Search

The current management of ectopic pregnancy in a main teaching hospital was reviewed in the lead up to the amalgamation of the services of three maternity hospitals. A retrospective analysis of 54 women treated surgically for suspected ectopic pregnancy from January 2005 to May 2006 was carried out. The diagnosis and management of ectopic pregnancy, including length of stay in hospital, was reviewed. Analysis revealed that 46% of women were treated laparoscopically, 28% underwent laparoscopy with subsequent conversion to laparotomy and 26% of women had a primary laparotomy, of which only half were clinically unstable. Inexperience in laparoscopic surgery was found to be the primary reason for conversion to laparotomy. As the majority of operations were performed by NCHDs, there is a need to increase the training received in laparoscopic surgery to reach an acceptable standard laparoscopic rate of greater than 90%. This would result in shorter lengths of stay in hospital, substantial financial savings and greater patient satisfaction.

Women with functioning renal transplants are a high-risk group for de novo malignancies and other gynaecological health problems. The objective of this study was to assess patients' awareness of gynaecological issues, and to assess uptake of cervical and breast cancer screening services. A structured questionnaire on family planning, menopausal issues and knowledge/use of cervical and breast cancer screening was administered to 64 female renal transplant recipients. 58 (91%) responded to the questionnaire. Mean age at first transplantation was 35 years (range 11 - 69). 84% were aware as to why they should have regular cervical smears. 15 (26%) had, however, never had a smear and only 9 (16%) were having yearly smears. 12 of 28 postmenopausal women entered the menopause under the age of 41 years, but only 5 of these had received Hormone Replacement Therapy. Breast self examination is practiced by 71%, but only 26% have had mammograms. These figures suggest that female renal transplant patients are not adequately screened for cervical and breast cancer. The results also indicate a need for further education regarding family planning issues and menopausal health concerns. We conclude that formal gynaecological review should be routinely available for women with renal transplants.