Review of Gynaecological Diagnoses and Surgeries Performed at a Tertiary Health Facility in Niger-Delta of Nigeria from 2012-2017: Implications for Healthcare Planning and Budgeting

Main Article Content

P. A. Awoyesuku
D. A. MacPepple
B. O. Altraide
D. H. John

Abstract

Background: Gynaecological disorders are a particularly common cause of morbidity and mortality among women of reproductive age and a common cause of hospital presentation/admission and surgery.

Objective: This study sought to review gynaecological diagnoses and surgeries performed in a tertiary health facility from 2012 to 2017 and its implication for healthcare planning and budgeting.

Methodology: This was a retrospective review of all gynaecological diagnoses and surgeries seen in the Rivers State University Teaching Hospital (RSUTH) from 2012 to 2017. Data were retrieved using a proforma comprising of year, gynaecological diagnosis and gynaecological surgeries. Data obtained was entered into Microsoft Excel for descriptive analysis.

Results: The proportion of clinic attendees declined from an average of 23% in the first three years (2012-2014) to about 10% in the last three years (2015-2017). The most common gynaecological diagnosis were uterine fibroid (33.3%), infertility 28.1% (primary 5.7%, secondary 22.4%), PID (5.9%), ovarian tumour (4.2%), secondary amenorrhea (3.4%) and pelvic malignancies (3.4%). The commonest major surgeries were myomectomy 441(33.7%), salpingectomy 345(26.4%), hysterectomy 168(12.8%) and cervical cerclage 122(9.3%). The commonest minor surgeries were manual vacuum aspiration 314(41.0%), examination under anaesthesia and biopsy 110(14.3%) and adhesiolysis for synechiae 97(12.6%). The duo of uterine fibroid and infertility made up 50%-70% of all gynaecological diagnoses.

Conclusion: This study showed that there has been a steady decline in gynaecological consultations over the years. However, the duo of uterine fibroid and infertility made up half to three-quarter of all gynaecological diagnoses over the 6 years. Infertility and uterine fibroids have a long cause and effect association. Healthcare policies and budgeting should be increased towards tackling these conditions, especially the setting up of a fertility center to provide assisted reproductive technologies and laparoscopy to improve practice and patient outcome.

Keywords:
Gynaecological disorders, gynaecological surgeries, healthcare budgeting, tertiary health.

Article Details

How to Cite
Awoyesuku, P. A., MacPepple, D. A., Altraide, B. O., & John, D. H. (2020). Review of Gynaecological Diagnoses and Surgeries Performed at a Tertiary Health Facility in Niger-Delta of Nigeria from 2012-2017: Implications for Healthcare Planning and Budgeting. Journal of Advances in Medicine and Medical Research, 32(2), 1-10. https://doi.org/10.9734/jammr/2020/v32i230361
Section
Review Article

References

Jonathan AK, Victor CP, Terkaa A, Philip PA, Michael R. Indications for gynaecological consultations by women at a Rural Outreach Centre in North-Central Nigeria. Int J Trop Dis Health. 2014;4:696-712.

Fawole AO, Awonuga DO. Gynaecological emergencies in the tropics: Recent advances in management. Ann Ibadan Postgrad Med. 2007;5:12-8.

Kamel RM. Management of the infertile: An evidence-based protocol. Reprod Biol Endocrinol. 2010;8:21.

Obuna JA, Ndukwe EO, Ugboma HA, Ejikeme BN, Ugboma WE. Clinical presentation of infertility in an outpatient clinic of a resource poor setting, South-East Nigeria. Internet J Trop Dis Health. 2012;2:123-31.

Ezeh AC, Mberu BU, Emina JO. Stall in infertility decline in Eastern African countries: Regional analysis of patterns, determinants and implications. Philos Trans R Soc Lond B Biol Sci. 2009;364: 2991-3007.

Idrisa A. Infertility. In: Kwawukume EY, Emuveyan EE. Editors. Comprehensive Gynaecology in the Tropics. Accra Graphics Packaging. 2005;333-43.

Panti AA, Sununu YT. The profile of infertility in a Teaching Hospital in North West Nigeria. Sahel Med J. 2014;17:7-11.

Dettijo LM, Andreadis N, Aminu BM, Umar NI, Black KI. The prevalence and clinical pattern of infertility in Bauchi, Northern Nigeria. Trop J Obstet Gynaecol. 2016; 33(1):76-85.

Odunvbun WO, Oziga DV, Oyeye LO, Ojeogwu CL. Pattern of infertility among infertile couple in a secondary health facility in Delta State, South-South Nigeria. Trop J Obstet Gynaecol. 2018;35:244-8.

Adeyemi AS, Adekanle DA, Afolabi AF. Pattern of gynaecological consultations at Ladoke Akintola University of Technology Teaching Hospital. Niger J Clin Pract. 2009;12:47-50.

Drinville JS, Memarzadeh S. Benign disorders of the uterine corpus. In: Decherney AH, Nathan I, Goodwin TM, Laufer N, editors. Current Diagnosis and Treatment in Obstetrics & Gynaecology. 10th ed. New York: McGraw-Hill. 2007;639-53.

Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of leiomyoma in black and white women: Ultrasound evidence. Am J Obstet Gynecol. 2003;188:100-7.

Anate M. Uterine fibroids in Federal Medical Centre, Lokoja: A five-year review 2002-2006. The Nigerian Clinical Review Journal. 2007;5-12.

Isah AD, Adewole N, Agida ET, Omonua KI. A Five-year Survey of Uterine Fibroids at a Nigerian Tertiary Hospital. Open Journal of Obstetrics and Gynaecology. 2018;8:468-476.
DOI:https://dx.doi.org/10.4236/ojog.2018.85053

Komolafe JO, Makinde NO, Ajadi AM, Dayo AA. Uterine leiomyomata in Lle-Ife, Nigeria. Trop J Obstet Gynaecol. 2004;21: 103-6.

Okezie O, Ezegwui HU. Management of uterine fibroids in Enugu, Nigeria. J Obstet Gynaecol. 2006;26:363-5.

Ezeama C, Ikechebelu J, Obiechina NJ, Ezeama N. Clinical presentation of uterine fibroids in Nnewi, Nigeria: A 5-year Review. Ann Med Health Sci Res. 2012; 2(2):114-118.
DOI:https://dx.doi.org/10.4103/2141-9248.105656

Aboyeji AP, Ijaiya MA. Uterine fibroids: A ten-year clinical review in Ilorin, Nigeria. Niger J Med. 2002;11:16-19.

Fasubaa OB, Sowemimo OO, Ayegbusi OE, Abdur-Rahim ZF, Idowu BS, Ayobami O, et al. Contributions of uterine fibroids to infertility at Ile-Ife, South-Western Nigeria. Trop J Obstet Gynaecol. 2018;35: 266-70.

Hrubosova E. Uterine fibroids and their treatment. Ceska Gynekol. 2011;76:152-7.

John CO, Alegbleye JO. Ectopic pregnancy experience in a tertiary health facility in South-South Nigeria. The Nigerian Health Journal. 2016;16(1):1-15.

Udigwe GO, Umeononihu OS, Mbachu II. Ectopic pregnancy: A 5-year review of cases at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. Niger Med J. 2010;51:160-3.

Lawani OL, Anozie OB, Ezeonu PO. Ectopic pregnancy: A life-threatening gynecological emergency. International Journal of Women’s Health. 2013;5:515-521. DOI:https://dx.doi.org/10.2147/IJWH.S49672.

Ibrahim SA, Natalia A, Abubakar IS, Garba ID. Pattern of gynaecological admissions in Aminu Kano Teaching Hospital: A 3-year review. Trop J Obstet Gynaecol. 2011;28:52-7.

Omole-Ohonsi A, Olayinka HT, Attah RA. Ectopic pregnancy at Aminu Kano Teaching Hospital Kano. Trop J Obstet Gynaecol. 2011;28:58-61.

Buowari D. Pattern of gynaecological admissions at a rural hospital in Nigeria. The Internet J Trop Med. 2009;7:15-19.

Garba I, Ayuba R, Adewale TM, Abubakar IS. Surgical management of uterine fibroids at Aminu Kano Teaching Hospital. Niger J Basic Clin Sci. 2016;13:50-54.

Omole-Ohonsi A, Belga F. Surgical management of uterine fibroid at Aminu Kano Teaching Hospital. Obstet Gynaecol Int. 2012;2012:702325.

Yakasai IA, Abdullahi J, Abubakar IS. Management of ectopic pregnancy in Aminu Kano Teaching Hospital: A 3-year review. Global Res J. 2012;1:181-5.

Isa B, Mairiga AG, Ibrahim SM, Bako BG, Usman HA. Experience with manual vacuum aspiration at the University of Maiduguri Teaching Hospital. Borno Med J. 2013;10(2):31-36.

Brado AT, Panti AA, Shehu CE, Ukwu AE. Elective hysterectomy at Usman Danfodio University Teaching Hospital Sokoto North West Nigeria. Bo Med J. 2013;10: 21-25.

Efetie ER, Abubakar JS, Habeeb SA. Audit of gynaecological laparoscopies in National Hospital Abuja Nigeria. Niger J Clin Pract. 2009;12:149-52.

Okonofua FE. Infertility in sub-Saharan Africa. In: Okonofua FE, Odunsi K. editors. Contemporary Obstetrics and Gynaecology for Developing Countries. Publishers: Women’s Health and Action Research Centre. Benin City. 2003;128-56.

Takai IU, Yakasai IA, Omeji IJ, Ugwa EA. An Audit of Gynaecological Procedures Performed at Aminu Kano Teaching Hospital, Kano. Journal of Basic and Clinical Reproductive Sciences. 2015;4(2): 64-69.

Awoyesuku PA, Altraide BOA. Contraceptive Choices and Acceptability among New Clients attending the Family Planning Unit of Rivers State University Teaching Hospital, Nigeria. Journal of Advances in Medicine and Medical Research. 2019;30(3):1- 7.
DOI:https://doi.org/10.9734/JAMMR/2019/v30i330180.