title: Symphysiotomy- a dying art: the experience at Federal Medical Centre Umuahia Nigeria.
abstract: OBJECTIVE
  To review the indications, outcome and complications of symphysiotomy done in Federal Medical Centre Umuahia during the study period.
  
  
  METHODS
  This study is a 5-year review of all women who had symphysiotomy at Federal Medical Centre Umuahia. The total number of the procedure performed, and all the deliveries conducted at the hospital in the study period were obtained from the labour ward register. The case notes of the patients were then retrieved and their biodata and other relevant information were obtained and summarized in frequency tables and percentages.
  
  
  RESULTS
  Ten (10) symphysiotomies were performed among 3702 deliveries conducted during the period under review giving a rate of 0.27%. Seventy per cent of the patients were aged 30 years and below, mean age was 26 (± SD4.9) years. Most of the patients were multiparous women, only one was grandmultiparous. All were for mild to moderate cephalopelvic disproportion (CPD). In one particular case, the patient also presented with retained second twin. They were all unbooked patients. Main complication was pelvic and leg pain but there were two cases of vesicovaginal fistula which may be a complication of obstructed labour since leakage of urine did not start immediately after the procedure. The birth weight of the babies ranged from 3kg to 4.2kg. There was no maternal mortality but two fresh stillbirths were recorded giving a perinatal mortality rate of 200 per 1000 total births.
  
  
  CONCLUSIONS
  Symphysiotomy if done by a trained person, in well selected patients is still safe and can be life saving in environments where caesarean delivery is not well accepted and late presentation is common.
authors.affiliation: Department of Obstetrics and Gynaecology, University College Hospital, Ibadan Nigeria. gcnkwocha@gmail.com
authors.forename: G C
authors.initials: GC
authors.lastname: Nkwocha
authors.forename: C C
authors.initials: CC
authors.lastname: Umezurike
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D052178:Cephalopelvic Disproportion / Q000601:surgery*; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay; D008423:Maternal Age; D009549:Nigeria; D007744:Obstetric Labor Complications / Q000601:surgery*; D010298:Parity; D011183:Postoperative Complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D013567:Symphysiotomy / Q000706:statistics & numerical data* / Q000639:trends; D055815:Young Adult