https://www.jogeca.com/index.php/jogeca/issue/feed Journal of Obstetrics and Gynaecology of Eastern and Central Africa 2025-07-11T03:28:48+00:00 Editor-in-Chief editor-in-chief@jogeca.com Open Journal Systems <p><em><span style="font-weight: 400;">JOGECA </span></em><span style="font-weight: 400;">publishes original, peer-reviewed, research and reviews in Obstetrics and Gynecology. It also publishes work in basic and translational science relevant to reproductive biology and medicine. </span><em><span style="font-weight: 400;">JOGECA </span></em><span style="font-weight: 400;">provides a portal for work that fall under but not limited to Fetomaternal Medicine, Adolescent Health and Sexuality, Family Planning and Contraception, Gynecological Oncology, Fertility and Endocrinology, Urogynecology, Health Policy and Implementation Science, Information Technology in Health, Developmental Biology, Genomics, and Basic and Translational Science research.</span></p> https://www.jogeca.com/index.php/jogeca/article/view/270 Phyllodes tumor, cardiovascular and chronic renal disease in a young lady on hormone replacement therapy: A case report 2024-11-25T11:24:12+00:00 Lauryn Mengesa lauryn.mengesa@gmail.com Daki Dido dakidido@gmail.com Dorcus Muchiri Muchiri.dorcus@gmail.com Philomena Owende akothowende@yahoo.com <p><strong>Background:</strong> Hormonal replacement therapy (HRT) has been associated with an<br />increased risk of developing breast cancer. The level of risk varies with different types of<br />HRT and the duration of use. Phyllodes tumor accounts for less than 1% of all breast<br />neoplasms and is associated with Li-Fraumeni syndrome.<br /><strong>Case presentation:</strong> A 37-year-old nulliparous woman presented with a left breast lump.<br />Histological examination revealed a spindle cell neoplasm consistent with a malignant<br />phyllodes tumor. She was diagnosed at age of 12 with ovarian dysgerminoma, had<br />subtotal hysterectomy and right oophorectomy, radiotherapy and chemotherapy. She<br />has been on HRT with conjugated equine estrogens for 13 years and tibolone for the<br />last 5 years. Following the diagnosis of phyllodes tumor, a mastectomy was performed,<br />and HRT was changed to vaginal estrogen gel.<br /><strong>Conclusion:</strong> Hormonal replacement therapy may pose a risk for certain types of breast<br />cancer, especially with prolonged use of combined therapy. Patients who develop<br />cancers early in life, as well as those on HRT, require close follow-up and adequate<br />patient education with an emphasis on self-breast examination. Sensitization of<br />healthcare providers and patients on the value of genetic screening would facilitate<br />early identification of such patients and follow-up at high-risk clinics.</p> 2025-06-30T00:00:00+00:00 Copyright (c) 2025 The authors. https://www.jogeca.com/index.php/jogeca/article/view/381 Type 2 cesarean section scar pregnancy managed by hysteroscopic resection and methotrexate: A case report 2025-07-01T03:14:03+00:00 Charles Muteshi murwa2006@yahoo.co.uk Kimani Morris morri.kimani@aku.edu Samuel Mukono samuel.mukono@aku.edu <p class="western" align="justify"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><span lang="en-US"><strong>Background:</strong></span></span></span></span> <span style="color: #000000;"><span style="font-family: Quadraat;"><span lang="en-US">Diagnosis and management of cesarean scar ectopic pregnancy (CSP) remain challeng</span></span></span><span style="font-family: Quadraat;"><span lang="en-US">ing</span></span><span style="font-family: Quadraat;"><span lang="en-US">. We describe ultrasound diagnosis followed by hysteroscopic resection and methotrexate administration. </span></span></span></p> <p class="western" lang="en-US" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Case presentation: </strong></span></span>A 42-year-old woman, para 2+1, presented with 8 weeks of amenorrhea and vaginal bleeding. She had two previous cesarean deliveries. Initial ultrasound suggested an incomplete miscarriage and beta human chorionic gonadotropin (β-HCG) was 46,129 mIU/ml. After failed medical management, repeat ultrasound diagnosed CSP. Hysteroscopic resection was performed, and she received methotrexate, resulting ß-HCG resolution.</span></span></p> <p class="western" lang="en-US" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Conclusion: </strong></span></span>Though rare, CSP should be entertained in any woman presenting with vaginal bleeding with a history of cesarean delivery. Hysteroscopic resection with methotrexate provides good fertility-preserving modality for management. </span></span></p> <p class="western" lang="en-US" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Keywords</strong></span></span><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">: </span></span>cesarean scar ectopic pregnancy; hysteroscopic resection; methotrexate</span></span></p> 2025-06-30T00:00:00+00:00 Copyright (c) 2025 The authors. https://www.jogeca.com/index.php/jogeca/article/view/16 Obstructive Hemivagina with Ipsilateral Renal Agenesis in a 16-year-old Diabetic African Girl: a case report 2025-07-01T03:14:13+00:00 JOEL OOKO OJWANDO jojwando@students.uonbi.ac.ke Ephantus Wachira Murage muragew@savannahhealth.co.ke Weston Wakasiaka Khisa westonkhisa@yahoo.com Rita Akoth Arogo ritakoth680@gmail.com <p class="western" align="justify"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><span lang="en-US"><strong>Background: </strong></span></span></span></span><span style="color: #000000;"><span style="font-family: Quadraat;"><span lang="en-US">The obstructed hemivagina with ipsilateral renal agenesis (OHVIRA) syndrome is a type of Müllerian duct anomaly (MDA) resulting from abnormal development of Müllerian ducts. Its features typically become apparent at puberty when girls present with menstrual abnormalities. </span></span></span><span style="color: #000000;"><span style="font-family: Quadraat;">The varied presentation of MDAs presents diagnostic and management challenges. </span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Case presentation:</strong></span></span></span> <span style="color: #000000;">A 16-year-old diabetic African girl presented to Savannah Healthcare with cyclical lower abdominal pain and foul-smelling per vagina discharge. Magnetic resonance imaging (MRI) showed complete duplication of the uterus, cervix, and vagina (uterine didelphys) with an obstructed left hemivagina with hematocolpos. The septum obstructing the hemivagina was resected with drainage of the hematocolpos. A follow-up abdominal renal ultrasound showed the absence of the left kidney. </span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Conclusion: </strong></span></span></span><span style="color: #000000;">Careful clinical examination and MRI are essential for diagnosing OHVIRA syndrome. Prompt surgical intervention improves outcomes.</span></span></span></p> 2025-06-30T00:00:00+00:00 Copyright (c) 2025 The authors. https://www.jogeca.com/index.php/jogeca/article/view/480 Diagnosis and management of misplaced intrauterine devices: A case series 2025-07-10T03:27:17+00:00 DORIS MWENDA dr.mwenda@gmail.com KHUSHBOO SONIGRA khushys90@gmail.com SYLVIA MULANDI slv.ndl@gmail.com DR. ALEX BOSIRE anybosire@outlook.com JAMES AMENGE drjamesamenge@gmail.com <p class="western" align="justify"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><span lang="en-US"><strong>Background:</strong></span></span></span></span> <span style="color: #000000;"><span style="font-family: Quadraat;"><span style="font-size: medium;">Intrauterine contraceptive devices (IUCDs) are widely used for long-term contraception and are generally safe. However, misplacement can occur, often presenting as a missing thread and typically remaining asymptomatic. A misplaced IUCD can lead to complications like uterine perforation, migration to adjacent organs, pelvic abscess, or ectopic pregnancy. </span></span></span><span style="font-family: Quadraat;"><span style="font-size: medium;">Various diagnostic and treatment modalities are available for management. </span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: medium;"><span style="font-family: Times New Roman, serif;"><strong>Case series:</strong></span> We present 10 cases of misplaced IUCDs encountered at Kenyatta National Hospital, highlighting their clinical presentations, diagnostic approaches, and treatment strategies.</span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: medium;"><span style="font-family: Times New Roman, serif;"><strong>Conclusion: </strong></span><span style="color: #000000;">This case series highlights the importance of vigilant monitoring for nonspecific symptoms indicative of IUCD displacement or migration. Timely evaluation and intervention are essential, with imaging and minimally invasive surgery playing a central role in achieving favorable outcomes.</span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: medium;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><strong>Keywords:</strong></span></span><span style="color: #000000;"> hysteroscopy, intrauterine contraceptive device, laparoscopy, misplaced IUCD</span></span></span></p> <p> </p> 2025-06-30T00:00:00+00:00 Copyright (c) 2025 DR DORIS MWENDA, DR KHUSHBOO JAYANT SONIGRA, DR SYLVIA MULANDI, DR. ALEX BOSIRE, DR JAMES AMENGE https://www.jogeca.com/index.php/jogeca/article/view/326 Cost of surgical management of laparoscopically treated ectopic pregnancies at a tertiary referral hospital: A 10-year review of admission costs and contributing factors 2025-07-11T03:28:48+00:00 Steve Mutiso steve_mutiso@yahoo.com <p class="western" align="justify"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><span lang="en-US"><strong>Background: </strong></span></span></span></span><span style="font-family: Quadraat;"><span style="font-size: medium;">Laparoscopic management is the gold standard for treating ectopic pregnancies (EP), but its cost limits its widespread use in developing nations</span></span><span style="font-family: Quadraat;"><span style="font-size: medium;"><span lang="en-GB">.</span></span></span><span style="font-family: Quadraat;"><span style="font-size: medium;"> A 10-year period audit was conducted evaluating laparoscopically treated EPs at a tertiary referral hospital, focusing on admission cost and contributing factors.</span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><span lang="en-GB"><strong>Methods: </strong></span></span></span><span style="font-size: medium;"><span lang="en-GB">This was a retrospective observational study conducted at the Aga Khan University Hospital. All women admitted with surgically managed Eps were included. Analysis of data was done against a preset checklist. Descriptive statistics for continuous variables were computed and presented in tables and figures.</span></span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><span lang="en-GB"><strong>Results:</strong></span></span></span></span> <span style="font-size: medium;"><span lang="en-GB">The adjusted admission cost for patients with surgically managed EP ranged from US $2 017 (KES 220 252) to US $ 6,326 (KES 690 828). The mean cost of admission was US $ 3 254 (KES 355 384; n=259). The following factors were significantly associated with an increased admission cost: increasing patient age (p=0.000), volume of hemoperitoneum(p=0.000) duration of surgery (p=0.003) and duration of hospital stay (p=0.000).</span></span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><span lang="en-GB"><strong>Conclusion:</strong></span></span></span> <span style="color: #000000;"><span style="font-size: medium;"><span lang="en-GB">The mean admission cost for surgically managed EP was similar to that in high-income countries. However, when adjusted for per capita gross domestic product, the cost was disproportionately high. No consistent decline in the mean annual cost was observed over the study period. Increasing patient age, hemoperitoneum volume, surgery duration, and duration of hospital stay all significantly impacted on the admission cost.</span></span></span></span></span></p> 2025-06-30T00:00:00+00:00 Copyright (c) 2025 Steve Mutiso https://www.jogeca.com/index.php/jogeca/article/view/368 Comparison of third-trimester indices in pregnant women with and without COVID-19 infection: A cross-sectional study 2025-07-10T03:27:33+00:00 DANIEL OKETCH danoketch82@gmail.com Diana K. Ondieki diana.ondieki@uonbi.ac.ke Omondi Ogutu oomogutu@gmail.com James O Amenge jamesyoungky@gmail.com Pamela I Mandela danoketch82@gmail.com Kennedy O Oduor danoketch82@gmail.com <p class="western" align="justify"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Background:</strong></span></span></span> <span style="color: #000000;"><span style="font-family: Quadraat;">The third trimester represents a critical window in pregnancy when these hematologic changes could have the greatest impact. Therefore, understanding how coronavirus disease 2019 (COVID-19) infection influences blood profiles during this period is vital for clinical management and risk stratification. In Kenya, while national guidelines recommend laboratory evaluation, including complete blood count, c-reactive protein (CRP), lactate dehydrogenase (LDH), and coagulation profiles for pregnant women with suspected or confirmed COVID-19, there is a paucity of local data documenting these hematologic trends.</span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Objective</strong></span></span></span><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">:</span></span></span><span style="color: #000000;"> To investigate hematologic profile differences between pregnant women in the third trimester with and without COVID-19 infection.</span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Methods</strong></span></span></span><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">:</span></span></span><span style="color: #000000;"> A cross-sectional comparative study was employed to compare hematological parameters in pregnant women with and without </span></span></span></p> <p class="western" align="justify"> </p> <p class="western" align="justify"> </p> <p class="western" align="justify"><span style="color: #000000;"><span style="font-family: Quadraat;"><span style="font-size: small;">COVID-19 between May 1st and August 31st, 2021. We recruited 60 eligible patients from the Nairobi hospital using purposive sampling. We assessed the complete blood count, coagulation profile, lactate dehydrogenase, and C-reactive protein.</span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Results</strong></span></span></span><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">:</span></span></span><span style="color: #000000;"> Pregnant women with COVID-19 had significantly higher levels of neutrophils, prothrombin time, CRP, and LDH compared to those without, with respective AORs of 9.50 (p&lt;0.01), 11.52 (p=0.001), and 3.06 (p=0.078). No significant differences were observed in white blood cells, basophils, and international normalized ratio after adjusting for age, parity, COVID-19 vaccination, and fetus number.</span></span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Conclusion</strong></span></span></span><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">: </span></span></span><span style="color: #000000;">This study reported significant associations between neutrophil count, prothrombin time, CRP, LDH levels, and COVID-19 infection status in pregnant women. These indices may aid in distinguishing healthy pregnant women from those with COVID-19 infection.</span></span></span></p> <p class="western" align="justify"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Keywords:</strong></span></span></span> <span style="color: #000000;"><span style="font-family: Quadraat;">COVID-19 infection, pregnant women, third trimester, blood profile</span></span> </span></p> 2025-06-30T00:00:00+00:00 Copyright (c) 2025 DANIEL OKETCH, Dr. Diana Ondieki, Prof. Ogutu O, Dr. James Amenge, Pamela Mandela, Kennedy Oduor https://www.jogeca.com/index.php/jogeca/article/view/389 Adverse Pregnancy Outcomes Among Khat Chewing Pregnant Mothers in Meru County, Kenya. 2025-07-10T03:27:25+00:00 Humphrey Obwaya obwaya.humphrey@gmail.com George Gwako gngwako@gmail.com Alfred Osoti alfosoti@yahoo.com Omondi Ogutu oomogutu@gmail.com <p class="western" align="justify"><span style="font-size: small;"><span style="color: #000000;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Background:</strong></span></span></span> <span style="color: #000000;"><span style="font-family: Quadraat;">Khat (</span></span><span style="font-family: Quadraat;"><em>Catha edulis</em></span><span style="font-family: Quadraat;">) is a green leafy plant containing psychoactive alkaloids, such as cathine and cathinone. </span><span style="font-family: Quadraat;">Khat use in pregnancy affects maternal and fetal well-being.</span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Objective</strong></span></span><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">:</span></span> This study aimed to determine the risk of adverse pregnancy outcomes among pregnant women who chew khat compared with pregnant women who do not chew khat in Meru County in 2023.</span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Methods</strong></span></span><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">:</span></span> A retrospective cohort study was employed at the Meru Teaching and Referral Hospital and Nyambene Level 4 Hospital that compared immediate postpartum mothers who chewed khat during pregnancy (exposed, n=150) and those who did not chew khat during pregnancy (unexposed, n=300). Data on khat chewing during pregnancy and various maternal, fetal, and early neonatal outcomes were collected using a questionnaire. Data were summarized as means, frequency, and percentages and com</span></span></p> <p class="western" align="justify"> </p> <p class="western" align="justify"> </p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;">pared using the Students t-test, Pearson’s Chi-square, and Fischer’s exact test. All statistical tests were considered significant if the p&lt;0.05.</span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Results</strong></span></span><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">:</span></span> There was a statistically significant increased risk of preterm birth (AOR 4.44, 3.31-10.92, p 0.001), low birth weight (AOR 2.95, 1.19-7.57, p 0.02), admission to neonatal intensive care unit or newborn unit (AOR 1.13, 1.03-4.10, p 0.01), and postpartum hemorrhage (AOR 12.85, 2.17 – 244.02, p 0.02). An increased risk of premature rupture of membranes was observed, but this was not statistically significant (OR 1.61, 0.9-2.85, p 0.11).</span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Conclusion</strong></span></span><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">: </span></span>Women who used khat during pregnancy had an increased risk of adverse pregnancy outcomes, including preterm birth, low birth weight, admission to neonatal intensive unit, and postpartum hemorrhage.</span></span></p> <p class="western" align="justify"><span style="font-family: Quadraat;"><span style="font-size: small;"><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;"><strong>Keywords</strong></span></span><span style="font-family: Times New Roman, serif;"><span style="font-size: medium;">: </span></span>adverse pregnancy outcomes, khat, Meru</span></span></p> 2025-06-30T00:00:00+00:00 Copyright (c) 2025 Humphrey Obwaya, George Gwako, Alfred Osoti, Omondi Ogutu