Biomedical subjects
Publications and source records attributed to J A Unuigbe.
There were 243 histologically proven ovarian tumours seen at the University of Benin Teaching Hospital, Benin-City, from 1973 to 1987. Out of these 198 (81%) were benign, with dermoid cyst (31%) being the commonest benign ovarian tumour. Granulosa cell tumours was the commonest malignant ovarian tumour seen (20% of malignant cases).
In an 8-year period (January 1978 to December, 1985), the 17,379 deliveries at the University of Benin Teaching Hospital (UBTH) consisted of 2089 cesarean sections (12.0%), 56 of which were associated with twin pregnancy. The main indications for cesarean section on the twin pregnancies were antepartum hemorrhage (placenta previa), malpresentation, cervical dystocia and previous cesarean section. The maternal mortality rate was 2% for all twin mothers delivered by cesarean section. There was no statistical difference in perinatal mortality rates (PMR) for all twin deliveries, vaginal twin deliveries and deliveries by cesareans section which were 111,113 and 100 per 1000 births, respectively. In the case of a retained second twin, however, recorded PMR was significantly higher (133 per 1000 births). Consideration of more liberal recourse to cesarean section in all cases of twins may reduce these unacceptably high perinatal death rates in twin pregnancy.
In a 13-year review of maternal deaths at the University of Benin Teaching Hospital, Benin City, abortion was one of the three major causes of death, accounting for 37 (22.4%) out of the 165 deaths. Induced abortion was responsible for 34 (91.9%) of these deaths. The usual victim is the teenage, inexperienced school girl who has no ready access to contraceptive practice. Death was mainly due to sepsis (including tetanus), hemorrhage and trauma to vital organs, complications directly attributable to faulty techniques by unskilled abortion providers, a by-product of the present restrictive abortion laws. Total overhaul of maternal child health services and the family health education system, as well as integration of planned parenthood at primary health care level into the health care delivery system, are suggested. Contraceptive practice should be made available to all categories of women at risk, and the cost subsidised by governmental and institutional bodies. Where unwanted pregnancies occur, the authors advocate termination in appropriate health institutions where lethal and sometimes fatal complications are unlikely to occur. In effect, from the results of this study and a review of studies on abortion deaths in Nigeria and other developing countries, it is obvious that a revision of abortion laws as they operate, notably in the African continent, is overdue.
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In a 13-year review of maternal deaths of the University of Benin Teaching Hospital, Benin City, abortion was one of the 3 major causes of death, accounting for 37 (22.4) out of 165 deaths. Induced abortion was responsible for 34 (91.9%) of these deaths. The usual victim is the teenage and inexperienced school girl who has no ready access to contraceptive practice. Death was mainly due to sepsis, (including tetanus) hemorrhage, and trauma to vital organs, complication directly attributable to faulty techniques by unskilled abortion providers, by- product of the present restrictive abortion laws. Total overhaul of maternal child health services and family health education system, as well as integration of planned parenthood at primary health care level into the health care delivery system, are suggested. Contraceptive practice should be made available to all categories of women at risk and the cost subsidized by governmental and institutional bodies. Where unwanted pregnancies occur, the authors advocate termination in appropriate health institutions where lethal and sometimes fatal complications are unlikely to occur. In effect, from the results of this study and review of studies on abortion deaths in Nigeria and other developing countries, it is obvious that a revision of abortion laws as they operate, notable, in the African continent, is overdue.
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Five hundred sixty grandmultiparous women were interviewed as to their contraceptive awareness, desirability and use in the three major hospitals in Benin City, Nigeria, between October 1, 1980 and September, 1981. Their parity ranged from 5 to 14 with a mean of 6.7. There was high level of awareness of contraceptive availability and usefulness (65%), but low level of practice (27.1%). The main causes of the low practice level included opposition from husband and other relatives, complications of previous methods used and the desire to have a large family. Oral contraceptives were the preferred method, followed by intrauterine devices. Educational attainment had a positive relationship to acceptance of contraceptive practice. We believe that with more concerted effort at family planning counseling, the community will be rid of the hazards and menace of grandmultiparity.
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From July 1973 to December 1980, 6942 patients were admitted to the Gynaecology unit of the University of Benin Teaching Hospital, Benin City, Nigeria. Fifty-nine patients presented with gynatresia (vaginal atresia and stenosis), an incidence of 8.5 1000. The most common causes of this condition were caustic vaginitis, secondary to local herb pessary insertion, and circumcision. The resulting vaginal adhesions were effectively treated surgically by simple adhesiolysis . There was a low incidence of congenital gynatresia . As the large proportion of cases of acquired gynatresia were preventable, improvement in health education should further reduce incidence of this condition in our community.
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An analysis of 931 consecutive inductions of labor over an eight-year period is presented. The success rate was 90.4%. Spontaneous vaginal delivery was achieved in 83.5% of cases and the induction-delivery interval was less than 12 hours in 82.6% of cases. The preinduction state of the cervix most significantly influenced the outcome of labor, followed by maternal age and parity. Provided induction of labor was by synchronous use of forewater amniotomy and oxytocin titration, labor outcome was regularly predictable two hours after induction using the concept of latent period of labor and the cervical dilatation at eight hours from the induction. When the latent period was two hours or less, 64.2% of the patients delivered within eight hours, and vaginal delivery was achieved in all women in whom the cervical dilatation was 8 cm or more at eight hours from the induction of labor. The maternal complication rate was 12.1%, the early neonatal morbidity was 11.6%, and the stillbirth rate was 2.3%.
Data from a one year prospective study of thirty-one tubal ectopic pregnancies and ninety-three matched controls is presented. Compared with the controls, a history of induced abortion, was not only statistically significantly more frequent amongst the subjects (P less than 001) but was the Penultimate cyesis in 41.9% of ectopic cases as against 3.2% of the controls (P less than 001). Non-physicians provided 51.6% and 3.3% of induced abortions in the study and control groups respectively. Complications occurred in 51.6% of study population and 6.5% of controls. It is concluded that induced abortions created the predispotion to tubal implantation in the study population and therefore a reduction in the incidence of illegally induced abortion in the community can reduce the incidence of ectopic tubal gestation and tubal infertility.