Pub Date : 2020-01-01DOI: 10.4103/tjog.tjog_111_19
S. Hemmanur, Sai Illa, Hanuman Krishna
Background: Onset of spontaneous labor occurs on completion of fetal functional maturity at amniotic fluid optical density (AFOD) 0.98 ± 0.27 (mean ± SD). All three events occurring together at any time from 35 weeks to 42 weeks indicate the individualized term for each fetus. No failures of induction of labor were reported when labors induced at AFOD 0.98 ± 0.27. As AFOD estimation needs invasive amniocentesis, we tried to induce women with liquor with mature AFOD by observing the sonographic appearances of fore-water by transvaginal sonography. Methods: In this comparative study, three groups of gestational age and parity matched uncomplicated singleton term pregnant women, underwent fore-water trans-vaginal sonography before induction of labor with Foley's catheter. Sonographic images were divided into three grades based on floating particle densities. Each group consisted of 20 women with each grade of sonographic images. Uncentrifuged fresh AF samples collected at amniotomy were used for AFOD measurement with colorimeter at 650 nm in all groups. After Foley's expulsion, labor was augmented with vaginal misoprostol. The mean AFOD values, Foley's insertion expulsion intervals, Foley's insertion delivery intervals (FIDI), T misoprostol required, and neonatal respiratory distress were recorded in each group and compared. Results: In groups 1, 2, and 3, the mean AFOD was found to be 0.29 ± 0.09, 0.68 ± 0.14, and 1.15 ± 0.20, respectively. Mean Foley's insertion expulsion intervals were 10.57 ± 3.76 h, 5.83 ± 2.24 h, and 4.08 ± 0.86 h, respectively. Mean FIDI were 20.00 ± 6.20 h, 11.22 ± 4.20 h, and 8.95 ± 2.98 h, respectively. The mean numbers of T misoprostol required in each group was 3 ± 1, 2 ± 1, and 2 ± 1, respectively. Significant differences were observed in all outcomes between groups (P < 0.05) favouring inductions with Grade 3 sonographic images. Conclusion: Labor induction with Grade 3 sonographic images of fore-water was successful in all women with shorter FIDI, and with better perinatal outcomes.
{"title":"Comparison of outcomes of Foley's induced labors with different sonographic floater densities in fore-water","authors":"S. Hemmanur, Sai Illa, Hanuman Krishna","doi":"10.4103/tjog.tjog_111_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_111_19","url":null,"abstract":"Background: Onset of spontaneous labor occurs on completion of fetal functional maturity at amniotic fluid optical density (AFOD) 0.98 ± 0.27 (mean ± SD). All three events occurring together at any time from 35 weeks to 42 weeks indicate the individualized term for each fetus. No failures of induction of labor were reported when labors induced at AFOD 0.98 ± 0.27. As AFOD estimation needs invasive amniocentesis, we tried to induce women with liquor with mature AFOD by observing the sonographic appearances of fore-water by transvaginal sonography. Methods: In this comparative study, three groups of gestational age and parity matched uncomplicated singleton term pregnant women, underwent fore-water trans-vaginal sonography before induction of labor with Foley's catheter. Sonographic images were divided into three grades based on floating particle densities. Each group consisted of 20 women with each grade of sonographic images. Uncentrifuged fresh AF samples collected at amniotomy were used for AFOD measurement with colorimeter at 650 nm in all groups. After Foley's expulsion, labor was augmented with vaginal misoprostol. The mean AFOD values, Foley's insertion expulsion intervals, Foley's insertion delivery intervals (FIDI), T misoprostol required, and neonatal respiratory distress were recorded in each group and compared. Results: In groups 1, 2, and 3, the mean AFOD was found to be 0.29 ± 0.09, 0.68 ± 0.14, and 1.15 ± 0.20, respectively. Mean Foley's insertion expulsion intervals were 10.57 ± 3.76 h, 5.83 ± 2.24 h, and 4.08 ± 0.86 h, respectively. Mean FIDI were 20.00 ± 6.20 h, 11.22 ± 4.20 h, and 8.95 ± 2.98 h, respectively. The mean numbers of T misoprostol required in each group was 3 ± 1, 2 ± 1, and 2 ± 1, respectively. Significant differences were observed in all outcomes between groups (P < 0.05) favouring inductions with Grade 3 sonographic images. Conclusion: Labor induction with Grade 3 sonographic images of fore-water was successful in all women with shorter FIDI, and with better perinatal outcomes.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"33 - 37"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44340252","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}
Objective: The study was designed to investigate the effectiveness of orally administered misoprostol versus intravenous ergometrine (stored at tropical temperatures) in the prevention of primary postpartum hemorrhage (PPH) among parturients undergoing vaginal delivery in a teaching hospital. Study Design: A double-blind randomized controlled clinical trial was conducted at the University of Benin Teaching Hospital. One hundred and fifty parturients were offered 400 ug misoprostol and an intravenous placebo for the management of the third stage of labor while another 150 parturients received oral placebo and 0.5 mg intravenous ergometrine. Results: There was no significant difference in the incidence of PPH (blood loss > 500 ml) between the two groups: 8 (5.3%) for the misoprostol group compared with 7 (4.7%) for the ergometrine group (P = 0.79, relative risk (RR) = 1.07, confidence interval (CI): 0.66–1.74). The incidence of severe PPH (blood loss > 1000 ml) was similar between the two groups: 2 (1.3%) in the misoprostol group compared with 1 (0.7%) in the ergometrine group. Similarly, the indices of postpartum blood loss (hematocrit change, need for blood transfusion, and surgical intervention) were comparable between the two groups. A subgroup analysis of high-risk parturients revealed comparable indices. The misoprostol group, however, had a significantly higher risk of shivering in the early postpartum period (P = 0.00, RR = 2.01, CI: 1.69–2.38). Conclusions: The results suggest that oral misoprostol has comparable efficacy to intravenous ergometrine at tropical conditions in the prevention of PPH. However, in view of its easier mode of administration, oral misoprostol may be preferable in rural situations in Africa.
{"title":"A double-blind randomized controlled clinical trial of oral misoprostol versus ergometrine in the prevention of primary postpartum hemorrhage","authors":"V. Otoide","doi":"10.4103/tjog.tjog_52_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_52_19","url":null,"abstract":"Objective: The study was designed to investigate the effectiveness of orally administered misoprostol versus intravenous ergometrine (stored at tropical temperatures) in the prevention of primary postpartum hemorrhage (PPH) among parturients undergoing vaginal delivery in a teaching hospital. Study Design: A double-blind randomized controlled clinical trial was conducted at the University of Benin Teaching Hospital. One hundred and fifty parturients were offered 400 ug misoprostol and an intravenous placebo for the management of the third stage of labor while another 150 parturients received oral placebo and 0.5 mg intravenous ergometrine. Results: There was no significant difference in the incidence of PPH (blood loss > 500 ml) between the two groups: 8 (5.3%) for the misoprostol group compared with 7 (4.7%) for the ergometrine group (P = 0.79, relative risk (RR) = 1.07, confidence interval (CI): 0.66–1.74). The incidence of severe PPH (blood loss > 1000 ml) was similar between the two groups: 2 (1.3%) in the misoprostol group compared with 1 (0.7%) in the ergometrine group. Similarly, the indices of postpartum blood loss (hematocrit change, need for blood transfusion, and surgical intervention) were comparable between the two groups. A subgroup analysis of high-risk parturients revealed comparable indices. The misoprostol group, however, had a significantly higher risk of shivering in the early postpartum period (P = 0.00, RR = 2.01, CI: 1.69–2.38). Conclusions: The results suggest that oral misoprostol has comparable efficacy to intravenous ergometrine at tropical conditions in the prevention of PPH. However, in view of its easier mode of administration, oral misoprostol may be preferable in rural situations in Africa.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"72 - 77"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42752177","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}
O. Adeniyi, O. Olayemi, T. Ojumu, S. Olateju, O. Makinde
With about 2–11% of pregnancy co-existing with fibroids, one in 10 women will have complications related to myoma in pregnancy. The procedure of cesarean myomectomy has been much discouraged and the need to perform inevitable myomectomy during the cesarean section (CS) when fibroids obstruct wound closure has been presented. A case of a primigravida with huge uterine fibroids displacing the fetus into a persistent oblique lie and causing maternal discomfort is presented. A planned cesarean myomectomy was performed. Hemorrhage was controlled with tourniquet using Foley catheter, misoprostol, and high dose oxytocin infusion. The mother and baby had a satisfactory outcome. Elective cesarean myomectomy is safe but should only be done by an experienced surgeon and in centers equipped with facilities for comprehensive emergency obstetric care.
{"title":"Planned cesarean myomectomy at term for huge intramural fibroids coexisting with pregnancy: A case report","authors":"O. Adeniyi, O. Olayemi, T. Ojumu, S. Olateju, O. Makinde","doi":"10.4103/tjog.tjog_70_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_70_19","url":null,"abstract":"With about 2–11% of pregnancy co-existing with fibroids, one in 10 women will have complications related to myoma in pregnancy. The procedure of cesarean myomectomy has been much discouraged and the need to perform inevitable myomectomy during the cesarean section (CS) when fibroids obstruct wound closure has been presented. A case of a primigravida with huge uterine fibroids displacing the fetus into a persistent oblique lie and causing maternal discomfort is presented. A planned cesarean myomectomy was performed. Hemorrhage was controlled with tourniquet using Foley catheter, misoprostol, and high dose oxytocin infusion. The mother and baby had a satisfactory outcome. Elective cesarean myomectomy is safe but should only be done by an experienced surgeon and in centers equipped with facilities for comprehensive emergency obstetric care.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"201 - 203"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47983765","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}
The first three in the series of Society of Gynaecology and Obstetrics of Nigeria (SOGON) lectures on “Frontiers in Medical Education,” in honor of Professor Linus Ajabor, had focused on internship and postgraduate medical education. This fourth lecture is about the evolution of undergraduate medical education in Nigeria from its rudimentary beginning in 1930 to the present. Lessons from the past include the desirability of tailoring medical education toward meeting national needs, doing proper needs assessment before planning and implementation, setting minimum standards for training institutions, and enforcing these standards through a credible process of accreditation. Recommendations for the future include a harmonization of the guidelines on minimum standards published by the Medical and Dental Council of Nigeria (MDCN) and the minimum academic standards published by Nigeria's National Universities Commission (NUC), and the conduct of joint accreditation by both agencies to maximize efficiency and reduce waste. There should also be mandatory training in pedagogy for clinician teachers, periodic curriculum reviews must be enforced, and simulation laboratories should be provided in all accredited medical schools.
{"title":"Improving undergraduate medical education in Nigeria: Insight into the past","authors":"A. Omigbodun","doi":"10.4103/tjog.tjog_62_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_62_19","url":null,"abstract":"The first three in the series of Society of Gynaecology and Obstetrics of Nigeria (SOGON) lectures on “Frontiers in Medical Education,” in honor of Professor Linus Ajabor, had focused on internship and postgraduate medical education. This fourth lecture is about the evolution of undergraduate medical education in Nigeria from its rudimentary beginning in 1930 to the present. Lessons from the past include the desirability of tailoring medical education toward meeting national needs, doing proper needs assessment before planning and implementation, setting minimum standards for training institutions, and enforcing these standards through a credible process of accreditation. Recommendations for the future include a harmonization of the guidelines on minimum standards published by the Medical and Dental Council of Nigeria (MDCN) and the minimum academic standards published by Nigeria's National Universities Commission (NUC), and the conduct of joint accreditation by both agencies to maximize efficiency and reduce waste. There should also be mandatory training in pedagogy for clinician teachers, periodic curriculum reviews must be enforced, and simulation laboratories should be provided in all accredited medical schools.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"3 - 17"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47996489","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}
Ovarian cancer (OC) is currently the 7th most common malignancy globally and the most lethal gynecological cancer.[1] It has been estimated that, in the United States, one woman in 70 will develop ovarian cancer, and one woman in 100 will die of the disease.[2] Ovarian cancer rates vary between different countries and appear to be related to socioeconomic status and reproductive factors. It is the second most common gynaecological cancer in sub Saharan Africa. Epithelial ovarian cancer (EOC) constitutes about 85-90% of all ovarian malignancies.[1] In both developed and developing nations, the case fatality of ovarian cancer is very high for some reasons. The disease is associated with late presentation as there are no specific early symptoms to warn the patients and caregivers, there are no significant screening tests to predict patients who might develop the cancer and no matter how good the immediate outcomes following the current standard modalities of treatment which includes optimum debulking surgery and chemotherapy, recurrence is the rule rather than the exception in most cases.
{"title":"Ovarian cancer: An undertreated and understudied entity in sub Saharan Africa","authors":"A. Akinfolarin","doi":"10.4103/tjog.tjog_28_20","DOIUrl":"https://doi.org/10.4103/tjog.tjog_28_20","url":null,"abstract":"Ovarian cancer (OC) is currently the 7th most common malignancy globally and the most lethal gynecological cancer.[1] It has been estimated that, in the United States, one woman in 70 will develop ovarian cancer, and one woman in 100 will die of the disease.[2] Ovarian cancer rates vary between different countries and appear to be related to socioeconomic status and reproductive factors. It is the second most common gynaecological cancer in sub Saharan Africa. Epithelial ovarian cancer (EOC) constitutes about 85-90% of all ovarian malignancies.[1] In both developed and developing nations, the case fatality of ovarian cancer is very high for some reasons. The disease is associated with late presentation as there are no specific early symptoms to warn the patients and caregivers, there are no significant screening tests to predict patients who might develop the cancer and no matter how good the immediate outcomes following the current standard modalities of treatment which includes optimum debulking surgery and chemotherapy, recurrence is the rule rather than the exception in most cases.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47951729","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}
Context: Symptomatic uterine fibroids are frequently encountered in gynecological practice in black populations. An evaluation of the surgical management is in order to audit practice, highlight complications, and facilitate care. Aims: This study aimed to evaluate morbidity following abdominal myomectomy and hysterectomy for symptomatic uterine fibroids. Settings and Design: A cross-sectional study retrospectively reviewing cases of symptomatic uterine fibroids that were managed surgically at a tertiary hospital in south-west Nigeria. Methods and Material: Surgeries performed over a five-year period were retrieved from the gynecological theatre of the hospital. The case notes were retrieved and information on socio-demographic, perioperative and postoperative characteristics was obtained. Statistical analysis used: Chi-square tests and Student's-t tests were performed to evaluate categorical and continuous variables, respectively. Significant P was set at < 0.05. Results: Of 214 eligible cases, 79 (36.9%) had hysterectomy and 135 (63.1%) had myomectomy. No other surgical treatment methods were employed. Age was the only significant socio-demographic feature; younger women were more likely to have myomectomy (P < 0.001). Mean blood loss and transfusion rates were comparable between the two groups. Complications included hemorrhage in 36.0%, wound infection in 4.7%, and postoperative fever in 1.9%. There were no conversions of myomectomy to hysterectomy and no mortalities. There was no significant difference in the prevalence of complications in either surgery group. Conclusions: Apart from hemorrhage, morbidities were few in this series. Gynecologists should ensure adequate preparations to control blood loss before and during fibroid surgery.
{"title":"Surgical management of uterine fibroids in a tertiary hospital in south-west Nigeria","authors":"O. Enabor, F. Bello","doi":"10.4103/tjog.tjog_49_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_49_19","url":null,"abstract":"Context: Symptomatic uterine fibroids are frequently encountered in gynecological practice in black populations. An evaluation of the surgical management is in order to audit practice, highlight complications, and facilitate care. Aims: This study aimed to evaluate morbidity following abdominal myomectomy and hysterectomy for symptomatic uterine fibroids. Settings and Design: A cross-sectional study retrospectively reviewing cases of symptomatic uterine fibroids that were managed surgically at a tertiary hospital in south-west Nigeria. Methods and Material: Surgeries performed over a five-year period were retrieved from the gynecological theatre of the hospital. The case notes were retrieved and information on socio-demographic, perioperative and postoperative characteristics was obtained. Statistical analysis used: Chi-square tests and Student's-t tests were performed to evaluate categorical and continuous variables, respectively. Significant P was set at < 0.05. Results: Of 214 eligible cases, 79 (36.9%) had hysterectomy and 135 (63.1%) had myomectomy. No other surgical treatment methods were employed. Age was the only significant socio-demographic feature; younger women were more likely to have myomectomy (P < 0.001). Mean blood loss and transfusion rates were comparable between the two groups. Complications included hemorrhage in 36.0%, wound infection in 4.7%, and postoperative fever in 1.9%. There were no conversions of myomectomy to hysterectomy and no mortalities. There was no significant difference in the prevalence of complications in either surgery group. Conclusions: Apart from hemorrhage, morbidities were few in this series. Gynecologists should ensure adequate preparations to control blood loss before and during fibroid surgery.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"156 - 159"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42585164","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}
Pub Date : 2020-01-01DOI: 10.4103/tjog.tjog_104_19
C. Akpata, P. Uadia, F. Okonofua
Background: Dyslipidemia is one of the most perplexing metabolic consequences in polycystic ovary syndrome (PCOS). Obesity, insulin resistance (IR), and hyperandrogenism, the pervasive features of PCOS, play significant pathophysiological roles in the lipidemic aberrations associated with the syndrome. Objective: This study aimed to assess the diagnostic utility of triglyceride (TG) and triglyceride to high-density lipoprotein-cholesterol (TG/HDL-C) ratio as surrogate markers for identifying IR in infertile Nigerian women with PCOS. Materials and Methods: Eighty-seven infertile women with PCOS were selected according to the Androgen Excess Society criteria and categorized into two groups. After anthropometric measurements, fasting blood samples were assayed for plasma glucose, serum insulin, total cholesterol, TG, HDL-C while lipoprotein ratios were calculated. Homeostasis model assessment for IR (HOMA-IR) was used in defining IR. The areas under the receiver operating characteristic (ROC) curve analysis were used to compare the power of the serum markers, and to obtain the optimal cutoffs of TG and TG/HDL-C with HOMA-IR. Results: TGs correlated significantly with HOMA-IR in the obese PCOS women. However, the areas under the ROC of potential markers showed no significant marker for HOMA-IR. The highest area under the curve of ROC for TG belongs to the obese group with a sensitivity of 56% and specificity of 53% (TG ≥ 92.5mg/dL) as a marker of IR in obese PCOS women. Conclusion: TG and TG/HDL-C would not be reliable markers of IR, and a concerted approach in finding surrogate markers will benefit future investigations.
{"title":"Triglycerides and TG/HDL-C ratio as surrogate markers for insulin resistance in Nigerian women with polycystic ovary syndrome","authors":"C. Akpata, P. Uadia, F. Okonofua","doi":"10.4103/tjog.tjog_104_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_104_19","url":null,"abstract":"Background: Dyslipidemia is one of the most perplexing metabolic consequences in polycystic ovary syndrome (PCOS). Obesity, insulin resistance (IR), and hyperandrogenism, the pervasive features of PCOS, play significant pathophysiological roles in the lipidemic aberrations associated with the syndrome. Objective: This study aimed to assess the diagnostic utility of triglyceride (TG) and triglyceride to high-density lipoprotein-cholesterol (TG/HDL-C) ratio as surrogate markers for identifying IR in infertile Nigerian women with PCOS. Materials and Methods: Eighty-seven infertile women with PCOS were selected according to the Androgen Excess Society criteria and categorized into two groups. After anthropometric measurements, fasting blood samples were assayed for plasma glucose, serum insulin, total cholesterol, TG, HDL-C while lipoprotein ratios were calculated. Homeostasis model assessment for IR (HOMA-IR) was used in defining IR. The areas under the receiver operating characteristic (ROC) curve analysis were used to compare the power of the serum markers, and to obtain the optimal cutoffs of TG and TG/HDL-C with HOMA-IR. Results: TGs correlated significantly with HOMA-IR in the obese PCOS women. However, the areas under the ROC of potential markers showed no significant marker for HOMA-IR. The highest area under the curve of ROC for TG belongs to the obese group with a sensitivity of 56% and specificity of 53% (TG ≥ 92.5mg/dL) as a marker of IR in obese PCOS women. Conclusion: TG and TG/HDL-C would not be reliable markers of IR, and a concerted approach in finding surrogate markers will benefit future investigations.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"182 - 188"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47646327","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}
Pub Date : 2020-01-01DOI: 10.4103/0189-5117.292287
{"title":"Erratum: Office cystometry in a resource-constrained setting: Spectrum of diagnoses and correlation with QUID","authors":"","doi":"10.4103/0189-5117.292287","DOIUrl":"https://doi.org/10.4103/0189-5117.292287","url":null,"abstract":"","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"217 - 217"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70732470","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}
First, on employing serology, the authors found that the estimated prevalence of syphilis in a cohort of Nigerian pregnant was 1.98% and the prevalence rates in urban and rural areas were 2.63% and 1.32%, respectively.[1] Owing to the presence of the following limitation, I assume that the study results must be handled with cautions. It is worthy to mention that there are different methods to test for syphilis. Studies have shown that polymerase chain reaction (PCR) technique is superior to serology in precisely detecting syphilis.[2,3] I presume that if the authors employed PCR instead of serology in the study methodology, more precise estimate of syphilis seroprevalence among Nigerian pregnant would be obtained.
{"title":"The prevalence of syphilis in pregnant women in Akwa Ibom State, Southern Nigeria","authors":"M. Al-Mendalawi","doi":"10.4103/tjog.tjog_91_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_91_19","url":null,"abstract":"First, on employing serology, the authors found that the estimated prevalence of syphilis in a cohort of Nigerian pregnant was 1.98% and the prevalence rates in urban and rural areas were 2.63% and 1.32%, respectively.[1] Owing to the presence of the following limitation, I assume that the study results must be handled with cautions. It is worthy to mention that there are different methods to test for syphilis. Studies have shown that polymerase chain reaction (PCR) technique is superior to serology in precisely detecting syphilis.[2,3] I presume that if the authors employed PCR instead of serology in the study methodology, more precise estimate of syphilis seroprevalence among Nigerian pregnant would be obtained.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"216 - 216"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44357447","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}
J. Nwafor, V. Obi, C. Obi, C. Ibo, D. Ugoji, B. Onwe, V. Onuchukwu
Introduction: There have been many advances in the management of miscarriage in recent times including the introduction of expectant and medical management protocols. However, a study of the psychological impact of the condition and its management has not received similar attention. Aim: To determine the psychosocial consequences of miscarriages and perceived needs of the patients compared to the care provided by the hospital. Materials and Method: This was a prospective cohort study conducted between January 15, 2018 and April 30, 2019. Participants were recruited on admission and psychological morbidity was assessed at 1 week after a miscarriage in the gynecological clinics. They were screened for psychological morbidities using DASS 21 (Depression, Anxiety and Stress Scale). Results: Of 140 women that participated in the study, severe depression was reported in 8 (5.7%) whereas 12 (8.5%) participants reported symptoms of extremely severe depression. Moderate to severe anxiety was present in 23.5% while extremely severe anxiety was noted among 21.5% of the women. Stress was reported in over half of respondents and severe to extremely severe stress occurred in 19.9% of the participants. Factors significantly associated with psychological morbidities following miscarriage include age ≥35 years, no living child, subfertility, planned pregnancy, and assisted conception. Healthcare providers not listening to the patient's concern, non-participation in decision making, and dissatisfaction with care were associated with adverse psychological outcomes. Conclusion: Psychological morbidity following a miscarriage is common among participants in our study. The provision of the correct information and psychological debriefing may be useful in enabling women to adjust emotionally following miscarriage.
{"title":"Mental health outcome and perceived care needs of women treated for a miscarriage in a low-resource setting","authors":"J. Nwafor, V. Obi, C. Obi, C. Ibo, D. Ugoji, B. Onwe, V. Onuchukwu","doi":"10.4103/tjog.tjog_44_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_44_19","url":null,"abstract":"Introduction: There have been many advances in the management of miscarriage in recent times including the introduction of expectant and medical management protocols. However, a study of the psychological impact of the condition and its management has not received similar attention. Aim: To determine the psychosocial consequences of miscarriages and perceived needs of the patients compared to the care provided by the hospital. Materials and Method: This was a prospective cohort study conducted between January 15, 2018 and April 30, 2019. Participants were recruited on admission and psychological morbidity was assessed at 1 week after a miscarriage in the gynecological clinics. They were screened for psychological morbidities using DASS 21 (Depression, Anxiety and Stress Scale). Results: Of 140 women that participated in the study, severe depression was reported in 8 (5.7%) whereas 12 (8.5%) participants reported symptoms of extremely severe depression. Moderate to severe anxiety was present in 23.5% while extremely severe anxiety was noted among 21.5% of the women. Stress was reported in over half of respondents and severe to extremely severe stress occurred in 19.9% of the participants. Factors significantly associated with psychological morbidities following miscarriage include age ≥35 years, no living child, subfertility, planned pregnancy, and assisted conception. Healthcare providers not listening to the patient's concern, non-participation in decision making, and dissatisfaction with care were associated with adverse psychological outcomes. Conclusion: Psychological morbidity following a miscarriage is common among participants in our study. The provision of the correct information and psychological debriefing may be useful in enabling women to adjust emotionally following miscarriage.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"37 1","pages":"85 - 94"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42825021","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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