Open Access Original Research Article

Immunohistochemical Study of Estrogen and Progesterone Receptors and the Proliferation Marker Ki-67 in Abdominal Wall Endometriosis

Francisco das Chagas Medeiros, Manoel Oliveira Filho, José Eleutério Junior, Angelina da Silva Medeiros

International Journal of Research and Reports in Gynaecology, Page 10-17

Introduction: The scar from pelvic surgery in the abdominal wall can be a site of endometriotic implants in 0.03 to 1% of patients. This study aims to evaluate the immunohistochemical expression of the estrogen receptor (ER), progesterone receptor (PR), and cell proliferation marker Ki-67 in patients with abdominal wall endometriosis.

Materials and Methods: We investigated seven women with abdominal wall endometriosis who underwent surgery to remove a lesion at the Assis Chateaubriand Maternity, Fortaleza, Brazil. From tissue blocks, histological sections were subjected to immunohistochemistry to identify ER, PR, and Ki-67. For statistical significance, an unpaired t-test was applied with a 95% confidence interval.

Results: The mean patient age was 30.4 ± 1.13 years. ER expression in the epithelium and stroma had a mean score of 33.45 and 17.14, respectively, and the difference was not significant. PR had a mean epithelial score of 175.71 and a mean stromal score of 72.29, significantly different (p = 0.0339). Ki-67 had epithelial and stromal scores of 14.14 and 12.14, respectively, which were not significantly different.

Conclusions: Abdominal wall endometriosis presents ER and variable PR expression in the epithelium and stroma. The Ki-67 marker demonstrated a reduced proliferation index.

Open Access Original Research Article

HPV among Females of Reproductive Age Attending a Tertiary Institution in Port Harcourt, Nigeria

Iheanyi O. Okonko, Ibinabo J. Altraide, Ifeyinwa N. Chijioke-Nwauche

International Journal of Research and Reports in Gynaecology, Page 18-27

Aims: The study was aimed at determining HPV seroprevalence among females of reproductive age and identify the demographic/behavioural profile associated with the seroprevalence.

Study Design:  Cross-sectional study.

Place and Duration of Study: O.B. Lulu-Briggs Health Centre, University of Port Harcourt, in Rivers State, Nigeria, from July 2013 to May 2014.

Methodology: Ninety-one females were included in this study. The age ranged from 15 to 45 years. Detection HPV infection was gotten using the ELISA and was performed according to the kit manufacturer’s stipulations. The demographic characteristics of the participants were obtained with a Performa designed for the study.

Results: Higher seropositivity of anti-HPV IgG antibodies occurred in the age group 18-25 years (18.2%) than other age groups (26-35 years, 4.1% and 36-45 years, 0.0%). The highest seronegativity (100.0%) occurred in the age group 36-45 years while the age group 18-25 years (81.8%) had the least. Higher seropositivity occurred in females with no formal education (33.3%) than primary (9.1%) secondary (3.8%) and tertiary education (0.0%). While higher seronegativity (100.0%) occurred in tertiary education compared to secondary (96.2%), primary (90.9%) and no education (66.7%). Higher seropositivity occurred among the married (27.3%) than the singles (1.2%). Higher seronegativity occurred among singles (98.8%) than the married (72.7%). Higher seropositivity occurred among other religions (4.9%) than Christianity (4.0%). Furthermore, Christians had higher seronegativity (96.0%) compared to other religions (95.1%).

Conclusion: The study clearly shows that although the seroprevalences are higher among younger females elsewhere in Nigeria, only 4.4% of the females had IgG antibodies to HPV-6, -11, -16 and -18 vaccine genotypes. It also established a high seronegativity among the females of reproductive age in Port Harcourt, Nigeria. To the best of our knowledge, this is the first documented report of high IgG seronegativity to HPV-6, -11, -16 and -18 vaccine genotypes in a higher institution in Port Harcourt, Nigeria. These findings reveal the susceptibility of a large population of females to infections with these four HPV genotypes in the University. With these findings, early screening and clinical evaluation for HPV-related manifestations are very imperative among females of reproductive age in Nigeria.

Open Access Original Research Article

A 6-Year Review of Cord Prolapse in a Tertiary Health Facility in Bayelsa State

I. J. Abasi, I. D. Akanatei

International Journal of Research and Reports in Gynaecology, Page 33-42

Background: Prolapse of the umbilical cord remains a life threatening obstetric emergency for the fetus. This study sought to evaluate the prevalence, associated factors, and outcomes of cord prolapse in Niger Delta University Teaching Hospital (NDUTH), Okolobiri, Nigeria.

Methodology: In a retrospective, descriptive, cross sectional study design, cases managed for cord prolapse between January 2012 and December 2017 were audited using a self-developed proforma. Data collected include sociodemographic information, obstetric history, antenatal care in the index pregnancy, associated factors, management and outcome (morbidity and mortality) of cord prolapse in the centre.

Results: Of the 3172 deliveries that occurred during the 6year period of study, 22 deliveries were complicated by cord prolapse, affecting 6 in 1000 live birth in the centre. Unbooked status (72.7%), malpresentation (72.7%), multiparity (45.5%), prematurity (45.5%), and abnormal lie (45.5%) were identified associated factors among the parturients. Other associated factors seen were polyhydramnious, abdominal massage in pregnancy and twin gestation.

The perinatal mortality due to cord prolapse was 1.6 per 1000 live births. All the babies with umbilical cord pulsation had immediate delivery by caesarean section. A Diagnosis-Delivery interval (DDI) < 30minutes was associated with better neonatal outcome and babies delivered within this time frame all required no admission into the SCBU.

Conclusion: In this study umbilical cord prolapse was associated with increased perinatal morbidity and mortality, especially amongst unbooked patients. The major associated factors identified were unbooked status, malpresentation, multiparity, prematurity and abnormal lie. A substantial number of parturients with cord prolapse had a history of culturally based abdominal massage in pregnancy prior to presentation. The possible aetiological contribution of this culturally based practice, with respect to cord prolapse needs further investigation.

Open Access Review Article

Technology Alternatives to Challenging Infertility Issues in Sub-Saharan Africa

Goodluck Azuonwu, Christiana Tabechire Nduka

International Journal of Research and Reports in Gynaecology, Page 1-9

Infertility has been a major reproductive issue worldwide causing instability in marriages. In the event of this, the society often views the woman as the cause of infertility and childlessness. Studies have proved that both males and females experience infertility issues. However, artificial reproductive technologies (ARTs) such as In vitro Fertilization and surrogacy have been used by couples in developed countries to produce offspring. This paper is thus a review on a public health issue which poses a grievous social problem in our society and brings about instability in relationships. This paper examines infertility and the use of technology alternatives in resolving the issue. Results from extensive review of literature shows that over 70 million couples have infertility issues worldwide amounting for 15% of reproductive aged couples globally. The prevalence in Nigeria is 30% as males contribute 40%, women 40% whilst the rest 20% are from a combination of other factors. Several measures are put in place to solve the problem of infertility including medical, surgical, artificial insemination or assisted reproductive technology (ART), which is one of the most successful, having a score of about 15 – 25% per cycle.  There is limited knowledge and fund to utilize assisted reproductive technologies especially in Nigeria, which has limited its use. It is therefore, recommended that the Ministry of Health carries out public enlightenment to educate the masses on ART to boost their fertility and subsidy should be put on the prices of ART services so as to make them affordable by infertile couples and aid childbearing.

Open Access Case Report

Postpartum Sigmoid Volvulus: A Case Report

Abdelillah El Bakouri, El Batloussi Yousra, Fakhri Yassine, Mounir Bouali, Fatimazahra Bensardi, Khalid El Hattabi, Abdelaziz Fadil

International Journal of Research and Reports in Gynaecology, Page 28-32

Sigmoid volvulus is a rare complication of pregnancy and the puerperium.A case of a35-year-old patient, gravida 1, para 1, recently delivered her foetus with caesarean section. Her postoperative period was complicated by abdominal distension, bilious vomiting and absolute constipation and the ultimate diagnosis of sigmoid volvulus. The patient was surgically treated by sigmoidectomy and potoperative medications ; and discharged 8 days postoperatively.  Conclusion: Prompt surgical evaluation of an acute abdomen during the postpartum period is important; delayed diagnosis and poor treatment can lead to significant maternal morbidity and mortality.