Obstetrics and gynaecology cases and commentaries

Abstract

This dissertation is submitted as part of the requirements for the award of the degree of master of medicine (m. med) of the university of dar es salaam. it consists of three parts the first section consists of ten gynaecological conditions which are important problems not only at muhimbili medical centre but other centres as well. the second part comprises of ten obstetric conditions. the management of all these twenty conditions was done according to the standard management protocol. due to limited facilities in some of these cases further investigations could not be done in the managment of these patients. after each presented case there is a commentary about it. recommendations as to the management of such patients under ideal conditions and when facilities are limited is discussed. part three is a research paper on pregnancy induced hypertension in primigravidae conducted at muhimbili medical centre maternity clinic. hypertension in pregnancy is the seeond commonest cause of maternal morbidity and mortality next to anaemia in developing countries. this is also supported by figures from muhimbili medical centre. there is evidence suggesting that aspirin in low doses favourably influences the course and outcome of pregnancy in primigravidae with high risk of developing pregnancy induced hypertension. those at high risk of developing pregnancy induced hypertension were screened osing the roll over test.

viii the roll over test proved to be of value in screening primigravidae who will develop pregnancy induced hypertension, and that aspirin at low doses had a protective value.