Background: The comparison of same,equal and low dose of misoprostol by the oral and vaginal routes for induction of labour at term requires further elucidation. Objective: To compare the efficacy and safety of 25 micrograms (ug) of oral misoprostol with 25ug vaginal misoprostol for induction of labor at term. Methods: A randomised control trial that involved 169 consented women with indication for induction of labor. A total of 85 women had oral misoprostol while 84 women had vaginal misoprostol. The oral misoprostol dose (25ug) was repeated every 2 hours, while the vaginal dose (25ug) was repeated every 6 hours for a maximum duration of 24 hours or when need arose for intervention. Data was analysed using SPSS version 20. Results: The mean induction-delivery interval was significantly shorter (18.48 +/- 2.01 vs. 22.82 +/- 2.50, P = 0.00), with more vaginal deliveries (88.2% vs. 85.7%, P = 0.00) in the oral group compared to the vaginal group respectively. The cardiotocographic abnormalities in the vaginal group were significantly higher than the oral group (8.3% vs. 1.2%, P = 0.03). There were more foetal distress and meconium stained liquor in the vaginal group but not statistically significant.
{"title":"A comparison of oral versus vaginal misoprostol for induction of labor at term, at the Ahmadu Bello University Teaching Hospital, Zaria","authors":"S. Hauwa, S. Shittu, H. Umar-Sulayman, B. Audu","doi":"10.4103/TJOG.TJOG_27_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_27_19","url":null,"abstract":"Background: The comparison of same,equal and low dose of misoprostol by the oral and vaginal routes for induction of labour at term requires further elucidation. Objective: To compare the efficacy and safety of 25 micrograms (ug) of oral misoprostol with 25ug vaginal misoprostol for induction of labor at term. Methods: A randomised control trial that involved 169 consented women with indication for induction of labor. A total of 85 women had oral misoprostol while 84 women had vaginal misoprostol. The oral misoprostol dose (25ug) was repeated every 2 hours, while the vaginal dose (25ug) was repeated every 6 hours for a maximum duration of 24 hours or when need arose for intervention. Data was analysed using SPSS version 20. Results: The mean induction-delivery interval was significantly shorter (18.48 +/- 2.01 vs. 22.82 +/- 2.50, P = 0.00), with more vaginal deliveries (88.2% vs. 85.7%, P = 0.00) in the oral group compared to the vaginal group respectively. The cardiotocographic abnormalities in the vaginal group were significantly higher than the oral group (8.3% vs. 1.2%, P = 0.03). There were more foetal distress and meconium stained liquor in the vaginal group but not statistically significant.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"189 - 195"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41355033","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: Labor induction with prostaglandin E1 (PGE1) vaginal tablet results in shorter induction delivery interval and decreased rate of failed induction of labor and reduced caesarean section rate. However, higher doses may be associated with uterine hyper stimulation. It is therefore necessary to determine the safe dose of PGE1 for labor induction. Aims: To assess the maternal and neonatal outcome with use of 25 mg vaginal misoprostol for induction of labor. Settings and Design: A retrospective analysis conducted in an obstetric department of a tertiary care teaching institute. Materials and Methods: The sample consists of women with singleton term pregnancy, with Bishop's score <6 compared with women with spontaneous onset of labor. Statistical Analysis Used: Statistical significance was assessed at 5% level of significance. Chi-square test, with correction for continuity where applicable, was carried out to compare proportions across subgroups or between induction and spontaneous onset groups. Results: The rate of vaginal delivery was higher among spontaneous onset group compared with induction group (χ2 (1) = 30.3, P < 0.001). The induction delivery interval of vaginal delivery was less than 24 h in 91.85% of women. Neonatal intensive care unit admission frequency was similar among both groups (χ2 (1) = 0.14, P = 0.704). The induction group was with less frequency of meconium staining than the control group (χ2 (1) = 8.05, P = 0.0046). Conclusion: Our study showed a higher rate of vaginal delivery with induction delivery interval less than 24 h in a majority of women with better neonatal and maternal outcomes.
{"title":"Outcome of induction of labor with prostaglandin E1 25 mg vaginal tablet – A retrospective study","authors":"G. Puliyath, A. Balakrishnan, L. Vinod, H. Hameed","doi":"10.4103/TJOG.TJOG_24_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_24_19","url":null,"abstract":"Context: Labor induction with prostaglandin E1 (PGE1) vaginal tablet results in shorter induction delivery interval and decreased rate of failed induction of labor and reduced caesarean section rate. However, higher doses may be associated with uterine hyper stimulation. It is therefore necessary to determine the safe dose of PGE1 for labor induction. Aims: To assess the maternal and neonatal outcome with use of 25 mg vaginal misoprostol for induction of labor. Settings and Design: A retrospective analysis conducted in an obstetric department of a tertiary care teaching institute. Materials and Methods: The sample consists of women with singleton term pregnancy, with Bishop's score <6 compared with women with spontaneous onset of labor. Statistical Analysis Used: Statistical significance was assessed at 5% level of significance. Chi-square test, with correction for continuity where applicable, was carried out to compare proportions across subgroups or between induction and spontaneous onset groups. Results: The rate of vaginal delivery was higher among spontaneous onset group compared with induction group (χ2 (1) = 30.3, P < 0.001). The induction delivery interval of vaginal delivery was less than 24 h in 91.85% of women. Neonatal intensive care unit admission frequency was similar among both groups (χ2 (1) = 0.14, P = 0.704). The induction group was with less frequency of meconium staining than the control group (χ2 (1) = 8.05, P = 0.0046). Conclusion: Our study showed a higher rate of vaginal delivery with induction delivery interval less than 24 h in a majority of women with better neonatal and maternal outcomes.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"177 - 182"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43196846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Ochejele, J. Musa, MJ Abdullahi, P. Odusolu, Attah Di, G. Alobo
Introduction: The maternal death surveillance and response (MDSR) responds to MDG 5 and Sustainable development goal 3. It was designed to achieve this goal by obtaining and strategically using information to guide public health actions and monitoring their impact. Objective: To determine the burden and avoidable causes of maternal mortality in midwives service scheme (MSS) communities in Northern Nigeria. Methodology: This was a cross-sectional study using baseline MDSR data on confidential enquiry into maternal deaths in all health facilities and their host communities under the MSS in Northern Nigeria from July 1st to December 31st, 2011. Results: The MMR was 181/100,000 live births. Most (80.9%) of the deaths were due to direct obstetric complications with obstetric hemorrhage and eclampsia accounting for 66.6% of the deaths. Most deaths occurred postpartum (93.6%) with the first 48 h accounting for 85.1% of cases. At presentation, 76.5% were in critical conditions. The TBAs conducted 50.0% of the deliveries. Delays in decision making contributed to 51 (63.8%), delay in arriving at the facility accounted for 48 (60.0%), financial constraints 28 (35.0%), unsafe traditional practice 27 (33.8%), and use of traditional medicines 22 (27.5%). The TBA failed to refer early in 42 (52.5%), failed to recognize dangers signs in 27 (33.8%). Stillbirths occurred in 22.2% of cases. Conclusion: Most maternal deaths in Northern Nigeria are preventable. Operational research using the MDSR is very useful in determining the causes and designing appropriate response to maternal deaths at the community level in Nigeria.
{"title":"Maternal death surveillance and response system in Northern Nigeria","authors":"S. Ochejele, J. Musa, MJ Abdullahi, P. Odusolu, Attah Di, G. Alobo","doi":"10.4103/TJOG.TJOG_73_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_73_18","url":null,"abstract":"Introduction: The maternal death surveillance and response (MDSR) responds to MDG 5 and Sustainable development goal 3. It was designed to achieve this goal by obtaining and strategically using information to guide public health actions and monitoring their impact. Objective: To determine the burden and avoidable causes of maternal mortality in midwives service scheme (MSS) communities in Northern Nigeria. Methodology: This was a cross-sectional study using baseline MDSR data on confidential enquiry into maternal deaths in all health facilities and their host communities under the MSS in Northern Nigeria from July 1st to December 31st, 2011. Results: The MMR was 181/100,000 live births. Most (80.9%) of the deaths were due to direct obstetric complications with obstetric hemorrhage and eclampsia accounting for 66.6% of the deaths. Most deaths occurred postpartum (93.6%) with the first 48 h accounting for 85.1% of cases. At presentation, 76.5% were in critical conditions. The TBAs conducted 50.0% of the deliveries. Delays in decision making contributed to 51 (63.8%), delay in arriving at the facility accounted for 48 (60.0%), financial constraints 28 (35.0%), unsafe traditional practice 27 (33.8%), and use of traditional medicines 22 (27.5%). The TBA failed to refer early in 42 (52.5%), failed to recognize dangers signs in 27 (33.8%). Stillbirths occurred in 22.2% of cases. Conclusion: Most maternal deaths in Northern Nigeria are preventable. Operational research using the MDSR is very useful in determining the causes and designing appropriate response to maternal deaths at the community level in Nigeria.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"212 - 217"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44341499","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: Cervical cancer is a leading cause of cancer death in many developing countries. Cervical cancer can be prevented by screening and treatment of premalignant lesions of the cervix. Primary healthcare centers are the health centers closest to the grassroots in Nigeria and thus may be appropriate for population-based cervical cancer screening programs. This study sought to assess awareness of cervical cancer and its screening methods among women attending primary healthcare centers in Zaria, Nigeria. Methodology: It was a cross-sectional study. Participants were women accessing healthcare in primary healthcare centers in Zaria. Eight primary healthcare centers in Zaria were purposively selected for the study. Data were obtained by focus group discussions (FGDs). The FGDs were tape-recorded and transcribed verbatim. The transcripts obtained were analyzed into themes based on the objectives of the study. Results: The mean age of respondents was 26 years (standard deviation 4.9 years). Many participants were aware of symptoms of cervical cancer; however, they were not aware of the risk factors. Pap smear was the only screening method known to participants. Conclusion: Awareness of cervical cancer and cervical screening did not reflect adequate knowledge about cervical cancer and screening methods. There is a need for healthcare providers to offer adequate health education about the disease and screening methods.
{"title":"Awareness and knowledge of cervical cancer and its screening methods among women attending primary healthcare centers in Zaria, North-Western, Nigeria","authors":"A. Yahya, A. Mande","doi":"10.4103/TJOG.TJOG_26_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_26_19","url":null,"abstract":"Background: Cervical cancer is a leading cause of cancer death in many developing countries. Cervical cancer can be prevented by screening and treatment of premalignant lesions of the cervix. Primary healthcare centers are the health centers closest to the grassroots in Nigeria and thus may be appropriate for population-based cervical cancer screening programs. This study sought to assess awareness of cervical cancer and its screening methods among women attending primary healthcare centers in Zaria, Nigeria. Methodology: It was a cross-sectional study. Participants were women accessing healthcare in primary healthcare centers in Zaria. Eight primary healthcare centers in Zaria were purposively selected for the study. Data were obtained by focus group discussions (FGDs). The FGDs were tape-recorded and transcribed verbatim. The transcripts obtained were analyzed into themes based on the objectives of the study. Results: The mean age of respondents was 26 years (standard deviation 4.9 years). Many participants were aware of symptoms of cervical cancer; however, they were not aware of the risk factors. Pap smear was the only screening method known to participants. Conclusion: Awareness of cervical cancer and cervical screening did not reflect adequate knowledge about cervical cancer and screening methods. There is a need for healthcare providers to offer adequate health education about the disease and screening methods.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"271 - 276"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49357456","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: Pain relief during labor has always been associated with myths and controversies. Several groups of people think that God has made this process painful and no interference should be done in it. In the present civilization, there is no circumstance where it is considered acceptable for a person to experience severe pain, amenable to safe intervention while under a physician's care. Objective: This study assessed the level of awareness of pregnant women about labor analgesia and factors preventing them from having analgesia in labor. Study Design: This study is a descriptive cross-sectional study. Methodology: Questionnaires were used to obtain information on awareness, attitude and use of labor analgesia from pregnant women at the booking clinic visit. Three hundred (300) consenting pregnant women were recruited into the study including provision for attrition. Data were analyzed with the Statistical Package for Social sciences (SPSS) 20. Proportions were calculated for independent variables while crosstabulation was done for related variables to find P value for statistical significance. Results: Level of awareness of labor analgesia was 21%. Majority of the respondents (70.3%) believe that among all health professionals, it is doctors that should inform them about labor analgesia. Only 4.4% had used labor analgesic in their previous deliveries. About 81% of respondents desire labor analgesia in their next delivery. Among factors analyzed, only severity of last labor had significant influence on the patient's desire for analgesia in their next delivery (P value = 0.026). Conclusion: The awareness rate of pregnant women about labor analgesia is very low. Therefore, all efforts must be made to ensure that discussions about labor analgesia are commenced as early as at the booking visit to improve on pregnant women's awareness about labor analgesia and help their acceptability and choices. Attitude towards labor analgesia is not influenced by type of facility where the delivery took place suggesting possibility of socio-cultural influence of the people in the area of study on the practice of labor analgesia.
{"title":"Awareness, attitude and use of labor analgesics by pregnant women at State Specialist Hospital, Akure","authors":"R. Omotayo, OR Akinsowon, S. Omotayo","doi":"10.4103/TJOG.TJOG_92_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_92_18","url":null,"abstract":"Background: Pain relief during labor has always been associated with myths and controversies. Several groups of people think that God has made this process painful and no interference should be done in it. In the present civilization, there is no circumstance where it is considered acceptable for a person to experience severe pain, amenable to safe intervention while under a physician's care. Objective: This study assessed the level of awareness of pregnant women about labor analgesia and factors preventing them from having analgesia in labor. Study Design: This study is a descriptive cross-sectional study. Methodology: Questionnaires were used to obtain information on awareness, attitude and use of labor analgesia from pregnant women at the booking clinic visit. Three hundred (300) consenting pregnant women were recruited into the study including provision for attrition. Data were analyzed with the Statistical Package for Social sciences (SPSS) 20. Proportions were calculated for independent variables while crosstabulation was done for related variables to find P value for statistical significance. Results: Level of awareness of labor analgesia was 21%. Majority of the respondents (70.3%) believe that among all health professionals, it is doctors that should inform them about labor analgesia. Only 4.4% had used labor analgesic in their previous deliveries. About 81% of respondents desire labor analgesia in their next delivery. Among factors analyzed, only severity of last labor had significant influence on the patient's desire for analgesia in their next delivery (P value = 0.026). Conclusion: The awareness rate of pregnant women about labor analgesia is very low. Therefore, all efforts must be made to ensure that discussions about labor analgesia are commenced as early as at the booking visit to improve on pregnant women's awareness about labor analgesia and help their acceptability and choices. Attitude towards labor analgesia is not influenced by type of facility where the delivery took place suggesting possibility of socio-cultural influence of the people in the area of study on the practice of labor analgesia.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"170 - 176"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48570369","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 prevalence of unwanted pregnancies and induced abortion among female undergraduates. Methodology: A cross-sectional survey was conducted among female undergraduates in University of Ibadan, Nigeria. The survey used a structured, self-administered questionnaire. Data analysis was conducted using Statistical Package for the Social Sciences version 20 with Chi-square and t-tests. Statistical significance was set at P < 0.05. Findings: The mean age of the participants was 20.3 (±2.7) years and 80% were single at the time of the study. The prevalence of induced abortion was 51%. The overall prevalence of unwanted pregnancy was 17%, and 92.7% of students who had ever been pregnant had considered the pregnancy unwanted. Only 7.3% reported willingness to be pregnant while engaged and 58.3% were unwilling to keep pregnancy if engagement ends. Unwanted pregnancy was less among those ever married (χ2 = 49.96, P < 0.001), and more of the induced abortions were found in the unmarried group albeit not statistically significant (χ2 = 0.21, P = 0.640). Unwanted pregnancy occurred more during the engaged period than any other time, which was statistically significant (χ2 = 20.24, P < 0.001), although no significant difference in induced abortion was found. Conclusion: The prevalence of unwanted pregnancy and induced abortion is high especially among university undergraduates. As it appears to happen more often while they are engaged, unprotected sex during the engagement period needs to be targeted.
{"title":"Unwanted pregnancy and induced abortion among female undergraduates in University of Ibadan, Nigeria","authors":"Chinedum C Onebunne, F. Bello","doi":"10.4103/TJOG.TJOG_35_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_35_19","url":null,"abstract":"Objectives: To assess the prevalence of unwanted pregnancies and induced abortion among female undergraduates. Methodology: A cross-sectional survey was conducted among female undergraduates in University of Ibadan, Nigeria. The survey used a structured, self-administered questionnaire. Data analysis was conducted using Statistical Package for the Social Sciences version 20 with Chi-square and t-tests. Statistical significance was set at P < 0.05. Findings: The mean age of the participants was 20.3 (±2.7) years and 80% were single at the time of the study. The prevalence of induced abortion was 51%. The overall prevalence of unwanted pregnancy was 17%, and 92.7% of students who had ever been pregnant had considered the pregnancy unwanted. Only 7.3% reported willingness to be pregnant while engaged and 58.3% were unwilling to keep pregnancy if engagement ends. Unwanted pregnancy was less among those ever married (χ2 = 49.96, P < 0.001), and more of the induced abortions were found in the unmarried group albeit not statistically significant (χ2 = 0.21, P = 0.640). Unwanted pregnancy occurred more during the engaged period than any other time, which was statistically significant (χ2 = 20.24, P < 0.001), although no significant difference in induced abortion was found. Conclusion: The prevalence of unwanted pregnancy and induced abortion is high especially among university undergraduates. As it appears to happen more often while they are engaged, unprotected sex during the engagement period needs to be targeted.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"238 - 242"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48271782","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: Retained fetal bones within the uterine cavity are rare. The incidence in an environment with restrictive abortion laws is however unknown. Aim: To document the incidence of retained fetal bones in an environment with highly restrictive abortion laws. Methods: Case records of patients who had hysteroscopy on account of retained fetal bones from April 1, 2010 to March 31, 2017 were retrieved. Data including age, number of terminations of pregnancy, gestational age at termination of pregnancy, duration of infertility, and treatment outcome were retrieved. Results: A total of 1,002 patients had hysteroscopy for various indications. Of these, 26 patients had retained fetal bones giving an incidence of 0.26%. The age range of the patients was 28--42 years, mean 34.7 ± 4.6 SD. Duration of infertility ranged from 2 to 8 years, mean 4.6 ± 2.3 SD. The number of terminations of pregnancy ranged from 1 to 6, mean 2.6 ± 1.7 SD. One patient had an unexplained intrauterine fetal death of one of a set of twins at 20 weeks gestation with subsequent elective cesarean section at 37 weeks gestation. All the cases had histological confirmation of fetal bones. Of the 24 patients who had secondary infertility, 6 (25.0%) achieved spontaneous pregnancies. Eight women underwent in vitro fertilization treatment with 2 (25%) clinical pregnancies. Conclusion: The incidence of intrauterine retained fetal bones in our environment with highly restrictive abortion laws is 0.26%. A review of these laws is probably long overdue.
{"title":"The incidence of retained fetal bones after 1,002 hysteroscopies in an environment with restrictive abortion laws","authors":"J. Okohue","doi":"10.4103/TJOG.TJOG_91_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_91_18","url":null,"abstract":"Background: Retained fetal bones within the uterine cavity are rare. The incidence in an environment with restrictive abortion laws is however unknown. Aim: To document the incidence of retained fetal bones in an environment with highly restrictive abortion laws. Methods: Case records of patients who had hysteroscopy on account of retained fetal bones from April 1, 2010 to March 31, 2017 were retrieved. Data including age, number of terminations of pregnancy, gestational age at termination of pregnancy, duration of infertility, and treatment outcome were retrieved. Results: A total of 1,002 patients had hysteroscopy for various indications. Of these, 26 patients had retained fetal bones giving an incidence of 0.26%. The age range of the patients was 28--42 years, mean 34.7 ± 4.6 SD. Duration of infertility ranged from 2 to 8 years, mean 4.6 ± 2.3 SD. The number of terminations of pregnancy ranged from 1 to 6, mean 2.6 ± 1.7 SD. One patient had an unexplained intrauterine fetal death of one of a set of twins at 20 weeks gestation with subsequent elective cesarean section at 37 weeks gestation. All the cases had histological confirmation of fetal bones. Of the 24 patients who had secondary infertility, 6 (25.0%) achieved spontaneous pregnancies. Eight women underwent in vitro fertilization treatment with 2 (25%) clinical pregnancies. Conclusion: The incidence of intrauterine retained fetal bones in our environment with highly restrictive abortion laws is 0.26%. A review of these laws is probably long overdue.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"249 - 251"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45048725","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}
B. Olofinbiyi, J. Ige, O. Olaogun, O. Alao, O. Adewumi, R. Olofinbiyi
Unsafe abortion in adolescents is of great public health challenge and it occupies a large armamentarium in contemporary adolescent reproductive health issues. This case report was that of induced unsafe abortion, done without analgesia and inside a sitting room, in a 15-year-old, secondary school girl, nullipara; complicated by gangrenous uterus and bowel for which she had subtotal hysterectomy, bowel resection, and anastomosis. Primary preventive strategies should be the cornerstone of prevention with more emphasis on advocacy for adolescent sexuality and reproductive health education, information, and family planning/emergency contraception.
{"title":"A stone age conduct of unsafe abortion in adolescent: Complicated by gangrenous uterus and bowel","authors":"B. Olofinbiyi, J. Ige, O. Olaogun, O. Alao, O. Adewumi, R. Olofinbiyi","doi":"10.4103/TJOG.TJOG_15_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_15_19","url":null,"abstract":"Unsafe abortion in adolescents is of great public health challenge and it occupies a large armamentarium in contemporary adolescent reproductive health issues. This case report was that of induced unsafe abortion, done without analgesia and inside a sitting room, in a 15-year-old, secondary school girl, nullipara; complicated by gangrenous uterus and bowel for which she had subtotal hysterectomy, bowel resection, and anastomosis. Primary preventive strategies should be the cornerstone of prevention with more emphasis on advocacy for adolescent sexuality and reproductive health education, information, and family planning/emergency contraception.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"315 - 318"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48303769","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}
Status epilepticus is a rare neurological complication of pregnancy, associated with significant maternal and fetal morbidity and mortality. Termination of pregnancy is not currently a management strategy. The clinical case was 35-year-old known epileptic presented with complaints of multiple convulsions of 2 days and loss of consciousness of a day. On examination, she was unconscious, with Glasgow Coma Scale 5/15, having repeated seizures, and blood pressure was normal. The assessment was status epilepticus and she was shortly admitted into the intensive care unit. She was eventually paralyzed and put on mechanical ventilation. She had a spontaneous delivery, subsequently improved, and was discharged on oral carbamazepine. Key aspects of this patient's management buttressed that status epilepticus can mimic eclampsia. That she significantly and progressively improved following delivery and that previous similar cases have been reported brings to bear that delivery might need to be considered as a management strategy for refractory status epilepticus.
{"title":"Clinical improvement of status epilepticus after delivery: A case report","authors":"C. Obikili, Makshwar L. Kahansim, A. Ocheke","doi":"10.4103/TJOG.TJOG_2_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_2_19","url":null,"abstract":"Status epilepticus is a rare neurological complication of pregnancy, associated with significant maternal and fetal morbidity and mortality. Termination of pregnancy is not currently a management strategy. The clinical case was 35-year-old known epileptic presented with complaints of multiple convulsions of 2 days and loss of consciousness of a day. On examination, she was unconscious, with Glasgow Coma Scale 5/15, having repeated seizures, and blood pressure was normal. The assessment was status epilepticus and she was shortly admitted into the intensive care unit. She was eventually paralyzed and put on mechanical ventilation. She had a spontaneous delivery, subsequently improved, and was discharged on oral carbamazepine. Key aspects of this patient's management buttressed that status epilepticus can mimic eclampsia. That she significantly and progressively improved following delivery and that previous similar cases have been reported brings to bear that delivery might need to be considered as a management strategy for refractory status epilepticus.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"304 - 307"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47056801","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: Despite the increasing knowledge about the potential effect of vitamin D deficiency on ovarian reserve of premenopausal women, the burden of this disorder among 'at risk' women in sub-Saharan Africa is notably scanty. Aims: To determine the prevalence of vitamin D deficiency among premenopausal Nigerian women To assess the relationship between serum 25-hydroxyvitamin D [25(OH)D] and serum anti-mullerian hormone (AMH). Settings and Design: A prospective cross-sectional study of 218 premenopausal Nigerian women, attending a tertiary hospital in Lagos. Materials and Methods: Serum levels of 25(OH)D and AMH were assayed using ELIZA technique, for each eligible participant. Statistical Analysis Used: To determine the association between serum vitamin D and serum AMH were Kruskal-Wallis test and Pearson's correlation coefficient. Data analysis was performed on 211 participants with complete data. Results: The mean (± SD) concentrations of serum 25(OH)D and AMH were 37.8 (± 21.4) ng/ml and 1.6 (± 0.6) ng/ml, respectively. The proportion of study participants with serum vitamin D deficiency, insufficiency and sufficiency were 18.5%, 24.6%, and 56.9%, respectively. There was no statistically significant difference in the mean serum AMH among participants with deficient, insufficient, and sufficient vitamin D levels (1.41 ng/ml versus 1.56 ng/ml versus 1.59 ng/ml, P value = 0.539). Overall, there was no correlation between serum 25(OH)D, and serum AMH (r = 0.056, P > 0.05). Conclusion: Although the proportion of women with subnormal levels of serum vitamin D was relatively high, there was no association between serum levels of vitamin D and AMH.
背景:尽管关于维生素D缺乏对绝经前妇女卵巢储备的潜在影响的知识越来越多，但在撒哈拉以南非洲的“高危”妇女中，这种疾病的负担明显很少。目的:了解尼日利亚绝经前妇女维生素D缺乏症的患病率，评估血清25-羟基维生素D [25(OH)D]与血清抗苗勒管激素(AMH)的关系。背景和设计:对在拉各斯一家三级医院就诊的218名尼日利亚绝经前妇女进行前瞻性横断面研究。材料和方法:采用ELIZA技术检测每位符合条件的受试者血清25(OH)D和AMH水平。统计学分析方法:采用Kruskal-Wallis检验和Pearson相关系数测定血清维生素D与血清AMH的关系。对211名数据完整的参与者进行数据分析。结果:血清25(OH)D和AMH的平均(±SD)浓度分别为37.8(±21.4)ng/ml和1.6(±0.6)ng/ml。血清维生素D缺乏、不足和充足的比例分别为18.5%、24.6%和56.9%。维生素D缺乏、不足和充足的参与者的平均血清AMH差异无统计学意义(1.41 ng/ml vs 1.56 ng/ml vs 1.59 ng/ml, P值= 0.539)。总体而言，血清25(OH)D与血清AMH无相关性(r = 0.056, P < 0.05)。结论:虽然血清维生素D水平低于正常的女性比例较高，但血清维生素D水平与AMH之间没有相关性。
{"title":"Relationship between 25-hydroxyvitamin D and ovarian reserve in premenopausal Nigerian women","authors":"C. Makwe, Z. Aliyu","doi":"10.4103/TJOG.TJOG_99_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_99_18","url":null,"abstract":"Context: Despite the increasing knowledge about the potential effect of vitamin D deficiency on ovarian reserve of premenopausal women, the burden of this disorder among 'at risk' women in sub-Saharan Africa is notably scanty. Aims: To determine the prevalence of vitamin D deficiency among premenopausal Nigerian women To assess the relationship between serum 25-hydroxyvitamin D [25(OH)D] and serum anti-mullerian hormone (AMH). Settings and Design: A prospective cross-sectional study of 218 premenopausal Nigerian women, attending a tertiary hospital in Lagos. Materials and Methods: Serum levels of 25(OH)D and AMH were assayed using ELIZA technique, for each eligible participant. Statistical Analysis Used: To determine the association between serum vitamin D and serum AMH were Kruskal-Wallis test and Pearson's correlation coefficient. Data analysis was performed on 211 participants with complete data. Results: The mean (± SD) concentrations of serum 25(OH)D and AMH were 37.8 (± 21.4) ng/ml and 1.6 (± 0.6) ng/ml, respectively. The proportion of study participants with serum vitamin D deficiency, insufficiency and sufficiency were 18.5%, 24.6%, and 56.9%, respectively. There was no statistically significant difference in the mean serum AMH among participants with deficient, insufficient, and sufficient vitamin D levels (1.41 ng/ml versus 1.56 ng/ml versus 1.59 ng/ml, P value = 0.539). Overall, there was no correlation between serum 25(OH)D, and serum AMH (r = 0.056, P > 0.05). Conclusion: Although the proportion of women with subnormal levels of serum vitamin D was relatively high, there was no association between serum levels of vitamin D and AMH.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":"36 1","pages":"243 - 248"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45955538","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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