7 research outputs found
Comparison of clinical and ultrasonographic estimation of foetal weight at term and their correlation with birth weight
The study compares the accuracy of clinical and ultrasonographic estimation of foetal weight at term in predicting birth weight. It was a prospective comparative study conducted in a tertiary hospital in Abuja, Nigeria between May and August 2018. Three hundred pregnant women planned for delivery were recruited. In-utero clinical estimation of foetal weight was carried out using Dareâs clinical method and sonographic estimation using Hadlock 3 formula. The newborn babies were weighed within 30 minutes of delivery. The difference in the accuracy of the clinical method (75.3%) and the ultrasonographic method (82.3%) was statistically significant (p-value=0.023). The accuracy of the clinical method among parturients whose BMI were <30kg/m2 and â„30.0kg/m2 were 83.5% and 68.5% respectively while that of the ultrasonographic method were 85.2% and 80% respectively. We conclude that ultrasonographic estimation of foetal weight is more accurate than the clinical method. However clinical method may be used when an ultrasound scan is not accessible.
L'Ă©tude compare l'exactitude de l'estimation clinique et Ă©chographique du poids foetal Ă terme dans la prĂ©diction du poids Ă la naissance. Il s'agissait d'une Ă©tude comparative prospective menĂ©e dans un hĂŽpital tertiaire Ă Abuja, au Nigeria, entre mai et aoĂ»t 2018. Trois cents femmes enceintes dont l'accouchement Ă©tait prĂ©vu ont Ă©tĂ© recrutĂ©es. L'estimation clinique in utero du poids foetal a Ă©tĂ© rĂ©alisĂ©e Ă l'aide de la mĂ©thode clinique de Dare et l'estimation Ă©chographique Ă l'aide de la formule Hadlock 3. Les nouveau-nĂ©s ont Ă©tĂ© pesĂ©s dans les 30 minutes suivant l'accouchement. La diffĂ©rence dans la prĂ©cision de la mĂ©thode clinique (75,3 %) et de la mĂ©thode Ă©chographique (82,3 %) Ă©tait statistiquement significative (valeur p = 0,023). La prĂ©cision de la mĂ©thode clinique chez les parturientes dont l'IMC Ă©tait <30kg/m2 et â„30,0kg/m2 Ă©tait respectivement de 83,5% et 68,5% tandis que celle de la mĂ©thode Ă©chographique Ă©tait de 85,2% et 80% respectivement. Nous concluons que l'estimation Ă©chographique du poids foetal est plus prĂ©cise que la mĂ©thode clinique. Cependant, la mĂ©thode clinique peut ĂȘtre utilisĂ©e lorsque l'Ă©chographie n'est pas accessible
The Prevalence of Human Immunodeficiency Virus Infection among Pregnant Women in Labour with Unknown Status and those with Negative status early in the Index Pregnancy in a Tertiary Hospital in Nigeria.
Rapid HIV test in labour provide an opportunity for the identification of HIV positive pregnant women who should benefit from interventions to reduce the risk of mother-to-child transmission (MTCT) of HIV. Between November 2013 and June 2014 we conducted rapid HIV testing of pregnant women in labour at the National Hospital Abuja to determine the HIV seroconversion rate in pregnancy and the prevalence of HIV in pregnant women in labour with previously unknown status. HIV testing and counseling (HTC) was acceptable to 224 (99.6%) of the pregnant women who met the study criteria. The mean 'turnaround' time for test result was 288 minutes and 16.2 minutes for tests performed in the hospital laboratory and those performed at the pointâofâcare (labour ward) respectively. HIV seroconversion was detected in 2(1.2%) of the 165 parturients with initial HIV negative result early in the index pregnancy. HIV infection was detected in four (2.7%) of the 59 parturients with unknown HIV status. Secondary school level education was significantly associated with HIV seroconversion in pregnancy P<0.001. HTC in labour using rapid testing strategy is feasible and acceptable in our setting. The introduction of HCT will lead to the diagnosis of HIV positive women in labour, appropriate interventions and prevention of MTCT of HIV. (Afr J Reprod Health 2015; 19[3]: 137-143). Keywords: Human Immunodeficiency Virus, motherâtoâchild transmission, rapid HIV testing, prevention of mother-to-child transmission of HIV, seroconversion, HIV prevalence Les analyses rapides pour dĂ©tecter le VIH pendant le travail fournit une opportunitĂ© pour l'identification des femmes enceintes sĂ©ropositives qui devraient bĂ©nĂ©ficier des interventions visant Ă rĂ©duire le risque de transmission du VIH de la mĂšre Ă l'enfant (TME). Entre novembre 2013 et juin 2014, nous avons menĂ© un dĂ©pistage rapide du VIH auprĂšs des femmes enceintes en travail Ă l'HĂŽpital National d'Abuja pour dĂ©terminer le taux de sĂ©roconversion du VIH pendant la grossesse et la prĂ©valence du VIH chez les femmes enceintes dans le travail avec lâĂ©tat de santĂ© jusque-lĂ inconnue. Le DĂ©pistage et les Conseils Ă propos du VIH (DCV) Ă©taient acceptables Ă 224 femmes enceintes (99,6%) qui rĂ©pondaient aux critĂšres de l'Ă©tude. Le temps moyen de «redressement» pour le rĂ©sultat de lâanalyse Ă©tait de 288 minutes et 16,2 minutes pour les analyses effectuĂ©es dans le laboratoire de l'hĂŽpital et celles effectuĂ©es au point des soins (salle dâaccouchement) respectivement. La sĂ©roconversion du VIH a Ă©tĂ© dĂ©tectĂ©e chez 2 (1,2%) des 165 parturientes initiales qui avaient des rĂ©sultats nĂ©gatifs du VIH au dĂ©but de la grossesse index. Infection par le VIH a Ă©tĂ© dĂ©tectĂ©e dans quatre (2,7%) des 59 parturientes dont lâĂ©tat d santĂ© par rapport au VIH Ă©tait inconnu. La scolaritĂ© de niveau secondaire Ă©tait significativement associĂ©e Ă la sĂ©roconversion du VIH pendant la grossesse P <0,001. Le DCV pendant le travail en utilisant la stratĂ©gie de dĂ©pistage rapide est possible et acceptable dans notre milieu. L'introduction du DCV mĂšnera au diagnostic des femmes sĂ©ropositives dans le travail, aux interventions appropriĂ©es et Ă la prĂ©vention de la TME du VIH. ((Afr J Reprod Health 2015; 19[3]: 137-143). Mots-clĂ©s: Virus de l'immunodĂ©ficience humaine, transmission de la mĂšre Ă lâenfant, dĂ©pistage rapide du VIH, prĂ©vention de la transmission de la mĂšre Ă l'enfant, sĂ©roconversion, prĂ©valence du VIH
Multiple Origins and Regional Dispersal of Resistant dhps in African Plasmodium falciparum Malaria
Cally Roper and colleagues analyze the distribution of sulfadoxine resistance mutations and flanking microsatellite loci to trace the emergence and dispersal of drug-resistant Plasmodium falciparum malaria in Africa
Management of HIV in pregnancy: a clinical review
Context: The prevalence rate of HIV infection in pregnant women in some African countries is over 30 percent. HIV may adversely affect pregnancy outcome leading to spontaneous abortion, premature delivery, intrauterine growth restriction and low birth weight infants. The natural perinatal transmission risk varies from 15-45%. With improved
scientific knowledge in antiretroviral therapy, obstetric care and infant feeding practices, it is now possible to achieve and sustain satisfactory maternal health and prevent perinatal transmission. The application of these strategies has resulted in substantial reduction in perinatal transmission risks (less than 2%) in developed countries. Objective: This article reviews the specific strategies in the management of HIV positive pregnant woman. It is also meant to serve as guide to health workers who provide care for HIV positive pregnant women.Methodology: Extensive literature search and review of journal/internet articles, WHO publications, international and local guidelines on management of HIV in pregnancy. Conclusion: Within the setting of maternity services, HIV positive women can be diagnosed and managed appropriately. The care should be multidisciplinary, sensitive, non-stigmatizing, non-discriminatory and supportive. The capacity to achieve this can be developed through training and retraining of health care workers. Keywords: human immunodeficiency virus, HIV, pregnancy, perinatal transmissionTropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 65-7
Management of Infertility in HIV infected couples: A Review
The HIV epidemic has continued to grow and remains a major challenge to
mankind. In the past, ethical considerations about the resulting child
and risks of sexual, vertical and nosocomial transmission of HIV
prevented practitioners from offering fertility services to people
living with HIV. In recent times however, the use of highly active
antiretroviral therapy (HAART), has not only improved the life
expectancy and quality of life of those infected but also reduced the
risk of HIV transmission. The need for fertility services in the
HIV-positive population has thus increased and may be employed for
management of infertility and protection from transmission or
acquisition of HIV infection. As such, preconception counseling, sexual
health and fertility screening have become routine in the management of
HIV-positive couples. The option of care include adoption, self
insemination with husband sperm, embryo donation from couples who have
been verified to be HIV negative, insemination with donor sperm, timed
unprotected intercourse (TUI) and sperm washing combined with
intrauterine insemination (IUI) and assisted reproductive technology
(ART) including in-vitro fertilization (IVF) or intracytoplasmic sperm
injection (ICSI). Access to these fertility services by HIV-positive
clients should be facilitated as part of efforts to promote their
reproductive health and rights.L'épidémie du VIH a continué de croßtre et reste un
défi majeur pour l'humanité. Dans le passé, les
considĂ©rations Ă©thiques concernant le bien-ĂȘtre de
l'enfant et le risque de la transmission sexuelle, verticale et
nosocomiale du VIH ont limité la dispensation des services de
fertilité pour les personnes vivant avec le VIH. Ces derniers
temps, cependant, l'utilisation de la thérapie
antirétrovirale hautement active (TARHA), a non seulement
amélioré l'espérance de vie et la qualité de vie
des personnes atteintes, mais aussi de réduire le risque de la
transmission du VIH. La nécessité de services de
fertilité dans la population séropositive a donc
augmentĂ© et peut ĂȘtre utilisĂ©es pour le traitement des
facteurs d'infertilité et de la protection de la transmission ou
l'acquisition de l'infection du VIH. En tant que tel, le Counselling
avant la reproduction, le dépistage de santé sexuelle et de
fertilité sont nécessaires pour le traitement des couples
séropositifs. L'option des soins comprendrait l'adoption,
lâauto-insĂ©mination avec le sperme du mari, le don
d'embryons de la part des couples qui ont été
authentifiés comme étant séronégatifs,
l'insémination avec le sperme du donneur, les rapports sexuels
chronométrés non protégés et le lavage du sperme
combinĂ© avec lâinsĂ©mination intra-utĂ©rine (IIU) et
les techniques de reproduction assistée (TRA), y compris la
fĂ©condation in vitro (FIV) ou lâinjection
intra-cytoplasmique de spermatozoĂŻdes (IICS). L'accĂšs Ă
ces services de fertilité par les clients séropositifs
devrait ĂȘtre facilitĂ© comme faisant partie de la santĂ©
de reproduction et des droit
Unavoidable caesarean myomectomy: a case report
The standard practice is to avoid myomectomy during caesarean section. We present a case of myomectomy performed during caesarean section in a 32 year old primiparous woman. Uterine fibroid was diagnosed at 25 weeks gestation at the antenatal booking clinic. Patient was however symptom free throughout pregnancy. Elective caesarean section was undertaken at 38 weeks gestation on account of breech presentation and major placenta praevia. After delivery of the baby and placenta, the fibroid mass made uterine wound closure impossible, necessitating myomectomy. High dose oxytocin infusion was used to control intra-operative and post-operative haemorrhage. Outcome for mother and baby were satisfactory. Caesarean myomectomy can be safely undertaken in experienced hands whilst applying measures to reduce intra-operative and post-operative blood loss. Keywords: uterine fibroid, caesarean myomectomy, haemorrhage Tropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 81-8