Gynaecologic and obstetrics cases and commentaries

Abstract

This dissertation has three parts. As shown in the contents both part one and two are each made up of 10 gynaecological and 10 obstetrical cases and commentaries respectively. All these 20 case reports and commentaries were managed by the author himself. For each case a thorough history, examination, investigations and treatment have been narrated. Cases were managed according to standard laid down management protocols though investigations were at times not exhaustive because of limited facilities. After each case there is a commentary followed by relevant references. A long obstetrical commentary is in part three(3). A prospective study on Maternal anthropometric measurements and gestational age in prediction of foetal weight in pregnant women at Muhimbili Medical Centre was done. A total of 600 patients were included in the study. The study revealed that Maternal anthropometric measurements (symphysio- fundal height and abdominal girth) were good predictors by birth weight. An equation of great predictive value utilizing these anthropometric measurements was derived and tested in another sample of hundred patients. It was found that sensitivity and specificity of detecting birth weight less than 2kg was 88.2% and 84.3% respectively. Sensitivity and specificity for detecting birth weight more than 3.8kg was 83.3% and 68.1 % respectively. Conclusively, it seems justified to investigate the value of equation of higher predictive value for use in antenatal care in developing countries.