Browsing by Author "Kilewo, C. D. S."

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    Obstetrics and gynaecology records and commentaries
    (University of Dar es Salaam, 1989) Kilewo, C. D. S.
    This dissertation is made up of ten Obstetric case records, ten Gynaecologic case records and one Obstetric long commentary. The Obstetric and Gynaecologic cases were managed according to standard and the investigations were done as per limited facilities. The short commentaries and criticisms are accompanied with a short list of literature for reference. The long commentary is on the outcome of pregnancy in primigravidas with breech delivery as seen at Muhimbili Medical Centre in the period January 1st to June 30th 1987. A total of 75 primigravidas were reviewed representing 1.2% of all deliveries at Muhimbili in 6 months. No factors or associated factors could be identified to explain breech presentation in 34.7% of the patients. Vaginal breech delivery was achieved in 84% and abdominal delivery in 16%. Perinatal mortality was 28% but most of this was associated with premature. Vaginal breech delivery in birth weight below 3500gm is safe provided the patient is closely monitored, and no other risk factors are associated and the obstetric team is prepared to revert to abdominal delivery immediately a problem develops. Abdominal delivery is the safest method for birth weights 3500gm and more. The low birth weight group (below 1800gm.) is an area for further study to see how the perinatal mortality can be reduced by the method of delivery.