Giant uterine fibroids (leiomyoma or myomas) which are fibroid masses greater than 11.4 kg are very rare. Although benign in nature, it may present with symptoms that impact negatively on the quality ...of life and health of the patient and impose greater management challenges. We present two cases of giant uterine fibroids that were successfully managed in a private specialist hospital without complications. Case 1 was a 38-year-old nulliparous Nigerian woman who presented with giant uterine fibroids (11.6 kg) who initially had delay of surgery due to fear that after surgery she may lose her "womb" or not be able to conceive after the operation. Later, she had successful open abdominal myomectomy, with the use of Foley catheters as improvise equipment for tourniquet and abdominal drain. Anti-adhesion agent was not used. Case 2 was a 47-year-old nulliparous Nigerian teacher with giant fibroids (13.2 kg) who also initially had delayed surgery due to fear that fibroid surgery is a major operation that it may get complicated and she may die. Also, she was afraid that she may not have her womb in her next world if she gets reincarnated. She had total abdominal hysterectomy and bilateral salpingo-oophorectomy without complications. For both cases, pre-surgery leiomyosarcoma assessment with computed tomography scan or magnetic resonance imaging and anti-adhesion agent were not used due to very unaffordable high costs. These reports of giant uterine fibroids (leiomyoma or myomas) are very rare gynecological entity, and management can be successful despite overwhelming challenges in low-income countries. Cheaper, affordable and available alternatives (improvises) can be resorted to for tackling its challenges in low-income settings.
Background: Preeclampsia is a major complication of pregnancy and a major cause of perinatal and maternal morbidity and mortality. Vitamin D deficiency has been implicated in the aetiology and ...pathophysiology of preeclampsia. However, there is no uniformity in the findings of previous studies on the association between vitamin D and preeclampsia. Aims and Objectives: The study is aimed at determining the association between preeclampsia and maternal vitamin D deficiency. Materials and Methods: This nested case-control study was conducted among 158 pregnant women (78 preeclamptic women and 80 controls) with singleton pregnancies. Case participants were women with preeclampsia. The controls were matched pregnant women without preeclampsia. Their serum vitamin D levels were determined. Statistics: Continuous data was analysed using T-test. The statistical significance was inferred at p- value ≤0.05. Results: The prevalence of hypovitaminosis D in our study was 7.0% overall. The proportion of women with hypovitaminosis D was not significantly different between preeclampsia group and control group (7.7% vs 6.3% respectively; p=0.76). The mean serum concentration of vitamin D in the preeclamptic group was lower than that in the control group, however, the difference was not statistically significant (118.8±17.4nmol/L vs 129.0±19.7nmol/L, p=0.17). There was a weak association between gestational age and the level of serum vitamin D in both groups (r= 0.062 and r= -0.13 respectively). Conclusions: Hypovitaminosis D is not significantly associated with preeclampsia when compared with control. However, there was a weak association between gestational age and the level of serum vitamin D in both groups.
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