Umbilical artery doppler velocimetry study on prediction of adverse pregnancy outcomes among high risk pregnant women with diabetes mellitus at Aminu Kano teaching hospital

Background: Doppler velocimetry studies of pregnant women with diabetes mellitus can predict adverse pregnancy outcomes.Objective: To identify pregnant women with diabetes mellitus for second trimester umbilical artery Doppler velocimetry to predict adverse pregnancy outcomes.Methods: It was a prospective study among pregnant women with diabetes mellitus. The umbilical artery Doppler study was carried outin second trimester using 3.5 m Hz convex of the Mindry Digital Ultrasound Imaging System (Model DP-8800Plus; ShenzenMindray Biomed electronics, China).Results:  a total of 64 pregnant women with diabetes mellitus were recruited at the gestational age of 20 to 24 weeks. The mean age ± SD was 33.06±4.79. Only 24 (37.50%) of the women had gestational diabetes of which 16 (66.67%) had abnormal RI but no diastolic notch. Fourty women were identified with pregestational diabetes and Half of them had abnormal RI of which 4 had diastolic notches.Conclusion: Diabetic pregnant women withhigh resistive indices following umbilical artery Doppler velocimetry were not associated with significant adverse pregnancy outcomes.Keywords: Umbilical artery Doppler velocimetry, diabetes in pregnancy, adverse pregnancy outcomes

Sero-prevalence of Hepatitis B Virus Infection and its Risk factors among Pregnant Women Attending Antenatal Clinic at Aminu Kano Teaching Hospital, Kano, Nigeria

Background: Pregnant women infected with hepatitis B virus (HBV) can transmit the infection to their fetuses and newborns. Neonates who contract the HBV have about 90% risk of developing chronic HBsAg carriage (HBsAg: hepatitis B surface antigen) and chronic liver disease. Neonatal immunization interrupts this vertical and perinatal transmission.Objectives: To determine the seroprevalence of HBsAg among pregnant women attending the antenatal clinic at Aminu Kano Teaching Hospital (AKTH) and to identify potential risk factors associated with HBV infection.Materials and Methods: A case control study was conducted involving a total of 303 pregnant women attending the antenatal clinic at AKTH and 303 nonpregnant women of childbearing age. Blood sample was collected from each woman and the serum tested for the presence of HBsAg using latex rapid agglutination slide test kit (Cal-Tech Diagnostic Inc., USA) in the laboratory of the hospital. Reactive samples were stored at -20ºC and further confirmed for HBsAg using enzyme-linked immunosorbent assay (ELISA) kits (Bio-Rad, France). HBsAg-positive samples were tested for hepatitis B e antigen (HBeAg) using ELISA kits (Orgenics, Israel). A pretested, structured questionnaire was used for the collection of sociodemographic data and possible risk factors. Results: The prevalence of HBsAg among pregnant women and nonpregnant women were 7.9 and 7.6%, respectively. There was no statistically significant difference in the prevalence of HBsAg in pregnant and nonpregnant women. The presence of HBeAg was statistically significant among both pregnant and nonpregnant women who tested positive for HBsAg. The risk factors associated with HBV infection were blood transfusion, ear piercing, history of an affected sibling with HBV infection, tattooing, and abortion among pregnant women.Conclusion: The prevalence of HBsAg in this study was not statistically different in pregnant and nonpregnant women. There was a high level of HBeAg infection among pregnant women who tested positive for HBsAg. History of an affected sibling with HBV infection, tattoo, and abortion were significant risk factors for HBV infection. Keywords: Africa, hepatitis B, pregnancy, risk factor

An analysis of postdural puncture headache in obstetric patients: A study from Kano, Nigeria

Background: One of the complications of spinal anesthesia is postdural puncture headache. Many risk factors have been identified which when addressed could reduce the incidence.Objectives: This was a prospective study that analyzed the incidence, onset and severity of postdural puncture headache among pregnant women who had cesarean section under a subarachnoid block in Aminu Kano Teaching Hospital, Kano, Nigeria.Patients and Methods: Spinal anesthesia was performed on 146 patients using size 25‑ or 26‑gauge Quincke, Whitacre, or Sprotte needles. Patients were followed up to determine the incidence, onset, and severity of post spinal headache. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 18.0 (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Demographic variables were presented using tables while summary was done using means, standard deviation, and percentages. Test of association was done using Fisher’s Exact test. A P value < 0.05 was considered statistically significant.Results: The overall incidence of postdural puncture headache was 15.8% with all cases presenting within the first 24 hours. Most patients rated their headache as mild to moderate on a 10‑cm visual analogue scale.Conclusion: Traumatic Quincke spinal needle is associated with high incidence of postdural puncture headache and therefore we recommend the use of atraumatic pencil tip needle especially in obstetric anesthesia.Key words: Cesarean section; postdural puncture headache; spinal anesthesia