Ectopic pregnancy remains an important cause of morbidity and mortality in the fi rst trimester of pregnancy, and has become a major public health challenge among women in the reproductive age group in this environment. A review of 139 consecutive cases of tubal ectopic gestations managed over a fi ve year period at the Ekiti State University Teaching Hospital, Ado – Ekiti, Nigeria was conducted. Ectopic pregnancies accounted for 1.8% of all deliveries. Most of the women were married (68.3%), between 26 – 30 years (28.8%) and of low parity [0 and 1] (61.9%), and all had abdominal pain. Induced abortion (72.7%) was the commonest factor and the levonorgestrel-containing pill was the commonest contraceptive (19/43) associated with ectopic pregnancy. 16.5% were severely anaemic at presentation, 1 in 6 women had prior uterine evacuation as a result of wrong diagnosis, 26.7% had massive haemoperitoneum (=2000 millilitres) and salpingectomy (84.1%) was the commonest operative procedure. Paracentesis was positive in 84.6% of cases and negative in the only unruptured case. The correct diagnosis was missed in a third of the patients at presentation. The case fatality rate was 0.7%.

Intrauterine devices (IUD) are a highly effective and safe form of contraception. However, many individuals, particularly nulligravidas, elect against IUD use due to fear of pain associated with insertion. Misoprostol has been proposed as an agent to ease IUD insertion and decrease associated pain. However, its efficacy in the literature is inconclusive and its use varies widely between healthcare providers. We present a review on the efficacy of vaginal misoprostol in facilitating IUD insertion and reducing procedureassociated pain.

Placenta percreta in early pregnancy is rare and only few cases are documented. We report a case of placenta percreta at 10 weeks gestation. Sonography revealed absence of line of demarcation between trophoblast and myometrium extending to the urinary bladder region. Termination of pregnancy by hysterotomy was done. The diagnosis and treatment of placenta accreta in early pregnancy must be taken seriously which might protect patients from considerable bleeding and further morbidity

Objectives: To evaluate awareness and acceptability of HPV vaccine amongst medical students in a tertiary teaching hospital. Materials and methods: This was a cross sectional descriptive study carried out in a tertiary hospital in South India in January 2015. A self-administered questionnaire in English was given to 310 undergraduate medical students after obtaining consent. Parameters studied included awareness and acceptability of HPV vaccine. Data was analysed using SPSS 16 software. Results: Response rate in this study was 100%.40% of students were <20 years of age, while the remaining were between 21-25 years, while gender distribution was equal (50%). 92% felt that HPV is preventable. 89% were aware of HPV vaccine and in 74% the source of information was medical books/ classes. 81% knew of barrier contraceptive as method of HPV prevention. 54% thought that the vaccine is approved for the age group 10-20 years. 50% didn’t know that that the vaccine could be administered to males and 60% felt that screening for cervical cancer is necessary prior to vaccination. Need for cervical cancer screening post vaccination was supported by 80% of students. Approximately 50% of the students were not aware of the types, route, doses and 76% were not aware of the contraindications of HPV vaccine. 40% felt that it is protective only against cervical cancer and were unsure of the efficacy. 68% didn’t know the duration of protection and 78% had no idea about the cost. Overall 40% said that they would have the vaccine, 41% were not sure and 18% didn’t want to have the vaccine. 50% of the students felt that HPV vaccine should be incorporated in National Immunisation programme.

Objective: The aim of this study is to identify the role of sFlt-1/PIGF ratio as a prognostic marker for cases of preeclampsia. Patients and methods: The current study is a case control study that was conducted over 90 cases of primigravida patients, 24-34 weeks of gestation, randomly selected patients from outpatient clinic and ER of Ain Shams Maternity Hospital, they were classified into two groups, first group is preeclampsia group which was 45 preeclamptic pregnancies (preeclampsia patients and cases with severe criteria) and the second group was control group which was 45 normal pregnancies. Each patient was examined by sFlt-1/ PlGF ratio immunoassay kits.

Objective: The study aims to test the effect of tranexamic acid (TA) on uterine vasculature and blood loss after vaginal delivery. Materials and methods: A randomized, double-blind, placebo-controlled trial, conducted in Assiut Woman’s Health Hospital, Egypt between the 1st of October 2015 and the 31st of March 2016 included pregnant women (37-42 weeks) with a single living cephalic fetus. The eligible women were randomized to receive TA or placebo after vaginal delivery. Doppler indices were measured for the subendometrial, intramyometrial and uterine blood vessels two hours after delivery. The main study outcome was the effect of TA on subendometrial and intramyometrial blood fl ow. Results: Two hundred women were enrolled (n=100 in each group). There was a significant increase in the Doppler indices of subendometrial and intramyometrial blood vessels with no difference in indices in uterine arteries between both groups. The mean of estimated blood loss decreased significantly in TA group (p<0.001). The haematocrit and hemoglobin levels were higher in TA group than the placebo group after delivery (p<0.001). Conclusions: The use of intravenous TA after vaginal delivery increases the resistance in the subendometrial and intramyometrial blood vessels and reduces postpartum hemorrhage.

Pregnancy, another state or gravidity, is the state of a woman who carries a new being. The fertilization and ends with childbirth. The fertilized egg develops and goes through several different stages of development: embryo and fetus. Diagnosing pregnancy is based on safe and unsafe signs, and most reliable evidence that ultrasound. Pregnancy lasts nine months and the vast majority of women is well tolerated. Unfortunately, there are women who do not stand up well due to certain health complications that can occur, it is necessary to perform abortions. The task of this paper is to consider abortion the legal aspects.