Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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A survey of 231 clinical directors in obstetrics and gynaecology in the British isles in 2005 asking about attitudes and practice relating to Caesarean Section (CS) had a 68.3% response rate. This paper reports on consultants' practice. Since our previous survey done in 1990 relating to births in 1989 the use of epidural anaesthesia had increased and the vast majority of caesarean sections were done under epidural or spinal aneasthesia and the majority of consultants allowed the partner to be present at the birth compared with 55% in 1989. ⋯ The proportion of women monitored routinely in labour had dropped from 45% to 11% although half still had an admission strip performed despite the 2001 guidelines. Few had read, the FIGO Ethics committee recommendations about non-medically indicated CS and it is suggested that the RCOG should bring such information to the attention of members through O&G news. A leaflet explaining the possible risks of CS and the long term implications should be produced by the RCOG alone or in conjunction with the Dept of Health so that women are better informed about these.
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There are considerable efforts in Kenya to increase awareness of the issues and health risks associated with female genital mutilation (FGM) through educational programmes. The Kenyan government formally outlawed FGM in 2001. ⋯ The need for further efforts to eradicate the practice and the importance of religion and culture in shaping social attitudes was evident. The outlawing of FGM was considered a positive advance but may have the detrimental effect of deterring women from seeking medical assistance for complications relating to FGM.
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We aim to assess the feasibility and efficacy of laparoscopic oophorectomy in women with pelvic pain after hysterectomy in this retrospective review of 35 consecutive women presenting with pelvic pain who had had their ovaries conserved at the time of hysterectomy. Pain was attributed to the presence of these residual ovaries if there was an adnexal mass--or the pain improved following ovarian suppression with a GnRH analogue. ⋯ Overall, 27 (77%) women reported symptomatic relief following surgery. We conclude that laparoscopic oophorectomy is safe and provides symptomatic relief in this group of women.
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In order to evaluate pain perception among parturients in Enugu, South-east Nigeria, a cross-sectional questionnaire study of parturients who delivered vaginally in four health institutions in Enugu from 2 December 2005 to 21 January 2006 was administered. Data analysis was by means of percentages, means +/- SD, correlation coefficients, t-tests, chi2-tests, one-way ANOVA and other inferential statistics using the statistical package SPSS for MS Windows at the 95% confidence level. A total of 250 questionnaires were distributed, out of which 181 were correctly filled and returned for a response rate of 72.4%. ⋯ It was concluded that parturients in Enugu, Eastern Nigeria, perceive labour as a very painful process with only a minority of them receiving any form of intra-partum analgesia. There is thus a large unmet need for pain relief among the parturients. Obstetric analgesia as is currently practiced in developed countries is long overdue in Nigeria.