Magnesium sulphate in the treatment of pre-eclampsia and eclampsia

No Abstract

Foeto-maternal outcome of HIV-positive pregnant women on highly active antiretroviral therapy

Background: A human immunodeficiency virus (HIV) infection in pregnant women is an important medical challenge. There exist varied reports on the foeto-maternal outcome amongst HIV positive women in Africa. Aim: The study was to compare the foeto-maternal outcome among HIV-positive pregnant women who are on HAART with those that are HIV-negative. Methods: A comparative, case-control study of booked HIV-positive and HIV-negative women attending ante-natal clinic (ANC) in Abuja. One hundred and five serial eligible HIV-positive women who booked for ante-natal care between October 8, 2012 and April 29, 2013 were recruited and matched with the control. They were followed up to six weeks post-partum. Live babies were tested for HIV using DNA polymerase chain reaction (PCR) at six weeks post-partum. The data was analysed using statistical package for social science (SPSS) version 16. Chisquare at < 0.05 at confidence level of 95% and Student t-test were used to determine significant association. Results: There were 112 HIV positive pregnant women among 1683 pregnant women during the study period giving a prevalence of 6.7%. The rate of preterm delivery was significantly higher among the HIV positive women (33% Vs 18%, P= 0.005). There was no case of vertical transmission. Conclusion: Maternal HIV infection was significantly associated with preterm delivery. There was no recorded vertical transmission. Strengthening the use of HAART may maintain zero vertical transmission among other precautionary measures. Key words: HIV, HAART, pregnancy outcome, maternal and child health, vertical transmission, booked patien

Age at menarche and the menstrual pattern of secondary school adolescents in northwest Ethiopia

<p>Abstract</p> <p>Background</p> <p>Population studies on normal and dysfunctional characteristics of menstrual cycles are scarce in Ethiopia. In addition variability in menarcheal age and menstrual characteristics are common. Knowledge on this variability is necessary for patient education and to guide clinical evaluation.</p> <p>Methods</p> <p>A cross sectional study was conducted in two small towns called Dabat and Kola Diba, northwest Ethiopia between April and May 2007. Systematic sampling method was used to select 622 school girls from two secondary schools. A pretested questionnaire prepared in Amharic was used to gather data. Selected girls cooperated in answering the questionnaire in their classrooms under the supervision of the research team. Only 612 of the adolescent females were included in the final analysis, of which 305 were from Koladiba High School and 307 from Dabat.</p> <p>Results</p> <p>The age of the study subjects ranges between 14 and 19 with a mean (standard deviation) of 16.9 ± 1 years. About 92.2% had attained menarche by the time the survey was conducted. The probit analysis of the <it>status quo </it>data yielded a median (CI) age at menarche of 14.8 (13.9-15.3) years. The average age at menarche by recall method was 15.8 ± 1 years. The mean age at menarche was 0.3 years younger for urban females compared with rural ones (p < 0.001). A cycle length between 21 and 35 days was observed in 70.3% of the girls. The mean duration of flow was 4 ± 1.3 days with a range of 2-7 days. The menstrual cycles were irregular in 42.8% of the subjects. The overall prevalence of dysmenorrhoea was 72% among these subjects. Premenstrual symptoms were present in 435 of the females (75.4%). The leading sources of menarcheal information to the adolescents were mothers (39.7%), followed by their friends (26.6%) and teachers (21.8%).</p> <p>Conclusion</p> <p>In this study age of menarche was found to be delayed which is even higher than the findings indicated similar studies conducted in Ethiopia and other African countries. A significant number of students complain of abnormal menstrual cycle, dysmenorrhoea and premenstrual symptoms which call for appropriate counselling and management.</p

Vesicovaginal fistula: Do the patients know the cause?

Background : So much has been written on vesicovaginal fistula (VVF) but there is little on the patients' perspective of the condition. The objectives of this study were to determine the knowledge of patients who have developed VVF on the causes of the fistula and their attitude toward measures that would prevent future occurrence. Methods : The questionnaire-based survey was conducted on VVF patients on admission from June to August 2003 at Maryam Abacha Women and Children Welfare Hospital, Sokoto, Nigeria. The case notes of the patients were reviewed after the interview to match the responses from the patients with those documented in the folders. Focus group discussions were held with the maternity staff to ascertain the content and quality of existing counseling. Results : One hundred and thirty patients were studied out of which 121 (93%) had no formal education. Teenagers constituted 37%, while 57% were primiparae. Thirty-five (27%) patients were divorced or separated because of the VVF. There were seven cases of recurrence after a previous successful repair. Prolonged obstructed labor was the cause of the VVF in 110 (85%) patients and 77 (70%) correctly attributed their problem to the prolonged labor. The 33 patients who could not identify the prolonged obstructed labor as the cause either attributed their condition to God/destiny or to the operation that was done to relief the obstruction and therefore would not have hospital delivery in their subsequent pregnancies. From the focus group discussions, it was confirmed that pre and post-operative counseling were inadequate. Conclusion : Even though majority (70%) of the patients knew the cause of their fistula from the health talks, some (32%) would still not change from risky obstetric behavior. Mandatory provision of accurate and appropriate information and education to all VVF patients and their relatives or spouses by trained counselors should be ensured. Such information and education should emphasize the etiology and management of obstetric fistula in order to prevent a recurrence

Ectopic pregnancy in Sokoto, Northern Nigeria

Ectopic pregnancy is an important cause of maternal mortality and morbidity in the first trimester of pregnancy. We report a descriptive, cross-sectional study of ectopic pregnancy presenting to the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, between 1990 and 1997. There were 140 cases of ectopic pregnancy with incidence of 18.1 per 1,000 deliveries. The mean age of patients was 26.7 years and the median parity of cases of ectopic gestation was 1; 32% were nulliparae. Abdominal pain and tenderness were the most frequent symptom and sign respectively. Diagnosis was usually based on clinical findings augmented by procedures including paracentesis abdominis, abdominal ultrasound scan and urine pregnancy test. The ectopic pregnancy was sited in the Fallopian tube in 92% of cases. In 56 cases (41%), there was macroscopic evidence of previous pelvic infection at surgery. 66% of ectopic pregnancies had ruptured at presentation. Treatment was surgical in all but one case, and unilateral salpingectomy was the procedure most frequently performed. The case fatality rate was 1.5%. Malawi Medical Journal Vol.17(1) 2005: 14-1