E R Efetie1. 1. Department of Obstetrics and Gynaecology National Hospital Abuja, Nigeria. efenae@yahoo.com
Abstract
CONTEXT: Infertility and menstrual abnormalities continue to constitute a significant bulk of gynaecological consultations. Both of these problems are sometimes traced to intrauterine adhesions (IUA) which is preventable in the majority of cases. Endoscopic lysis under direct vision is being introduced into contemporary practice in Nigeria for the treatment of this condition, and is about to commence in this centre. OBJECTIVE: To evaluate the reproductive outcome following treatment of intrauterine adhesions with the mainly traditional division of adhesions, Lippes loop insertion and exogenous hormone supplementation. STUDY DESIGN, SETTING AND SUBJECTS: A retrospective analysis of IUA at the National Hospital Abuja, Nigeria from the period: from 1st September 1999 to 31st August 2004 was carried out in September 2005 for evaluation of their treatment. One patient was lost to follow up and a total of 71 case records were analyzed. MAIN OUTCOME MEASURES: Reproductive outcome among participants with regard to resumption of normal menstruation and becoming pregnant. RESULTS: The incidence of IUA was 1.73% of new patients. Mean age +/- SD was 29.97 +/- 4.82 years. Patients who were Para 0 to 1 constituted 81.9% of the total. Resumption of normal menstruation occurred in 34 (47.9%) patients. At the time of assessment, 17 women (23.9%) were still amenorrhoeic, 15 women (21.1%) were hypomenorrhoeic while 5 women (7.0%) still had oligomenorrhoea. Eight women (11.3%) had achieved a pregnancy within the study period. CONCLUSION: The reproductive outcome following treatment of intrauterine adhesions in this centre is not encouraging and needs improvement. Adoption of more successful treatment modalities like hysteroscopic adhesiolysis is advocated.
CONTEXT: Infertility and menstrual abnormalities continue to constitute a significant bulk of gynaecological consultations. Both of these problems are sometimes traced to intrauterine adhesions (IUA) which is preventable in the majority of cases. Endoscopic lysis under direct vision is being introduced into contemporary practice in Nigeria for the treatment of this condition, and is about to commence in this centre. OBJECTIVE: To evaluate the reproductive outcome following treatment of intrauterine adhesions with the mainly traditional division of adhesions, Lippes loop insertion and exogenous hormone supplementation. STUDY DESIGN, SETTING AND SUBJECTS: A retrospective analysis of IUA at the National Hospital Abuja, Nigeria from the period: from 1st September 1999 to 31st August 2004 was carried out in September 2005 for evaluation of their treatment. One patient was lost to follow up and a total of 71 case records were analyzed. MAIN OUTCOME MEASURES: Reproductive outcome among participants with regard to resumption of normal menstruation and becoming pregnant. RESULTS: The incidence of IUA was 1.73% of new patients. Mean age +/- SD was 29.97 +/- 4.82 years. Patients who were Para 0 to 1 constituted 81.9% of the total. Resumption of normal menstruation occurred in 34 (47.9%) patients. At the time of assessment, 17 women (23.9%) were still amenorrhoeic, 15 women (21.1%) were hypomenorrhoeic while 5 women (7.0%) still had oligomenorrhoea. Eight women (11.3%) had achieved a pregnancy within the study period. CONCLUSION: The reproductive outcome following treatment of intrauterine adhesions in this centre is not encouraging and needs improvement. Adoption of more successful treatment modalities like hysteroscopic adhesiolysis is advocated.