Correlation between serum uric acid levels and outcomes of pre-eclampsia in Abakaliki, South-east, Nigeria

Background: Pre-eclampsia is a leading cause of fetomaternal and perinatal morbidity and mortality. The role of serum uric acid (SUA) in determining the complications of preeclampsia has been controversial. This study compared mean SUA levels between severe pre-eclamptics and normotensive women at term and ascertained its correlation with outcomes of preeclampsia; as well as determined if there is a threshold value of SUA level beyond which fetomaternal complications occur.Methods: A case-controlled study where 80 severe pre-eclamptics at term and 80 normotensive women matched for gestational age were recruited. Blood samples were collected from them for assay of SUA levels and they were followed till delivery. The fetomaternal outcomes and the corresponding SUA levels at diagnosis were documented and variables statistically analyzed. A receiver operating characteristic curve was used to determine the cut-off value of SUA beyond which adverse fetomateral complications are likely to occur in pre-eclampsia.Results: The mean SUA level in severe pre-eclamptics (0.283±0.09 mmol/l) was not significantly higher than that of normotensive women (0.263±0.09 mmol/l, p=0.13). There was a weak positive correlation between the SUA levels and fetomaternal outcomes [maternal (r=0.102, p=0.236) and fetal (r=0.096, p=0.226)]. The study was unable to identify the threshold SUA level at which adverse fetomaternal outcomes occur as the values of SUA were closely related.Conclusions: SUA levels of pre-eclamptics and normotensive women did not show significant difference and correlated weakly with fetomaternal outcomes and are therefore poor predictor of fetomaternal outcomes in pre-eclampsia

Evaluating the management outcomes of gynaecological emergencies at a tertiary hospital, Abakaliki Southeast, Nigeria

Background: Gynaecological emergencies are common causes of emergency hospital presentation/admission. Majority of the emergencies are mostly pregnancy related and pose threat to two lives as well as the women’s future reproductive careers. There is therefore need to evaluate them to make better preparations in managing them. Methods: This was a 10 year (from 01 January 2012 to 31 December 2021) retrospective study of gynaecological emergencies managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), evaluating their management and outcomes. Results: The commonest cause of gynaecological emergency at AEFUTHA was miscarriage accounting for up to 69.1% out of which incomplete miscarriage contributed 70.8% and majority had manual vacuum aspiration with good outcome. Ruptured ectopic pregnancies were the commonest surgical emergencies with the incidence of 7.1% and all had laparotomy and partial salpingectomy. Gestational trophoblastic diseases accounted for 2.0% of gynaecological emergencies. The commonest non-pregnancy related gynaecological emergency was acute pelvic inflammatory diseases which accounted for 9.3% of cases. Other gynaecological emergencies reviewed were ovarian accidents (2.9%), abnormal uterine bleeding (3.9%), gynaecological malignancies (2.3%), coital laceration (1.5%), sexual assault (2.4%) and Bartholin’s abscess (0.2%). Factors that affected the outcome were the age of the patients, marital status and disease type and were statistically significant (p<0.05). Conclusions: Management outcomes of gynaecological emergencies were optimum. Mortality occurred in 1.3% of cases, with gynaecological malignancies accounting for 81.4%. There is usually a good prognosis when prompt, accurate diagnosis and treatment are administered

Assessing aspects of better birth initiatives: a single centre experience

Background: Better birth initiative is a global initiative that promotes humane and evidence-based care for women during childbirth. This study was designed to assess compliance to aspects of better birth initiative and maternal satisfaction with a view to making recommendations. Methods: This study was a descriptive cross-sectional study of 396 consenting post-partum women to assess maternity services at AEFUTHA. A sample size of 423 was determined at power of 90% and α-error of 0.05. Data was analyzed using SPSS version 22. Chi-square was used to analyze categorical variables and odds ratios determined. Continuous variables were expressed as mean or standard deviation. P value of <0.05 was taken to be statistically significant. Results: Out of a total of 423 questionnaires deployed, only 396 were completed and duly returned (giving a 93.6% response rate). Majority of the parturient were between the ages of 20 to 34 years (80.3%), multiparas (74.2%) and with tertiary education (74.2%). Although many (74.2%) were not allowed companions, free mobility (78.8%), food (70.7%) and position of choice in labour (100%), they were satisfied with the care. Factors that likely affected maternal satisfaction were the age of participants, having a companion in labour, having a dedicated midwife to each parturient, free mobility in labour, oral fluid intake in labour and good health worker attitude (p value: 0.002, 0.024, 0.002, 0.0002, 0.0001 and 0.00001 respectively). Conclusions: There is need to continuously enlighten health professionals on aspects of better birth initiatives in order to improve client’s satisfaction