Intussusception in pregnancy--a rarely considered diagnosis

Intussusception in pregnancy is rare and making a preoperative diagnosis is extremely difficult. The objective of this paper is to report a case of intussusception in a pregnant woman and to review the literature on the subject with a view to highlighting the peculiarities of this condition. The case file of a 26 year old Gravida 3, Para(0+2) lady who had appendectomy 5 years earlier and now presented at 33 weeks of gestation with features of intestinal obstruction was evaluated. Ultrasound scan showed dilated bowel loops suggestive of intestinal obstruction. At operation, an ileo-ileal intussusception was found without a lead point. Histology of the resected bowel segment showed haemorrhagic infarction without evidence of malignancy. Even though bands and adhesions are the commonest causes of intestinal obstruction in a patient that has had a previous abdominal surgery, possibility of other aetiological factors should always be considered.

HIV status of partners of HIV positive pregnant women in different regions of Nigeria: matters arising

This study was conducted to determine the pattern of HIV sero-status of Partners of HIV Positive Pregnant Women in three different regions of Nigeria and to explore the implications for HIV prevention interventions. The Site Coordinators of PMTCT programs in three Nigerian cities obtained data of the HIV status of the partners of HIV positive pregnant women. The selection of Benin City, Jos and Kano was made after consideration of their ethnic, religious and cultural representation of Nigeria. Benin City represents a traditional southern Nigeria city, Kano a traditional northern city and Jos, a middle-belt, ethnically diverse cosmopolitan setting. The data were analyzed using frequencies. A total of 500 partners of HIV infected pregnant women were tested for HIV using Determine Abbott test kits. Positive results were confirmed using Western blot or a second rapid test kit. The city-by-city results showed that in Benin City (Southern Nigeria), 78.8% (104/132) of the partners were HIV negative (sero-discordant), Jos (Middle-Belt) had 48.4% (103/213) sero-discordance while Kano (Northern Nigeria) recorded a sero-discordance rate of only 7.7% (12/155). These results indicate that the dynamics of HIV transmission in marital settings in Nigeria are different in the various regions of the country. Socio-cultural and religious settings play a significant role in HIV transmission among couples. These findings should guide prevention interventions in order to achieve maximal impact.