Ectopic Pregnancy in Lagos State University Teaching Hospital. Ikeja, Lagos .Nigeria

We set out to determine the socio-demographic factors,pattern of presentation and management of ectopic pregnancy in a University Teaching Hospital in Lagos, Nigeria. A retrospective descriptive analysis of all cases of ectopic pregnancy over a 2-year period was carried out. The case notes were retrieved from the Records Department and the following information extracted; age, parity, clinical presentation, findings at laparatomy, estimated blood loss and the need for blood transfusion. Statistical analysis was done using Epi-info 3.5 statistical software (2008 version). The incidence during the period of study was 38.85/1000 live births.The mean age at presentation was 29.5 _ + 5.7 year(SD) and 124 patients constituting 30.1% were nulliparous .Presentation was usually late with rupture and haemoperitoneum as demonstrated by the large percentage (99.2%). Ampullary part of the fallopian tube was most commonly affected accounting for 360(87.6%) of the cases. Salpingectomy was done in majority of cases - 376(91.3%), while 181 (44%) did not require blood transfusion. There were 3 maternal deaths during the study period..Ectopic presents a major public health challenge among women of reproductive age group in Nigeria. Efforts should be directed to public awareness on sex education , contraception , prevention and treatment of common risk factors for ectopic pregnancy and in cases of early rupture, auto-tansfusion should be encouraged.Key words: Ectopic pregnancy, Factors, Operatio

Hematological profile of normal pregnant women in Lagos, Nigeria

Background: Hematological profile is considered one of the factors affecting pregnancy and its outcome. Anemia is the most common hematological problem in pregnancy, followed by thrombocytopenia. Leukocytosis is almost always associated with pregnancy. The study reported here was designed to evaluate the overall mean values of seven major hematological parameters and their mean values at different trimesters of pregnancy. Subjects and methods: This examination was a cross-sectional study of 274 pregnant women who registered to attend the Lagos University Teaching Hospital or Lagos State University Teaching Hospital antenatal clinics between their first and third trimester. Blood (4.5 mL) was collected from each participant into a tube containing the anticoagulant ethylenediaminetetraacetic acid (EDTA). A full blood count was performed on each sample and the results were analyzed. Results: Overall, the values obtained were (mean ± standard deviation [SD]): hematocrit level, 30.16% ± 5.55%; hemoglobin concentration, 10.94 ± 1.86 g/dL; white blood cells, 7.81 ± 2.34 × 109; platelets, 228.29 ± 65.6 × 109; cell volume 78.30 ± 5.70 fL, corpuscular hemoglobin, 28.57 ± 2.48 pg; and corpuscular hemoglobin concentration, 36.45 ± 1.10 g/dL. When grouped by trimester, the mean ± SD value of packed cell volume at first trimester was 32.07% ± 6.80%; of second trimester, 29.76% ± 5.21%; and of third, 33.04% ± 3.88%. The mean ± SD hemoglobin concentration values were 11.59 ± 2.35 g/dL, 10.81 ± 1.72 g/dL, and 10.38 ± 1.27 g/dL for women in their first, second, and third trimester, respectively. Mean ± SD white blood cell concentration for first, second, and third trimesters were 7.31 ± 2.38 × 109, 7.88 ± 2.33 × 109, and 8.37 ± 2.15 × 109, respectively, while the mean ± SD platelet values for first, second, and third trimesters were 231.50 ± 79.10 × 109, 227.57 ± 63 × 109, and 200.82 ± 94.42 × 109, respectively. A statistically significant relationship was found to exist between packed cell volume and white blood cell count with increase in gestational age (P = 0.010 and 0.001, respectively). However, there was no statistically significant association between platelet count and increase in gestational age (P = 0.296). Conclusion: These findings reinforce the need for supplementation and provide additional information on hematological reference values in pregnancy in Nigeria

The changing pattern of obstructed labour in Lagos

Background: Obstructed labour is still a major cause of maternal mortality and morbidity and of adverse perinatal outcome in developing countries.Objectives: To determine the incidence, pattern of presentation, source of referral, complications, maternal and perinatal mortality and morbidity from obstructed labour as seen in a university teaching hospital.Methods: A longitudinal descriptive study of all cases of obstructed labour managed at Ayinke House; the Obstetric and Gynecology unit of the Lagos State University Teaching Hospital (LASUTH) Ikeja, between January 2007 and December 2008 was carried outResults: There were 7,470 deliveries during the study period and 316 of these were complicated by obstructed labour giving an incidence of 4.2%. Of the 316 women, 189 (59.8%) were nullipara. One hundred and eleven cases (35.1%) with obstructed labour were booked in LASUTH, while the remainder were unbooked. Cephalopelvic disproportion was the commonest cause of obstruction and accounted for 69.6% of cases and lower segment cesarean section was the most common intervention. Most of the women (42.4%) were in occupational social class IV. The leading complication of obstructed labour was wound infection/ puerperal sepsis accounting for 18.7% of cases There were 15(4.7%) maternal deaths giving a maternal mortality ratio of 1,415 /100,000 and perinatal mortality was 19.9%.Conclusion: Obstructed labour remains one of the leading causes of maternal mortality in this centre with majority being booked for antenatal care.Keywords: obstructed labour, new trend, maternal morbidity and mortalit

Cluster of differentiation 4+ cell count mean value, reference range and its influencing factors in Human Immunodeficiency Virus-seronegative pregnant women in Lagos

Background: Immunity in pregnancy is physiologically compromised and this may affect cluster of differentiation four (CD4) count levels. It is well established that several factors affect CD4 count level in pregnancy. This study aims to determine the effects of maternal age, gestational age, parity and level of education as they influence CD4 count in pregnancy and also to determine the mean and reference range of CD4 count in pregnancy in Lagos, Nigeria. Materials and Methods: A descriptive cross-sectional study was carried out at Ante-natal clinics in Lagos State, Nigeria. About 5 mls of blood was collected into Ethylene Diamine Tetracetic Acid (EDTA) bottles from HIV-negative pregnant women in various gestational ages of pregnancy. CD4+ cell count and full blood count of all samples were done within 3 hours of collection. The descriptive data was given as means ± standard deviation (SD). Pearson's chi-squared test and correlation were used for analytical assessment. Results: A total of 74 pregnant women were recruited. The age range was 19-41 years and a mean age of 30.42 ± 5.34 years. The CD4+ cell count was not statistically significant when compared with participants ages P = 0.417, neither with gestational ages P = 0.323, nor with parity P = 0.247 nor level of education P = 0.96. An overall mean CD4+ cell count was 771.96 ± 250 cells/μl and the range was 193-1370 cells/μl. Conclusion: Maternal age, gestational age, parity and level of education had no significant effects on CD4+ cell count levels in pregnancy. The mean CD4+ cell count of HIV-negative pregnant women in Lagos is 771.96 ± 250 cells/μl