A. Kulkarni, M. Tinmaswala, S. Shetkar, S. Kondekar
Angiomyofibroblastomas, aggressive angiomyxomas and cellular angiofibromas are rare mesenchymal tumours with many overlapping radiological, histopathological and immunohistochemical features. Amongst these tumours angiomyofibroblastoma is relatively benign mesenchymal tumour with very low chances of recurrence. It is clinically confused with bartholin gland cyst due to its well demarcated and smooth appearance. Due to overlapping histopathological features its very difficult even for experienced pathologists to differentiate between these mesenchymal tumours. Earlier desmin reactivity was thought to be specific for angiomyofibroblastoma but recently many aggressive angiomyxomas have also been found to be positive for desmin. Ultrasound, computed tomography and magnetic resonance imaging may be useful in diagnosis and ruling out more sinister malignancies. A well demarcated lesion with characteristic histopathological appearance of alternating hypo and hypercellular edematous regions with abundant blood vessels and stromal cells with dispersed chromatin is usually seen in angiomyofibroblastoma. Immunohistochemistry may further help in diagnosis. We here report a case of vaginal angiomyofibroblastoma. The diagnosis was made on the basis of imaging and was confirmed by histopathology and immunohistochemistry.
{"title":"Angiomyofibroblastoma: Imaging and histopathology of a rare benign mesenchymal tumor","authors":"A. Kulkarni, M. Tinmaswala, S. Shetkar, S. Kondekar","doi":"10.4103/TJOG.TJOG_79_17","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_79_17","url":null,"abstract":"Angiomyofibroblastomas, aggressive angiomyxomas and cellular angiofibromas are rare mesenchymal tumours with many overlapping radiological, histopathological and immunohistochemical features. Amongst these tumours angiomyofibroblastoma is relatively benign mesenchymal tumour with very low chances of recurrence. It is clinically confused with bartholin gland cyst due to its well demarcated and smooth appearance. Due to overlapping histopathological features its very difficult even for experienced pathologists to differentiate between these mesenchymal tumours. Earlier desmin reactivity was thought to be specific for angiomyofibroblastoma but recently many aggressive angiomyxomas have also been found to be positive for desmin. Ultrasound, computed tomography and magnetic resonance imaging may be useful in diagnosis and ruling out more sinister malignancies. A well demarcated lesion with characteristic histopathological appearance of alternating hypo and hypercellular edematous regions with abundant blood vessels and stromal cells with dispersed chromatin is usually seen in angiomyofibroblastoma. Immunohistochemistry may further help in diagnosis. We here report a case of vaginal angiomyofibroblastoma. The diagnosis was made on the basis of imaging and was confirmed by histopathology and immunohistochemistry.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70848445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A lithopedion (stone baby) is a rare phenomenon seen in advanced abdominal pregnancy. There are few cases reported in Africa. This is a case report of a 50-year-old woman who presented with a complaint of an abdominal swelling for 15 years. She was suspected to have a uterine fibroid. She was subsequently prepared for myomectomy. Intraoperatively, she was found to have a calcified intact fetus with a coexisting huge uterine fibroid. She had extirpation of the calcified fetus and myomectomy. She did well postoperatively and was discharged home on the 7th day.
{"title":"Lithopedion coexisting with a huge uterine fibroid: A case report","authors":"B. Sulaiman, M. Sani, A. Binji, R. Ibrahim","doi":"10.4103/TJOG.TJOG_32_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_32_18","url":null,"abstract":"A lithopedion (stone baby) is a rare phenomenon seen in advanced abdominal pregnancy. There are few cases reported in Africa. This is a case report of a 50-year-old woman who presented with a complaint of an abdominal swelling for 15 years. She was suspected to have a uterine fibroid. She was subsequently prepared for myomectomy. Intraoperatively, she was found to have a calcified intact fetus with a coexisting huge uterine fibroid. She had extirpation of the calcified fetus and myomectomy. She did well postoperatively and was discharged home on the 7th day.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43774028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The argument on what bacteria make up healthy vagina and bacterial vaginosis (BV) remain unresolved. Black women most often are placed in grade IV vaginal communities as lacking Lactobacillus-dominated microbes. We sought to determine the vaginal microbiota compositions of healthy and those with BV using 16S rRNA metagenomics methods. Materials and Methods: Twenty-eight women provided vaginal swabs for Nugent scoring. Fifteen had BV (Nugent score 7–10), whereas 13 were normal (Nugent score 0–3). DNA was extracted and 16S rRNA V4 region amplified using custom bar-coded primers prior to sequencing with MiSeq platform. Sequence reads were imported into Illumina BaseSpace Metagenomics pipeline for 16S rRNA recognition. Distribution of taxonomic categories at different levels of resolution was done using Greengenes databases. Manhattan principal component analysis was used for similarity clustering. Results: Non-BV subjects were colonized by 12 taxonomic phyla that represent 182 genera and 357 species. Overall, 23 phyla representing 388 genera and 805 species were identified in BV subjects. Firmicutes represented 95% of the sequence reads in non-BV subjects with Lactobacillus-dominated genera and Lactobacillus crispatus–dominated species, followed by Proteobacteria (3.78%), Actinobacteria (0.74%), and Bacteriodetes (0.05%). In BV subjects, Firmicutes represented 59% of the classified sequence reads, followed by Bacteroidetes (19%), Actinobacteria (15.8%), Fusobacteria (4.08%), Proteobacteria (1.48%), and Tenericutes (1.25%). Conclusion: Non-BV healthy Black African, Nigerian women had Lactobacillus genera as the predominant microbiota, contrary to published reports. The study shows that BV subjects had varying proportions of diverse bacteria similar to studies from other parts of the world.
{"title":"Vaginal bacteriome of Nigerian women in health and disease: A study with 16S rRNA metagenomics","authors":"K. Anukam, N. Agbakoba, A. Okoli, C. Oguejiofor","doi":"10.4103/TJOG.TJOG_67_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_67_18","url":null,"abstract":"Introduction: The argument on what bacteria make up healthy vagina and bacterial vaginosis (BV) remain unresolved. Black women most often are placed in grade IV vaginal communities as lacking Lactobacillus-dominated microbes. We sought to determine the vaginal microbiota compositions of healthy and those with BV using 16S rRNA metagenomics methods. Materials and Methods: Twenty-eight women provided vaginal swabs for Nugent scoring. Fifteen had BV (Nugent score 7–10), whereas 13 were normal (Nugent score 0–3). DNA was extracted and 16S rRNA V4 region amplified using custom bar-coded primers prior to sequencing with MiSeq platform. Sequence reads were imported into Illumina BaseSpace Metagenomics pipeline for 16S rRNA recognition. Distribution of taxonomic categories at different levels of resolution was done using Greengenes databases. Manhattan principal component analysis was used for similarity clustering. Results: Non-BV subjects were colonized by 12 taxonomic phyla that represent 182 genera and 357 species. Overall, 23 phyla representing 388 genera and 805 species were identified in BV subjects. Firmicutes represented 95% of the sequence reads in non-BV subjects with Lactobacillus-dominated genera and Lactobacillus crispatus–dominated species, followed by Proteobacteria (3.78%), Actinobacteria (0.74%), and Bacteriodetes (0.05%). In BV subjects, Firmicutes represented 59% of the classified sequence reads, followed by Bacteroidetes (19%), Actinobacteria (15.8%), Fusobacteria (4.08%), Proteobacteria (1.48%), and Tenericutes (1.25%). Conclusion: Non-BV healthy Black African, Nigerian women had Lactobacillus genera as the predominant microbiota, contrary to published reports. The study shows that BV subjects had varying proportions of diverse bacteria similar to studies from other parts of the world.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43840993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fetal congenital anomalies are among the leading causes of perinatal death or survival with disability worldwide. Their accurate antenatal detection employing a range of fetal imaging techniques enables parental choices to be made and for postnatal care of affected babies to be planned. While such prenatal care is well developed in developed countries of the world, it remains poor in many low- and middle-income countries (LMICs). This review article examines the scope of the problem and proffers strategies for service organization and fetal imaging that will improve care in LMIC settings.
{"title":"Fetal imaging and diagnosis services in developing countries – A call to action","authors":"J. Akinmoladun, D. Anumba","doi":"10.4103/TJOG.TJOG_59_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_59_18","url":null,"abstract":"Fetal congenital anomalies are among the leading causes of perinatal death or survival with disability worldwide. Their accurate antenatal detection employing a range of fetal imaging techniques enables parental choices to be made and for postnatal care of affected babies to be planned. While such prenatal care is well developed in developed countries of the world, it remains poor in many low- and middle-income countries (LMICs). This review article examines the scope of the problem and proffers strategies for service organization and fetal imaging that will improve care in LMIC settings.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45938735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Ibrahim, E. Nwobodo, K. Tunau, A. Burodo, B. Sulaiman, J. Garba, A. Saidu
Background: Active management of labor reduces the number of prolonged labor and the duration of labor without having any adverse effects on the mother and the fetus. Intervention with drugs is among the options used for active management of labor. This includes use of analgesics, oxytocics, prostaglandins derivatives, and smooth muscle relaxants. The objectives of the study were to determine whether hyoscine N butyl bromide (HNBB) shortens the first stage of labor in term pregnancies, to compare the mean duration of labor between primigravidae and multigravidae in HBB group, to compare the maternal and fetal outcome between HBB and control group, and also to determine the side effects of HBB in parturients. Materials and Methods: The study was a single-blind randomized control study carried out in Usmanu Danfodiyo University Teaching Hospital (UDUTH) over 4-month period. A total of 204 pregnant women at term in spontaneous labor who presented in active phase of labor at UDUTH and have met the inclusion criteria were recruited and randomized into 102 women as case group and 102 women as control. The women in the case group received 40 mg (2 mls) of HBB, while those in the control group received 2 mls of normal saline. Data entry and analysis was done with IBM SPSS version 20. The duration and outcome was monitored. Results: The mean duration of labor in the first stage among the case group was 5:44 ± 2:11, while it was 6:52 ± 2:11 among the control group representing a decrease of 16.5%. This was statistically significant (P < 0.05). There was no difference in the duration of the second and third stages of labor among the two groups. There was no difference in the maternal and neonatal outcome among the two groups. Vomiting was the only maternal side effect that was statistically significant among the HBB group. Conclusion: HBB reduced the duration of first stage of labor in both primigravid and multigravid women without adverse maternal and neonatal complications. It is recommended that HBB to be given to women in active phase of labor to reduce the incidence of prolonged labor.
背景:积极管理产程可减少产程延长次数和产程持续时间，对母婴无不良影响。药物干预是积极管理分娩的选择之一。这包括使用镇痛药、催产素、前列腺素衍生物和平滑肌松弛剂。本研究的目的是确定海莨菪碱N丁基溴化剂(HNBB)是否缩短足月妊娠的第一产程，比较HBB组初产妇和多胎产妇的平均产程，比较HBB组与对照组的母胎结局，以及确定HBB对产妇的不良反应。材料与方法:本研究为单盲随机对照研究，在乌斯马努丹佛迪约大学教学医院(UDUTH)进行为期4个月的研究。本研究共招募了204例在UDUTH产程处于活跃期的自然分娩足月孕妇，符合纳入标准，随机分为102例作为病例组，102例作为对照组。病例组的妇女接受40毫克(2毫升)的HBB，而对照组的妇女接受2毫升生理盐水。数据输入和分析使用IBM SPSS version 20完成。监测治疗的持续时间和结果。结果:病例组第一产程平均为5:44±2:11，对照组为6:52±2:11，缩短了16.5%。差异有统计学意义(P < 0.05)。两组第二、三产程的持续时间无差异。两组的产妇和新生儿结局没有差异。呕吐是HBB组中唯一有统计学意义的产妇副作用。结论:HBB减少了原孕和多孕妇女第一产程的持续时间，没有不良的产妇和新生儿并发症。建议在产程活跃期给予HBB，以减少延长产程的发生。
{"title":"The effect of hyoscine butyl bromide in shortening the duration of first stage of labor: A single-blind randomized control study","authors":"R. Ibrahim, E. Nwobodo, K. Tunau, A. Burodo, B. Sulaiman, J. Garba, A. Saidu","doi":"10.4103/TJOG.TJOG_57_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_57_18","url":null,"abstract":"Background: Active management of labor reduces the number of prolonged labor and the duration of labor without having any adverse effects on the mother and the fetus. Intervention with drugs is among the options used for active management of labor. This includes use of analgesics, oxytocics, prostaglandins derivatives, and smooth muscle relaxants. The objectives of the study were to determine whether hyoscine N butyl bromide (HNBB) shortens the first stage of labor in term pregnancies, to compare the mean duration of labor between primigravidae and multigravidae in HBB group, to compare the maternal and fetal outcome between HBB and control group, and also to determine the side effects of HBB in parturients. Materials and Methods: The study was a single-blind randomized control study carried out in Usmanu Danfodiyo University Teaching Hospital (UDUTH) over 4-month period. A total of 204 pregnant women at term in spontaneous labor who presented in active phase of labor at UDUTH and have met the inclusion criteria were recruited and randomized into 102 women as case group and 102 women as control. The women in the case group received 40 mg (2 mls) of HBB, while those in the control group received 2 mls of normal saline. Data entry and analysis was done with IBM SPSS version 20. The duration and outcome was monitored. Results: The mean duration of labor in the first stage among the case group was 5:44 ± 2:11, while it was 6:52 ± 2:11 among the control group representing a decrease of 16.5%. This was statistically significant (P < 0.05). There was no difference in the duration of the second and third stages of labor among the two groups. There was no difference in the maternal and neonatal outcome among the two groups. Vomiting was the only maternal side effect that was statistically significant among the HBB group. Conclusion: HBB reduced the duration of first stage of labor in both primigravid and multigravid women without adverse maternal and neonatal complications. It is recommended that HBB to be given to women in active phase of labor to reduce the incidence of prolonged labor.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46308635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Bola-Oyebamiji, O. Badejoko, I. Awowole, Z. Abdur-Rahim, M. Ajayi, A. Salako
Background: Office cystometry is an appropriate technology alternative to urodynamics, especially in resource-poor settings. The combination of a validated screening tool such as the Questionnaire for Urinary Incontinence Diagnosis (QUID) and office cystometry stands as the gold standard in the evaluation of urinary incontinence, where urodynamics is not available. Objectives: This study aimed to determine the spectrum of urinary incontinence diagnoses using a combination of urogynecological examination and office cystometry among women in a resource-constrained sub-Saharan African setting and to correlate this with their QUID diagnoses. Methods: Sixty consenting women who had urinary incontinence diagnosed with QUID were recruited from a related study. The cough stress test was performed to elicit stress incontinence. Standard digital and speculum examinations were performed. Postvoid residual urine volume was determined by catheterization. Simple cystometry was performed to detect detrusor overactivity. Using urogynecological examination and simple cystometry as the gold standard, sensitivity, specificity, positive, and negative predictive values were calculated for QUID. Results: The spectrum of diagnoses made using urogynecological examination and office cystometry included no incontinence 13 (21.7%), urge incontinence 23 (38.3%), stress incontinence 18 (30.0%), mixed incontinence 5 (8.3%), and overflow incontinence in 1 (1.7%) woman, respectively. Using this as the gold standard, QUID demonstrated sensitivity of 87.0%, 55.6%, and 60.0% for urge, stress, and mixed incontinence, respectively, with corresponding specificity of 73.0%, 81.0%, and 83.6%, respectively. Conclusion: Urogynecological examination and office cystometry identified stress, urge, mixed, and overflow urinary incontinence in the study population. Overall, good correlation existed between the QUID and office cystometric diagnoses.
{"title":"Office cystometry in a resource-constrained setting: Spectrum of diagnoses and correlation with QUID","authors":"S. Bola-Oyebamiji, O. Badejoko, I. Awowole, Z. Abdur-Rahim, M. Ajayi, A. Salako","doi":"10.4103/TJOG.TJOG_4_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_4_19","url":null,"abstract":"Background: Office cystometry is an appropriate technology alternative to urodynamics, especially in resource-poor settings. The combination of a validated screening tool such as the Questionnaire for Urinary Incontinence Diagnosis (QUID) and office cystometry stands as the gold standard in the evaluation of urinary incontinence, where urodynamics is not available. Objectives: This study aimed to determine the spectrum of urinary incontinence diagnoses using a combination of urogynecological examination and office cystometry among women in a resource-constrained sub-Saharan African setting and to correlate this with their QUID diagnoses. Methods: Sixty consenting women who had urinary incontinence diagnosed with QUID were recruited from a related study. The cough stress test was performed to elicit stress incontinence. Standard digital and speculum examinations were performed. Postvoid residual urine volume was determined by catheterization. Simple cystometry was performed to detect detrusor overactivity. Using urogynecological examination and simple cystometry as the gold standard, sensitivity, specificity, positive, and negative predictive values were calculated for QUID. Results: The spectrum of diagnoses made using urogynecological examination and office cystometry included no incontinence 13 (21.7%), urge incontinence 23 (38.3%), stress incontinence 18 (30.0%), mixed incontinence 5 (8.3%), and overflow incontinence in 1 (1.7%) woman, respectively. Using this as the gold standard, QUID demonstrated sensitivity of 87.0%, 55.6%, and 60.0% for urge, stress, and mixed incontinence, respectively, with corresponding specificity of 73.0%, 81.0%, and 83.6%, respectively. Conclusion: Urogynecological examination and office cystometry identified stress, urge, mixed, and overflow urinary incontinence in the study population. Overall, good correlation existed between the QUID and office cystometric diagnoses.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44531224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Birth preparedness is a strategy that has been found effective in preventing obstetric delays. Use of mobile technology can enable access and efficiency of health messages delivered during antenatal care. The mobile technology can be more effective in conveying health messages owing to its accessibility and enables follow up. Materials and Methods: This was a randomized control trial carried out among pregnant women attending public health antenatal clinics in Migori County. Four health facilities were randomized. Two facilities each were randomly picked for the study and control groups respectively. A total of 379 participants were recruited into the study. The study group participants received a verbal message on birth preparedness and a mobile phone text message reminder one month to their expected date of delivery. Follow up was done to both groups through their mobile phone contacts. Data was collected using an interviewer-administered questionnaire and analyzed using Stata version 11. Proportion tests were done to compare the groups. Results: The success rate of the study was 90.5% (n = 343). Most of the participants (73%) were aged between 20 and 34 years. Majority of them were married (79.2%) and most of them had primary level of education. Protestant was the predominant religion (55.2%). Housewives and businesswomen constituted 34.2% and 27%, respectively. The respondents in the study group who were birth prepared were 74.3% (n = 136) while those in the control group were 48.1% (n = 77). Conclusion: The use of mobile phone text message reminder in addition to verbal messages is more effective.
{"title":"Effectiveness of mobile phone text message reminder on birth preparedness in a rural community in Kenya","authors":"C. Joyce, Omoni Grace, M. Waithira","doi":"10.4103/TJOG.TJOG_84_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_84_18","url":null,"abstract":"Background: Birth preparedness is a strategy that has been found effective in preventing obstetric delays. Use of mobile technology can enable access and efficiency of health messages delivered during antenatal care. The mobile technology can be more effective in conveying health messages owing to its accessibility and enables follow up. Materials and Methods: This was a randomized control trial carried out among pregnant women attending public health antenatal clinics in Migori County. Four health facilities were randomized. Two facilities each were randomly picked for the study and control groups respectively. A total of 379 participants were recruited into the study. The study group participants received a verbal message on birth preparedness and a mobile phone text message reminder one month to their expected date of delivery. Follow up was done to both groups through their mobile phone contacts. Data was collected using an interviewer-administered questionnaire and analyzed using Stata version 11. Proportion tests were done to compare the groups. Results: The success rate of the study was 90.5% (n = 343). Most of the participants (73%) were aged between 20 and 34 years. Majority of them were married (79.2%) and most of them had primary level of education. Protestant was the predominant religion (55.2%). Housewives and businesswomen constituted 34.2% and 27%, respectively. The respondents in the study group who were birth prepared were 74.3% (n = 136) while those in the control group were 48.1% (n = 77). Conclusion: The use of mobile phone text message reminder in addition to verbal messages is more effective.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46542688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Enabudoso, G. A. Oko-oboh, A. Ehigiegba, Jedidiah D. K. Sodje, J. Erhabor, Matthew Oriakhi, J. Onakewhor
Context: The harm elimination model is designed to improve access to pre- and postabortion care including free contraception and address the challenges posed by unsafe abortion to the sexual and reproductive health of the women recruited for the study. Aims: To determine the impact of the “Harm Elimination Project For Unsafe Abortion in Nigeria” (HELPUSAN) model on the rate of decision to keep the pregnancy by women seeking termination of pregnancy and the determinants of this decision. Subjects and Methods: Over the 6-month period of this pilot survey, all women presenting for abortion were offered preabortion and postabortion counseling and services according to the study protocol. The study did not offer abortion services based on the abortion law in Nigeria. The clients were followed up for 6 weeks and assessed on decision to continue the pregnancy or not. Results: Of 105 attendees, 12.4% declined enrolment, 59.8%had induced abortion, and 45.8% had spontaneous abortion. Among those who presented for postabortion care following induced abortion, the main method used for inducing the abortion process was drugs (80.5%). A total of 90 (97.8%) of the participants were confirmed to be pregnant of which 52 (57.8%) were viable. Also, of the 52 participants with viable pregnancies, 19 (36.5%) decided to retain their pregnancies, while 33 (63.5%) decided not to retain their pregnancies. Conclusion: Almost 40% of clients presenting as pre abortion clients decided to retain the pregnancy. This work also once again highlights the high unmet need for contraception in Nigeria.
{"title":"Harm elimination project for unsafe abortion in Nigeria: An operations research","authors":"E. Enabudoso, G. A. Oko-oboh, A. Ehigiegba, Jedidiah D. K. Sodje, J. Erhabor, Matthew Oriakhi, J. Onakewhor","doi":"10.4103/TJOG.TJOG_70_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_70_18","url":null,"abstract":"Context: The harm elimination model is designed to improve access to pre- and postabortion care including free contraception and address the challenges posed by unsafe abortion to the sexual and reproductive health of the women recruited for the study. Aims: To determine the impact of the “Harm Elimination Project For Unsafe Abortion in Nigeria” (HELPUSAN) model on the rate of decision to keep the pregnancy by women seeking termination of pregnancy and the determinants of this decision. Subjects and Methods: Over the 6-month period of this pilot survey, all women presenting for abortion were offered preabortion and postabortion counseling and services according to the study protocol. The study did not offer abortion services based on the abortion law in Nigeria. The clients were followed up for 6 weeks and assessed on decision to continue the pregnancy or not. Results: Of 105 attendees, 12.4% declined enrolment, 59.8%had induced abortion, and 45.8% had spontaneous abortion. Among those who presented for postabortion care following induced abortion, the main method used for inducing the abortion process was drugs (80.5%). A total of 90 (97.8%) of the participants were confirmed to be pregnant of which 52 (57.8%) were viable. Also, of the 52 participants with viable pregnancies, 19 (36.5%) decided to retain their pregnancies, while 33 (63.5%) decided not to retain their pregnancies. Conclusion: Almost 40% of clients presenting as pre abortion clients decided to retain the pregnancy. This work also once again highlights the high unmet need for contraception in Nigeria.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47125144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Diagnostic laparoscopy affords smaller incisions, shorter recovery time, and fewer complications. In developing countries, access is limited by cost, infrastructural deficit, and expertise. In a bid to reduce cost at our center, conscious sedation for diagnostic laparoscopy was introduced as far back as 1980. We present here a 5-year audit of our outpatient diagnostic laparoscopy highlighting the various indications, findings, and complications observed. Methodology: A retrospective review of case files of patients who had diagnostic gynecological laparoscopy between 1st January 2011 and 31st December 2015. The retrieved case files had data extracted and analysed using the Statistical Package for Social Sciences version 20 (Chicago IL USA). Data was presented as simple percentages using tables and figures. Results: During the period, 1,329 outpatient gynecological procedures were performed with 207 diagnostic gynecologic laparoscopies (15.6%). Only 187 case notes were retrieved (retrieval rate of 90%). The mean age was 33.04 (±5.2) years, 84.5% (158) had post-secondary education, and 69.0% (129) were nulliparous. Majority, 131 (70.0%), had laparoscopy and dye test, 26 (14.0%) had laparoscopy alone, and 30 (16.0%) had a combination of laparoscopy, dye test, and hysteroscopy. The commonest indications were secondary infertility (51.9%), primary infertility (24.1%), and chronic pelvic pain (11.2%). Common findings at laparoscopy were pelvic adhesions (53.5%), uterine fibroids (35.1%), and bilateral tubal blockage (30.3%). Normal findings were reported in only 19 patients (10.3%). Conclusion: Diagnostic laparoscopy under conscious sedation is cost-effective and safe. It has very minimal complications when performed by skilled personnel. It is thus recommended for low resource settings with the view to avail low income patients the opportunity for endoscopic evaluation.
{"title":"A 5-year audit of diagnostic gynaecologic laparoscopy under conscious sedation at the university college hospital, Ibadan","authors":"O. Adesina, G. O. Obajimi, T. Abo-Briggs","doi":"10.4103/TJOG.TJOG_15_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_15_18","url":null,"abstract":"Introduction: Diagnostic laparoscopy affords smaller incisions, shorter recovery time, and fewer complications. In developing countries, access is limited by cost, infrastructural deficit, and expertise. In a bid to reduce cost at our center, conscious sedation for diagnostic laparoscopy was introduced as far back as 1980. We present here a 5-year audit of our outpatient diagnostic laparoscopy highlighting the various indications, findings, and complications observed. Methodology: A retrospective review of case files of patients who had diagnostic gynecological laparoscopy between 1st January 2011 and 31st December 2015. The retrieved case files had data extracted and analysed using the Statistical Package for Social Sciences version 20 (Chicago IL USA). Data was presented as simple percentages using tables and figures. Results: During the period, 1,329 outpatient gynecological procedures were performed with 207 diagnostic gynecologic laparoscopies (15.6%). Only 187 case notes were retrieved (retrieval rate of 90%). The mean age was 33.04 (±5.2) years, 84.5% (158) had post-secondary education, and 69.0% (129) were nulliparous. Majority, 131 (70.0%), had laparoscopy and dye test, 26 (14.0%) had laparoscopy alone, and 30 (16.0%) had a combination of laparoscopy, dye test, and hysteroscopy. The commonest indications were secondary infertility (51.9%), primary infertility (24.1%), and chronic pelvic pain (11.2%). Common findings at laparoscopy were pelvic adhesions (53.5%), uterine fibroids (35.1%), and bilateral tubal blockage (30.3%). Normal findings were reported in only 19 patients (10.3%). Conclusion: Diagnostic laparoscopy under conscious sedation is cost-effective and safe. It has very minimal complications when performed by skilled personnel. It is thus recommended for low resource settings with the view to avail low income patients the opportunity for endoscopic evaluation.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42797380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Multifetal pregnancies remain a challenge to both parents and clinicians. With the increasing application of assisted reproductive technology in infertility management, the incidence is likely to continue to rise. Aim and Objective: To determine maternal characteristics of multifetal pregnancies, maternal and fetal outcomes, at the Ahmadu Bello University Teaching Hospital (ABUTH), Nigeria. Patients and Methods: A retrospective observational study of women who had multifetal pregnancy in ABUTH Zaria over a period of 5 years was conducted. Information regarding maternal determinants and fetal outcome was collated. The data were analyzed using SPSS version 20.0. Demographic variables were presented using tables and figures, while summaries were done using means, standard deviation, and percentages. Test of association was done using Chi-square. P value <0.05 was considered statistically significant. Results: The total number of deliveries during the study period was 9399 out of which 254 were twins and 2 were higher order multifetal pregnancies. Giving us a rate of 27/1000 multifetal deliveries, majority of the women were booked (91%) and the average number of antenatal visits was 7.4 ± 3.1. The mean maternal age was 29 ± 6 and the mean parity was 2.4 ± 2.2. The mean gestational age at delivery was 36.5 ± 2.2. History of ovulation induction was present in 33% and 57% gave a family history of twinning. The Yoruba ethnic group had the highest incidence with 42.7%. A total of 19% were admitted for various indications, the commonest indication was hypertensive disorders (18%), 64% of the women had preterm deliveries, and 7.5% of the women delivered before 34 weeks. The caesarean section (CS) rate was 39.7%. The commonest presentation was cephalic. There was statistical significant difference between presentation and mode of delivery X2 = 31.579 and P = 0.000. The mean birth weight of T1= 2.3 ± 0.5, and that of T2= 2.7 ± 3, and 68.3% of T1 compared to 60.2% of T2 had weight <2.5 kg. There was statistically significant difference between the mean birth weight and Apgar score of the leading fetuses P = 0.009. Up to 92.6% of T1 were delivered alive, compared to 84.6% of T2, Mean interbaby delivery interval between T1 and T2 was 11.7 minutes. Male:female ratio was 1:1.1. A total of 23% were admitted to neonatal intensive care unit and the commonest indication for admission was low birth weight (35%). The commonest causes of perinatal mortality were asphyxia and sepsis. Perinatal mortality was 114 per 1000 births and maternal mortality rate was 1,639/100,000 live births. Conclusion: Parity, ethnicity, maternal age, ovulation induction, and family history were the major determinants of multifetal pregnancies. There was association between presentation and mode of delivery and also the birth weight and Apgar score of the leading twins. Our multifetal pregnancy rate and cesarean section rate were high, associated with high maternal and perinatal mor
{"title":"Maternal determinants and fetal outcome of multifetal pregnancies in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria","authors":"S. Adelaiye, H. Adelaiye, P. Onwuhafua","doi":"10.4103/TJOG.TJOG_75_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_75_18","url":null,"abstract":"Background: Multifetal pregnancies remain a challenge to both parents and clinicians. With the increasing application of assisted reproductive technology in infertility management, the incidence is likely to continue to rise. Aim and Objective: To determine maternal characteristics of multifetal pregnancies, maternal and fetal outcomes, at the Ahmadu Bello University Teaching Hospital (ABUTH), Nigeria. Patients and Methods: A retrospective observational study of women who had multifetal pregnancy in ABUTH Zaria over a period of 5 years was conducted. Information regarding maternal determinants and fetal outcome was collated. The data were analyzed using SPSS version 20.0. Demographic variables were presented using tables and figures, while summaries were done using means, standard deviation, and percentages. Test of association was done using Chi-square. P value <0.05 was considered statistically significant. Results: The total number of deliveries during the study period was 9399 out of which 254 were twins and 2 were higher order multifetal pregnancies. Giving us a rate of 27/1000 multifetal deliveries, majority of the women were booked (91%) and the average number of antenatal visits was 7.4 ± 3.1. The mean maternal age was 29 ± 6 and the mean parity was 2.4 ± 2.2. The mean gestational age at delivery was 36.5 ± 2.2. History of ovulation induction was present in 33% and 57% gave a family history of twinning. The Yoruba ethnic group had the highest incidence with 42.7%. A total of 19% were admitted for various indications, the commonest indication was hypertensive disorders (18%), 64% of the women had preterm deliveries, and 7.5% of the women delivered before 34 weeks. The caesarean section (CS) rate was 39.7%. The commonest presentation was cephalic. There was statistical significant difference between presentation and mode of delivery X2 = 31.579 and P = 0.000. The mean birth weight of T1= 2.3 ± 0.5, and that of T2= 2.7 ± 3, and 68.3% of T1 compared to 60.2% of T2 had weight <2.5 kg. There was statistically significant difference between the mean birth weight and Apgar score of the leading fetuses P = 0.009. Up to 92.6% of T1 were delivered alive, compared to 84.6% of T2, Mean interbaby delivery interval between T1 and T2 was 11.7 minutes. Male:female ratio was 1:1.1. A total of 23% were admitted to neonatal intensive care unit and the commonest indication for admission was low birth weight (35%). The commonest causes of perinatal mortality were asphyxia and sepsis. Perinatal mortality was 114 per 1000 births and maternal mortality rate was 1,639/100,000 live births. Conclusion: Parity, ethnicity, maternal age, ovulation induction, and family history were the major determinants of multifetal pregnancies. There was association between presentation and mode of delivery and also the birth weight and Apgar score of the leading twins. Our multifetal pregnancy rate and cesarean section rate were high, associated with high maternal and perinatal mor","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48598362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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