Human Papilloma Virus Vaccine: Determinants of Acceptability by Mothers for Adolescents in Nigeria

Vaccination of adolescent females against Human Papilloma Virus (HPV), the causative agent for cervical cancer has recently become available. As minors, parental acceptance of the vaccines for adolescent daughters requires exploration. This was a cross-sectional survey of 201 mothers attending the gynaecology clinic in a University Teaching Hospital in Nigeria on acceptability of the HPV vaccines and its determinants. Although 70% accepted vaccination of their daughters, 30% were unwilling and the commonest reason for unwillingness was that it may encourage sexual promiscuity (62.3%). Mothers with poor knowledge of STI were significantly more unwilling to accept HPV vaccines compared to those with average or good knowledge (p=0.002). Furthermore, perception of susceptibility to HPV infection by daughters was significantly associated with acceptance of the vaccines (p=0.0001). Increased advocacy and public enlightenment on cervical cancer control and the role of HPV vaccines in its prevention is still necessary especially in developing countries. (Afr J Reprod Health 2014; 18[3]: 154-158)Keywords: Cervical cancer, Human papilloma virus, vaccine, Nigeri

Maternal Obesity in Early Pregnancy and Subsequent Pregnancy Outcome in a Nigerian Population

Despite a rising prevalence worldwide, there is limited data on pregnancy outcome among African women with prepregnancy or early pregnancy obesity. This was a case-control study to determine the prevalence of maternal obesity in early pregnancy and compare the subsequent pregnancy outcome between 201 women with obesity and 201 non-obese controls in a University Teaching Hospital in Nigeria. The prevalence of obesity in early pregnancy was 9.63%. Obesity was significantly associated with advanced maternal age and parity ≥ 1. It was also a risk factor for pregnancy induced hypertension, admissions during pregnancy, caesarean delivery and associated with 5th minute apgar score ≤3 (0.044). Obesity in early pregnancy is a risk factor for adverse pregnancy outcome among pregnant Nigerian women. This information should be utilised by physicians to improve the outcome of pregnancy and promote safe motherhood

Maternal understanding of fetal movement in third trimester: A means for fetal monitoring and reducing stillbirth

Background: Fetal movement, a sign of life, is widely considered as an indicator of fetal health status. Therefore, perceived alteration in regular fetal movement after the age of viability may signify impending adverse perinatal outcome.Aims: This study aimed to determine maternal knowledge, behavior, and concerns about abnormal fetal movement in the third trimester of pregnancy.Materials and Methods: A total of 225 women were surveyed using a self.administered questionnaire at the out-patient prenatal clinics of two tertiary health facilities in Nigeria between December 1, 2012 through January 31, 2013. Questions addressed knowledge, perception behavior, and concerns about experience of abnormal fetal movement.Results: Correct Knowledge of excessive and decreased fetal movement was found in 47% and 31.1% of respondents, respectively. Majority of women (87.6%) either had no knowledge of normal parameters of fetal activity or did not recall being told that movement frequency and strength should increase in the third trimester. The proportion of women who expressed concern over excessive and decreased fetal movement was 31.1% and 21.8%, respectively. Maternal education was significantly associated with correct knowledge of decreased fetal movement (P = 0.026). Almost 36% of respondents had knowledge of at least one potential consequence of abnormal fetal movement.Conclusion: Maternal educational level is an important factor in the early identification of abnormality of fetal movement. The unsatisfactory  knowledge and poor perception behavior among respondents reflect the need for a guideline, particularly during antenatal care, on information and management of abnormal fetal movement in our setting to preventavoidable stillbirth. Key words: Antenatal care, concerns, fetal movement, knowledge,  maternal knowledge, pregnancy, surveillance, stillbirt

Maternal death and obstetric care audits in Nigeria: A systematic review of barriers and enabling factors in the provision of emergency care.

Acknowledgements We would like to thank Yutaka Osakabe for co-ordinating the retrieval of full text articles. The John D. and Catherine T. MacArthur Foundation supported this study, grant number 12-100074-000-INPPeer reviewedPublisher PD

EDITORIAL: Attaining MDG 5 in northern Nigeria: Need to focus on skilled birth attendance

No Abstract

HIV-AIDS Related Maternal Mortality in Benin City, Nigeria

Objective: To determine the causes and characteristics of maternal deaths in HIV-infected women.Design: A retrospective study of maternal deaths in a cohort of HIV-infected women.Setting: A facility-based maternal death review using case records and mortality summaries.Methods: Thirty seven maternal deaths which occurred in HIV-infected women were reviewed in a university teaching hospital in southern Nigeria over a 4- year period. Causes and circumstances surrounding each maternal death were identified. Result: One in every four maternal deaths occur in women with HIV infection. Majority (64.9%) of the  women presented in advanced stage (WHO stage III/IV) of HIV syndrome while 86.5% had missed opportunities for antiretroviral programme. Pregnancyrelated sepsis was the commonest cause of maternal death. Other common causes were death from tuberculosis and pneumonia.Conclusion: HIV-related maternal death is emerging as a leading cause of pregnancy related death in Nigeria. There is need to scale-up preconception care and ensure comprehensive and sustainable prevention of mother -to-child transmission service for all pregnant women throughout Nigeria to reduce the burden of HIV/AIDS infection and minimize avoidable deaths from opportunistic infections