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Objectives: There is currently a limited ability to accurately identify women at risk of postpartum hemorrhage (PPH). We conducted the "Predict‐PPH" study to develop and evaluate an antepartum prediction model and its derived risk‐scoring system. Methods: This was a prospective cohort study of healthy pregnant women who registered and gave birth in five hospitals in Lagos, Nigeria, from January to June 2023. Maternal antepartum characteristics were compared between women with and without PPH. A predictive multivariable model was estimated using binary logistic regression with a backward stepwise approach eliminating variables when P was greater than 0.10. Statistically significant associations in the final model were reported when P was less than 0.05. Results: The prevalence of PPH in the enrolled cohort was 37.1%. Independent predictors of PPH such as maternal obesity (adjusted odds ratio [aOR] 3.25, 95% confidence interval [CI] 2.47–4.26), maternal anemia (aOR 1.32, 95% CI 1.02–1.72), previous history of cesarean delivery (aOR 4.24, 95% CI 3.13–5.73), and previous PPH (aOR 2.65, 95% CI 1.07–6.56) were incorporated to develop a risk‐scoring system. The area under the receiver operating characteristic curve (AUROC) for the prediction model and risk scoring system was 0.72 (95% CI 0.69–0.75). Conclusion: We recorded a relatively high prevalence of PPH. Our model performance was satisfactory in identifying women at risk of PPH. Therefore, the derived risk‐scoring system could be a useful tool to screen and identify pregnant women at risk of PPH during their routine antenatal assessment for birth preparedness and complication readiness. Synopsis: We recorded a postpartum hemorrhage (PPH) prevalence of 37.1%. The developed prediction model in the study performed satisfactorily in identifying women at risk of PPH. [ABSTRACT FROM AUTHOR]

Background: The study determined the pattern and distribution of gynaecological cancer cases seen at a university teaching hospital in southwest Nigeria over a 5-year period. Methodology: It was a 5-year retrospective review of all gynaecological cancer cases seen and managed at the hospital from 1 September 2013 to 31 August 2018. Results: A total of 6247 gynaecological admissions and 902 gynaecological cancers were seen in the hospital during the study period accounting for a proportion of 14.4%. Of these 902 cases, 835 (92.6%) women had their detailed records available for data extraction and analyses. Cervical cancer was the most commonly seen malignancy (61.7%). The mean age of the patients was 52.5 ± 12.4 years with the largest proportion of the women being in the age group of 50-59 years (26.9%). A large proportion (35.6%) of the patientshad a parity of 5 or more with an overall median parity of 4 (1QR, 1-5) while the largest proportion (59.1%) were postmenopausal women. The highest mean age was seen in women with vulvar cancer (67.2 ± 0.6 years) while the lowest was in those with sarcoma botryoides (12.3±1.01 years). Conclusion: There was a steady annual increase in the number of gynaecological cancer cases at the hospital during the period under review. The most common cancers seen in this study are associated with advanced age, increased parity and postmenopausal status. There is a need for improved public enlightenment on the importance of routine screening and for consistent government policy on the institution of an effective organised screening programme for cervical cancer. [ABSTRACT FROM AUTHOR]

We present a case of a 30-year-old primigravida, at 38-week gestation, who had a posterior classical uterine incision due to a huge anterior wall leiomyoma associated with uterine torsion and breech presentation. The rarity of this type of uterine incision, the size of the uterine myoma and the uterine torsion prompted this case report. During caesarean section, the diagnoses of uterine torsion and a huge anterior wall leiomyoma were made. She had safe delivery of the fetus through a posterior classical caesarean section. The patient had an uneventful post-operative period and was discharged home with her baby on the fourth post-operative day. [ABSTRACT FROM AUTHOR]

Primary vaginal leiomyosarcoma (VLMS) is an extremely rare variant of primary vaginal cancers with very poor prognosis irrespective of the stage at presentation and the type of treatment received. It is easily recurrent and has a high propensity for haematogenous spread especially to the lungs. We present the case of a 34-year-old Para 1 + 1 (1 alive) woman with recurrent vaginal mass of 8 years duration after two surgical excisions without histological evaluation. She had examination under anaesthesia and a wide local excision of the vaginal mass. Histological examination of the mass revealed poorly differentiated VLMS with positive surgical margins and she was commenced on adjuvant chemo-radiation. Histological evaluation remains the hallmark for diagnosing rare malignancies like VLMS, which unfortunately is not a standard practice in some resource-constraint settings. [ABSTRACT FROM AUTHOR]

The high burden of anaemia during pregnancy underscores the urgent need to gain a comprehensive understanding of the factors contributing to its widespread occurrence. Our study assessed the prevalence and the trends of moderate-to-severe anaemia (MSA) in late pregnancy (28 to 36 weeks) and then investigated the key determinants driving this prevalence among women in Lagos, Nigeria. We conducted a secondary data analysis involving 1216 women enrolled in the Predict-PPH study between January and March 2023. We employed a multivariate binary logistic regression model with a backward stepwise selection approach to identify significant predictors of MSA. The study revealed a 14.5% prevalence of MSA during pregnancy. Independent predictors of MSA included having given birth to two or more children (adjusted odds ratio = 1.46, 95% confidence interval: 1.03–2.07), having a maternal body mass index (BMI) of 28 kg/m2 or higher (adjusted odds ratio = 1.84, 95% confidence interval: 1.29–2.61), having less than tertiary education (adjusted odds ratio = 1.51, 95% confidence interval: 1.08–2.11), and being unemployed (adjusted odds ratio = 1.97, 95% confidence interval: 1.19–3.26). It is crucial for pregnant women, particularly those with higher parities and elevated BMI, to be monitored regularly for anaemia and its consequences during their antenatal care. Additionally, addressing the link between low education, unemployment, and anaemia necessitates comprehensive strategies that empower women in terms of education and economic status to enhance the overall well-being of individuals and communities, ultimately reducing the prevalence of anaemia and associated health issues in pregnancy. [ABSTRACT FROM AUTHOR]

Vaginal cancer is rare and accounts for only 1 to 2% of all gynaecological malignancies. They arise as primary squamous cell cancers or are the result of extension from the cervix or vulva. Primary mucinous vaginal adenocarcinoma of intestinal-type is an extremely rare malignancy of unknown histogenesis with a diagnostic dilemma for the clinician and histopathologist. We presented the case of a 40-year-old Para 0+2 woman with the complaint of a mass in the vagina and recurrent vaginal bleeding who was evaluated and worked-up for examination under anaesthesia and biopsy of the vaginal mass. The histological examination revealed the unusual intestinal-type variant of adenocarcinoma of the vagina. Recognition of this rare entity is important, particularly to avoid the pitfall of misdiagnosing metastatic disease as primary vaginal cancer. [ABSTRACT FROM AUTHOR]

We assessed the predictors of Pap smear testing uptake within 6 months after cervical cancer prevention education among women in Lagos, Nigeria. This was a prospective follow-up study conducted as part of the ‘mHealth-Cervix trial’ in the two teaching hospitals in Lagos, Nigeria, between August 2020 and April 2021. Participants were followed up for 6 months after pre-enrolment cervical cancer prevention education. The potential socio-demographic and clinical predictors of Pap smear testing uptake during the 6-month follow-up were tested using the predictive model in a binary logistic regression analysis. Statistical significance was reported as p < 0.05. The rate of Pap smear testing uptake during the 6-month follow-up was 35.7%. Following the adjustments in the final multivariate analysis, participants’ previous awareness of Pap smearing (RR = 6.92, 95% CI: 8.37–56.68, p = 0.001) and attendance at the general outpatient clinic during the period of follow-up (RR = 11.22, 95% CI: 1.54–81.51, p = 0.017) independently predict Pap smear testing uptake. We will, therefore, explore the impact of continuous provision of health promotion on cervical cancer prevention and its effect in the context of routine clinical care in our next implementation research agenda. We recommend, in the meantime, that regular health education of women on cervical cancer prevention by healthcare providers should be further reinforced as an integral part of health promotion in clinics to reduce the burden of cervical cancer in most low- and middle-income settings. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of selenium supplementation on pregnancy outcomes and disease progression among HIV‐infected pregnant women in Lagos. Methods: A randomized, placebo‐controlled trial conducted among HIV‐positive pregnant women between September 2018 and August 2019. At enrollment, 90 women were randomly assigned into each treatment arm to receive either a daily tablet of 200 μg elemental selenium or a placebo. Relevant participants' sociodemographic and clinical data were collected at enrollment and delivery. Results: Women in the selenium arm had a significantly lower risk of preterm delivery (relative risk [RR] 0.32, 95% confidence interval [CI] 0.11–0.96) and a non‐significant reduction in the risk of delivering term neonates with a low delivery weight (RR 0.24, 95% CI 0.05–1.19). Supplemental selenium does not increase the risk of perinatal death and adverse drug events. Conclusion: The study reported a beneficial effect of prenatal selenium supplements on the risk of preterm delivery with no further reduction in risk among HIV‐infected women who used the supplements for more than 14 weeks. Trial registration: Pan African Clinical Trial Registry (PACTR201809756724274). Synopsis: There is a beneficial effect of prenatal selenium supplements on the risk of preterm delivery, irrespective of the duration of use, in HIV‐infected pregnant women. [ABSTRACT FROM AUTHOR]