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Background: There are over four million people living with HIV/AIDS in Nigeria. Cervical cancer is the most common genital cancer in Nigeria. There are many reports on the association of HIV with increased risk of cervical dysplasia., Objective: To determine the prevalence of abormal cervical smears in Nigerian women who are HIV positive in Lagos., Methods: Cervical smears were taken from 233 HIV positive women and 235 HIV negative women who attended the HIV clinic and the family planning clinic respectively of the Lagos University Teaching Hospital during the period January-April 2004. Proportions were compared with the X2 test., Results: Data were complete for analysis in 227 of HIV positive and 228 of HIV negative women. Mean (SD) ages of HIV positive and HIV negative patients were respectively 35.2 (9.81) and 34.5 (7.37) years. Prevalence of squamous intraepithelial lesion (SIL) was higher in those who were HIV positive than in those who were HIV negative, 10.9% vs 4.3% (X2, 7.04; p=0.00798). Prevalence of high grade SIL was higher in HIV positive than HIV negative subjects, 7.9% vs 2.6% (X2, 6.38; p=0.0115). There was no significant difference in the prevalence of inflammatory smears, 15.7% in HIV positive vs 16.2% in HIV negative., Conclusion: Prevalence of cervical dysplasia is high in women who harbour HIV.

Unlabelled: The objectives of this study were to identify obstetric and medical conditions in transfused patients, appraise the justification for the transfusion and recommend measures for reducing transfusion in obstetrics in Nigeria. Available case records of obstetric patients transfused at the Lagos University Teaching Hospital between the period 1st November 1995 and 31 October 1998 were reviewed retrospectively. Data collected included booking status, mode of delivery, amount of blood-transfused, post transfusion packed cell volume (PCV), and obstetric and medical conditions found in the patients. There were 4,159 cases out of which 503 were transfused. The overall transfusion rate was 12.1%, in booked and unbooked patients, it was 6.6% and 45.8% respectively. Only 231 cases were available for full analysis, mean age was 28.9 +/- 5.2 years (range 16-43 years). Sixty-three (27.3%) had unit-transfusions. Mean post transfusion PCV was 28.4% +/- 4.3% (range 17%-43%). In 63 (27.3%), the post transfusion PCV was above 30%. Some of the obstetric and medical conditions in the transfused patients were caesarean section (68.8%), previous caesarean section (20.4%), antepartum haemorrhage (16.9%), pregnancy induced hypertension (15.6%), anaemia and malaria (14.0%), induction of labour (13.0%), ruptured uterus (8.8%), and sickle cell anaemia (5.2%). Multi-unit transfusions were found in ruptured uterus (5.8 units), sickle cell anaemia (4.9 units), vaginal and cervical lacerations (4.0 units), forceps delivery (3.9 units) and malaria and anaemia (2.9 units)., Conclusion: The study shows a high transfusion rate; an appreciable number were unnecessary transfusions. A number of the obstetric and medical factors for blood transfusion were avoidable. A reduction in blood transfusion rate can be achieved by the provision of adequate, available and affordable maternal health services in Nigeria.

A retrospective study of pregnancy outcome in 60 HbSS sickle cell disease patients, exclusively managed in accordance with standard management modality, as obtained in the obstetric Unit of the Lagos University Teaching Hospital (LUTH), was carried out over a 3-year period (1995-1997). The study shows an increase in the number HbSS patients seeking antenatal care in the LUTH. Although the patients maintained a stable haematological profile, all through pregnancy and delivery, as reflected by the booking, pre-delivery and post-delivery PCV of 23.2 +/- SD 4.6% and 23.6 +/- SD 4.5% respectively; pregnancy was complicated in 96.6% of cases (n = 58). Sickle cell crises of bone pain (41.4%), acute haemolysis with anaemia (34.4%); malaria (22.4%) and other systemic infections (22.4%) were the major causes of pregnancy complications. Antenatal and postpartum blood transfusion rates were 45.0% and 81.6% respectively. The perinatal and maternal mortality rates were 121 and 67/1000 respectively, while caesarean section rate was 43.2%. It is observed that while more patients with HbSS sickle cell disease are seeking antenatal care in the LUTH, with improved prognosis, pregnancy complications from sickle cell crisis, remain a major problem in the care of these patients.