The burden of caesarean section refusal in a developing country setting.

Objective: To investigate the prevalence, aetiology and outcomes of caesarean section refusal in pregnant women.

Design: A prospective controlled study.

Setting: University of Nigeria Teaching Hospital and Aghaeze Hospital, Enugu, Nigeria.

Cesarean section on request in a developing country.

Objective: To assess the prevalence of cesarean sections (CSs) and women's reasons for requesting the procedure in a developing country.

Method: Pregnant women scheduled for elective CS were interviewed to determine whether the procedure was requested by them or suggested by a physician. The women who personally requested a CS filled out questionnaires before surgery and at the postnatal visit 6 weeks later, and their answers were analyzed.

Juxtacervical vesicovaginal fistulae: outcome by route of repair.

Vesicovaginal fistula is a major public health problem in Nigeria with diverse medical, psychological and social consequences for the patient. This study compared the outcome of vaginal vs abdominal repair of juxtacervical vesicovaginal fistulae. It was a retrospective review undertaken at the University of Nigeria Teaching Hospital, Aghaeze Hospital and Mbanefo Hospital, all in Enugu, Nigeria, from 1 January 1992 to 31 December 2004.

Factors associated with the use of maternity services in Enugu, southeastern Nigeria.

The maternal mortality ratio and other maternal health indicators are worse for developing countries than for the developed world due to improved access to quality care during pregnancy and especially at delivery in the industrialized world. This study was carried out to identify the factors which influenced choice of place of delivery by pregnant women in Enugu, southeastern Nigeria, and to recommend ways to improve women's access to skilled attendants at delivery. A pre-tested questionnaire was administered by interviewers to women who had delivered within 3 months prior to date of data collection.

Influence of formal maternal education on the use of maternity services in Enugu, Nigeria.

Although some previous studies have suggested formal maternal education as the most potent tool for reducing the mortality ratio in Nigeria, other studies found that the depressed Nigerian economy since 1986 has marginalised the benefits of education with the result that educated women stopped making use of existing health facilities because they could not afford the cost of health services. This study was carried out to determine the current influence of formal maternal education and other factors on the choice of place of delivery by pregnant women in Enugu, south-eastern Nigeria. It was a pre-tested interviewer-administered questionnaire study of women who delivered within 3 months before the date of data collection in the study area.

Conservative management of early-onset pre-eclampsia and fetomaternal outcome in Nigerians.

The aim of this study was to determine the effect of conservative management of pre-eclampsia with onset in the second trimester on fetomaternal outcome. This was a prospective study of 749 consecutive cases of pre-eclampsia seen over a 5-year period in a tertiary care centre in Enugu, Eastern Nigeria. One hundred and seventy-five (23.

Cervico-vaginal fistula from induced abortions causing subsequent spontaneous midtrimester abortions in Nigerians: case report.

A report of three cases of cervico-vaginal fistula (CVF) from induced abortions causing subsequent spontaneous mid-trimester abortions and a literature review is presented. Restrictive abortion laws, low contraceptive usage and increased sexual activity consequent upon adverse socio-economic conditions have led to an increase in the prevalence of illegal abortions in Nigeria over the previous two decades. CVF appears to be an emerging complication of such abortions.

Nigerian male sexual activity during pregnancy.

Objectives: To determine the prevalence of extra-marital sexual affairs as well as other aspects of male sexual behavior during pregnancy in Nigeria.

Methods: A questionnaire survey of the husbands of consecutive women who delivered in three tertiary care centers in south-eastern Nigeria within an 8-week period. The data were analyzed by means of simple percentages and descriptive and inferential statistics, using t-tests, chi-square tests and regression equations at the 95% confidence level.

"Pregnancy and Landry Gullian Barre syndrome".

Landry Gullian Barre Syndrome is rare in pregnancy. The case described occurred in a 30 year old woman at a gestational age of 33 weeks. This is probably the 30th case described in the Literature.

Cervico-isthmic twin pregnancy carried to 37 weeks.

The management of twin pregnancy located in the cervico-isthmic region of the uterus in a primigravida has been described. Cesarean section performed at 37 weeks resulted in live female and male infants weighing 2.5 kg and 2.

260 cases of juxta cervical fistula.

A review of 260 juxta cervical fistulae over a 10 year period revealed that the fistula was more common in grandmultiparous women with brim disproportion. High rectovaginal fistula was a more likely complication than vaginal stenosis. Proximity of the ureteric orifices to the fistulae may lead to post-operative anuria even when adequate care has been taken.

The diagnosis of ectopic pregnancy by real-time ultrasonography.

The value of ultrasonography in the diagnosis of ectopic gestation was jointly investigated at UNTH and Hansa Clinics. One hundred and two doubtful ectopic pregnancies had ultrasonic evaluation after initial clinical work up. 52 (76.

The increasing incidence and declining mortality of ruptured uterus in Enugu.

A 10-year review of ruptured uterus at the University of Nigeria Teaching Hospital disclosed an incidence of 1 in 500 deliveries. The average incidence for booked patients alone was 1 in 1271 deliveries. The maternal and perinatal mortalities were 17% and 91% respectively, while the contributions of ruptured uterus to the overall hospital maternal and perinatal mortalities for the period under review were 4.

Two-stage repair of giant vesico-vaginal fistula.

A review of 840 bladder fistulae over 10 years revealed that 64 (7.6%) were giant vesico-vaginal fistulae. Association with vaginal stenosis and recto-vaginal fistulae were 23.

Vesico-uterine fistula.

Nine cases of vesico-uterine fistula caused by injury to the bladder at Caesarean section or by rupture of the uterus and bladder following obstructed labour are described. Symptoms depend on the level of the lesion, menstruation into the bladder and menouria occurring when the fistula is above the internal cervical os: whatever the level, most patients with vesico-uterine fistula present with incontinence of urine. A transperitoneal approach appears to give better results than a transvesical repair.