eighty years. Mean age of presentation was 44.2 years, (SD +/- 13). Cancer of the uterine cervix was the most common (70.5%), followed by ovarian cancer (16.3%), then cancer involving the uterus (8.5%). There was a steep rise in reported cases within the period of study especially for cancer of the cervix. Ovarian tumours were the most common tumours in the teenage group. CONCLUSION: The high incidence of cancer of the uterine cervix and the early mean age of presentation of all malignancies underlies the importance of screening programmes and awareness campaign in our community. The study also provides the basis for further analysis of female genital malignancies.

Urticarial reactions in obstetric transfusion in Maiduguri, north east Nigeria.

A total of 135 obstetric patients who were first-time transfusion recipients at the University of Maiduguri Teaching Hospital were studied with respect to the incidence and clinical severity of urticarial transfusion reactions (UTR) in relation to the number of previous pregnancies. The overall incidence of UTR was 12.6%. Analysing the data with respect to the number of previous pregnancies the incidence of UTR were 0%, 0%, 3.8%, 8.3%, 21.7% and 37.5% among patients with 0.1, 2, 3.4 and 5 previous pregnancies respectively. However, all cases of UTR in the affected patients were clinically mild, manifesting with urticarial rashes and pruritus without any features of anaphylaxis. This data would suggest that the risk of UTR increases with the number of previous pregnancies. Therefore, multiparous patients need closer observation during transfusion therapy.

Prevalence of human immunodeficiency virus-infection among pregnant women attending ante-natal clinic in Maiduguri, north-eastern Nigeria.

A seroepidemiological survey conducted among 1,059 pregnant women in Maiduguri, North-eastern Nigeria from September, 1988 to April, 1990 showed that 5 women or 0.47% were positive for HIV antibodies. Three of the women (0.28%) were positive for HIV-1 while 2 others (0.19%) were positive for HIV-2; this is consistent with the known fact that both viruses are active in West Africa, a sub-region of which Nigeria is part. Detailed information available on 4 of the 5 seropositive women and their husbands did not reveal any known risk factor favouring HIV-infection. In addition to the 5 confirmed seropositive women, 10 others (0.94%) gave Western blot patterns that were neither HIV-1 nor HIV-2. The significance of this observation, if any, needs to be clarified.

Prevention of mother-to-child transmission of HIV at Maiduguri, Nigeria.

The human immunodeficiency virus (HIV) can be transmitted vertically through the placenta in utero, during labour and delivery and through breast milk. In Nigeria, about 5.8% of women attending antenatal clinics were HIV infected as of December 2002. It was projected that by the end of the year 2002, there were about 849,000 orphans resulting from AIDS and about 755,000 established paediatric AIDS in this country. Interventions to prevent mother-to-child transmission of HIV include voluntary counselling and testing (VCT), administration of antiretroviral drugs (ARV), modification of obstetric practices and infant feeding options in HIV infection. Over the period July 2002-June 2003, 262 pregnant women received VCT at the antenatal clinic of the University of Maiduguri Teaching Hospital, and 207 (79%) agreed to be tested. Thirty-one (11.8%) were HIV positive. The majority of the HIV positive mothers received nevirapine in labour while 35% had combination ARV drugs in pregnancy. All the infants received nevirapine suspension within 72 hours of delivery. Expensive and slow testing facilities, insufficient and inconsistent counsellors, lack of ARV drugs for both mother and baby as well as unaffordable caesarean delivery were some of the constraints being faced at this centre. It is recommended that the governments at various levels should show more commitment to the programme of preventing mother-to-child transmission of HIV.

Diagnostic features of cervical incompetence among women in Maiduguri.

The study was a review of the clinical features used to diagnose cervical incompetence. One hundred and forty-one clinical records of patients who had cervical cerclage inserted for cervical incompetence at the University of Maiduguri Teaching Hospital over a 5-year period, were studied retrospectively. Previous mid-trimester abortion occurred in 80.1% of the patients and was consecutive in 98 patients (69.5%). Sixty-eight (50.7%) patients had previous preterm deliveries, while 65 (46.1%) had a cervical cerclage inserted in a previous pregnancy. They had associated characteristic rapid painless expulsions of the fetus in previous pregnancies. One hundred and thirty-six patients had the McDonald's method of insertion (96.5%). There was a significant association between histories of previous midtrimester abortions, consecutive mid-trimester abortions and preterm delivery, with a significantly greater proportion of women with a previous history of preterm delivery having a recurrence in spite of the insertion of the cervical cerclage.