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XIII World Congress of Perinatal Medicine Belgrade – October 26-29, 2017 J. Perinat. Med. 45 (2017) • Copyright © by Walter de Gruyter • Berlin • Boston. DOI 10.1515/jpm-2017-2007 47 XIII World Congress of Perinatal Medicine Belgrade – October 26-29, 2017 INVITED SPEAKERS ABSTRACTS Unauthenticated Download Date | 10/29/17 6:05 PM 48 J. Perinat. Med. 45 (2017) • Copyright © by Walter de Gruyter • Berlin • Boston. DOI 10.1515/jpm-2017-2007 A ONE YEAR REVIEW OF ECLAMPSIA IN AN ETHIOPIAN TERTIARY CARE CENTER (SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, SPHMMC) Abdulfetah Abdulkadir Eclampsia remains one of the five major causes of maternal mortality in developing countries. Advances in diagnosis and management have led to a significant reduction in maternal mortality and morbidity from this disease in developed countries. In developing countries the incidence of maternal death attributed to eclampsia remains high and, in Ethiopia, maternal mortality from this complication has instead risen over the last decade. The purpose of this study was to review the incidence of eclampsia at the largest feto-maternal center in the country over one year in an attempt to determine what quality improvement measures are needed and could realistically be implemented within the system to decrease this complication. There were a total of 104 eclamptic patients during the study period. The hospital incidence of eclampsia was 82/10,000 deliveries excluding those arriving to the hospital in the postpartum period (28 cases). There were 8 maternal deaths making the case fatality rate 1 in 13 cases. The median convulsion to arrival time, referral to arrival time and magnesium sulphate administration time were found to be 3, 2 and 3 hours respectively. The probability of multiple seizures (≥ 3 episodes) was increased significantly with the prolongation of these time variables. Occurrence of multiple seizures was intern significantly associated with adverse maternal outcomes (ICU admission, morbidities and mortalities). As expected, there was a high incidence of eclampsia and eclampsia related maternal death in the hospital. We recommend a thorough assessment of the referral system, upgrading and capacity building of more health facilities, organizing trainings and drills in health facilities; and availing magnesium sulphate in all health centers among others. Unauthenticated Download Date | 10/29/17 6:05 PM 49 J. Perinat. Med. 45 (2017) • Copyright © by Walter de Gruyter • Berlin • Boston. DOI 10.1515/jpm-2017-2007 DEEP TONGUE LACERATION; A RARE COMPLICATION OF INTRAPARTUM ECLAMPSIA Huawa Abdullahi Background: Eclampsia remains a common cause of maternal morbidities and mortalities with higher incidence in developing than developed counties. This is attributed to poor utilization of maternal health care facilities. A good understanding of eclampsia is important in the communities of Northern Nigeria because of the socio-cultural and religious barrier which prevent the women from attending clinics coupled with scarcity of antenatal facilities and inadequate manpower. This is a case of a 23years old unbooked primigravida who is unsure of her date but said to be nine month Amenorrhoec. She presented with complain of convulsions several times at home and bite her tongue in the process. She bled torrentially from the site. They went to three Hospitals before coming to Aminu Kano Teaching Hospital. She was resuscitated, stabilized and delivered via Caesarean Section. The tongue was also repaired by Maxillo fascial surgeons. Conclusion: Preventing pre eclampsia is the main tool of preventing Eclampsia. This is only possible through antenatal care attendance, availability of antenatal facilities and adequate manpower. Addressing socio-cultural barriers and preventing delays will play a significant role in preventing its complications. KEY WORDS: Deep tongue laceration, Complication, Intrapartum eclampsia Unauthenticated Download Date | 10/29/17 6:05 PM 50 J. Perinat. Med. 45 (2017) • Copyright © by Walter de Gruyter • Berlin • Boston. DOI 10.1515/jpm-2017-2007 MANAGEMENT OF THE ADNEXAL MASS IN PREGNANCY Uchenna Acholonu, Jr. Background: Adnexal masses in pregnancy are fairly uncommon but once detected they can cause a great deal of concern. This presentation will discuss the evaluation, management and prognosis of adnexal masses in pregnancy. Methods: We conducted a thorough literature review to answer questions such as incidence of adnexal masses in pregnancy, presentation, physical exam findings, utility of serologic testing, preferred imaging studies for evaluation, criteria for conservative management, options for surgical intervention and findings on pathology. Conclusions: The vast majority of adnexal masses in pregnancy are benign. Some adnexal masses may be managed conservatively but when surgical intervention is indicated this may be successfully accomplished with careful planning and execution. Unauthenticated Download Date | 10/29/17 6:05 PM 51 J. Perinat. Med. 45 (2017) • Copyright © by Walter de Gruyter • Berlin • Boston. DOI 10.1515/jpm-2017-2007 PERINATAL DEATH IN THE REPUBLIC OF MACEDONIA - NATIONAL AUDIT STRATEGY Gordana Adamova Macedonia is a republic that has the highest rate of perinatal mortality in the region of the former Yugoslavia, whose rate oscillates from 19 to 12.8 / 1000. For the record of data, there is a lack of an effective system of registration of maternal and perinatal mortality. This condition required urgent measures to improve the quality of registration, standardization of data and procedures for monitoring these indicators. As a priority, it was pointed out the need for the designation of a reference institution that will officially collect data and report to the Perinatal and May Committee act mortality situation in the whole Republic. In the past period, data for the annual reports were used. The National Institute of Statistics, the Institute of Public Health and the Institute for the Health Protection of Mothers and Children. The data obtained from beards showed problems in the collection and quality of data. With the support of UNICEF, the Ministry of Health has designated a team of experts - members of the Perinatal Mortality Audit Committee, who proposed the audit methodology. The audit target is to obtain data to improve existing clinical practice by creating new forms for obtaining quality data, which will be the basis for the creation of a database for perinatal and neonatal health. For the reference institution for data collection, the National Center for Reproductive Health has been designated (newly formulated). The function is defined and the task is a regulated, as well as her multidisciplinary composition, and maternity obligations. The Perinatal Mortality Review Package was taken from the Perinatal Association of Australia and consists of the following forms. A. COLLECTION OF DATA AND REPORTS - HOUSEHOLD APPLIANCES 1. Individual report for perinatal death 2. Because of the dead man's life 3. Cause of neonatal death 4. The 4th phase of placental examination 5. Depending on the clinical examination of the baby 6. Confidential report for perinatal death B. COLLECTION OF DATA AND REPORTS - COMMISSION FOR EXPERT AUDIT COMMITMENTS 7. Education for the professional revision of perinatal death C. FORMULAR FOR CLINICAL TRAINING - PATOLOGY INSTITUTE All forms are made in electronic form. The parcels must have completed forms to be sent to the State Center for Reproductive Health. The application of this methodology should contribute to the improvement of the perinatal results of our country. Note: This methodology is in function partly and initially due to objective reasons – political situation in the country, where the responsible persons for putting in the function of the project - representatives of the government and the ministries of health, have for a long time engaged in political events in the country. We hope that in the near future, they will be able to present the work of the committee and the results. Unauthenticated Download Date | 10/29/17 6:05 PM 52 J. Perinat. Med. 45 (2017) • Copyright © by Walter de Gruyter • Berlin • Boston. DOI 10.1515/jpm-2017-2007 PRENATAL ULTRASOUND SCREENING FOR FETAL ANOMALIES IN SUB-SAHARAN AFRICA: AN INITIAL EXPERIENCE Janet Ainmoladun INTRODUCTION: Fetal anomalies are important causes of fetal and infant morbidity and mortality worldwide. With the introduction of prenatal ultrasound screening, majority of the congenital anomalies can now be diagnosed in utero. Prenatal ultrasound screening for fetal anomalies was commenced at the University College Hospital, Ibadan, Southwestern Nigeria, in the year 2012. The aim of this study is to describe our initial 4 years’ experience in prenatal screening for fetal anomalies. METHODOLOGY: This hospital-based prospective descriptive study highlights the prevalence and pattern of prenatally diagnosed fetal Anomalies among the pregnant women who presented for routine prenatal ultrasound screening within the study period. Demographic details, associated risk factors and the types of anomalies in the fetuses were recorded. RESULTS. Nine hundred and eighty-nine (989) fetuses (including 15 sets of twins and 1 set of triplets) were presented for prenatal ultrasound screening for fetal anomalies during the study period. The mothers were aged between 18 and 51years old with a mean of 31.7. Sixty- two (6.3%) of the fetuses had fetal anomalies. Twenty- five (40.3%) of the fetuses had minor anomalies while thirty–seven (59.7%) had major anomalies. Minor anomalies were found mostly in the genitourinary
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