Obstetrics and gynaecology cases and commentaries

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University of Dar es Salaam
This dissertation is presented as partial fulfillment for the award of the Degree of Master of Medicine(M.Med) of the University of Dar es Salaam. It consists of three main parts i and Part ii consist of ten Gynaecologic and ten Obstetric cases, which were managed by the author, among others, during the three year period of residency. The management of these cases is according to the acceptable standard protocol available where facilities are limited, this has been clearly pointed out in the management of the particular case or in the brief commentary which follow each of the presented cases. Recommendations on current management advances of some of these cases given the ideal situation, are also discussed. Part iii consist of one long commentary on eclampsin. Although this condition, in the developed world, is now becoming rare occurrence, it is still a common problem in the developing countries and its associated with high morbidity and mortality. At our centre it is the second leading causes of maternal mortality. A systematic documentation of the associated factors contributing to this situation in Tanzania is lacking. The author conducted a prospective descriptive study of all patients admitted with this condition at Muhimbili Medical Centre for period of six months. The main outcome measures of the study were age, perity, booking status, fits, blood pressure, gestational age, education, occupation, mode of delivery, feto-martenal outcome and complications. The incidence of this condition at the centre is high (24.4 per 1.000 deliveries). The mean maternal age was 21.9±5.5 SD years. Primigravids had a higher incidence than the multigravida is all age groups. Majority of the patients had booked for antenatal care sub standard care in the peripheral levels was common. Both maternal and perinatal mortalities were high. The author’s findings in this study reflect similar situation as revealed by extensive literature search from other developing countries. An active programme aimed at reducing eclampsia; its maternal and fetal mortality is therefore emphasized.
Available in print form, East Africana Collection, Dr.Wirbert Chagula Library, Class mark (THS EAF RG106.4.T34K58)
Gynecology, Obstetrics, Dar es Salaam (Tanzania)
Kiwale, C. R (1999) Obstetrics and gynaecology cases and commentaries, Masters dissertation, University of Dar es Salaam, Dar es Salaam.