O. Asiegbu, U. Asiegbu, E. Mamah, C. Anikwe, O. Ogah, U. Nnadozie
Background: Despite its increasing acceptance as a safe alternative to vaginal delivery, caesarean section (CS) in developing countries continue to be associated with maternal and fetal morbidity and mortality. Objectives: This study was aimed at evaluating the indications, outcomes and factors associated with increased CS at the Federal Teaching Hospital, Abakaliki. Methods: This was a six year retrospective study covering 2012 to 2017. Case notes of patients were identified and retrieved from the records unit of the hospital. Information extracted include sociodemographic variables, indications and types of CS performed and the complications. These data were entered into a personal computer and analysed with Epi Info version 7. Results: These were presented using tables and percentages. A p-value of 0.05 was considered significant. In 6 years, 11,215 women were delivered, 2405 (21.4%) had emergency CS while 1445 (12.9%) had elective CS; giving a CS rate of 34.3%. The most common indication for emergency CS was cephalopelvic disproportion (22.0%) while previous caesarean section (27.7%) formed the major indication for elective CS. Severe birth asphyxia was recorded in 17.2% and 4.2% of babies delivered by emergency and elective CS respectively. Booking status, parity and patient's age had statistically significant association with the chance of having a CS. Maternal and perinatal deaths were recorded in 2.6% and 5.0% for emergency CS compared to 1.0% and 0.2% for elective CS. Although lifesaving, CS, due to an existing condition or complication in the patient, may be associated with an increase in maternal and fetal morbidities and mortalities. Conclusion: There was a higher burden of complication with emergency CS due to its associated determinants. Adequate training of healthcare personnel on ways of minimizing complications against the backdrop of an existing problem and an efficient referral system will help reduce these morbidities and mortalities.
{"title":"Determinants and outcomes of elective and emergency caesarean section at a tertiary hospital in Abakaliki, Southeast Nigeria: A 6-year review","authors":"O. Asiegbu, U. Asiegbu, E. Mamah, C. Anikwe, O. Ogah, U. Nnadozie","doi":"10.4103/TJOG.TJOG_19_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_19_19","url":null,"abstract":"Background: Despite its increasing acceptance as a safe alternative to vaginal delivery, caesarean section (CS) in developing countries continue to be associated with maternal and fetal morbidity and mortality. Objectives: This study was aimed at evaluating the indications, outcomes and factors associated with increased CS at the Federal Teaching Hospital, Abakaliki. Methods: This was a six year retrospective study covering 2012 to 2017. Case notes of patients were identified and retrieved from the records unit of the hospital. Information extracted include sociodemographic variables, indications and types of CS performed and the complications. These data were entered into a personal computer and analysed with Epi Info version 7. Results: These were presented using tables and percentages. A p-value of 0.05 was considered significant. In 6 years, 11,215 women were delivered, 2405 (21.4%) had emergency CS while 1445 (12.9%) had elective CS; giving a CS rate of 34.3%. The most common indication for emergency CS was cephalopelvic disproportion (22.0%) while previous caesarean section (27.7%) formed the major indication for elective CS. Severe birth asphyxia was recorded in 17.2% and 4.2% of babies delivered by emergency and elective CS respectively. Booking status, parity and patient's age had statistically significant association with the chance of having a CS. Maternal and perinatal deaths were recorded in 2.6% and 5.0% for emergency CS compared to 1.0% and 0.2% for elective CS. Although lifesaving, CS, due to an existing condition or complication in the patient, may be associated with an increase in maternal and fetal morbidities and mortalities. Conclusion: There was a higher burden of complication with emergency CS due to its associated determinants. Adequate training of healthcare personnel on ways of minimizing complications against the backdrop of an existing problem and an efficient referral system will help reduce these morbidities and mortalities.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"200 - 205"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44260943","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: The impairment of male fertility has been linked to exercise in a volume-, intensity-, and modality-dependent manner. Infertility is a worldwide problem and male factor infertility is found to be increased. Chronic administration of honey results in elevating sorbitol dehydrogenase activity and decreases lactose dehydrogenase activity, which was found to be in abundance in spermatids and spermatozoa, and a decrease in this enzyme significantly affects the semen parameters and decreases ATP synthesis due to oxidative stress. Objective: The study aimed to evaluate the effect of honey and intensity of swimming exercise on semen parameters of male albino Wistar rats. Methodology: A randomized control trial study was adopted involving 50 sexually mature male Wistar rats (180 ± 20 g). The selected rats were divided into five groups of 10 rats each: group I served as normal control while group II was induced with honey only and served as study control. Groups III–V were study groups induced orally with 7.5 mL/kg of honey twice per week for 8 weeks and exposed to mild, moderate, and high-intensity swimming exercises 5 days/week for 8 weeks, respectively. Results: Chronic oral administration of pure honey showed that motility, viability, sperm count, and semen morphology were significantly lower, and percentages of abnormal morphology were found to be significantly higher (P < 0.05) in group II compared with normal control rats (group I). There was a significant decrease in motility, viability, and morphology in group V when compared with groups I, III, and IV. However, they were significantly higher when compared with test control group. The decrease was found to be swimming exercise time-dependent. Conclusion: Chronic consumption of pure honey has a deleterious effect on semen parameters, and mild, moderate, and intensity swimming exercises were found to have a positive effect of induced semen parameters of male albino Wistar rats.
{"title":"Effect of honey and intensity of swimming exercise on semen parameters of male albino Wistar rats","authors":"HM Abdullahi, MK Atiku, Y. Abdulmumin, WH Sadiya","doi":"10.4103/TJOG.TJOG_5_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_5_19","url":null,"abstract":"Background: The impairment of male fertility has been linked to exercise in a volume-, intensity-, and modality-dependent manner. Infertility is a worldwide problem and male factor infertility is found to be increased. Chronic administration of honey results in elevating sorbitol dehydrogenase activity and decreases lactose dehydrogenase activity, which was found to be in abundance in spermatids and spermatozoa, and a decrease in this enzyme significantly affects the semen parameters and decreases ATP synthesis due to oxidative stress. Objective: The study aimed to evaluate the effect of honey and intensity of swimming exercise on semen parameters of male albino Wistar rats. Methodology: A randomized control trial study was adopted involving 50 sexually mature male Wistar rats (180 ± 20 g). The selected rats were divided into five groups of 10 rats each: group I served as normal control while group II was induced with honey only and served as study control. Groups III–V were study groups induced orally with 7.5 mL/kg of honey twice per week for 8 weeks and exposed to mild, moderate, and high-intensity swimming exercises 5 days/week for 8 weeks, respectively. Results: Chronic oral administration of pure honey showed that motility, viability, sperm count, and semen morphology were significantly lower, and percentages of abnormal morphology were found to be significantly higher (P < 0.05) in group II compared with normal control rats (group I). There was a significant decrease in motility, viability, and morphology in group V when compared with groups I, III, and IV. However, they were significantly higher when compared with test control group. The decrease was found to be swimming exercise time-dependent. Conclusion: Chronic consumption of pure honey has a deleterious effect on semen parameters, and mild, moderate, and intensity swimming exercises were found to have a positive effect of induced semen parameters of male albino Wistar rats.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"258 - 264"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45748129","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: Major birth defects are common causes of perinatal morbidity and mortality which have become a global phenomenon. Its occurrence in the developing nations like Nigeria requires due consideration most especially to its pattern and risk factors. Objectives: This review was conducted to determine the pattern of birth defects and investigate the factors associated with birth defects and its outcome at Aminu Kano Teaching Hospital (AKTH), Kano. Methods: This was a 10-year retrospective study conducted in the Department of Obstetrics and Gynaecology and the Department of Paediatrics (Special Care Baby Unit) of AKTH, Kano, between April 2007 and March 2017. Data retrieved from patients' file were collected using a purpose-designed proforma to obtain information on the required parameters and analyzed using IBM SPSS version 20, 2009 software. Frequencies and percentages were calculated and the results were presented in tabular forms. Results: There were 6990 deliveries within the study period, out of which 305 babies had birth defects, giving a prevalence of 4.4%. Among women who delivered baby with birth defects, maternal age ranged from 16 to 45 years with a mean age of 30 ± 5 years. The highest incidence (48%) of birth defects occurred among the 26–35 years age group. Anomalies that affected single system are significantly higher than anomalies that affected multiple systems. A higher percentage (52.5%) of birth defects occurred in male neonates. The gastrointestinal system was the most commonly affected (32.5%), while musculoskeletal system was the least (3.75%) affected system. Drug intake among 120 mothers who delivered neonates with birth defects when considered as a risk factor was found to constitute 81% of traditional concoction/herbs; while 12.5% were orthodox and intake of social drug was found to be only 6.5%. Hypertension was found to be the highest chronic medical disorder, while chorioamnionitis following premature rupture of membrane was recorded as the most commonly occurring maternal infection. Sixty percent of these neonates with birth defects were managed conservatively, surgical treatment was given in 23.5%, while 16.5% underwent medical treatment. Discharge rate was 82.5%; 9% left against medical advice, while neonatal mortality rate was about 8.5% and a majority (91.8%) of the death occurred among the neonates with multiple birth defects. Conclusion: The prevalence of birth defect in AKTH was 4.4% of the total deliveries over the study period. Gastrointestinal system was found to be the most commonly affected system. Hypertensive disorders of pregnancy and ingestion of traditional herbs were found to be the most common medical disorder and drug intake, respectively, among the mothers who delivered neonates with birth defects. Although the outcome of the management was good, and the study could not establish direct causation, there is need to counsel mothers on the inherent dangers of traditional herbs ingestion and the
{"title":"Pattern of birth defects at a university teaching hospital in Northern Nigeria: Retrospective review over a decade","authors":"I. Takai, S. Gaya, M. Sheu, M. Abdulsalam","doi":"10.4103/TJOG.TJOG_28_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_28_19","url":null,"abstract":"Background: Major birth defects are common causes of perinatal morbidity and mortality which have become a global phenomenon. Its occurrence in the developing nations like Nigeria requires due consideration most especially to its pattern and risk factors. Objectives: This review was conducted to determine the pattern of birth defects and investigate the factors associated with birth defects and its outcome at Aminu Kano Teaching Hospital (AKTH), Kano. Methods: This was a 10-year retrospective study conducted in the Department of Obstetrics and Gynaecology and the Department of Paediatrics (Special Care Baby Unit) of AKTH, Kano, between April 2007 and March 2017. Data retrieved from patients' file were collected using a purpose-designed proforma to obtain information on the required parameters and analyzed using IBM SPSS version 20, 2009 software. Frequencies and percentages were calculated and the results were presented in tabular forms. Results: There were 6990 deliveries within the study period, out of which 305 babies had birth defects, giving a prevalence of 4.4%. Among women who delivered baby with birth defects, maternal age ranged from 16 to 45 years with a mean age of 30 ± 5 years. The highest incidence (48%) of birth defects occurred among the 26–35 years age group. Anomalies that affected single system are significantly higher than anomalies that affected multiple systems. A higher percentage (52.5%) of birth defects occurred in male neonates. The gastrointestinal system was the most commonly affected (32.5%), while musculoskeletal system was the least (3.75%) affected system. Drug intake among 120 mothers who delivered neonates with birth defects when considered as a risk factor was found to constitute 81% of traditional concoction/herbs; while 12.5% were orthodox and intake of social drug was found to be only 6.5%. Hypertension was found to be the highest chronic medical disorder, while chorioamnionitis following premature rupture of membrane was recorded as the most commonly occurring maternal infection. Sixty percent of these neonates with birth defects were managed conservatively, surgical treatment was given in 23.5%, while 16.5% underwent medical treatment. Discharge rate was 82.5%; 9% left against medical advice, while neonatal mortality rate was about 8.5% and a majority (91.8%) of the death occurred among the neonates with multiple birth defects. Conclusion: The prevalence of birth defect in AKTH was 4.4% of the total deliveries over the study period. Gastrointestinal system was found to be the most commonly affected system. Hypertensive disorders of pregnancy and ingestion of traditional herbs were found to be the most common medical disorder and drug intake, respectively, among the mothers who delivered neonates with birth defects. Although the outcome of the management was good, and the study could not establish direct causation, there is need to counsel mothers on the inherent dangers of traditional herbs ingestion and the","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"287 - 292"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46781845","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}
G. Obajimi, A. Smart, A. Adekanmi, A. Adeniji-Sofoluwe, F. Jinadu
Introduction: Ectopic pregnancy in Sub-Saharan Africa has an incidence of 1%-5% of all deliveries and 5%-10% of all gynaecological admissions. The fallopian tube is the most common site of occurrence of an ectopic pregnancy and ruptured ectopic is the commonest variety seen in low resource settings. Materials and Method: This is a 2-year retrospective diagnostic accuracy test of transabdominal ultrasonographic findings in ectopic pregnancy, using surgical findings as the gold-standard. The study was conducted at the Radiology Department of the University College Hospital, Ibadan, Nigeria between 1 January 2013 and 31 December 2014. Radiological request cards of 41 women who were clinically suspected to have an ectopic pregnancy and had a transabdominal ultrasound scan were retrieved, however, only 34 were suitable for analysis. Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 20 (Chicago, IL, USA). A P value of <0.05 was regarded as statistically significant. Results: The ages of the women ranged between 20 and 40 years with a mean age of 29.94 ± 5.06 years. The mean gestational age at time of scan was 44.8 days (6 weeks + 3 days). Out of 34 patients reviewed in this study, 29 had surgical interventions in the course of their management and 26 had ectopic gestation confirmed at surgery. This study found a Sensitivity of 88.4%, Specificity of 37.5% and Positive and Negative predictive values of 82.1% and 50%, respectively. Conclusion: This preliminary study suggests that transabdominal ultrasonography is a useful and reliable means of diagnosing ectopic pregnancy particularly in low-resource settings where availability and or technical skill for transvaginal ultrasonography is not readily available.
{"title":"Correlation between transabdominal ultrasound features of ectopic gestation and surgical findings at the university college hospital, Ibadan: A preliminary review","authors":"G. Obajimi, A. Smart, A. Adekanmi, A. Adeniji-Sofoluwe, F. Jinadu","doi":"10.4103/TJOG.TJOG_39_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_39_18","url":null,"abstract":"Introduction: Ectopic pregnancy in Sub-Saharan Africa has an incidence of 1%-5% of all deliveries and 5%-10% of all gynaecological admissions. The fallopian tube is the most common site of occurrence of an ectopic pregnancy and ruptured ectopic is the commonest variety seen in low resource settings. Materials and Method: This is a 2-year retrospective diagnostic accuracy test of transabdominal ultrasonographic findings in ectopic pregnancy, using surgical findings as the gold-standard. The study was conducted at the Radiology Department of the University College Hospital, Ibadan, Nigeria between 1 January 2013 and 31 December 2014. Radiological request cards of 41 women who were clinically suspected to have an ectopic pregnancy and had a transabdominal ultrasound scan were retrieved, however, only 34 were suitable for analysis. Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 20 (Chicago, IL, USA). A P value of <0.05 was regarded as statistically significant. Results: The ages of the women ranged between 20 and 40 years with a mean age of 29.94 ± 5.06 years. The mean gestational age at time of scan was 44.8 days (6 weeks + 3 days). Out of 34 patients reviewed in this study, 29 had surgical interventions in the course of their management and 26 had ectopic gestation confirmed at surgery. This study found a Sensitivity of 88.4%, Specificity of 37.5% and Positive and Negative predictive values of 82.1% and 50%, respectively. Conclusion: This preliminary study suggests that transabdominal ultrasonography is a useful and reliable means of diagnosing ectopic pregnancy particularly in low-resource settings where availability and or technical skill for transvaginal ultrasonography is not readily available.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"265 - 270"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47130926","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. Owa, A. Lemadoro, B. Temenu, J. Ayeyemi, O. Loto
Objective: To compare low dose sublingual misoprostol with the standard 10 IU of intramuscular oxytocin in active management of third stage of labor. Materials and Methods: A total of 104 women with term pregnancy were randomized to receive either 200 μg misoprostol sublingually or 10 IU oxytocin intramuscularly after vaginal delivery. Primary outcome measured was mean blood loss and incidence of primary postpartum hemorrhage (PPH). Secondary outcome measured included duration of third stage of labor, side effects of drugs and need for additional oxytocics to treat life-threatening hemorrhage. Results: A total of 104 women with term pregnancy in two groups of 52 were studied. The mean blood loss with sublingual misoprostol and oxytocin groups was 320.58 ± 244.12 vs. 253.27 ± 171.74 ml; P = 0.11. There was no significant differences between the misoprostol and oxytocin groups with regard to the incidence of PPH (19.2% vs. 13.5% respectively; P = 0.43). More women in the misoprostol group experienced side effects compared with those in oxytocin group; however, the difference was not statistically significant (P = 0.26). The mean duration of third stage of labor was similar and the difference was statistically not significant (6.65 ± 3.47 vs. 6.08 ± 3.07 minutes) (P = 0.38), as well as need for additional oxytocics (13.5% vs. 5.8% P = 0.18) misoprostol and oxytocin, respectively. Conclusion: Sublingual misoprostol has similar efficacy to standard intramuscular oxytocin in preventing PPH following vaginal birth. Misoprostol at 200 μg with its thermostability may be an effective alternative to intramuscular oxytocin in active management of third stage of labor.
目的:比较低剂量舌下米索前列醇与标准10 IU肌内催产素在第三产褥期积极治疗中的作用。材料与方法:104例足月妊娠妇女阴道分娩后随机接受200 μg米索前列醇舌下或10 IU催产素肌内注射。主要观察指标为平均失血量和原发性产后出血(PPH)发生率。测量的次要结果包括第三产程持续时间、药物的副作用以及是否需要额外的催产素来治疗危及生命的出血。结果:共对104例足月妊娠妇女分为两组，每组52例。米索前列醇组和催产素组的平均失血量分别为320.58±244.12 ml和253.27±171.74 ml;P = 0.11。米索前列醇组和催产素组在PPH发生率方面无显著差异(分别为19.2%和13.5%;P = 0.43)。与催产素组相比，米索前列醇组有更多的女性出现了副作用;但差异无统计学意义(P = 0.26)。第三产程平均持续时间相似，差异无统计学意义(6.65±3.47 vs 6.08±3.07 min) (P = 0.38)，以及需要额外使用的催产素(13.5% vs 5.8% P = 0.18)米索前列醇和催产素(P = 0.18)。结论:舌下米索前列醇预防阴道分娩后PPH的效果与标准肌内催产素相似。米索前列醇200 μg的热稳定性可能是肌注催产素在第三产褥期积极管理的有效替代。
{"title":"Misoprostol versus oxytocin in preventing postpartum hemorrhage: A randomized controlled trial","authors":"O. Owa, A. Lemadoro, B. Temenu, J. Ayeyemi, O. Loto","doi":"10.4103/TJOG.TJOG_16_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_16_19","url":null,"abstract":"Objective: To compare low dose sublingual misoprostol with the standard 10 IU of intramuscular oxytocin in active management of third stage of labor. Materials and Methods: A total of 104 women with term pregnancy were randomized to receive either 200 μg misoprostol sublingually or 10 IU oxytocin intramuscularly after vaginal delivery. Primary outcome measured was mean blood loss and incidence of primary postpartum hemorrhage (PPH). Secondary outcome measured included duration of third stage of labor, side effects of drugs and need for additional oxytocics to treat life-threatening hemorrhage. Results: A total of 104 women with term pregnancy in two groups of 52 were studied. The mean blood loss with sublingual misoprostol and oxytocin groups was 320.58 ± 244.12 vs. 253.27 ± 171.74 ml; P = 0.11. There was no significant differences between the misoprostol and oxytocin groups with regard to the incidence of PPH (19.2% vs. 13.5% respectively; P = 0.43). More women in the misoprostol group experienced side effects compared with those in oxytocin group; however, the difference was not statistically significant (P = 0.26). The mean duration of third stage of labor was similar and the difference was statistically not significant (6.65 ± 3.47 vs. 6.08 ± 3.07 minutes) (P = 0.38), as well as need for additional oxytocics (13.5% vs. 5.8% P = 0.18) misoprostol and oxytocin, respectively. Conclusion: Sublingual misoprostol has similar efficacy to standard intramuscular oxytocin in preventing PPH following vaginal birth. Misoprostol at 200 μg with its thermostability may be an effective alternative to intramuscular oxytocin in active management of third stage of labor.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"196 - 199"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43656201","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: Efavirenz is now a first-line non-nucleoside reverse transcriptase inhibitor used as highly active antiretroviral therapy (HAART) though its use is fraught with maternal side effects, usually of the central nervous system (CNS) and fetal complications. Objective: The study aims to comparatively document the maternal side-effect profile of an efavirenz-containing fixed-dosage HAART and compliance with its use in HIV-positive pregnant and nonpregnant women at the Lagos University Teaching Hospital (LUTH), Idi-Araba. Methodology: A prospective study among HIV-positive pregnant (40) and nonpregnant women (40) on efavirenz-containing fixed-dose HAART (Atripla®) who were recruited purposively at the antenatal clinic and AIDS Prevention Initiative Nigeria (APIN) clinics of LUTH. Data analysis was done with EPI Info 2014, and the results are presented in frequencies. Results: The mean age of respondents was 31 ± 5.7 years. Atripla® was the only fixed-dose combination used. Fifty-three percent and 62.5% of pregnant and nonpregnant HIV-positive women, respectively, reported CNS side effects of Atripla® [odds ratio: 0.66, 95% confidence interval 0.27–1.62]. Adherence to the use of Atripla® was 100% among HIV-positive pregnant women. Women with baseline viral load values greater than 400 copies/mL reported more side effects to Atripla®. Conclusion: There are similar side-effect profiles of Atripla® in HIV-positive women irrespective of pregnancy. Education and counselling can help foster adherence, resulting in improved immunological and virological outcome.
背景:Efavirenz目前是一线非核苷类逆转录酶抑制剂，用于高效抗逆转录病毒治疗(HAART)，尽管其使用充满了母体副作用，通常是中枢神经系统(CNS)和胎儿并发症。目的:本研究旨在比较记录在拉各斯大学教学医院(LUTH)，含有依非韦伦的一种固定剂量HAART药物的产妇副作用及其在艾滋病毒阳性孕妇和非孕妇中的使用依从性。方法:一项前瞻性研究，在hiv阳性孕妇(40名)和非孕妇(40名)中进行含依非韦伦的固定剂量HAART治疗(Atripla®)，这些孕妇是在LUTH的产前诊所和艾滋病预防倡议尼日利亚(APIN)诊所有目的招募的。数据分析使用EPI Info 2014进行，结果以频率表示。结果:调查对象平均年龄31±5.7岁。Atripla®是唯一使用的固定剂量组合。妊娠期和非妊娠期hiv阳性妇女分别有53%和62.5%报告了Atripla®的中枢神经系统副作用[优势比:0.66,95%可信区间0.27-1.62]。在hiv阳性孕妇中，Atripla®的使用依从性为100%。基线病毒载量值大于400拷贝/mL的女性报告了Atripla®的更多副作用。结论:Atripla®在hiv阳性妇女中存在相似的副作用。教育和咨询可以帮助促进依从性，从而改善免疫和病毒学结果。
{"title":"Maternal side effects of efavirenz-containing highly active antiretroviral therapy (HAART): A comparative study of HIV-positive pregnant and nonpregnant women in a tertiary hospital","authors":"K. Makinde, B. Okusanya, OR Akinajo","doi":"10.4103/TJOG.TJOG_1_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_1_19","url":null,"abstract":"Background: Efavirenz is now a first-line non-nucleoside reverse transcriptase inhibitor used as highly active antiretroviral therapy (HAART) though its use is fraught with maternal side effects, usually of the central nervous system (CNS) and fetal complications. Objective: The study aims to comparatively document the maternal side-effect profile of an efavirenz-containing fixed-dosage HAART and compliance with its use in HIV-positive pregnant and nonpregnant women at the Lagos University Teaching Hospital (LUTH), Idi-Araba. Methodology: A prospective study among HIV-positive pregnant (40) and nonpregnant women (40) on efavirenz-containing fixed-dose HAART (Atripla®) who were recruited purposively at the antenatal clinic and AIDS Prevention Initiative Nigeria (APIN) clinics of LUTH. Data analysis was done with EPI Info 2014, and the results are presented in frequencies. Results: The mean age of respondents was 31 ± 5.7 years. Atripla® was the only fixed-dose combination used. Fifty-three percent and 62.5% of pregnant and nonpregnant HIV-positive women, respectively, reported CNS side effects of Atripla® [odds ratio: 0.66, 95% confidence interval 0.27–1.62]. Adherence to the use of Atripla® was 100% among HIV-positive pregnant women. Women with baseline viral load values greater than 400 copies/mL reported more side effects to Atripla®. Conclusion: There are similar side-effect profiles of Atripla® in HIV-positive women irrespective of pregnancy. Education and counselling can help foster adherence, resulting in improved immunological and virological outcome.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"218 - 223"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41561850","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}
Ascites is a rare manifestation of endometriosis. The case reported is that of a 26-year-old woman with recurrent massive hemorrhagic ascites. The analysis of biopsy specimens made at laparoscopy confirmed the diagnosis. The report noted pelvic endometriosis associated but there was no umbilical or pleural involvement. The evolution was favorable under a long term hormone treatment (by GnRH analogues) with relay through continuous estrogen-progestogen. The diagnostic and therapeutic difficulties of this rare form of endometriosis are presented through a review of the literature.
{"title":"Endometriosis with massive recurrent hemorrhagic ascites: A case report","authors":"E. N’guessan, N. Kouamé, F. Gbeli, P. Guié","doi":"10.4103/TJOG.TJOG_9_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_9_19","url":null,"abstract":"Ascites is a rare manifestation of endometriosis. The case reported is that of a 26-year-old woman with recurrent massive hemorrhagic ascites. The analysis of biopsy specimens made at laparoscopy confirmed the diagnosis. The report noted pelvic endometriosis associated but there was no umbilical or pleural involvement. The evolution was favorable under a long term hormone treatment (by GnRH analogues) with relay through continuous estrogen-progestogen. The diagnostic and therapeutic difficulties of this rare form of endometriosis are presented through a review of the literature.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"312 - 314"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47748374","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}
Objectives: To assess the problems faced by pregnant women with prosthetic cardiac valves in terms of maternal and neonatal outcomes. Settings: Tertiary-level teaching hospital. Population: All pregnant women with prosthetic cardiac valves visiting the hospital in the period between January 2008 and September 2012. Method: Retrospective observational case series study. Results: Among the women presenting for antenatal visits to the hospital in the study period, eight were found to be have prosthetic cardiac valves. All cases had rheumatic origin of their cardiac lesion. Five cases had a mitral valve replacement. One had aortic and two had double-valve replacement. All patients had mechanical valves and were on anticoagulant regimen. Among them, one patient developed valve thrombosis and another developed embolic transient ischemic attack while in labor. Two patients developed symptomatic arrhythmia requiring treatment, while one patient had pneumonia with parapneumonic effusion. Three cases had abortions, while the other five pregnancies delivered live babies. All deliveries took place by lower segment Caesarean section (LSCS) for indications other than the cardiac condition. One pregnancy was complicated by intrauterine growth restriction and oligohydramnios. No patient developed any complications during the LSCS. There were no cases of warfarin embryopathy observed. Conclusion: Maternal complications tend to be higher in pregnant women with prosthetic cardiac valves requiring strict adherence to anticoagulant regimens and specialized treatment in tertiary care centers.
{"title":"Pregnancy and prosthetic heart valves: A case series","authors":"B. Barnali, S. Ranjan","doi":"10.4103/TJOG.TJOG_68_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_68_18","url":null,"abstract":"Objectives: To assess the problems faced by pregnant women with prosthetic cardiac valves in terms of maternal and neonatal outcomes. Settings: Tertiary-level teaching hospital. Population: All pregnant women with prosthetic cardiac valves visiting the hospital in the period between January 2008 and September 2012. Method: Retrospective observational case series study. Results: Among the women presenting for antenatal visits to the hospital in the study period, eight were found to be have prosthetic cardiac valves. All cases had rheumatic origin of their cardiac lesion. Five cases had a mitral valve replacement. One had aortic and two had double-valve replacement. All patients had mechanical valves and were on anticoagulant regimen. Among them, one patient developed valve thrombosis and another developed embolic transient ischemic attack while in labor. Two patients developed symptomatic arrhythmia requiring treatment, while one patient had pneumonia with parapneumonic effusion. Three cases had abortions, while the other five pregnancies delivered live babies. All deliveries took place by lower segment Caesarean section (LSCS) for indications other than the cardiac condition. One pregnancy was complicated by intrauterine growth restriction and oligohydramnios. No patient developed any complications during the LSCS. There were no cases of warfarin embryopathy observed. Conclusion: Maternal complications tend to be higher in pregnant women with prosthetic cardiac valves requiring strict adherence to anticoagulant regimens and specialized treatment in tertiary care centers.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"277 - 282"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46026718","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 : 2019-09-01DOI: 10.4103/tjog.tjog_101_19
O. Allen, O. Badejoko
Gynatresia is the narrowing or complete occlusion of the vagina, which may be congenital or acquired. In Nigeria, acquired gynatresia is more common, usually resulting from the use of herbal pessaries. Its mere occurrence is indeed one social calamity to many. We present a case of a 37-year-old P0+1 with acquired gynatresia following insertion of herbal pessaries at a trado medical center. This was in an attempt to treat cryptomenorrhea which had developed following an abortion complicated by uterine perforation at a private hospital 20 years prior. Poor quality of medical care may push women to seek unsafe alternatives, resulting in even more harm.
{"title":"Once treated, twice harmed: A case report of acquired gynatresia following vaginal insertion of herbs","authors":"O. Allen, O. Badejoko","doi":"10.4103/tjog.tjog_101_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_101_19","url":null,"abstract":"Gynatresia is the narrowing or complete occlusion of the vagina, which may be congenital or acquired. In Nigeria, acquired gynatresia is more common, usually resulting from the use of herbal pessaries. Its mere occurrence is indeed one social calamity to many. We present a case of a 37-year-old P0+1 with acquired gynatresia following insertion of herbal pessaries at a trado medical center. This was in an attempt to treat cryptomenorrhea which had developed following an abortion complicated by uterine perforation at a private hospital 20 years prior. Poor quality of medical care may push women to seek unsafe alternatives, resulting in even more harm.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"472 - 473"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48441962","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}
AO Fehintola, F. Fehintola, AO Adetoye, EO Ayegbusi, OA Alaba, AD Ajiboye, O. Badejoko, BA Adeyemi
Background: Obstetric fistula is an abnormal communication between the epithelium of female genital tract and the bladder and (or) the rectum. It is not just “a hole”; it affects every aspect of the life of the sufferers. Objective: This study examined the etiology, psychosocial and medical consequences of obstetric fistula on the patients. Methodology: It was a cross-sectional study with quantitative and qualitative data collection methods employed. Quantitative data collection was done by the aid of a structured interviewer-administered questionnaire while qualitative data collection was by focus group discussions (FGDs) and in-depth interviews (IDIs). The sample consists of eligible and consenting patients with obstetric fistula admitted for repair at the Wesley Guild Hospital, Ilesha between July 2017 and August 2018. Purposive sampling technique was used to select 86 patients. Results: The mean age of patients was 28.7 years ± 7.5 (SD) with a divorce rate of 40%. Only 10% of them had their first marriage between ages 15 and 20 years. Prolong obstructed labor accounted for 55.8% of all the obstetric fistula in this study. The remaining were either following hysterectomy or cesarean section. Reported medical problems were dermatitis (60%), dyspareunia (25%), recurrent urinary tract infection (UTI) (10%), infertility (5%), and amenorrhea (5%). Socially, 45% felt ostracized, and 50% were economically impoverished by job loss. Some 56.6% respondents suggested that hospital delivery was a preventive measure, while 8% felt that avoidance of early marriage would prevent obstetric fistula. Conclusion: Obstetric fistula is still a major reproductive health problem. Most of these patients understand the role of unsupervised childbirth in its development.
{"title":"Birth and sorrow: The medico-social consequences of obstetric fistula in Ilesha, Nigeria","authors":"AO Fehintola, F. Fehintola, AO Adetoye, EO Ayegbusi, OA Alaba, AD Ajiboye, O. Badejoko, BA Adeyemi","doi":"10.4103/TJOG.TJOG_32_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_32_19","url":null,"abstract":"Background: Obstetric fistula is an abnormal communication between the epithelium of female genital tract and the bladder and (or) the rectum. It is not just “a hole”; it affects every aspect of the life of the sufferers. Objective: This study examined the etiology, psychosocial and medical consequences of obstetric fistula on the patients. Methodology: It was a cross-sectional study with quantitative and qualitative data collection methods employed. Quantitative data collection was done by the aid of a structured interviewer-administered questionnaire while qualitative data collection was by focus group discussions (FGDs) and in-depth interviews (IDIs). The sample consists of eligible and consenting patients with obstetric fistula admitted for repair at the Wesley Guild Hospital, Ilesha between July 2017 and August 2018. Purposive sampling technique was used to select 86 patients. Results: The mean age of patients was 28.7 years ± 7.5 (SD) with a divorce rate of 40%. Only 10% of them had their first marriage between ages 15 and 20 years. Prolong obstructed labor accounted for 55.8% of all the obstetric fistula in this study. The remaining were either following hysterectomy or cesarean section. Reported medical problems were dermatitis (60%), dyspareunia (25%), recurrent urinary tract infection (UTI) (10%), infertility (5%), and amenorrhea (5%). Socially, 45% felt ostracized, and 50% were economically impoverished by job loss. Some 56.6% respondents suggested that hospital delivery was a preventive measure, while 8% felt that avoidance of early marriage would prevent obstetric fistula. Conclusion: Obstetric fistula is still a major reproductive health problem. Most of these patients understand the role of unsupervised childbirth in its development.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"442 - 447"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41792485","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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