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Background: The resolution of hypertension, proteinuria and AKI postpartum among women with preeclampsia is not well documented in Uganda., Objective: To determine the time to resolution of hypertension, proteinuria and AKI postpartum until 6 weeks among women with preeclampsia in Mulago Hospital, Uganda., Methods: Between August 2017 and April 2018, we measured blood pressure, urine protein and serum creatinine on days 1,7,21 and 42 postpartum among 86 women with preeclampsia. The primary outcomes were time to the resolution of hypertension, proteinuria and AKI. We fitted accelerated failure models using Stata 17's stintreg . command with a log normal distribution and obtained time ratios of selected exposures on time to resolution of hypertension, proteinuria and AKI intervals., Results: The median time to resolution of hypertension, proteinuria and AKI was seven (7) days (Inter quartile range, IQR 1-21). The time to resolution of hypertension among primiparous women was 3.5 times that of multiparous women [TR 3.5, 95%CI 1.1, 11.3]. No differences were observed in resolution of hypertension, proteinuria and acute kidney injury., Conclusion: The time to resolution of hypertension, proteinuria and AKI was seven days. We recommend larger studies with longer follow-up beyond six-weeks postpartum to inform revision of our guidelines., Competing Interests: The authors have no conflict of interest to declare., (© 2023 Muteke K et al.)

Background: Oxidative stress plays a role in the aetiology of pre-eclampsia and vitamin C may prevent pre-eclampsia., Objective: To determine the association between plasma vitamin C and pre-eclampsia in Mulago Hospital, Kampala, Uganda., Methods: This case-control study was conducted at Mulago Hospital from 1(st) May 2008 to 1(st) May 2009; 207 women were the cases and 352 women were the controls. Plasma vitamin C was assayed in the women using a colorimetric method. An independent t test was used to find the difference in the means of plasma vitamin C and logistic regression was used to find the association between plasma vitamin C and pre-eclampsia., Results: The mean plasma vitamin C was 1.7(SD=0.7) × 10(3) µg/L in women with pre-eclampsia and 1.9(SD=0.7) × 10(3) µg/L in women with normal pregnancy (P=0.005). Women with low plasma vitamin C were at an increased risk of pre-eclampsia (OR 2.91, 95% CI: 1.56-5.44)., Conclusion: There was a strong association between low plasma vitamin C, and pre-eclampsia in women attending antenatal clinics at Mulago Hospital, Kampala. Health workers need to advise women at risk in the antenatal period about diet, especially foods which are rich in vitamin C to probably reduce pre-eclampsia.

Objective: To determine the presentation and treatment offered to sexually assaulted females attending emergency gynaecological ward in Mulago Hospital, Kampala, Uganda., Setting: Mulago hospital gynaecological emergency ward., Study Design: Prospective descriptive study., Participants: Fifty eight sexually assaulted females were recruited from 1 st March 2000 to 31 st December 2000. They were interviewed, examined, given appropriate treatment and followed up for three months., Outcome Variables: Socio demographic characteristics, genital and bodily injuries, relationship to the assailant, and prevalence of sexually transmitted infections., Results: The mean age was 9.5 with a range of 1-35 years. Seventy two percent of the victims were children below 12 years. Fifty percent of the assault occurred at the assailant's home. The majority (79.3%) of the victims knew the assailant and cases of gang rape were only 6.9%. The injuries sustained were extra genital (19.0%), genital (75.4%). The emotional or psychological disturbance was present in 22.4% of the patients. The sexually transmitted infections found included trichomonas vaginalis (1.7%) and syphilis (3.7%). All cases received counseling and prophylactic treatment for sexually transmitted infections. Those in reproductive age group were offered emergency contraception. None of the victims got post exposure HIV therapy because it was not available in the hospital., Conclusion: Sexual assault is common in Uganda and is one of the most dehumanizing human crimes against women. It is associated with adverse medical and social problems. There is urgent need to sensitize the community about reporting early for medical treatment after sexual assault.

Spontaneous rupture of bladder and extravasation of urine in the peritoneum without evidence of trauma is rare. This condition is an emergency. It presents in a unique way therefore, the diagnosis and treatment is usually delayed. This patient presented with an acute abdominal pain and oliguria. She had delivered normally eight days before re-admission. Investigations were done and an exploratory laparotomy was performed. There was a tear in the fundus of the bladder and the peritoneal cavity contained urine. Peritoneal lavage was done and the bladder was repaired in layers. She was put on continuous bladder drainage for three weeks followed by bladder training. The bladder resumed its normal function. Early diagnosis and appropriate management decreases the morbidity and mortality associated with this condition.

Objective: To determine the maternal and foetal outcomes in mothers with gestational diabetes mellitus attending antenatal clinics in Mulago Hospital Kampala Uganda., Design: This was a cohort study., Setting: Mulago Hospital antenatal clinics., Participants: Ninety mothers with gestational ages between 24-32 weeks were recruited from April to September 2001.They were followed up to the time of delivery. The WHO criterion for the diagnosis of gestational diabetes was used. Thirty mothers with a 2 hrs post prandial capillary blood sugar more than 140 mg/dl were the exposed group and 60 mothers with less than 140 mg/dl were the unexposed group. Blood sugar was measured using a one touch glucometer., Outcome Variables: Socio demographic characteristics, maternal complications, mode of delivery and the foetal outcomes., Results: The mean age of mothers in both groups was similar: 28.6 years vs 27.5 years. Both groups had similar body mass index more than 26. The mothers with gestational diabetes mellitus (GDM) were four times more likely to have hypertensive disease(p=0.04) and nine times more likely to have vaginal candidiasis(p=0.002). The modes of delivery were similar in both groups but genital injuries were more common among mothers with GDM. The indications of Caesarian section in mothers with GDM were two times more likely to be due to big babies and obstructed labour. The babies for mothers with GDM were more likely to be macrocosmic, still born, and have shoulder dystocia than those of normal mothers., Conclusion: Gestational diabetes mellitus exists in Uganda and is associated with adverse maternal and foetal outcomes. There is need to routinely screen mothers for gestational diabetes in this environment.

Objectives: To establish the sexual practices and their associated morbidity among women within 6 months of childbirth in Kampala Uganda., Design: Cross-sectional descriptive study., Setting: The three Mulago hospital child immunization clinics., Participants: Two hundred and seventeen eligible mothers took part in the study from November to December 2001., Outcome Measures: Time to resumption of sexual intercourse after childbirth, reasons for resumption and problems associated with it., Methods: Partially coded questionnaires, Results: Sexual intercourse was resumed by 66.4% of the women within six months of childbirth. Of these 49.3% did so during the puerperium. The main reasons for early resumption of sexual intercourse were husbands' demands, cultural demands and inherent inability to do without sexual intercourse but not level of education of mothers. Of the mothers who resumed sexual intercourse 22.2% had sexual problems. The problems included vaginal pain (62.5%), discharge (18.8%), bleeding (15.6%) and bruises or tears (3.1%). Perineal or genital damage at the time of delivery was not associated with a delayed resumption of sexual intercourse with (OR1.08, 95% CI 0.51-2.30). Of those who had sexual intercourse and had problems only 59.4% sought medical assistance. The reasons for not resuming sexual intercourse within six months of delivery included advise from health workers (38.4%), husbands were away (21.9%), no interest (21.9%) and not feeling well(17.8%)., Conclusion: Most women resumed sexual intercourse within six months of childbirth and had high morbidity. There is need for appropriate postpartum sexual practice advice. SITE OF STUDY: Mulago hospital.