Background: Multiple gestation is associated with higher risk of maternal complications in the antenatal, intrapartum, and postpartum periods compared with singleton pregnancies, as well as higher risk for perinatal morbidity and mortality. Objective: The objective of this study was to determine the incidence and obstetric outcomes of twin deliveries in Federal Medical Centre Katsina. Methods: It is a retrospective study of twin deliveries over a 5-year period from January 1st 2010 to December 31st 2014 conducted at the Federal Medical Centre Katsina (FMCK), Katsina state. Results: There were 172 cases of twin deliveries out of 9,947 deliveries giving an overall twinning rate of 17.3 per 1,000 deliveries. There were three cases of triplet delivery during this period. The most common complication was preterm delivery which occurred in 40.1% of cases. The mode of delivery was vaginal in 64.5% while 35.5% had caesarean section. Emergency caesarean section for delivery of both babies was carried out in 24.42% while elective caesarean section for both babies accounted for 8.72%. Combined vaginal and abdominal delivery occurred in 2.33% of deliveries. The stillbirth rate was 81.4 per 1,000 births. There were 11 (6.4%) and 17 (9.9%) stillbirths among the first and the second babies respectively. Babies that had normal birth weight constituted 42.2%. The male to female ratio was 1:1.15. Conclusion: The rate of twin deliveries in our centre is high. There is also associated high rate of maternal complications and adverse perinatal outcomes.
{"title":"Twin pregnancies at federal medical centre Katsina: A 5 year review","authors":"A. Lawal, Ojonigwu Atabo-Peter, A. Abdurrahman","doi":"10.4103/TJOG.TJOG_82_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_82_18","url":null,"abstract":"Background: Multiple gestation is associated with higher risk of maternal complications in the antenatal, intrapartum, and postpartum periods compared with singleton pregnancies, as well as higher risk for perinatal morbidity and mortality. Objective: The objective of this study was to determine the incidence and obstetric outcomes of twin deliveries in Federal Medical Centre Katsina. Methods: It is a retrospective study of twin deliveries over a 5-year period from January 1st 2010 to December 31st 2014 conducted at the Federal Medical Centre Katsina (FMCK), Katsina state. Results: There were 172 cases of twin deliveries out of 9,947 deliveries giving an overall twinning rate of 17.3 per 1,000 deliveries. There were three cases of triplet delivery during this period. The most common complication was preterm delivery which occurred in 40.1% of cases. The mode of delivery was vaginal in 64.5% while 35.5% had caesarean section. Emergency caesarean section for delivery of both babies was carried out in 24.42% while elective caesarean section for both babies accounted for 8.72%. Combined vaginal and abdominal delivery occurred in 2.33% of deliveries. The stillbirth rate was 81.4 per 1,000 births. There were 11 (6.4%) and 17 (9.9%) stillbirths among the first and the second babies respectively. Babies that had normal birth weight constituted 42.2%. The male to female ratio was 1:1.15. Conclusion: The rate of twin deliveries in our centre is high. There is also associated high rate of maternal complications and adverse perinatal outcomes.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46680905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: High premium is placed on childbirth particularly after marriage in our society. Sub-Sahara Africa is known to have the high incidence of infertility and the woman is usually blamed for the problem. Stress is known to have effect on ovulation and therefore conception thereby forming a vicious cycle. The study was to determine the psychosocial problems and psychiatric morbidity among infertile women and to determine the difference in psychosocial problems in primary and secondary infertility patients. Method: The Satisfaction with Life Scale (SWLS) questionnaire, the 12 -item General Health Questionnaire (GHQ-12) and the HADS (Hospital Anxiety and Depression Scale) were administered to 111 patients. Result: The mean age for the respondents was 33.6 ± 5.8 years. There were more cases of secondary infertility 58 (52.3%) compared to primary fertility 53 (47.7%). The study revealed a fairly high degree of psychological morbidity among the respondents, a depressive rate of 39.6%, anxiety rate of 48.6% and psychiatry morbidity of 39.6%.There was no significant difference in prevalence of these morbidity between the patients with primary and secondary infertility. Conclusion: Both primary and secondary infertility are associated with significant psychosocial and psychiatric morbidity. Psychological strain itself can also be a cause or aggravate infertility therefore psychological assessment and co-management with the psychiatrist should be encouraged.
{"title":"Psychosocial characteristics of infertile women in a Nigerian tertiary hospital","authors":"A. Olarinoye, P. Ajiboye","doi":"10.4103/TJOG.TJOG_54_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_54_18","url":null,"abstract":"Introduction: High premium is placed on childbirth particularly after marriage in our society. Sub-Sahara Africa is known to have the high incidence of infertility and the woman is usually blamed for the problem. Stress is known to have effect on ovulation and therefore conception thereby forming a vicious cycle. The study was to determine the psychosocial problems and psychiatric morbidity among infertile women and to determine the difference in psychosocial problems in primary and secondary infertility patients. Method: The Satisfaction with Life Scale (SWLS) questionnaire, the 12 -item General Health Questionnaire (GHQ-12) and the HADS (Hospital Anxiety and Depression Scale) were administered to 111 patients. Result: The mean age for the respondents was 33.6 ± 5.8 years. There were more cases of secondary infertility 58 (52.3%) compared to primary fertility 53 (47.7%). The study revealed a fairly high degree of psychological morbidity among the respondents, a depressive rate of 39.6%, anxiety rate of 48.6% and psychiatry morbidity of 39.6%.There was no significant difference in prevalence of these morbidity between the patients with primary and secondary infertility. Conclusion: Both primary and secondary infertility are associated with significant psychosocial and psychiatric morbidity. Psychological strain itself can also be a cause or aggravate infertility therefore psychological assessment and co-management with the psychiatrist should be encouraged.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47009373","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}
Conjoined twin is a rare phenomenon. This is a report of suspected undiagnosed bicephalus conjoined twin that presented as hanging breech which was delivered by craniotomy. It presented with management challenge, from attempted home delivery to a primary healthcare facilty and finally refered to the Specialist Hospital. The diagnosis was made after delivery. The finding was a male stillborn infant with normal body parts but two heads. Clinicians should look out for these complications when confronted with hanging breech.
{"title":"Conjoined twin presenting as a case of “hanging breech” in labor – Case report","authors":"C. Laima, T. Meller, G. Nwukwa","doi":"10.4103/TJOG.TJOG_29_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_29_19","url":null,"abstract":"Conjoined twin is a rare phenomenon. This is a report of suspected undiagnosed bicephalus conjoined twin that presented as hanging breech which was delivered by craniotomy. It presented with management challenge, from attempted home delivery to a primary healthcare facilty and finally refered to the Specialist Hospital. The diagnosis was made after delivery. The finding was a male stillborn infant with normal body parts but two heads. Clinicians should look out for these complications when confronted with hanging breech.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43336025","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}
Transperineal delivery is a traumatic childbirth whereby the baby is forcefully ejected out through a contraction and pushing-induced laceration of the perineum in the presence of intact vaginal and anal orifices. We presented a 23-year-old primipara who presented 3 days after delivery with infected perineal injury and pains following unsupervised childbirth. She delivered a fresh stillborn baby through the perineum (between the fourchette and the anal orifice). She was, however, continent of urine and feces. She was optimized and repair of the perineal injury was scheduled after puerperium. The postoperative condition was satisfactory. We therefore call and appeal on the relevant stakeholders, to provide more skilled birth attendants, especially at the densely populated areas and ensure their presence and willingness to participate in conducting all deliveries with good supervision in all health facilities, so as to prevent future occurrence of transperineal delivery.
{"title":"Traumatic transperineal delivery, a tragedy in unassisted vaginal delivery: A case report and review of literature","authors":"A. Rabiu, Z. Ahmed, A. Yola","doi":"10.4103/tjog.tjog_94_18","DOIUrl":"https://doi.org/10.4103/tjog.tjog_94_18","url":null,"abstract":"Transperineal delivery is a traumatic childbirth whereby the baby is forcefully ejected out through a contraction and pushing-induced laceration of the perineum in the presence of intact vaginal and anal orifices. We presented a 23-year-old primipara who presented 3 days after delivery with infected perineal injury and pains following unsupervised childbirth. She delivered a fresh stillborn baby through the perineum (between the fourchette and the anal orifice). She was, however, continent of urine and feces. She was optimized and repair of the perineal injury was scheduled after puerperium. The postoperative condition was satisfactory. We therefore call and appeal on the relevant stakeholders, to provide more skilled birth attendants, especially at the densely populated areas and ensure their presence and willingness to participate in conducting all deliveries with good supervision in all health facilities, so as to prevent future occurrence of transperineal delivery.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44213318","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}
Severe Obstetric Emergencies: Use of Maternal Early Warning Scores (M-EWS) in Nigeria. Maternal Early Warning Scores (M-EWS) is a patient illness severity scoring system that aids tracking and timely escalation of acutely deteriorating obstetric patients. M-EWS has been demonstrated to reduce substandard care, obstetric complications, and maternal mortality in the United Kingdom and a number of other countries. Background: Successes in the prevention of maternal mortality attributed to this tool in the United Kingdom where it is in established use coupled with high potential for its usefulness in other countries prompted the inclusion of the M-EWS in the post 2015 United Nations Sustainable Development Goals for the 193 member nations. Aims: We set out to explore the availability of M-EWS for the recognition and escalated timely interventions in obstetric emergencies in Nigeria and a desire for its application. Methods: A combination of SurveyMonkey (online) and paper-based questionnaires distributed to clinicians of all teams and grades involved in obstetric care was used. Results: In all, 76 responses (17 online and 59 paper-based questionnaire) were received out of 30 e-mails and 70 paper-based questionnaires. Nineteen (25%) clinicians reported use of a physician-specific calling system but none had the M-EWS in use. Three respondents (4%) were not certain whether M-EWS would be welcomed in their service, but 73 (96%) welcomed the introduction of the M-EWS. Conclusion: This survey shows the lack of M-EWS in obstetric practice in Nigeria and strong desire for its introduction. Consequently, some collaborative work aimed at refining this tool for the Nigerian obstetric environment has commenced.
{"title":"Obstetric morbidity and mortality: Exploration of the use of Maternal Early Warning Scores (M-EWS) for recognition and escalated timely interventions in acute obstetric emergencies in Nigeria","authors":"AO Isemede, J. Unuigbe","doi":"10.4103/TJOG.TJOG_6_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_6_19","url":null,"abstract":"Severe Obstetric Emergencies: Use of Maternal Early Warning Scores (M-EWS) in Nigeria. Maternal Early Warning Scores (M-EWS) is a patient illness severity scoring system that aids tracking and timely escalation of acutely deteriorating obstetric patients. M-EWS has been demonstrated to reduce substandard care, obstetric complications, and maternal mortality in the United Kingdom and a number of other countries. Background: Successes in the prevention of maternal mortality attributed to this tool in the United Kingdom where it is in established use coupled with high potential for its usefulness in other countries prompted the inclusion of the M-EWS in the post 2015 United Nations Sustainable Development Goals for the 193 member nations. Aims: We set out to explore the availability of M-EWS for the recognition and escalated timely interventions in obstetric emergencies in Nigeria and a desire for its application. Methods: A combination of SurveyMonkey (online) and paper-based questionnaires distributed to clinicians of all teams and grades involved in obstetric care was used. Results: In all, 76 responses (17 online and 59 paper-based questionnaire) were received out of 30 e-mails and 70 paper-based questionnaires. Nineteen (25%) clinicians reported use of a physician-specific calling system but none had the M-EWS in use. Three respondents (4%) were not certain whether M-EWS would be welcomed in their service, but 73 (96%) welcomed the introduction of the M-EWS. Conclusion: This survey shows the lack of M-EWS in obstetric practice in Nigeria and strong desire for its introduction. Consequently, some collaborative work aimed at refining this tool for the Nigerian obstetric environment has commenced.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44708133","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}
Z. Lawan, B. Bako, A. Idrisa, M. Bukar, G. Gadzama
Background: Prelabor rupture of membranes (PROM) is a common obstetrics problem associated with maternal and perinatal morbidity and mortality. Patients and Methods: This was a hospital-based cross-sectional study to determine the risk factors for PROM among women presenting to the Department of Obstetrics and Gynecology of the University of Maiduguri Teaching Hospital, Maiduguri. It was conducted between 1st May 2016 and 28th February 2017. Sociodemographic and obstetrics variables were obtained from the patients, and risk factors such as previous preterm delivery, previous PROM, miscarriages, fever, abnormal vaginal discharge, urinary tract infection, abdominal distension, trauma, and coitus were sought. For each patient, an endocervical swab, high vaginal swab, and urine samples were taken for microbacteriologic studies. The next patient without PROM is used as control. Data were analyzed using SPSS 20. A total of 258 (129 with PROM and another 129 without PROM) were analyzed. Results: The mean age, gestational age, and parity were 27 ± 6 years, 33 ± 0.3 weeks, and 1 ± 0.92, respectively. A majority of the women (55%) had parity between 1 and 4. Term PROM recorded the highest frequency [49 (37.9%)]. Previous history of PROM [odds ratio (OR) 5.18, 95% confidence interval (CI): 2.31–11.62], history of Preterm Delivery (OR 3.26, 95% CI: 1.16– 9.19), low socioeconomic status (OR 1.95 95%, CI: 1.15–3.31), and genitourinary infection are highly predictive of PROM. Conclusion: The modifiable or treatable risk factors should be addressed during the antenatal care to reduce the risk of PROM. High-risk patients should be counseled and monitored closely to optimize pregnancy outcomes.
{"title":"Risk factors of prelabor rupture of membranes at University of Maiduguri Teaching Hospital, Maiduguri: A cross-sectional study","authors":"Z. Lawan, B. Bako, A. Idrisa, M. Bukar, G. Gadzama","doi":"10.4103/TJOG.TJOG_51_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_51_19","url":null,"abstract":"Background: Prelabor rupture of membranes (PROM) is a common obstetrics problem associated with maternal and perinatal morbidity and mortality. Patients and Methods: This was a hospital-based cross-sectional study to determine the risk factors for PROM among women presenting to the Department of Obstetrics and Gynecology of the University of Maiduguri Teaching Hospital, Maiduguri. It was conducted between 1st May 2016 and 28th February 2017. Sociodemographic and obstetrics variables were obtained from the patients, and risk factors such as previous preterm delivery, previous PROM, miscarriages, fever, abnormal vaginal discharge, urinary tract infection, abdominal distension, trauma, and coitus were sought. For each patient, an endocervical swab, high vaginal swab, and urine samples were taken for microbacteriologic studies. The next patient without PROM is used as control. Data were analyzed using SPSS 20. A total of 258 (129 with PROM and another 129 without PROM) were analyzed. Results: The mean age, gestational age, and parity were 27 ± 6 years, 33 ± 0.3 weeks, and 1 ± 0.92, respectively. A majority of the women (55%) had parity between 1 and 4. Term PROM recorded the highest frequency [49 (37.9%)]. Previous history of PROM [odds ratio (OR) 5.18, 95% confidence interval (CI): 2.31–11.62], history of Preterm Delivery (OR 3.26, 95% CI: 1.16– 9.19), low socioeconomic status (OR 1.95 95%, CI: 1.15–3.31), and genitourinary infection are highly predictive of PROM. Conclusion: The modifiable or treatable risk factors should be addressed during the antenatal care to reduce the risk of PROM. High-risk patients should be counseled and monitored closely to optimize pregnancy outcomes.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44180065","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: Mother-to-child transmission (MTCT), is the main route of paediatric human immunodeficiency virus (HIV) infection. While paediatric HIV has been virtually eliminated in most developed countries with structured interventions, many developing countries still record high transmission rates. Maternal knowledge on MTCT is a corner stone for effective implementation of the World Health Organization (WHO) recommendation of the four-pronged approach to reduce mother-to-child transmission of HIV. Aims and Objectives: The study was carried out to assess the knowledge of prevention of mother-to-child transmission (PMTCT) of HIV among our pregnant women as well as their attitude and practice of HIV counselling and testing. Methodology: The study population included pregnant women attending antenatal clinic at the State Specialist Hospital, Akure, Ondo State. It was an institutional based descriptive cross-sectional study conducted over a period of one month (May 2018). Systematic random sampling technique was used to select 400 pregnant women. Data was obtained using structured pre-tested questionnaire, and analysed using SPSS Windows 20. Results: The study showed that majority were between 30-39 years, were educated, and married. Among the respondents, 389 (97.3%) have heard about HIV while 11 (2.8%) have not heard about HIV. Overall 85.3% of the respondents had a good knowledge of HIV and its mode of transmission. Among the women, 83% were aware of mother-to-child-transmission of HIV with the information mostly obtained from health workers. Only 252 (63.2%) had been tested for HIV in this pregnancy while 148 (36.8%) were not yet tested with many of them blaming this on lack of counsellors. On multivariable analysis, younger women were more knowledgeable about HIV and MTCT, those who were public servants and had partners educated to tertiary level were more likely to practice PMTCT. Conclusion: The knowledge of HIV and PMTCT was high among the women. However, not all the women were tested for HIV in the index pregnancy as a result of lack of counsellors. Adequate counsellors are essential for effective PMTCT programme.
背景:母婴传播(MTCT)是儿童人类免疫缺陷病毒(HIV)感染的主要途径。虽然通过有组织的干预措施，大多数发达国家几乎已经消除了儿童艾滋病毒，但许多发展中国家的传播率仍然很高。孕产妇对母婴传播的了解是有效执行世界卫生组织(世卫组织)关于减少艾滋病毒母婴传播的四管齐下方法建议的基石。目的和目的:本研究旨在评估我国孕妇对预防母婴传播艾滋病毒(PMTCT)的知识，以及她们对艾滋病毒咨询和检测的态度和做法。方法学:研究人群包括在翁多州阿库雷国家专科医院产前门诊就诊的孕妇。这是一项基于机构的描述性横断面研究，为期一个月(2018年5月)。采用系统随机抽样方法对400名孕妇进行抽样调查。采用结构化预测问卷获得数据，并使用SPSS Windows 20进行分析。结果:研究显示，大多数人年龄在30-39岁之间，受过教育，已婚。受访者中有389人(97.3%)听说过HIV, 11人(2.8%)没有听说过HIV。总体而言，85.3%的受访者对艾滋病毒及其传播方式有良好的了解。在这些妇女中，83%的人知道艾滋病毒的母婴传播，这些信息主要是从卫生工作者那里获得的。只有252人(63.2%)在怀孕期间接受了艾滋病毒检测，148人(36.8%)尚未接受检测，其中许多人将此归咎于缺乏咨询师。在多变量分析中，年轻妇女对艾滋病毒和母婴传播更了解，公务员和伴侣受过高等教育的妇女更有可能实施母婴传播。结论:妇女对艾滋病毒和预防母婴传播知识知晓率较高。然而，由于缺乏咨询师，并不是所有的妇女在第一次怀孕时都接受了艾滋病毒检测。适当的咨询人员对于有效的预防母婴传播规划至关重要。
{"title":"Knowledge and practice of HIV testing for PMTCT among antenatal clinic attendees","authors":"T. Irinyenikan","doi":"10.4103/TJOG.TJOG_96_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_96_18","url":null,"abstract":"Background: Mother-to-child transmission (MTCT), is the main route of paediatric human immunodeficiency virus (HIV) infection. While paediatric HIV has been virtually eliminated in most developed countries with structured interventions, many developing countries still record high transmission rates. Maternal knowledge on MTCT is a corner stone for effective implementation of the World Health Organization (WHO) recommendation of the four-pronged approach to reduce mother-to-child transmission of HIV. Aims and Objectives: The study was carried out to assess the knowledge of prevention of mother-to-child transmission (PMTCT) of HIV among our pregnant women as well as their attitude and practice of HIV counselling and testing. Methodology: The study population included pregnant women attending antenatal clinic at the State Specialist Hospital, Akure, Ondo State. It was an institutional based descriptive cross-sectional study conducted over a period of one month (May 2018). Systematic random sampling technique was used to select 400 pregnant women. Data was obtained using structured pre-tested questionnaire, and analysed using SPSS Windows 20. Results: The study showed that majority were between 30-39 years, were educated, and married. Among the respondents, 389 (97.3%) have heard about HIV while 11 (2.8%) have not heard about HIV. Overall 85.3% of the respondents had a good knowledge of HIV and its mode of transmission. Among the women, 83% were aware of mother-to-child-transmission of HIV with the information mostly obtained from health workers. Only 252 (63.2%) had been tested for HIV in this pregnancy while 148 (36.8%) were not yet tested with many of them blaming this on lack of counsellors. On multivariable analysis, younger women were more knowledgeable about HIV and MTCT, those who were public servants and had partners educated to tertiary level were more likely to practice PMTCT. Conclusion: The knowledge of HIV and PMTCT was high among the women. However, not all the women were tested for HIV in the index pregnancy as a result of lack of counsellors. Adequate counsellors are essential for effective PMTCT programme.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44732911","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: Eclampsia is a life-threatening obstetric emergency and one of the major causes of preventable maternal and perinatal mortality worldwide. Some women suffered eclampsia and died, while some live to tell their stories; what determines who dies? Aims: To determine the pattern and determinants of mortality among eclamptic women in our institution. Materials and Methods: This was a 5-year retrospective study of eclampsia managed between 1st January 2012 and 31st December 2016. Results: From this study, the incidence of eclampsia was 13.3 per 1000 deliveries and it contributes 21.1% of the maternal death and fetal case fatality rate of 30.2%. Women between the age range of 20–24 years accounted for majority (33.3%) of cases of eclampsia. The modal parity was Para 0 (50%) and most (89.6%) were unbooked. Antepartum eclampsia (53.1%) was the commonest form of eclampsia. Vaginal delivery was the commonest route of delivery. The determinants of maternal death were late presentation (>24 hours) (x2 = 15.37, P < 0.001), unconsciousness (x2 = 7.35, P < 0.01), severe blood pressure (x2 = 8.42, P < 0.01), and fetal death (x2 = 8.71, P < 0.01), while antepartum eclampsia (x2 = 6.23, P = 0.04), late presentation (>24 hours) (x2 = 16.76, P < 0.001), vaginal delivery (x2 = 4.82, P = 0.03), and maternal death (x2 = 12.00 P < 0.001) were determinants of fetal demise. Conclusion: Eclampsia is still a huge burden in our environment affecting maternal and perinatal morbidity and mortality profile. Early presentation and adequate treatment can help to reduce the incidence of this preventable obstetric disaster in our environment.
{"title":"Pattern and determinants of mortality among eclamptic women that presented in the Federal Teaching Hospital Abakaliki, Southeast, Nigeria","authors":"Johnbosco Ifunanya Nwafor","doi":"10.4103/TJOG.TJOG_63_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_63_18","url":null,"abstract":"Background: Eclampsia is a life-threatening obstetric emergency and one of the major causes of preventable maternal and perinatal mortality worldwide. Some women suffered eclampsia and died, while some live to tell their stories; what determines who dies? Aims: To determine the pattern and determinants of mortality among eclamptic women in our institution. Materials and Methods: This was a 5-year retrospective study of eclampsia managed between 1st January 2012 and 31st December 2016. Results: From this study, the incidence of eclampsia was 13.3 per 1000 deliveries and it contributes 21.1% of the maternal death and fetal case fatality rate of 30.2%. Women between the age range of 20–24 years accounted for majority (33.3%) of cases of eclampsia. The modal parity was Para 0 (50%) and most (89.6%) were unbooked. Antepartum eclampsia (53.1%) was the commonest form of eclampsia. Vaginal delivery was the commonest route of delivery. The determinants of maternal death were late presentation (>24 hours) (x2 = 15.37, P < 0.001), unconsciousness (x2 = 7.35, P < 0.01), severe blood pressure (x2 = 8.42, P < 0.01), and fetal death (x2 = 8.71, P < 0.01), while antepartum eclampsia (x2 = 6.23, P = 0.04), late presentation (>24 hours) (x2 = 16.76, P < 0.001), vaginal delivery (x2 = 4.82, P = 0.03), and maternal death (x2 = 12.00 P < 0.001) were determinants of fetal demise. Conclusion: Eclampsia is still a huge burden in our environment affecting maternal and perinatal morbidity and mortality profile. Early presentation and adequate treatment can help to reduce the incidence of this preventable obstetric disaster in our environment.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44576733","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}
H. Okoye, J. Chinawa, E. Aniwada, L. Eweputanna, T. Nwagha, U. Nwagha
Background: Pregnancy losses (PLs) are usually a source of pain and psychological stress to the expectant couples. The association between ABO blood groups and some thrombogenic markers with PL among Nigerian women is mostly unknown. Aim: This study investigates the association between ABO blood group, deficiencies of protein C (PC), and protein S (PS) and PL. Patients and Methods: A cross-sectional study involving 170 pregnant women grouped into two, those with or without a history of clinically- or ultrasonographically recognizable PL. ABO blood groups using the tile method, plasma concentrations of free protein S (fPS) antigen, protein C antigen (PCAg) by the enzyme-linked immunosorbent assay-based method, and PC activity (PCAc) by PROTAC method was determined. Results: There was no difference in mean values between the two groups for PCAg, PCAc, FPS, and blood group (P > 0.05). The chances of PL were; non-O blood group (AOR 1.29; 95% CI 0.65--2.54), deficient PCAg (AOR 1.75; 95% CI 0.87--3.54), and deficient PCAc (AOR 1.05;95%CI 0.25--4.13). There was a very poor correlation of miscarriage with FPS (rho 0.04), PCAg (rho 0.09), and PCAc (rho = 0.05). Conclusion: There was no significant association between PLs and ABO blood group phenotypes, PCAg, PCAc, fPS.
{"title":"Thrombogenic indices in an evaluation of pregnant Nigerian women with pregnancy loss","authors":"H. Okoye, J. Chinawa, E. Aniwada, L. Eweputanna, T. Nwagha, U. Nwagha","doi":"10.4103/TJOG.TJOG_65_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_65_18","url":null,"abstract":"Background: Pregnancy losses (PLs) are usually a source of pain and psychological stress to the expectant couples. The association between ABO blood groups and some thrombogenic markers with PL among Nigerian women is mostly unknown. Aim: This study investigates the association between ABO blood group, deficiencies of protein C (PC), and protein S (PS) and PL. Patients and Methods: A cross-sectional study involving 170 pregnant women grouped into two, those with or without a history of clinically- or ultrasonographically recognizable PL. ABO blood groups using the tile method, plasma concentrations of free protein S (fPS) antigen, protein C antigen (PCAg) by the enzyme-linked immunosorbent assay-based method, and PC activity (PCAc) by PROTAC method was determined. Results: There was no difference in mean values between the two groups for PCAg, PCAc, FPS, and blood group (P > 0.05). The chances of PL were; non-O blood group (AOR 1.29; 95% CI 0.65--2.54), deficient PCAg (AOR 1.75; 95% CI 0.87--3.54), and deficient PCAc (AOR 1.05;95%CI 0.25--4.13). There was a very poor correlation of miscarriage with FPS (rho 0.04), PCAg (rho 0.09), and PCAc (rho = 0.05). Conclusion: There was no significant association between PLs and ABO blood group phenotypes, PCAg, PCAc, fPS.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43985345","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: Asherman's syndrome is a clinical entity that can cause menstrual abnormalities and infertility. Objectives: This study was done to determine the risk factors, and management outcome of intrauterine adhesions in our hospital. Subjects and Methods: We carried out a retrospective study of the patients who were treated for intrauterine adhesions at the University of Uyo Teaching Hospital over a 10 years period-from January 1st 2006 to December 2016. Results: During the study period, a total of 1977 gynecological surgeries were performed of which 83 were for intrauterine adhesions, giving a rate of 4.2%. However, only 52 folders were retrieved, giving a retrieval rate of 62.5%. Analyses, using ratios and percentages, was based on these. Most patients belonged to the 30-34 age group (28.9%) followed by the 20-24 age group (25.0%). The majority of the patients were nulliparous (58.9%), married (65.4%) and had a tertiary education (50.0%). Dilatation and curettage for induced abortion (42.3%), open myomectomy (26.9%), and caesarean section (19.2%) were the common risk factors. Amenorrhoea (65.4%), and hypomenorrhoea (30.8%) were the commonest modes of presentation. All the patients were managed by blind adhesiolysis, done overwhelmingly by the resident doctors, under anaesthesia with a significant percentage (65.3%) showing that there is no change in menstrual condition. Conclusion: Ashermans syndrome is a relatively common condition, and it is necessary to train doctors in the use of, and acquire, a hysteroscope, for the proper management of this condition. Meanwhile, more senior personnel should be involved in the blind adhesiolysis, and Foley catheter that appears superior as a uterine splint to the intrauterine contraceptive device.
{"title":"Intrauterine adhesions in the University of Uyo Teaching Hospital, Uyo, South-South, Nigeria: A ten year review","authors":"N. Utuk, A. Abasiattai, O. Asuquo","doi":"10.4103/TJOG.TJOG_42_18","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_42_18","url":null,"abstract":"Background: Asherman's syndrome is a clinical entity that can cause menstrual abnormalities and infertility. Objectives: This study was done to determine the risk factors, and management outcome of intrauterine adhesions in our hospital. Subjects and Methods: We carried out a retrospective study of the patients who were treated for intrauterine adhesions at the University of Uyo Teaching Hospital over a 10 years period-from January 1st 2006 to December 2016. Results: During the study period, a total of 1977 gynecological surgeries were performed of which 83 were for intrauterine adhesions, giving a rate of 4.2%. However, only 52 folders were retrieved, giving a retrieval rate of 62.5%. Analyses, using ratios and percentages, was based on these. Most patients belonged to the 30-34 age group (28.9%) followed by the 20-24 age group (25.0%). The majority of the patients were nulliparous (58.9%), married (65.4%) and had a tertiary education (50.0%). Dilatation and curettage for induced abortion (42.3%), open myomectomy (26.9%), and caesarean section (19.2%) were the common risk factors. Amenorrhoea (65.4%), and hypomenorrhoea (30.8%) were the commonest modes of presentation. All the patients were managed by blind adhesiolysis, done overwhelmingly by the resident doctors, under anaesthesia with a significant percentage (65.3%) showing that there is no change in menstrual condition. Conclusion: Ashermans syndrome is a relatively common condition, and it is necessary to train doctors in the use of, and acquire, a hysteroscope, for the proper management of this condition. Meanwhile, more senior personnel should be involved in the blind adhesiolysis, and Foley catheter that appears superior as a uterine splint to the intrauterine contraceptive device.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/TJOG.TJOG_42_18","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46356631","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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