3 research outputs found
Contraceptive Use in Two Semi-Urban Primary Health Care Centres in Ogun State Southwest Nigeria: Determinants and barriers
Background: Contraceptive uptake is low in Nigerian women and this is associated with a high incidence of unintended pregnancies and unsafe abortions with their attendant complications. This study was designed to elucidate the pattern, determinants, and barriers of contraceptive use in two primary health care centres in Ogun State south-west Nigeria.
Materials and Methods: This was a cross-sectional study. The convenience sampling technique was used to recruit 250 women who presented for contraceptive services in two primary health care centres. A structured questionnaire was used to obtain contraceptive information. Data were analysed using IBM-SPSS version 23.0 (IBM Corp., Armonk, NY, USA). The level of significance was set at a p-value less than 0.05.
Results: Out of 250 study participants, 234(93.6%) were aware of contraceptives but only 142 (56.8%) had used any method. The male condom was the most commonly used contraceptive method (61; 24.4%). Fear of side effects (128; 51.2%) was the most frequently reported barrier to contraceptive use. Women who attained secondary and tertiary levels of education had a higher likelihood of using contraceptives than those who attained primary level (aOR 7.4, CI 2.0-27.1, P=0.003) and (aOR 10.8, CI 2.7-42.3, P=0.001) respectively.
Conclusion: The male condom was the most commonly used contraceptive method while fear of side effects was the most commonly reported barrier to contraceptive use. Despite the high level of awareness, contraceptive uptake is still low in Sagamu, Ogun State, Nigeria.
Recommendation: Awareness campaigns should be instituted in the media to provide credible information about the benefits of contraceptives and dispel misconceptions regarding their use
Eclampsia: A Five-year Retrospective Review in Sagamu, South-West Nigeria
Context: Eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in developing countries. This is the result of poor health-seeking behavior of pregnant women and inadequate comprehensive emergency obstetric services. This study reviewed the presentation and management of eclampsia in Sagamu over a 5‑year period.
Aims: This study aims to determine the prevalence, pattern of clinical presentation and fetomaternal outcomes of eclampsia.
Settings and Design: This was a retrospective study conducted in Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun state.
Subjects and Methods: Relevant information was retrieved from case notes of all patients who presented with eclampsia from January 2014 to December 2018. Data were analyzed using SPSS version 21.
Results: Out of the 4656 deliveries, there were 45 cases of eclampsia giving a prevalence of 0.97%. The modal age was 20–24 years. Majority were unbooked 41 (91.1%) and 29 (64.4%) of the women were nulliparas. Antepartum eclampsia was commonest occurring in 36 women (80%). The most common premonitory symptom was headache occurring in as high as 37 women (82.2%). Most of the patients 37 (84.4%) had an abdominal delivery. There were two maternal mortalities (4.4%) and four perinatal deaths (8.9%). There was no statistically significant association between factors such as booking status, type of eclampsia, mode of delivery and parity, and the fetal outcome (APGAR score at 1 min).
Conclusions: Eclampsia is still one of the preventable causes of maternal and perinatal mortality in our environment. The prevalence of eclampsia in sagamu was 0.97%. Improved health-seeking behavior, antenatal care monitoring, and prompt diagnosis and management of preeclampsia will invariably reduce the prevalence of eclampsia.
Keywords: Eclampsia, maternal, morbidity, mortality, perinata
Inflammatory Marker Levels in Preeclampsia versus Normal Pregnancies and Prediction of Preeclampsia Occurrence: A Prospective Mixed Methods Study
Introduction: Preeclampsia is an important cause of adverse
maternal and perinatal outcomes. However, this condition
remains poorly understood, and since the only cure is delivery,
prediction and prevention are crucial to prevent preterm birth or
maternal compromise.
Aim: To determine the levels of acute phase reactants, namely
high-sensitivity C-reactive Protein (hsCRP) and fibrinogen,
between preeclamptic and non preeclamptic pregnancies.
Additionally, the study aims to determine the predictive value of
these acute phase reactants for preeclampsia.
Materials and Methods: A prospective mixed methods study
was conducted in two tertiary hospitals and two specialist
hospitals in the Ijebu/Remo axis of Ogun state, Nigeria.
Preeclamptic participants were recruited during pregnancy
and postpartum and matched with non preeclamptic controls
(case-control arm, n=179, comprised of 87 preeclamptics and
92 controls). Additionally, a cohort of non preeclamptic women
(n=71) was recruited and biomarker-assayed before 20 weeks
gestation, followed-up for the development of preeclampsia.
The biomarker assay was performed using the ELISA technique.
The Student's t-test was used to compare the mean levels of
markers between the studied groups. Categorical data were
compared using the Chi-square test. A p-value <0.05 was
considered to be statistically significant
Results: The levels of hsCRP were significantly higher in
pregnant preeclamptic women (12.71±1.99 mg/L) compared
to non preeclamptic women (4.39±3.41 mg/L) (p-value=0.001).
Similarly, fibrinogen levels were elevated in preeclamptic
women (9.45±1.28 g/L) compared to non preeclamptic women
(7.19±1.86 g/L) (p-value =0.001). This trend was also observed
among postpartum women, with hsCRP levels of 10.39±2.43
mg/L in preeclamptics compared to 2.53±2.06 mg/L in non
preeclamptics (p-value=0.001). The mean fibrinogen level
was 8.63±1.91 g/L in preeclamptics compared to 4.09±1.66
g/L in non preeclamptics. Fibrinogen demonstrated a higher
specificity (88.9%) and Negative Predictive Value (NPV) of 100%
compared to hsCRP (specificity=47.1% and NPV=76.1%). The
biomarker levels also correlated significantly with the severity of
preeclampsia. For hsCRP, there was a correlation with Systolic
Blood Pressure (SBP) (r-value=0.385, p-value=0.001), Diastolic
Blood Pressure (DBP) (r-value=0.364, p-value=0.001), and
proteinuria (r-value=0.314, p-value=0.001). For fibrinogen, there
was a correlation with SBP (r-value=0.252, p-value=0.014), DBP
(r-value=0.378, p-value=0.001), and proteinuria (r-value=0.356,
p-value=0.001).
Conclusion: Although hsCRP and fibrinogen levels were
significantly higher and correlated well with the severity of
preeclampsia, their use for prediction may be limited. However,
fibrinogen appears to have better prospects