Breastfeeding Practices among Mothers in Southwest Nigeria

BACKGROUND፡ This study was conducted to determine the breastfeeding practices among parous antenatal attendees in two teaching hospitals in Southwest Nigeria.METHODS: A cross-sectional study was carried out on 340 parous antenatal clinic attendees in two teaching hospitals in Ogun State, Nigeria. A structured questionnaire was used to obtain data on breastfeeding practices. Data were analyzed using Statistical Package for Social Sciences (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA).RESULTS: Out of a total of 340 women, 319 (93.8%) breastfed their last babies. The median duration of breastfeeding was 15 months. One hundred and thirty two women (38.8%) initiated breastfeeding within 30 minutes of delivery, and 200 women (58.8%) exclusively breastfed their babies for six months. The majority of the women, 299(87.9%k) did not report any problem associated with breastfeeding. Logistic regression analysis showed that women who had no breastfeeding problems were more likely to exclusively breastfeed their infants for six months compared to those with breastfeeding problems (AOR 3.4; CI 1.6-7.1; P=0.001). Similarly, women who got breastfeeding information from mass media were more likely to practice exclusive breastfeeding for six months compared to those that got breastfeeding information from other sources (AOR42.2; CI 3.1-568.5; P=0.005).CONCLUSION: Exclusive breastfeeding is suboptimal in Ogun State, Nigeria. Provision of breastfeeding information via mass media will assist in improving breastfeeding practice. Educating mothers on the techniques that help to prevent breastfeeding complications will also be beneficial

Hypertensive disorders of pregnancy: A five-year review in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

Objective: To determine the prevalence and outcome of hypertensive disorder of pregnancy in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State Nigeria Method: This was a retrospective descriptive study of all documented cases of hypertensive disorder of pregnancy between the 1st of June 2012 and 31st May, 2017. Information such as age, parity, booking status, level of education, blood pressure at presentation, urinalysis at presentation, gestational age at presentation, and delivery, mode of delivery, baby’s birth weight was extracted from patients’ case files. Result: There were 1,118 deliveries during the study period out of which 55 (4.9%) patients had hypertensive disorders in pregnancy. The mean age was 31.5years ±48.1 and mean parity, 1.2± 1.1.  The mean systolic and diastolic blood pressures were 180.4 ± 1.88mmHg and 105.1± 1.5mmHg, respectively. Thirty-four (75.5%) of the women had preeclampsia/ eclampsia, while 7 (15.5%) had gestational hypertension. Most women were delivered preterm (22 patients, 48.7%).  The majority of them (33, 73.3%) were delivered by cesarean section, out of which 2 (4.4%) were elective cesarean section and 31 patients (68.8%) were emergency cesarean section. The case fatality rate was 1.8%. Conclusion: Pre-eclampsia was the most prevalent t hypertensive disorder of pregnancy.  It was more prevalent among primigravidae patients and the most common complication was preterm delivery. Strengthening antenatal care services will enable early identification of cases. Prompt referral of cases for specialist care will help in reducing the adverse outcomes associated with the condition

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

Caesarean section-related blood transfusion: risk factors in a private teaching hospital in Nigeria

Background: Comprehensive emergency obstetric care, which includes the life-saving procedure of blood transfusion, is one of the essential components of effective emergency obstetric care that leads to a reduction in maternal mortality. In this study, blood transfusion risk factors were found in patients who had Caesarean deliveries at our facility.Methods: This was a retrospective study of all pregnant women who had caesarean section at Babcock University Teaching Hospital, Nigeria between 2016 and 2020. Their medical records were retrieved and reviewed using pro-forma. Chi square analysis was used to determine significant association between blood transfusion status and independent variables. Information was extracted from medical records using pro-forma.Results: Of 1568 obstetric admissions, there were 1210 deliveries and 369 (30.5%) caesarean sections. Ninety-five women (25.7%) of those that had caesarean sections were transfused. The incidence of blood transfusion was 13.7%. The preoperative packed cell volume, age and caesarean delivery type were significantly associated with blood transfusion status (p<0.05).Conclusions: Preoperative anemia, age and caesarean delivery type were all associated with blood transfusion status. To maximize hemoglobin levels at delivery and to identify high-risk patients, regular antenatal checkups should be given more importance

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&nbsp; 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

Vaginal Candida infection in pregnancy and its implications for fetal well-being

Vaginal Candida infection is one of the most common genital tract infections reported in pregnant women. This study was designed to determine the prevalence of vaginal Candida infection and pattern of Candida species isolates in the genital tract of pregnant women during antenatal period and in early labour; and the associated fetal outcome. The study was conducted at the antenatal clinic and labor ward of Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun State, Nigeria. High vaginal swabs were collected from 408 pregnant women at the antenatal clinic and repeated in early labour. The samples were processed to isolate Candida species. Data were analysed using Statistical Package for Social Science (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA). Prevalence of Candida infection was significantly higher in early labour (46%) than during antenatal period (38%) (P=0.02). Candida albicans was the predominant isolate, followed by Candida glabrata and Candida tropicalis. Candida infection was associated with increased likelihood of low birth weight babies (AOR 2.8, CI: 1.1-6.8; P= 0.03). However there was no statistically significant effect of Candida infection on the likelihood of preterm delivery (AOR 1.4, CI: 0.7-2.6; P= 0.35). Routine screening and prompt treatment of women at risk of delivering low birth weight babies is advocated. Keywords: Candida; Pregnancy; Preterm birth; Prevalence &nbsp; L'infection vaginale à Candida est l'une des infections des voies génitales les plus courantes signalées chez les femmes enceintes. Cette étude a été conçue pour déterminer la prévalence de l'infection vaginale à Candida et le profil des isolats d'espèces de Candida dans le tractus génital des femmes enceintes pendant la période prénatale et au début du travail; et l'issue foetale associée. L'étude a été menée à la clinique prénatale et au service d'accouchement de l'hôpital universitaire Olabisi Onabanjo de Sagamu, dans l'État d'Ogun, au Nigéria. Des écouvillons vaginaux élevés ont été prélevés sur 408 femmes enceintes à la clinique prénatale et répétés au début du travail. Les échantillons ont été traités pour isoler les espèces de Candida. Les données ont été analysées à l'aide de la version 21.0 de Windows Package for Social Science (SPSS) (IBM Corp., Armonk, NY, USA). La prévalence de l'infection à Candida était significativement plus élevée au début du travail (46%) qu'au cours de la période prénatale (38%) (P = 0,02). Candida albicans était l'isolat prédominant, suivi de Candida glabrata et Candida tropicalis. L'infection à Candida était associée à une probabilité accrue de bébés de faible poids à la naissance (AOR 2,8, IC: 1,1-6,8; P = 0,03). Cependant, il n'y avait aucun effet statistiquement significatif de l'infection à Candida sur la probabilité d'accouchement prématuré (AOR 1,4, IC: 0,7-2,6; P = 0,35). Le dépistage systématique et le traitement rapide des femmes à risque d'accoucher de bébés de faible poids à la naissance sont recommandés. Mots-clés: Candidose; Grossesse; Naissance prématurée; Prévalenc

The ability and safety of community-based health workers to safely initiate lifesaving therapies for pre-eclampsia in Ogun State, Nigeria: An analysis of 260 community treatments with MgSO4 and/or methyldopa

Objectives: To evaluate community-based health workers\u27 ability to identify cases of hypertension in pregnancy, safely deliver methyldopa and magnesium sulphate and make referrals when appropriate.Study design: This was part of Nigeria Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial (NCT01911494). Community-based Health Workers (CHW) recruited pregnant women from five Local Government Areas (clusters) and used mobile health aid for clinical assessment of pre-eclampsia.Main outcome measures: The primary outcome was the number of adverse events that occurred after the administration of magnesium sulphate and/or methyldopa to pregnant women by CHWs.Findings: Of 8790 women receiving mobile health-guided care, community-based health workers in Nigeria provided 309 women with hypertension (4.2% of delivered women), and safely administered 142 doses of intramuscular magnesium sulphate. Community Heath Extension Workers (CHEWs) and nurses gave fifty-two and sixty-seven doses of intramuscular magnesium sulphate respectively, twenty-three doses were given by other health care workers (midwives, community health officers, health assistants). The high rate of administration by nurses can be explained by turf protection as well as their seniority within the health system. Also, CHEWs and nurses gave 124 doses of oral methyldopa and 126 urgent referrals were completed. There were no complications related to administration of treatment or referral.Interpretation: These findings demonstrate the ability of community-based health workers to safely administer methyldopa and intramuscular magnesium sulphate. The use of task-sharing, therefore, could drastically reduce the three delays (triage, transport and treatment) associated with high maternal mortality and morbidity in rural communities in low- and middle-income countries

Bacterial vaginosis in pregnancy and early labour using Nugent scoring and the implication on foetal outcome

Background: To compare the pattern of vaginal microflora during pregnancy with pattern in early labour using Nugent scoring and determine the effect of these changes on fetal outcome. Design: A prospective longitudinal study. Setting and Population: Pregnant women attending antenatal clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria between June 2017 and May 2018. Methods: Consenting pregnant women who attended antenatal clinics were recruited. Vaginal secretions were obtained for Nugent scoring during pregnancy and at presentation in labour. Main Outcome Measures: Prevalence of abnormal vaginal flora in pregnancy and early labour, birth outcome, birth weight, gestational age at delivery, APGAR scores, need for neonatal ward admission. Results: Sixty-seven (33.3%) of pregnant women had abnormal flora which was consistent with bacterial vaginosis.At the presentation of these women in labour, 14.4% of them had bacterial vaginosis thus indicating a significant reduction in abnormal vaginal flora in labour compared to the proportion of abnormal flora in antenatal period(P&lt;0.001). There were no significant differences in the fetal outcomes of mothers with bacterial vaginosis when compared with those with normal vaginal flora (P-value &gt;0.05). Conclusions: Persistence of abnormal vaginal microflora from pregnancy till early labour did not seem to be associated with poorer foetal outcomes when compared with women with normal vaginal microflora in labour. The possibility of persistent infection or re-infection before labour may justify the need for re-evaluation of vaginal smears in the late third trimester to allow for prompt treatment before the onset of labour. Keywords: Bacterial vaginosis, foetal outcome, Lactobacillus, pregnancy, vaginal microflora. Funding: This research work was sponsored by the Tertiary Education Trust Fund, Nigeria (TETFund) with referencenumber OOU/IBR/010

Institutional Repositories: The Untapped Academic Goldmine

This paper looked at the influence of the Internet on scholarly communication and the emergence of various access-to knowledge initiatives, with stronger emphasis on institutional repositories (IRs). It highlighted the benefits of IRs and the efforts made by Redeemer's University (RUN) towards the implementation of RUNIR. It concluded that Nigerian universities stand to benefit tremendously from IR if they take up the challenges of understanding its features and implementing it