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Caesarian Section Rates And Perinatal Outcome At The Aga Khan University Hospital, Nairobi, Sikolia Wanyonyi, Evan Sequeira, Timona Obura

Obstetrics and Gynaecology, East Africa

Background: There has been a persistent rise in the rate of Caesarean sections over the years.Whether this rise is the cause of the decline in infant mortality and improved neonatal outcome still remains debatable.

Objective: To compare the Caesarian section rate and the perinatal outcome at the Aga Khan University Hospital for the years 2001and 2004.

Design: Retrospective study.

Setting: The Aga Khan University Hospital, Nairobi.

Main outcome measures: The total Caesarian section rates, their indication and the perinatal outcome. Results: The overall Caesarian section rate was 20.4% in 1996,25.9% in 2001and 38.1% in 2004.The rate among patients managed by …

Right Ectopic Gestation Following In Vitro Fertilisation: Case Report, R. B. Parkar, Yamal Patel

Obstetrics and Gynaecology, East Africa

The management of ectopic gestation has in recent years transformed from the normally accepted laparotomy to the laparoscopic approach. The objective of this case report is to describe a rare occurrence of an ectopic gestation following in vitro fertilisation procedure.A 35-year-old para 0 + 0, presented with lower abdominal pain and per vaginal bleeding six weeks after an in vitro fertilisation was done in South Africa. The patient was admitted with severe lower abdominal pain and per vaginal bleeding at six weeks gestation following an in vitro fertilisation procedure. She had undergone an "evacuation" one-week prior to this episode due …

Comparison Between Gram Stain And Culture For The Characterization Of Vaginal Microflora: Definition Of A Distinct Grade That Resembles Grade I Microflora And Revised Categorization Of Grade I Microflora, Rita Verhelst, Hans Verstraelen, Geert Claeys, Gerda Verschraegen, Leen Van Simaey, Catharine De Ganck, Ellen De Backer, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Background: The microbiological diagnosis of bacterial vaginosis is usually made using Nugent's criteria, a useful but rather laborious scoring system based on counting bacterial cell types on Gram stained slides of vaginal smears. Ison and Hay have simplified the score system to three categories and added a fourth category for microflora with a predominance of the Streptococcus cell type. Because in the Nugent system several cell types are not taken into account for a final score, we carried out a detailed assessment of the composition of the vaginal microflora in relation to standard Gram stain in order the improve the …

Increased Risk Of Hiv In Women Experiencing Physical Partner Violence In Nairobi, Kenya, Karoline Fonck, Leye Els, Nancy Kidula, Jeconiah Ndinya-Achola, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

As part of a study on etiology of sexually transmitted infections (STI) among 520 women presenting at the STI clinic in Nairobi, data on partner violence and its correlates were analyzed. Prevalence of lifetime physical violence was 26%, mainly by an intimate partner (74%). HIV seropositive women had an almost twofold increase in lifetime partner violence. Women with more risky sexual behavior such as early sexual debut, number of sex partners, history of condom use and of STI, experienced more partner violence. Parity and miscarriage were associated with a history of lifetime violence. We found an inverse association between schooling …

Comparison Of Pap Smear, Visual Inspection With Acetic Acid, Human Papillomavirus Dna-Pcr Testing And Cervicography, H De Vuyst, Patricia Claeys, S Njiru, L Muchiri, Sophia Steyaert, Petra De Sutter, E Van Marck, J Bwayo, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: To assess the test qualities of four screening methods to detect cervical intra-epithelial neoplasia in an urban African setting.

Method: Six hundred fiftythree women, attending a family planning clinic in Nairobi (Kenya), underwent four concurrent screening methods: pap smear, visual inspection with acetic acid (VIA), PCR for high risk human papillomavirus (HR HPV) and cervicography. The presence of cervical intra-epithelial neoplasia (CIN) was verified by colposcopy or biopsy.

Result: Sensitivity (for CIN2 or higher) and specificity (to exclude any CIN or cancer) were 83.3% (95% CI [73.6, 93.0]) and 94.6% (95% CI [92.6, 96.5]), respectively, for pap smear; 73.3% …

Signs And Symptoms Of Urethritis And Cervicitis Among Women With Or Without Mycoplasma Genitalium Or Chlamydia Trachomatis Infection, Rita Verhelst, Hans Verstraelen, Geert Claeys, Gerda Verschraegen, Joris Delanghe, Leen Van Simaey, Catharine De Ganck, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme.

Methods: A cross sectional study among female STD clinic attendees in Örebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis.

Results: The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% …