Awareness and Practice of Contraception among Female Secondary School Students in Uyo, Nigeria

Adolescent sexual activity is very prevalent in many countries. Unprotected premature sexual intercourse results in a high incidence of induced abortion, unwanted pregnancy and sexually transmitted infections. Objective: The aim of this study was to determine the degree of awareness of contraception and its practice among female secondary school students in Itu, Akwa-Ibom State, Nigeria. Method: A descriptive cross sectional study design was used to recruit 378 consenting female students selected by simple random sampling. Semi-structured, self-administered questionnaires were administered after explanation of the study and assurance of confidentiality. Three hundred and twelve forms were properly filled and analysis was done manually on these using simple proportions and percentages. Results: Majority of the respondents were Ibibio 220 (70.5%) and between 13 and 17 yrs old (89.6%). Two hundred and thirty six (75.6%) were aware of contraception. Twenty nine (16.0%) of those who were sexually active had ever practice any form of contraception. The three common forms of contraception known were the male condom (36.0%), the calendar method (34.0%) and the oral contraceptive pills (25%). The foremost sources of information about contraception were from TV/radio (36.0%), parents (25.0%) and female friends (14.8%). Of those who were sexually active 116(64.8%) had sexual debut at 11-15years of age. Conclusion: This study demonstrated that the level of awareness of contraception was high but the practice of contraception was comparatively low. It also demonstrated that the age at sexual debut was early and the rate of sexual intercourse high. This emphasizes the need for provision of timely and accurate contraceptive information through sex education in secondary schools in our environment. Key words: Contraception, Awareness, Practice, Sexual debu

Asymptomatic Bacteriuria in a University Teaching Hospital in Southern Nigeria: Prevalence, Uropathogens, and Antibiotic Susceptibility

Background: Asymptomatic bacteriuria (ASB) has been documented as the main risk factor for the development of symptomatic urinary tract infection in pregnancy and is associated with maternal and fetal complications. Objective: To determine the ASB prevalence, the causative microorganisms, their drug sensitivity patterns, and the factors associated with its occurrence in pregnant women in the Uyo, Nigeria. Methodology: Three hundred and twenty women were recruited during their first antenatal visit over a period of 13 weeks. A midstream urine specimen was obtained from each patient, cultured, isolates identified and antimicrobial sensitivity done. Data were analyzed using the Statistical Package for the Social Sciences version 20.  Results: The ASB prevalence was 9.1% with the two commonest identified isolates being Escherichia coli (41.4%) and Klebsiella pneumoniae (24.1%). Imipenem(100.0%) and gentamycin (37.9%) were the two most sensitive drugs. The association between respondents’ educational level and the occurrence of ASB was significant statistically. Conclusion: The prevalence of ASB was relatively high among the respondents. This, therefore, emphasizes the need for routine  screening  of our antenatal female population for ASB in all our health facilities

Awareness and desirability of antenatal attendees about analgesia during childbirth in a university teaching hospital in southern Nigeria

Background: Labour pain is among the most severe pains humans experience and when unrelieved, is associated with adverse maternal and foetal effects. Methods: Structured questionnaires were administered to 268 consenting parous women in the antenatal clinic of the University of Uyo Teaching Hospital, Nigeria over a 4-months period. Results: The majority of the respondents were between 25-34 years (84.0%), and were well educated (64.4%). About half (59.7%) of the respondents did not know that pain free labour was possible, while only 6.7% of the women had pain relief in their last delivery. The majority (81.4%) desired pain relief during their next delivery. Books (35.1%) and friends/relatives (32.4%) were the most common sources of information on pain relief in labour. Perception of pain was positively associated with the educational level of the women (P=0.013).There was also a significant association between ethnicity and desirability for labour pain relief. Conclusions: The practice of obstetric analgesia in labour is far from optimal in our center. The need to create awareness about pain relief in labour and its importance specifically among our antenatal clients cannot be overemphasized. Keywords: Labour analgesia, Antenatal attendees, Uy

The prevalence of syphilis in pregnant women in Akwa Ibom State, Southern Nigeria

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

Maternal death and obstetric care audits in Nigeria: A systematic review of barriers and enabling factors in the provision of emergency care.

Acknowledgements We would like to thank Yutaka Osakabe for co-ordinating the retrieval of full text articles. The John D. and Catherine T. MacArthur Foundation supported this study, grant number 12-100074-000-INPPeer reviewedPublisher PD

Intrauterine adhesions in the University of Uyo Teaching Hospital, Uyo, South-South, Nigeria: A ten year review

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

Combined Oral Contraceptive Pills: Profile of Acceptors in a Tertiary Hospital in South-South Nigeria

Background: Combined oral contraceptive pills were the first contraceptive method to provide sexual freedom of choice for women through reliable, personal and private control of fertility. They are the most widely used hormonal contraceptives and also the most popular non-surgical method of contraception. Objective: To review the profile of acceptors of combined oral contraceptive pills at the University of Uyo Teaching Hospital, Uyo. Methodology: An 8 year review of all clients that accepted combined oral contraceptive pills in the family planning clinic. Results: There were 1,146 new contraceptive acceptors during the period of study out of which 309 (27.9%) accepted the pills. Majority of the clients were between 20 and 29 years of age (54.0%), were multiparous (72.8%), Christians (99.7%) and 61.2% had tertiary level education. Two hundred and fifty-five women (82.5%) desired to use combined oral contraceptive pills to space births while 7.8% wanted to limit child bearing. There was a high discontinuation rate among the women (45.0%) and out of these 87.9% of the clients changed to other contraceptive methods. All the clients commenced their pills within seven days of menstruation and only the low dose monophasic preparations were available in the family planning unit and thus were given to the clients. Conclusion: Women who accept to initiate combined oral contraceptive pills in our center are young, well educated, multiparous women who want to space their pregnancies. However, due to the high discontinuation rate among the clients, there is need for further studies evaluating reasons for the high discontinuation rate, exploring interactions between clients and providers′ and also providers′ attitude towards combined pills in our environment

Factors contributing to uterine rupture in women having vaginal births after caesarean section

Context: Ruptured gravid uterus is a common occurrence in our environment with higher risk in scarred uterus. Some women will attempt vaginal delivery at home after a caesarean section had been performed for cephalopelvic disproportion. Objective: To evaluate the various reasons put forward by our women for attempting vaginal delivery at home despite previous caesarean section. Subjects and Methods: Patients with ruptured gravid uterus during labour with history of previous caesarean section were studied using structured interview formats. Their demographic characteristics, social class, booking status, place of attempted vaginal delivery and various reasons for seeking unorthodox care. Close relative of patients were interviewed in unconscious or moribund patients. Results: Some 24(96.0%) of the patient had no antenatal care in the index pregnancy and had laboured in spiritual churches or in traditional birth attendants homes. Ninteen (76.0%) were of low social class. Various reasons for attempting vaginal delivery at TBA's or spiritual churches included lack of funds 9(37.5%) husbands or close relative not available to take decision for hospital delivery 6(25.0%), not appreciating the need for hospital delivery 3(12.5%) and no reason 1(4.2%). There were 12 maternal deaths giving a case fatality rate of 48%. Conclusion: The study shows socio economic factors, dependency on family decisions and belief in supernatural powers as major reasons our women chose unorthodox delivery despite prior caesarean section and recommend ways of preventing it.Keywords: vaginal birth after caesarean section, uterine rupture Tropical Journal of Obstetrics and Gynaecology Vol. 22(2) 2005: 177-17

Outcome of twin pregnancy in Calabar, Nigeria

A ten year retrospective study (between January 1989 to December 1998) to determine the incidence, pregnancy complication and outcome of twin births at the University of Calabar Teaching Hospital was carried out. There were 342 twin births out of 12,877 deliveries giving a twin delivery incidence of 26.5/1000 births. The highest twining rate was found in women aged 25 to 29 years (33.5%) and para 2 mothers (23.5%). The main complications encountered were preterm labour (41.2%), pregnancy induced hypertension (11.1%), hyperemesis gravidarum (8.7%) and anaemia (6.8%). The caesarean section rate was 26%. The perinatal mortality rate was 100.6 per 1,000 births and the main cause of perinatal mortality was prematurity. To reduce the associated high maternal morbidity and perinatal mortality, early booking and improvement in existing neonatal facilities are recommended. (Global Journal of Medical Science, 2004, 3 (1&2): 13-15