Gynaecological Emergencies in the Tropics: Recent Advances in Management

No AbstractKeywords: Gynaecological emergencies, ectopic pregnancy, unsafe abortion, pelvic infection, adnexal mas

Anaemia in pregnancy maternal and perinatal outcome in Ibadan, south western Nigeria

Background: Anaemia during pregnancy is a global public health issue that may be associated with adverse pregnancy outcomes. Ante natal care should be concerned with early detection and management of all degrees of anaemia in pregnancy.Objectives: To determine the prevalence of anaemia and associated pregnancy outcomes among expectant mothers attending ante natal clinic at the University College Hospital, Ibadan.Subjects, Methods and Materials:A descriptive, longitudinal study of the maternal and perinatal outcomes of anaemia among an obstetric population at the University College Hospital, Ibadan.Results: Prevalence of anaemia in pregnancy was 6.5% with mild and moderate anaemia accounting for 4.6% and 2.2% respectively. Mild to moderate anaemia were not associated with adverse maternal and perinatal outcomes Conclusion: Prevalence of anaemia in our environment appears to be falling. Adverse maternal and perinatal outcome are unlikely with mild to moderate levels of anaemia.Keywords: Anaemia in pregnancy, prevalence, maternal outcome, perinatal outcome

Family Planning Behaviour of Male Civil Servants in Ibadan, South Western Nigeria

Men play critical roles in women's ability to seek health care and Reproductive Health programmes are likely to be more effective when men are involved in some way. The study was designed to assess the family planning (FP) behaviour of male civil servants in Ibadan, and determine their roles in their spouses' FP practices. This was a descriptive, cross-sectional survey carried out among 403 currently married male civil servants working in 8 selected ministries in Oyo State Secretariat, Ibadan, Nigeria. The mean age of the respondents' in this study was 44 ±9.74. Two hundred and twenty two (55.1%) desired to have 1 – 4 children in their lives while 117 (29.0%) desired 5-8 children. Though most of all the respondents, 292 (72.5%) opined that decisions on family planning practice should be jointly reached by the couple and many, 202 (50.1%) remind their wives to use contraceptive, only 91 (22.6%) attended family planning clinics with their wives. The results showed that though many of the male civil servants in Ibadan desired small sized family and actually encouraged their wives to use their contraceptives, most were not willing to attend FP clinic with their spouses. FP clinics and services should be made more men-friendly and strategies to reach out to men should be devised.  Key words: Family planning behaviour, clinic attendance, Male civil servant

Overcoming phase 1 delays: the critical component of obstetric fistula prevention programs in resource-poor countries

<p>Abstract</p> <p>Background</p> <p>An obstetric fistula is a traumatic childbirth injury that occurs when labor is obstructed and delivery is delayed. Prolonged obstructed labor leads to the destruction of the tissues that normally separate the bladder from the vagina and creates a passageway (fistula) through which urine leaks continuously. Women with a fistula become social outcasts. Universal high-quality maternity care has eliminated the obstetric fistula in wealthy countries, but millions of women in resource-poor nations still experience prolonged labor and tens of thousands of new fistula sufferers are added to the millions of pre-existing cases each year. This article discusses fistula prevention in developing countries, focusing on the factors which delay treatment of prolonged labor.</p> <p>Discussion</p> <p>Obstetric fistulas can be prevented through contraception, avoiding obstructed labor, or improving outcomes for women who develop obstructed labor. Contraception is of little use to women who are already pregnant and there is no reliable screening test to predict obstruction in advance of labor. Improving the outcome of obstructed labor depends on prompt diagnosis and timely intervention (usually by cesarean section). Because obstetric fistulas are caused by tissue compression, the time interval from obstruction to delivery is critical. This time interval is often extended by delays in deciding to seek care, delays in arriving at a hospital, and delays in accessing treatment after arrival. Communities can reasonably demand that governments and healthcare institutions improve the second (transportation) and third (treatment) phases of delay. Initial delays in seeking hospital care are caused by failure to recognize that labor is prolonged, confusion concerning what should be done (often the result of competing therapeutic pathways), lack of women’s agency, unfamiliarity with and fear of hospitals and the treatments they offer (especially surgery), and economic constraints on access to care.</p> <p>Summary</p> <p>Women in resource-poor countries will use institutional obstetric care when the services provided are valued more than the competing choices offered by a pluralistic medical system. The key to obstetric fistula prevention is competent obstetrical care delivered respectfully, promptly, and at affordable cost. The utilization of these services is driven largely by trust.</p