Year : 2018 | Volume
: 35 | Issue : 2 | Page : 97--98
From the editorial board
Assistant Editor, TJOG, Department of Obstetrics and Gynaecology, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria
A B Ande
Assistant Editor, TJOG, Department of Obstetrics and Gynaecology, School of Medicine, College of Medical Sciences, University of Benin, Benin City
|How to cite this article:|
Ande A B. From the editorial board.Trop J Obstet Gynaecol 2018;35:97-98
|How to cite this URL:|
Ande A B. From the editorial board. Trop J Obstet Gynaecol [serial online] 2018 [cited 2019 Mar 26 ];35:97-98
Available from: http://www.tjogonline.com/text.asp?2018/35/2/97/239168
Time past it was the hallmark of the dexterity of a well-trained obstetrician the ability to perform instrumental vaginal deliveries: forceps, vacuum/ventouse, destructive operative, and symphysiotomy to circumvent unnecessary caesarean sections. Over the years, for various reasons, there has been a worldwide decline in instrumental vaginal deliveries and symphysiotomy with subsequent loss of skills and consequent increase in caesarean sections when vaginal delivery is not feasible or considered unsafe.
While the current favored resort to caesarean section without recourse to instrumental deliveries for challenging deliveries in developed countries may be acceptable, the same may not be always proper in developing (low/middle resource, low/middle income) countries. In developing countries, caesarean sections are not readily available, they are relatively unsafe, and the peculiarities of the obstetric patients make consideration of instrumental vaginal deliveries and symphysiotomy invertible. The strong aversion to caesarean section and poor supervision of vaginal delivery after caesarean section also necessitates strong consideration in such settings. An intelligent discussion of the appropriateness of selective instrumental vaginal deliveries and symphysiotomy in contemporary practice in developing countries to improve overall materno-fetal outcomes is necessary, even now.
The lead article in this edition, “Instrumental vaginal deliveries: A review,” by Unuigbe et al. masterly details the role of instrumental vaginal deliveries in developing countries, taking a critical look at the current techniques of operations and procedures. It emphasizes the importance of case selection, documentation, avoidance of complications, need for training, and so on. It is a must read to educate, refresh, and help appropriately situate instrumental vaginal deliveries and symphysiotomy in current obstetric practice for all cadre (and generation) of obstetrics and gynecology specialists, plus trainees.
In furtherance of the focus of this edition on instrumental vaginal deliveries, Daru et al., Alegbeleye et al., Sowemimo et al., and Emem Bassey et al. review experiences in five teaching hospitals from different geo-political locations in Nigeria: Jos University Teaching Hospital (JUTH), Jos; University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt; Usman Danfodiyo University Teaching Hospital (UDUTH), Sokoto; Obafemi Awolowo University Teaching Hospital, Ile-Ife; and University of Uyo Teaching Hospital, Akwa Ibom. The articles vividly demonstrate some of the issues earlier highlighted in the Review Article. One common factor in these articles is the general low prevalence of forceps and vacuum deliveries. Obstetricians in these region need to be worried about this trend and this requires intervention inform of advocacy, retraining, and redefining indications for the use of these equipments to save the instruments and the procedures of forceps and vacuum deliveries and other forms of assisted instrumental delivery from going into extinction.
Considering the high fertility and low contraception rates, contraception remains topical in our practice, hence the number and quality of articles on it. The articles presented in this edition address various aspects of contraception: specific methods, experiences with uptake, sociodemographics, and the possible influence of economic recession on uptake, among others. It was fascinating reading through the articles. The two articles on menstrual hygiene, one among adolescent school girls in Kano, Nigeria, and the other among women in urban Delhi, India, address an issue of Reproductive Health significance from different continents and age groups.
This edition also contains other articles on important contemporary Women Health and Reproductive Health issues. The areas covered include preterm labor prediction, abruptio placentae, hysterectomies, HIV-infertility, menopause, twin-to-twin transfusion, and female genital tract oncology. The rarity of some of the oncology cases and their reportage makes them even more informative.
On behalf of the Editorial Board, I attest to the content and quality of the articles contained in this edition. I recommend it as a must read (and possession) for all Obstetrician–Gynecologists (practicing or in training), and relevant others for knowledge and practice update.