Introduction: Ovarian epithelial tumors account for the majority of female ovarian neoplasms but seromucinous tumors are rare and not adequately described in the literature. The recent World Health Organization (WHO) 2014 classification of tumors of female reproductive organs introduced this new category of ovarian neoplasm as “seromucinous tumors. Materials and Method: Sectioning of tissue followed by staining and immunohistochemistry. Results: Four of our cases which were diagnosed as cystic lesion clinically and radiologically , on histopathological examination two of them reported as seromucinous cystadenoma and rest two as seromucinous borderline tumors (SMBT). One of the case of SMBT also showed microinvasion along with focal areas of intraepithelial carcinoma high grade and clear cell component. Conclusion: Proper histopathological diagnosis is very important for better treatment and to reduce the use of aggressive therapies.
{"title":"Ovarian seromucinous tumor: A case series of WHO newly introduced entity","authors":"E. Dwivedi, N. Dhameja, M. Lader, A. Kar","doi":"10.4103/TJOG.TJOG_30_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_30_19","url":null,"abstract":"Introduction: Ovarian epithelial tumors account for the majority of female ovarian neoplasms but seromucinous tumors are rare and not adequately described in the literature. The recent World Health Organization (WHO) 2014 classification of tumors of female reproductive organs introduced this new category of ovarian neoplasm as “seromucinous tumors. Materials and Method: Sectioning of tissue followed by staining and immunohistochemistry. Results: Four of our cases which were diagnosed as cystic lesion clinically and radiologically , on histopathological examination two of them reported as seromucinous cystadenoma and rest two as seromucinous borderline tumors (SMBT). One of the case of SMBT also showed microinvasion along with focal areas of intraepithelial carcinoma high grade and clear cell component. Conclusion: Proper histopathological diagnosis is very important for better treatment and to reduce the use of aggressive therapies.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"408 - 411"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43495048","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, A. Ande, N. Enaruna, Collins Ejakhianghe Maximilian Okoror, S. Igbarumah
Electronic fetal monitoring with special emphasis on cardiotocography (CTG) has become indispensable in the management of pregnancy and labor, especially in the high-risk parturient. While this is an essential part of the practice in high-income countries, many low- and medium-income countries (LMICs) lack the facilities and skill to deploy the technology in their centers. The reasons for this stem from various issues including lack of knowledge on the significance of the tool, lack of training in the acquisition and interpretation of the trace, inordinate fear of the presumed increase in Caesarean section rate, equipment cost and maintenance, among others. In this commentary, the lessons learnt from the 10-year experience of the implementation of CTG monitoring at the Maternal and Fetal Unit of the Department of Obstetrics and Gynecology of the University of Benin Teaching Hospital, Benin City are shared. The basic steps necessary to commence the service are proposed. The issue of training and retraining is emphasized while also highlighting the necessity of preventive maintenance of the equipment. The challenges of the program and limitations of the report are also brought to the fore. Despite these drawbacks, in the spirit of the peer review system for the introduction and sustenance of contemporary medical technology in LMICs, it is believed that sharing these experiences will help build an enduring system capable of improving service delivery and practice in these regions.
{"title":"Challenges and practical steps to optimizing the utilization of electronic fetal monitoring in low and medium income countries: The UBTH experience","authors":"E. Enabudoso, A. Ande, N. Enaruna, Collins Ejakhianghe Maximilian Okoror, S. Igbarumah","doi":"10.4103/TJOG.TJOG_76_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_76_19","url":null,"abstract":"Electronic fetal monitoring with special emphasis on cardiotocography (CTG) has become indispensable in the management of pregnancy and labor, especially in the high-risk parturient. While this is an essential part of the practice in high-income countries, many low- and medium-income countries (LMICs) lack the facilities and skill to deploy the technology in their centers. The reasons for this stem from various issues including lack of knowledge on the significance of the tool, lack of training in the acquisition and interpretation of the trace, inordinate fear of the presumed increase in Caesarean section rate, equipment cost and maintenance, among others. In this commentary, the lessons learnt from the 10-year experience of the implementation of CTG monitoring at the Maternal and Fetal Unit of the Department of Obstetrics and Gynecology of the University of Benin Teaching Hospital, Benin City are shared. The basic steps necessary to commence the service are proposed. The issue of training and retraining is emphasized while also highlighting the necessity of preventive maintenance of the equipment. The challenges of the program and limitations of the report are also brought to the fore. Despite these drawbacks, in the spirit of the peer review system for the introduction and sustenance of contemporary medical technology in LMICs, it is believed that sharing these experiences will help build an enduring system capable of improving service delivery and practice in these regions.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"319 - 324"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41557822","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. Luthra, Pritha Halder, Laijun Nahar, N. Sultana, A. Banerjee, Ashutosha Kumar, Manjari Rai, Ompriya Mishra, A. Chattopadhyay, Sangita Saha, A. Modak, Anamika Basu, S. Ali, J. Banerjee, M. Koley, S. Saha
Background: The Uterine Fibroids Symptom and Health-related Quality of Life (UFSQOL) is a validated questionnaire assessing symptom severity and Health-Related Quality of Life (HRQL) in patients with uterine fibroids. The English version contains 37 items measuring 7 components—symptom severity, concern, activities, energy/mood, control, self-consciousness, and sexual function. To date, no validated Bengali version of the questionnaire is available. We aimed to translate the UFSQOL into Bengali and validate the same. Methods: The UFSQOL-Bengali version (UFSQOL-B) was produced by standardized forward-backward translations. A cross-sectional, multi-center, observational study was conducted to gather responses by convenience sampling. Reliability was tested using internal consistency and test-retest reliability analyses, while construct validity by exploratory factor analysis (EFA; n = 120) using principal component analysis (PCA; varimax rotation). Subsequently, confirmatory factor analysis (CFA; n = 120) was performed to verify the a priori scales by the goodness-of-fit model. Results: Both the internal consistency (Cronbach's α) and the intra-class correlation (ICC) coefficient were 0.92. All the items loaded above the pre-specified value of 0.4. The factor analyses using varimax identified 10 components (activities, energy and control, concern about clothing, mood, sexual function, self-consciousness, associated symptoms, heavy bleeding, cycle disturbance, and concern about flooding); explaining 70.2% of the variation. The Kaiser-Meyer-Olkin (KMO) was 0.801 and Bartlett's test of sphericity was P < 0.001. The goodness-of-fit of CFA model was mediocre. Therefore, the final version consisted of 37 items, framed within 10 components. Conclusion: The UFSQOL-B was a valid and reliable questionnaire but measured different dimensions from the English version.
{"title":"Evaluation of psychometric properties of the Uterine Fibroids Symptoms and Health-related Quality of Life (UFSQOL) questionnaire: The translated Bengali version","authors":"J. Luthra, Pritha Halder, Laijun Nahar, N. Sultana, A. Banerjee, Ashutosha Kumar, Manjari Rai, Ompriya Mishra, A. Chattopadhyay, Sangita Saha, A. Modak, Anamika Basu, S. Ali, J. Banerjee, M. Koley, S. Saha","doi":"10.4103/TJOG.TJOG_37_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_37_19","url":null,"abstract":"Background: The Uterine Fibroids Symptom and Health-related Quality of Life (UFSQOL) is a validated questionnaire assessing symptom severity and Health-Related Quality of Life (HRQL) in patients with uterine fibroids. The English version contains 37 items measuring 7 components—symptom severity, concern, activities, energy/mood, control, self-consciousness, and sexual function. To date, no validated Bengali version of the questionnaire is available. We aimed to translate the UFSQOL into Bengali and validate the same. Methods: The UFSQOL-Bengali version (UFSQOL-B) was produced by standardized forward-backward translations. A cross-sectional, multi-center, observational study was conducted to gather responses by convenience sampling. Reliability was tested using internal consistency and test-retest reliability analyses, while construct validity by exploratory factor analysis (EFA; n = 120) using principal component analysis (PCA; varimax rotation). Subsequently, confirmatory factor analysis (CFA; n = 120) was performed to verify the a priori scales by the goodness-of-fit model. Results: Both the internal consistency (Cronbach's α) and the intra-class correlation (ICC) coefficient were 0.92. All the items loaded above the pre-specified value of 0.4. The factor analyses using varimax identified 10 components (activities, energy and control, concern about clothing, mood, sexual function, self-consciousness, associated symptoms, heavy bleeding, cycle disturbance, and concern about flooding); explaining 70.2% of the variation. The Kaiser-Meyer-Olkin (KMO) was 0.801 and Bartlett's test of sphericity was P < 0.001. The goodness-of-fit of CFA model was mediocre. Therefore, the final version consisted of 37 items, framed within 10 components. Conclusion: The UFSQOL-B was a valid and reliable questionnaire but measured different dimensions from the English version.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"338 - 347"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47076274","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. Sule-Odu, O. Jaiyesimi, A. Adejumo, A. Akiseku, O. Odelola
Cement Dust and Pregnancy Outcome: Cement factory poses major health challenge to human health especially those living around the vicinity. The inhaled particulate matters are deposited in most organs in the body. Some of the pollutants migrate through the placenta which could adversely affect the growing fetus. Aims: To compare the fetal and maternal outcomes of pregnant women living within to those living outside Sagamu. Settings and Design: A retrospective study conducted among booked deliveries in Olabisi Onabanjo university teaching hospital in Sagamu from 1st of January 2017 and 31st December 2018. Subjects and Methods: Case notes were retrieved from central medical records. A total of 848 women were living within Sagamu, whereas 236 women were those living outside Sagamu. Statistical Analysis Used: Information retrieved was entered into SPSS version 21 and analyzed. Results: The mean age in years for the study and control group respectively were 29.1 ± 4.9 years and 30.2 ± 5.0 years and the difference was statistically significant (t = 2.723; P < 0.007). The rate of preterm delivery among the study group was significantly higher than the control (x2 = 5.29; P = 0.021). The mean gestational age at delivery for preterm babies was 29.6 ± 7.5 weeks (study) and 31.2 ± 6.0 weeks (control) and there was no significant difference (t-0.843; P < 0.401). The mean packed cell volume of the study and control at booking was 31.7 ± 8.1% and 31.4 ± 4.1% and the difference did not achieve significant level (t-0.538; P < 0.591). The mean birth weight was 3.2 ± 1.6 kg and 3.3 ± 2.1 kg for the study and control groups respectively and there was no significant difference between the two populations (t-0.885; P < 0.376). Conclusions: Pregnant women residing within Sagamu had significant increase risk of preterm deliveries than those living outside Sagamu.
{"title":"Pregnancy outcome among parturients living in and outside Sagamu: A cement factory town","authors":"A. Sule-Odu, O. Jaiyesimi, A. Adejumo, A. Akiseku, O. Odelola","doi":"10.4103/TJOG.TJOG_80_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_80_19","url":null,"abstract":"Cement Dust and Pregnancy Outcome: Cement factory poses major health challenge to human health especially those living around the vicinity. The inhaled particulate matters are deposited in most organs in the body. Some of the pollutants migrate through the placenta which could adversely affect the growing fetus. Aims: To compare the fetal and maternal outcomes of pregnant women living within to those living outside Sagamu. Settings and Design: A retrospective study conducted among booked deliveries in Olabisi Onabanjo university teaching hospital in Sagamu from 1st of January 2017 and 31st December 2018. Subjects and Methods: Case notes were retrieved from central medical records. A total of 848 women were living within Sagamu, whereas 236 women were those living outside Sagamu. Statistical Analysis Used: Information retrieved was entered into SPSS version 21 and analyzed. Results: The mean age in years for the study and control group respectively were 29.1 ± 4.9 years and 30.2 ± 5.0 years and the difference was statistically significant (t = 2.723; P < 0.007). The rate of preterm delivery among the study group was significantly higher than the control (x2 = 5.29; P = 0.021). The mean gestational age at delivery for preterm babies was 29.6 ± 7.5 weeks (study) and 31.2 ± 6.0 weeks (control) and there was no significant difference (t-0.843; P < 0.401). The mean packed cell volume of the study and control at booking was 31.7 ± 8.1% and 31.4 ± 4.1% and the difference did not achieve significant level (t-0.538; P < 0.591). The mean birth weight was 3.2 ± 1.6 kg and 3.3 ± 2.1 kg for the study and control groups respectively and there was no significant difference between the two populations (t-0.885; P < 0.376). Conclusions: Pregnant women residing within Sagamu had significant increase risk of preterm deliveries than those living outside Sagamu.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"356 - 362"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41725856","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. Omotayo, O. Akinsowon, E. Bello, O. Akadiri, A. Akintan, S. Omotayo
Background: When abnormalities of the fetal heart rate are recognized promptly and dealt with, asphyxia and therefore perinatal morbidity and mortality can be reduced. The objective of fetal monitoring during labor is the prediction and diagnosis of fetal asphyxia before fetal/newborn morbidity with particular reference to brain damage occurs. Fetal distress is one of the conditions in which the obstetrician is required to hasten the process of delivery. This urgency is also usually transferred to the anesthetists, whereas the burden of adverse fetal outcome falls squarely on the pediatrician. Objective: This study found out the form of anesthesia mostly used for caesarean sections (CS) in cases of fetal distress, its appropriateness in terms of achieving management goals, and advantages over the other form of anesthesia. Study Design: This study is a retrospective descriptive cross-sectional study. Materials and Methods: Records of patients that had caesarean section for suspected fetal distress over a period of 5 years were reviewed. The fetal status at the point of making diagnosis, type of anesthesia used, suite-arrival-incision-interval, and the baby's condition after surgery were retrieved from the case notes. Data were analyzed with the Statistical Package for Social Sciences (SPSS) version 20.0. Frequencies and proportions of data from the type-of-anesthesia groups were compared. Variables were compared for significance using Chi-square. Results: Most of the surgeries for fetal distress were done under spinal anesthesia in 90% of the patients. Suite arrival-to-incision interval which is largely affected by type of anesthesia was within 1 h 30 min in 91.6% of those that had spinal anesthesia compared to 100% for those that had general anesthesia (GA). P value = 0.000. APGAR score of <4 was more in neonates delivered with GA (61.1%) than those delivered with spinal anesthesia (14.5%). Percentage of neonatal admission into special care baby unit (SCBU) was more in those that had GA (85%) than those that had spinal anesthesia (14%). Conclusion: The predominant type of anesthesia used for caesarean section for fetal distress from this study was spinal anesthesia which had better neonatal outcome.
{"title":"Fetal distress, options of anesthesia, and immediate postdelivery outcome at state specialist hospital Akure","authors":"R. Omotayo, O. Akinsowon, E. Bello, O. Akadiri, A. Akintan, S. Omotayo","doi":"10.4103/TJOG.TJOG_66_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_66_19","url":null,"abstract":"Background: When abnormalities of the fetal heart rate are recognized promptly and dealt with, asphyxia and therefore perinatal morbidity and mortality can be reduced. The objective of fetal monitoring during labor is the prediction and diagnosis of fetal asphyxia before fetal/newborn morbidity with particular reference to brain damage occurs. Fetal distress is one of the conditions in which the obstetrician is required to hasten the process of delivery. This urgency is also usually transferred to the anesthetists, whereas the burden of adverse fetal outcome falls squarely on the pediatrician. Objective: This study found out the form of anesthesia mostly used for caesarean sections (CS) in cases of fetal distress, its appropriateness in terms of achieving management goals, and advantages over the other form of anesthesia. Study Design: This study is a retrospective descriptive cross-sectional study. Materials and Methods: Records of patients that had caesarean section for suspected fetal distress over a period of 5 years were reviewed. The fetal status at the point of making diagnosis, type of anesthesia used, suite-arrival-incision-interval, and the baby's condition after surgery were retrieved from the case notes. Data were analyzed with the Statistical Package for Social Sciences (SPSS) version 20.0. Frequencies and proportions of data from the type-of-anesthesia groups were compared. Variables were compared for significance using Chi-square. Results: Most of the surgeries for fetal distress were done under spinal anesthesia in 90% of the patients. Suite arrival-to-incision interval which is largely affected by type of anesthesia was within 1 h 30 min in 91.6% of those that had spinal anesthesia compared to 100% for those that had general anesthesia (GA). P value = 0.000. APGAR score of <4 was more in neonates delivered with GA (61.1%) than those delivered with spinal anesthesia (14.5%). Percentage of neonatal admission into special care baby unit (SCBU) was more in those that had GA (85%) than those that had spinal anesthesia (14%). Conclusion: The predominant type of anesthesia used for caesarean section for fetal distress from this study was spinal anesthesia which had better neonatal outcome.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"424 - 430"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48102478","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: Preterm prelabor rupture of membranes (PPROM) is a significant risk factor for prematurity, maternal, and early-onset neonatal sepsis. A study of the microbial isolates and antibiotic sensitivity pattern is needed in a resource poor country. Objectives: To identify the microbial isolates and antibiotic sensitivity pattern of patients with early PPROM. Materials and Methods: It was a comparative study between 60 pregnant women who had PPROM and 60 matched controls without PPROM. Study variables of interest were sociodemographic characteristics and gestational age at recruitment, microbial isolates, and antibiotic sensitivity pattern. Data obtained were presented in tabular forms and recorded as frequencies and percentages. x2 and students' t – tests were used to compare qualitative and quantitative variables, respectively. Statistical significance was considered at P value < 0.05. Results: Sociodemographic characteristics did not show any significant association between the two groups except for social class (x2 = 11.659, P = 0.003) and booking status (x2 = 53.494, P < 0.001). Positive culture rate of 51 (85.0%) and 9 (15.0%) were found in the PPROM and non-PPROM groups, respectively. Escherichia coli 18 (30.0%) was the most frequently isolated organism in the PPROM group. Chlamydia trachomatis antigen was detected in six cases (10.0%) among the PPROM group. Antibiotics that had excellent sensitivity to the isolated organisms were meropenem, ceftazidime, and piperacillin. Conclusion: Genital tract infection was significantly related to the occurrence of PPROM and E. coli was the commonest microbial organism isolated. Intravenous ceftriaxone followed by oral cefixime met national institute of child health and human development, maternal-fetal medicine units (NICHD-MFMU) criteria for selection as prophylactic antibiotic in PPROM.
背景:早产产前膜破裂(PPROM)是早产、产妇和早发新生儿脓毒症的重要危险因素。在资源贫乏的国家，需要对微生物分离株和抗生素敏感性模式进行研究。目的:了解早期PPROM患者的微生物分离株及抗生素敏感性。材料与方法:对60例有PPROM的孕妇与60例无PPROM的对照组进行比较研究。感兴趣的研究变量是社会人口学特征和招募时的胎龄，微生物分离物和抗生素敏感性模式。获得的数据以表格形式呈现，并以频率和百分比记录。定性变量和定量变量的比较分别采用X2检验和学生t检验。P值< 0.05认为差异有统计学意义。结果:除社会阶层(x2 = 11.659, P = 0.003)和订票状况(x2 = 53.494, P < 0.001)外，两组间社会人口学特征无显著相关。PPROM组和非PPROM组的阳性培养率分别为51例(85.0%)和9例(15.0%)。大肠杆菌18(30.0%)是PPROM组中最常见的分离菌。PPROM组检出沙眼衣原体抗原6例(10.0%)。对分离的微生物有极好的敏感性的抗生素是美罗培南、头孢他啶和哌拉西林。结论:生殖道感染与PPROM的发生有显著关系，大肠杆菌是最常见的分离微生物。静脉注射头孢曲松后口服头孢克肟符合国家儿童健康和人类发展研究所，母胎医学单位(NICHD-MFMU)作为PPROM预防性抗生素的选择标准。
{"title":"Microbial isolates and antibiotic sensitivity pattern among women with early preterm spontaneous prelabor rupture of fetal membranes in a Nigerian teaching hospital","authors":"R. Habib, A. Rabiu, Z. Muhammad, O. Abiodun","doi":"10.4103/TJOG.TJOG_41_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_41_19","url":null,"abstract":"Background: Preterm prelabor rupture of membranes (PPROM) is a significant risk factor for prematurity, maternal, and early-onset neonatal sepsis. A study of the microbial isolates and antibiotic sensitivity pattern is needed in a resource poor country. Objectives: To identify the microbial isolates and antibiotic sensitivity pattern of patients with early PPROM. Materials and Methods: It was a comparative study between 60 pregnant women who had PPROM and 60 matched controls without PPROM. Study variables of interest were sociodemographic characteristics and gestational age at recruitment, microbial isolates, and antibiotic sensitivity pattern. Data obtained were presented in tabular forms and recorded as frequencies and percentages. x2 and students' t – tests were used to compare qualitative and quantitative variables, respectively. Statistical significance was considered at P value < 0.05. Results: Sociodemographic characteristics did not show any significant association between the two groups except for social class (x2 = 11.659, P = 0.003) and booking status (x2 = 53.494, P < 0.001). Positive culture rate of 51 (85.0%) and 9 (15.0%) were found in the PPROM and non-PPROM groups, respectively. Escherichia coli 18 (30.0%) was the most frequently isolated organism in the PPROM group. Chlamydia trachomatis antigen was detected in six cases (10.0%) among the PPROM group. Antibiotics that had excellent sensitivity to the isolated organisms were meropenem, ceftazidime, and piperacillin. Conclusion: Genital tract infection was significantly related to the occurrence of PPROM and E. coli was the commonest microbial organism isolated. Intravenous ceftriaxone followed by oral cefixime met national institute of child health and human development, maternal-fetal medicine units (NICHD-MFMU) criteria for selection as prophylactic antibiotic in PPROM.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"378 - 386"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47303153","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}
Cervical ectopic pregnancy (CP) is a rare form of ectopic gestation. It is associated with high morbidity and mortality if not properly managed. Transabdominal ultrasonography (TAS) alone without transvaginal ultrasonography (TVS) could create diagnostic dilemmas. Minimally invasive treatment with local or systemic methotrexate is effective and has no effect on subsequent reproductive carrier. We present a 39-year-old G5P2+2 woman who presented with pregnancy of unknown location following TAS. The TVS confirmed CP. She had a successful medical treatment with a single dose of intramuscular methotrexate and subsequently got pregnant and delivered a live-born infant 11 months after treatment.
{"title":"Cervical ectopic pregnancy patient treated with intramuscular methotrexate who subsequently had live birth: A case report and literature review","authors":"M. Bukar, H. Usman, S. Ibrahim, A. Numan","doi":"10.4103/TJOG.TJOG_46_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_46_19","url":null,"abstract":"Cervical ectopic pregnancy (CP) is a rare form of ectopic gestation. It is associated with high morbidity and mortality if not properly managed. Transabdominal ultrasonography (TAS) alone without transvaginal ultrasonography (TVS) could create diagnostic dilemmas. Minimally invasive treatment with local or systemic methotrexate is effective and has no effect on subsequent reproductive carrier. We present a 39-year-old G5P2+2 woman who presented with pregnancy of unknown location following TAS. The TVS confirmed CP. She had a successful medical treatment with a single dose of intramuscular methotrexate and subsequently got pregnant and delivered a live-born infant 11 months after treatment.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"465 - 467"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45248800","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}
M. Adegboye, C. Oyewopo, K. Adegboye, J. Josiah, E. Ibegbula
Background: The rate of caesarean delivery is on the rise globally and our institution is not left out. Therefore we set out to assess the trends, indications and anaesthetic techniques for caesarean delivery in our environment. Methods: This was a retrospective review of all caesarean deliveries between 1st January 2015 and 31st December 2017 from the anaesthetic chart, anaesthetic theatre records and labour ward record of the University of Ilorin Teaching Hospital (UITH). Patient's demographic data, indication for caesarean section, nature of caesarean section, ASA physical status, anaesthetic technique used, cadre of anaesthetist and the total number of deliveries were recorded. Data were analysed and presented as frequencies and percentages using statistical package for social sciences (SPSS software version 22). Results: During the study period a total of 7940 patients delivered and 1822 patients had undergone caesarean delivery. The caesarean section rate at the institution is around 22.9%. The commonest indication for caesarean delivery was previous caesarean section (31.6%) followed by hypertensive disorder in pregnancy(14.7%). Most of the caesarean section was performed as emergency (80%). Regional anaesthesia was the most frequently used for both emergency(91.3%) and elective (98.7%) caesarean section, and spinal anaesthesia(88.9%) was the commonest regional anaesthetic technique used. Conclusion: The rate of caesarean section is high in our institution, with majority being performed under spinal anaesthesia. We need to improve on other regional anaesthetic technique so that our parturients can have the best and safest option.
{"title":"An appraisal of anaesthetic technique for caesarean delivery in a tertiary Institution North Central Nigeria","authors":"M. Adegboye, C. Oyewopo, K. Adegboye, J. Josiah, E. Ibegbula","doi":"10.4103/TJOG.TJOG_63_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_63_19","url":null,"abstract":"Background: The rate of caesarean delivery is on the rise globally and our institution is not left out. Therefore we set out to assess the trends, indications and anaesthetic techniques for caesarean delivery in our environment. Methods: This was a retrospective review of all caesarean deliveries between 1st January 2015 and 31st December 2017 from the anaesthetic chart, anaesthetic theatre records and labour ward record of the University of Ilorin Teaching Hospital (UITH). Patient's demographic data, indication for caesarean section, nature of caesarean section, ASA physical status, anaesthetic technique used, cadre of anaesthetist and the total number of deliveries were recorded. Data were analysed and presented as frequencies and percentages using statistical package for social sciences (SPSS software version 22). Results: During the study period a total of 7940 patients delivered and 1822 patients had undergone caesarean delivery. The caesarean section rate at the institution is around 22.9%. The commonest indication for caesarean delivery was previous caesarean section (31.6%) followed by hypertensive disorder in pregnancy(14.7%). Most of the caesarean section was performed as emergency (80%). Regional anaesthesia was the most frequently used for both emergency(91.3%) and elective (98.7%) caesarean section, and spinal anaesthesia(88.9%) was the commonest regional anaesthetic technique used. Conclusion: The rate of caesarean section is high in our institution, with majority being performed under spinal anaesthesia. We need to improve on other regional anaesthetic technique so that our parturients can have the best and safest option.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"412 - 417"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45123132","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. Alajiki, O. Fasubaa, E. Babalola, M. Ajayi, A. Sule, C. Umelo, A. Magaji, E. Orji, K. Ajenifuja
Background: The incidence of preterm birth is increasing worldwide. Preterm birth is a common cause of neonatal morbidity and mortality commonly associated with low-birth weight and deficiency of lung surfactants in the newborn. Children who were born preterm have higher rates of cerebral palsy, neurodevelopmental anomalies, learning disabilities, and respiratory illnesses compared with children born at term with attendant psychosocial and financial burden on the parents or carers. These problems may be minimized via the use of a preterm birth prediction test such as the maternal cervicovaginal fetal fibronectin test (FFT) to determine those women in genuine preterm labor and at a higher risk for preterm birth. Effective treatment can then be focused on this group of women to reduce the incidence of preterm birth. However, the FFT in preterm birth prediction is underutilized in Nigeria. Aim: To determine the role of cervicovaginal fetal fibronectin testing as a predictor of spontaneous preterm birth in symptomatic pregnant women in a local setting. Setting: This study was conducted at the obstetrics unit of the Department of Obstetrics and Gynaecology at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun state, Nigeria. The OAUTHC comprises two obstetrics units – Ife Hospital Unit (IHU) and Wesley Guild Hospital Unit at Ilesha (WGH). Design: Cross-sectional, descriptive study. Methods: In this study, 182 booked and unbooked singleton antenatal mothers between 28 weeks and 36 weeks 6 days gestation who had symptoms suggestive of preterm labor were recruited. An interviewer administered questionnaire was filled for each subject and a sterile speculum vaginal examination was then performed to obtain a specimen of the subject's cervicovaginal secretion using a sterile cotton swab. A qualitative FFT was done on each sample collected, then recruited mothers were monitored till delivery and further data obtained. Outcome Measures: The main outcome measures were the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of FFT in predicting spontaneous preterm birth in symptomatic pregnant women. Results: A total of 182 women presenting with symptoms suggestive of preterm labor were recruited: 171 (93.96%) women delivered at term, whereas 11 (6.04%) women had preterm birth with a calculated preterm birth rate of 7.33 per 1000 deliveries during the study period. Also, 7 (3.85%) women had a positive FFT, while 175 (96.15%) women had a negative test. FFT had a sensitivity, specificity, PPV, and NPV of 9.09%, 96.49%, 14.29%, and 94.29%, respectively; a LR+ and LR- of 2.59 (95% confidence interval, CI, 0.34–19.68) and 0.94 (95% CI, 0.78–1.14) respectively; a relative risk of 2.59 (95% CI, 0.341–19.675); a calculated accuracy of 91.21% (95% CI, 86.12%–94.89%); and an area under the receiver operating characteristic curve of 0.60. Conclusion: The high NPV of fetal fibronectin sampling in a po
{"title":"Accuracy of qualitative maternal cervicovaginal fetal fibronectin test in predicting spontaneous preterm birth in symptomatic pregnant women","authors":"E. Alajiki, O. Fasubaa, E. Babalola, M. Ajayi, A. Sule, C. Umelo, A. Magaji, E. Orji, K. Ajenifuja","doi":"10.4103/TJOG.TJOG_93_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_93_19","url":null,"abstract":"Background: The incidence of preterm birth is increasing worldwide. Preterm birth is a common cause of neonatal morbidity and mortality commonly associated with low-birth weight and deficiency of lung surfactants in the newborn. Children who were born preterm have higher rates of cerebral palsy, neurodevelopmental anomalies, learning disabilities, and respiratory illnesses compared with children born at term with attendant psychosocial and financial burden on the parents or carers. These problems may be minimized via the use of a preterm birth prediction test such as the maternal cervicovaginal fetal fibronectin test (FFT) to determine those women in genuine preterm labor and at a higher risk for preterm birth. Effective treatment can then be focused on this group of women to reduce the incidence of preterm birth. However, the FFT in preterm birth prediction is underutilized in Nigeria. Aim: To determine the role of cervicovaginal fetal fibronectin testing as a predictor of spontaneous preterm birth in symptomatic pregnant women in a local setting. Setting: This study was conducted at the obstetrics unit of the Department of Obstetrics and Gynaecology at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun state, Nigeria. The OAUTHC comprises two obstetrics units – Ife Hospital Unit (IHU) and Wesley Guild Hospital Unit at Ilesha (WGH). Design: Cross-sectional, descriptive study. Methods: In this study, 182 booked and unbooked singleton antenatal mothers between 28 weeks and 36 weeks 6 days gestation who had symptoms suggestive of preterm labor were recruited. An interviewer administered questionnaire was filled for each subject and a sterile speculum vaginal examination was then performed to obtain a specimen of the subject's cervicovaginal secretion using a sterile cotton swab. A qualitative FFT was done on each sample collected, then recruited mothers were monitored till delivery and further data obtained. Outcome Measures: The main outcome measures were the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of FFT in predicting spontaneous preterm birth in symptomatic pregnant women. Results: A total of 182 women presenting with symptoms suggestive of preterm labor were recruited: 171 (93.96%) women delivered at term, whereas 11 (6.04%) women had preterm birth with a calculated preterm birth rate of 7.33 per 1000 deliveries during the study period. Also, 7 (3.85%) women had a positive FFT, while 175 (96.15%) women had a negative test. FFT had a sensitivity, specificity, PPV, and NPV of 9.09%, 96.49%, 14.29%, and 94.29%, respectively; a LR+ and LR- of 2.59 (95% confidence interval, CI, 0.34–19.68) and 0.94 (95% CI, 0.78–1.14) respectively; a relative risk of 2.59 (95% CI, 0.341–19.675); a calculated accuracy of 91.21% (95% CI, 86.12%–94.89%); and an area under the receiver operating characteristic curve of 0.60. Conclusion: The high NPV of fetal fibronectin sampling in a po","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"448 - 454"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47234346","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: Treponema pallidum, the causative organism of syphilis has been a public health challenge for centuries. Syphilis is a significant cause of morbidities and mortalities in pregnant women, and information regarding its prevalence in Nigerian pregnant women is scanty particularly from the south-south zone. Objective: To determine the prevalence of syphilis in women receiving antenatal care in twelve health care centres in Akwa Ibom State, Nigeria. Methodology: Pre-coded structured questionnaires were administered to 911 participants over an eight week period. Venous blood samples were collected from each participant and tested with a Treponema pallidum immunochromatographic test. Results: There were about 18 women (1.98%) tested positive to syphilis. Prevalence rates in urban and rural areas were 2.63% and 1.32% respectively. The women from urban areas had a 3.22 (95% CI 1.05-9.85) increased risk of acquiring syphilis when compared to the rural dwellers. Women with tertiary level of education had a significantly reduced risk of acquiring syphilis compared to those with primary level education while having an unemployed husband increased the risk of acquiring the infection by 10 times. Conclusion: Though VDRL is part of routine antenatal care screening, a policy of its use in the screening of all women receiving antenatal care in Akwa Ibom state should emphasized and it should be incorporated into the state Government's free antenatal care program. Preferably, a single rapid test should be employed for screening, so that women testing positive could be treated at same clinic visit. Economic empowerment of women should be accorded priority and the practice of safe sex and use of contraception, especially barrier methods should be promoted.
{"title":"The prevalence of syphilis in pregnant women in Akwa Ibom State, Southern Nigeria","authors":"C. Opone, A. Abasiattai, M. Utuk, E. Bassey","doi":"10.4103/TJOG.TJOG_97_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_97_18","url":null,"abstract":"Background: Treponema pallidum, the causative organism of syphilis has been a public health challenge for centuries. Syphilis is a significant cause of morbidities and mortalities in pregnant women, and information regarding its prevalence in Nigerian pregnant women is scanty particularly from the south-south zone. Objective: To determine the prevalence of syphilis in women receiving antenatal care in twelve health care centres in Akwa Ibom State, Nigeria. Methodology: Pre-coded structured questionnaires were administered to 911 participants over an eight week period. Venous blood samples were collected from each participant and tested with a Treponema pallidum immunochromatographic test. Results: There were about 18 women (1.98%) tested positive to syphilis. Prevalence rates in urban and rural areas were 2.63% and 1.32% respectively. The women from urban areas had a 3.22 (95% CI 1.05-9.85) increased risk of acquiring syphilis when compared to the rural dwellers. Women with tertiary level of education had a significantly reduced risk of acquiring syphilis compared to those with primary level education while having an unemployed husband increased the risk of acquiring the infection by 10 times. Conclusion: Though VDRL is part of routine antenatal care screening, a policy of its use in the screening of all women receiving antenatal care in Akwa Ibom state should emphasized and it should be incorporated into the state Government's free antenatal care program. Preferably, a single rapid test should be employed for screening, so that women testing positive could be treated at same clinic visit. Economic empowerment of women should be accorded priority and the practice of safe sex and use of contraception, especially barrier methods should be promoted.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"224 - 231"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45267071","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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