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Poorly managed miscarriage may cause infertility, gynaecologists warn

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By Francesca Hangeior.

 

Citing various complications associated with poorly managed miscarriages, maternal health experts have warned women to avoid visiting untrained and unskilled health practitioners for treatment whenever they experience the condition.

The gynaecologists stressed the need for pregnant women who had a miscarriage to visit health facilities with maternal health specialists for appropriate treatment.

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Miscarriage, the loss of a pregnancy before 20 weeks, is a common event that occurs in an estimated 15 per cent of all pregnancies, according to the American College of Obstetricians and Gynaecologists.

They noted that visiting a gynaecologist for the management of a miscarriage was crucial to ensuring proper treatment and evacuation of the foetus as well as to prevent the risk of complications and infections, which could lead to secondary infertility or even death.

The experts warned that poorly managed miscarriage has been identified as one of the causes of infertility in women.

According to the Nigeria Demographic and Health Survey 2018, the country still records a maternal mortality ratio of 512 per 100,000 live births, which is a far cry from achieving the Sustainable Development Goal target of less than 70 per 100,000 live births.

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However, a Consultant Obstetrician and Gynaecologist at the Family Health Department, Federal Ministry of Health, Abuja, Dr. Kamil Shoretire, said stated that miscarriage can profoundly affect the health and well-being of the mother, either from the complications of the process itself or from the complications arising from the treatment and management of the condition.

For those who survive a dangerous miscarriage, the gynaecologist says, there can be untold complications afterwards, including infertility.

Shoretire said, “It is always good for women who have miscarriages to go to the hospital where the experts are and they will be well taken care of.

“Apart from treating them, the experts will also counsel them. “They will tell them the possible causes of the miscarriage and what to do in preparation for the next pregnancy.”

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The gynaecologist noted that by going to the hospital, the women would be well-educated and enlightened to know about the condition itself

“A woman that has a miscarriage cannot assess herself. So, the right thing for her to do is to go to the hospital.

“Some women will not know that they have things like diabetes. It is only at such a time that they have a miscarriage that it will be detected.

“So, it is always good for women who have miscarriages to go to the hospital where the experts are and they will be well taken care of.”

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He also warned that poorly managed miscarriage could lead to an infection that might cause severe damage to the womb.

In a 2019 article published in PMC journal, titled, ‘Causes and Prevalence of Factors Causing Infertility in a Public Health Facility’, the authors said infertility affects roughly 10 per cent of the world’s population. The authors noted that the problem of infertility has become universal now, and thus, understanding the causes is the first step in solving this issue.

“In the population coming to a public sector tertiary care centre, the incidence of primary infertility is more than secondary infertility.

“Increasing age of marriage influences the causes with unexplained infertility and male factors more commonly seen as the age of marriage increases. Female factor remains the main cause of infertility followed by unexplained causes. Male factor is a significant cause of infertility with semen parameters being affected by age and by consumption of tobacco and alcohol”, the authors said.

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Speaking in the same vein, an Associate Professor and Consultant Obstetrician and Gynaecologist at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Dr. Uche Agu, urged women who have fibroid to stop patronizing quacks and traditional homes for treatment to avoid exposing themselves to the risk of infertility.

Warning against the dangers of seeking help in unorthodox places and taking local concoctions, the gynaecologist said, “The problem with fibroid comes from people who are not experienced.

“They could injure the lining of the womb and the woman may not see her menses again. They may have complications. Those who have their tubes inadvertently removed may not be pregnant again.

“Some will even take those local concoctions and will never see their menses again. Some may take the concoction and it will knock off their ovaries and they will never see their menses.

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“Some of the local concoctions get the fibroid matted together and by the time they come for surgery, it becomes difficult to operate. I have seen cases like that.”

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Health

70% of women with polycystic ovary syndrome not aware – Gynaecologist

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*Says, they risk infertility

By Francesca Hangeior.

As the world commemorates this year’s Polycystic Ovary Syndrome Awareness Month, a fertility specialist, Dr. Abayomi Ajayi, has said about 70 percent of women living with the condition are not aware that they have it due to ignorance.

PCOS is a common hormonal condition that affects women of reproductive age.

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Ajayi, who is Medical Director, Nordica Fertility Centre, Lagos, said PCOS was a prevalent cause of infertility, especially anovulatory infertility.

He also stated that PCOS was the most common cause of hormonal disorders in women of reproductive age, causing disrupted ovulation and a lack of regular menstruation.

The consultant gynaecologist disclosed this during a webinar organised by the fertility centre to commemorate this year’s PCOS awareness month aimed at raising awareness about the condition.

PCOS Awareness Month is a global healthcare event observed annually throughout September. It aims to improve the lives of those affected by the condition, help them overcome their symptoms, and prevent and reduce their risks for life-threatening diseases such as diabetes.

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The World Health Organisation says PCOS affects an estimated eight to 13 per cent of reproductive-aged women.

The global health body also states that up to 70 percent of women with the condition remain undiagnosed worldwide despite being a leading cause of infertility.

“PCOS is a common hormonal condition that affects women of reproductive age. It usually starts during adolescence, but symptoms may fluctuate over time.

“PCOS can cause hormonal imbalances, irregular periods, excess androgen levels, and cysts in the ovaries. Irregular periods, usually with a lack of ovulation, can make it difficult to become pregnant.

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“PCOS is a chronic condition and cannot be cured. However, some symptoms can be improved through lifestyle changes, medications, and fertility treatments”, the WHO said.

Ajayi pointed out that the exact cause of PCOS was unknown, adding however that the condition could be genetic.

The consultant gynaecologist said, “September is PCOS awareness month, and that is why we have gathered here today to dispel the myths about PCOS, raise awareness, and offer support to women who are living with the condition so that we can empower them to take care of their health.

“PCOS has no cure, so it is something that they are going to live with for the rest of their lives. So they should understand it. It is a common abnormality in women, and it is a common cause of infertility, especially anovulatory infertility.

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“It is estimated that 10 to 15 percent of women will have PCOs. Unfortunately, about 50 to 70 percent of them will not be diagnosed. So, there are still a lot of misdiagnoses and underdiagnoses going on.”

He noted that due to misdiagnoses, a lot of women were labeled to have PCOS when they were not, and the people who had PÇOs were not diagnosed most of the time.
“So, we must talk about this and ask questions. Why are we having misdiagnosis? We have this because people rely on laboratory results and that might not be true. Two out of three symptoms must be present before diagnosis of PCOS is done”, he said.

According to him, symptoms vary from woman to woman, with some experiencing milder symptoms and others more severe.

“Symptoms are linked to hormones, with women with PCOS having slightly higher testosterone levels, leading to facial hair growth, and insulin resistance, a condition where the body doesn’t respond to insulin, increasing glucose levels and leading to weight gain and fertility issues”, he added.

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The maternal health expert explained that the treatment for PCOS and infertility often begins with an ultrasound diagnosis, which helps determine the necessary tests.

“Physical examinations, including height, weight, facial or body hair growth, acne, and discoloration of the skin under the arms, breasts, and groin, can help diagnosis. Insulin resistance, common to PCOS, may play a role in weight gain and the difficulty of losing any extra weight.

“With fertility medications, the chances of getting pregnant with PCOS are quite favorable. Although there is currently no cure for PCOS, some women’s periods do normalize after birth, and those with fertility issues may find it easier to conceive again. IVF is an excellent choice, but its effectiveness depends on individual factors such as age, length of infertility, and weight.

“Many women with PCOS suffer from physical or psychological manifestations of depression, which should be sought by a doctor who is willing to listen to concerns and not dismiss this potential side effect of PCOS,” Ajayi said.

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He advised women with the condition to see a maternal health specialist for proper evaluation and appropriate treatment.

“Women with PCOS need a proper evaluation of infertility. If the cause is just PCOS, they will do ovulation induction with drugs and drugs are available.

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Health

Nigerian man becomes fourth person worldwide to get cured of HIV

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By Francesca Hangeior.

A Nigerian man, Salisu Ahmed, has opened up on how he lived with the Human Immunodeficiency Virus for 31 years.

In a recent interview with reality star, Doyin David, Ahmed disclosed that he contracted the virus after his first extramarital affair.

The 66-year-old shared the challenges he faced, including the stigma of being denied access to shared facilities, losing his teaching job, and being abandoned by his wife and children.

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“I am Salisu Ahmed, I have been living with this virus for 31 years. The first experiment of going outside my matrimonial home is how it happened. It has been proven that about 85 to 90 per cent of people living with HIV contracted this thing through sexual intercourse.

“I was denied the use of the bathroom of the compound, I was not allowed to access the toilet, I was formerly a teacher so I was asked honourably to stop coming to the school.

“She packed everything including the children at home, they left me,” he stated.

He was cured of HIV following a stem cell transplant.
According to a statement from the City of Hope Medical Center in the US, where the procedure was performed, the man entered remission after discontinuing antiretroviral therapy.

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The centre noted that the patient became the fourth person in the world, and the oldest, to achieve long-term remission from HIV after receiving stem cells from a donor with a rare genetic mutation.

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Health

READ about indicators that you maybe having liver related problems

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The liver is an organ that sits just under the rib cage on the right side of the abdomen.

It can weigh up to 4 pounds (1.8 kilograms).

The liver is needed to help digest food, rid the body of waste products and make substances, called clotting factors, that keep the blood flowing well, among other tasks.

If there are symptoms of liver disease, they may include:

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*Yellowing of the skin and the whites of the eyes, called jaundice. …

*Belly pain and swelling.

*Swelling in the legs and ankles.

*Itchy skin.

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*Dark urine.

*Pale stool.

*Constant tiredness.

*Nausea or vomiting.

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If you’re experiencing these symptoms please see your doctor.

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