Factors Influencing The Use Of Episiotomy During Vaginal Delivery In South Eastern Nigeria

Background: Given considerable evidence that routine episiotomy increases maternal morbidity and without evidence to support maternal or neonatal benefit, has episiotomy use changed among health care providers? To date, very limited information exists relating to the past and current practice of episiotomy in many developing countries. Objective: To determine the prevalence of episiotomy at Aba in South Eastern Nigeria, examine factors influencing the performance of episiotomy and document complications associated with the procedure. Design: A hospital based retrospective study. Setting: The Abia State University Teaching Hospital (ABSUTH), Aba in South Eastern Nigeria, from January 2001 to December 2005. Subjects: Four thousand, one hundred and seventy two mothers who delivered vaginally within the study period. Results: There were 1877 episiotomies, for an episiotomy rate of 45%. Ninety per cent of the primigravid parturients had episiotomy. Women undergoing episiotomy were younger (mean age 24.7 years; range 16-37) than women without episiotomy (mean age 28.5 years, range 20-43). When controlled for parity and maternal age, other risk factors were occipito-posterior position, vacuum extraction, forceps delivery, vaginal breech delivery, and a history of Caesarean section. Episiotomy use was also associated with major perineal lacerations and increased length of hospital stay. Conclusion: The episiotomy rate of 45 per 100 vaginal deliveries in this study is obviously higher than evidence-based recommendations for optimal patient care. A policy of systematic reduction in the incidence of episiotomy can be pursued in this hospital. Greater attention needs to be paid to selection of women to undergo episiotomy. East African Medical Journla Vol. 85 (5) 2008: pp. 240-24

Rupture of the uterus in a primigravida: A case report

No Abstract

Contraceptive choices of women in rural southeastern Nigeria

No Abstract

Pregnancy outcome in booked and unbooked mothers in Southeastern Nigeria

Background: In order for individual health institutions in Nigeria to contribute towards the achievement of the Millennium Development Goals (MDG) with regards to maternal health, there is need for research on the local causes of and factors influencing adverse maternal outcomes. This would enable care providers and policy makers appreciate the burden of the problem and know where to focus as they distribute resources.Objectives: To compare the socio-demographical characteristics, obstetrical complications and foetal outcome in booked verses unbooked mothers who delivered at this hospital.Design: A hospital based retrospective study.Setting: The Abia State University Teaching Hospital (ABSUTH), Aba in South Eastern Nigeria.Subjects: Three thousand, seven hundred and thirty four mothers who delivered in the hospital between 1st January 2005 and 31st December 2007.Results: Unbooked mothers constituted 17.0% of the 3734 deliveries in the studied period. Compared to booked mothers, unbooked mothers were younger in age (28.2 ± 5.80 vs. 29.3 ± 6.04; p < 0.001) and had a lower educational status (

Knowledge of genital herpes infection among antenatal clinic attendees in South-Eastern Nigeria

Background: Herpes simplex virus (HSV) is a major cause of genital ulcer disease worldwide and a significant factor for increased risk of acquisition and transmission of the Human Immune Deficiency Virus (HIV). The determination of the level of knowledge of genital herpes is necessary for the design and implementation of its specific preventive strategies as well as the reduction of the contribution of genital herpes to HIV transmission.Objective: To determine antenatal women’s knowledge on genital herpes infection. Design: A cross sectional descriptive study.Setting: Antenatal clinic of Abia State University Teaching, Hospital, Aba, Nigeria. Subjects: Three hundred and fifty consecutive and consenting antenatal clinic attendees of Abia State University Teaching Hospital (ABSUTH), Aba, South Eastern, Nigeria. Results: Seventy nine respondents (22.6%) had ever heard of genital herpes whilst sixty two (17.7%) had ever had recurrent blisters around their genitals. Two hundred and sixteen respondents (61.7%) reported having had cold sores or blisters around thelips or mouth following an episode of fever. Seventy four (21.1 %) of the respondents knew that the virus that causes cold sores or blisters can be sexually transmitted. Higher educational levels attained and occupations other than being a housewife or farmer were associated with a greater awareness of genital herpes (

Risk Factors for Hepatitis B Virus Infection during Pregnancy in South Eastern Nigeria

Objective: To determine the seroprevalence of hepatitis B surface antigen (HBsAg) and possible risk factors in pregnant women.Design: A cross –sectional serological survey of women attending antenatal clinics.Setting: Five antenatal clinics in Aba, South Eastern Nigeria.Subjects: Eight hundred and ten consecutive and consenting antenatal clinic attendees over the period 15 June- 15 November 2010.Main Outcome measures: For each pregnant woman, the medical and sociodemographic data were documented. Hepatitis B surface antigen seropositivity determined.Results: Twenty two (2.7%) of the 810 subjects were found to be HBsAg seropositive and asymptomatic. Maternal age, parity, educational level attained, marital status, history of blood transfusion, intravenous drug use, tattooing, jaundice in the past and Human Immunodeficiency Virus seropositivity did not show any association with HBsAg sseropositivity.Conclusion: HBsAg seropositive women in the study were asymptomatic and showed no association with the medical and sociodemographic characteristics examined. These findings affirm the recommendation for universal HBsAg screening in pregnancy and imply that screening on the basis of the presence of risk factors alone may be insufficient

Trichomoniasis as an Indicator for Existing Sexually Transmitted Infections in Women in Aba, Nigeria

Background: Trichomoniasis is a common clinical problem. Many young women in Aba indulge in high-risk sexual behaviours. A large number of these young women are illiterates, and are in the habit of indiscriminate use of antibacterial agents at the slightest symptoms of a lower genital tract infection. Evaluation of bacterial agents associated with lower genital tract infections is therefore met with much frustration. The diagnosis of Trichomoniasis from lower genital tract is simple and its routine screening among women attending clinics would serve as an indicator for serious sexually transmitted infections in Aba. Methods: This study was undertaken among women attending a women hospital in Aba, Abia State, Nigeria (PrincessMaryHospital, Aba). In the study, 360 women who were attending the family and antenatal clinics were selected. Also, those with gynaecological problems, obvious symptoms of lower genital tract infections and those who visited the hospital for "well women examination" were included in the study population. High vaginal swabs collected from these women were examined microscopically by wet mount preparations and bacteriologically by cultures. Results: Out of 360 women screened for Trichomonas vaginalis through wet mount preparation, and other organisms by culture, 40 (11.1%) werepositive for Trichomonas vaginalis, 6(1.7%), 48(13.3%) and 140(38.9%) were positive for Neisseria gonorrhoeae , Gadnerella vaginalis , and Candida albicans respectively. The difference in age specific distribution of Trichomoniasis was statistically significant using the chi-square (P&lt;0.01). Conclusion: The finding of co-infections of T. vaginalis with G. vaginalis (0.6%), N. gonorrhoeae (0.6%), and C. albicans (2.8%) in this study suggests its role in predisposing the carriers to other serious sexually transmitted infections, including HIV infection. There is therefore the need for routine examination of sexually active women for the screening of Trichomonas vaginalis in order to effect increased control efforts. Also, the isolation of T. vaginalis in the genital secretions should lead to a search for other sexually transmitted organisms.Fond : Trichomonase est un probl\ue8me clinique commun. Beaucoup de jeunes femmes \ue0 Aba se livrent aux comportements sexuels \ue0 haut risque. Un grand nombre de ces jeunes femmes sont des illettr\ue9s, et sont dans l'habitude d'une utilit\ue9 aveugle des agents antibact\ue9riens aux plus l\ue9gers sympt\uf4mes d'une infection g\ue9nitale inf\ue9rieure. L'\ue9valuation des agents bact\ue9riens associ\ue9s aux infections g\ue9nitales inf\ue9rieures a donc rencontr\ue9 beaucoup de frustration. Le diagnostic de Trichomonase de g\ue9nitale inf\ue9rieure est simple et son criblage courant parmi des femmes s'occupant des cliniques servirait d'indicateur aux infections sexuellement transmissibles s\ue9rieuses \ue0 Aba. M\ue9thodes: Cette \ue9tude a \ue9t\ue9 entreprise parmi des femmes s'occupant d'un h\uf4pital de femmes \ue0 Aba, dand l'\ue9tat d'Abia auNig\ue9ria (H\uf4pital Princesse Mary, Aba). Dans l'\ue9tude, 360 femmes qui s'occupent les cliniques familiales et pr\ue9natales ont \ue9t\ue9 choisies. En outre, ceux avec les probl\ue8mes gyn\ue9cologiques, les sympt\uf4mes \ue9vidents des infections g\ue9nitales inf\ue9rieures et ceux qui ont visit\ue9 l'h\uf4pital pour "l'examen de femmes en bonne sant\ue9" ont \ue9t\ue9 inclus dans la population d'\ue9tude. Les hauts pr\ue9l\ue8vements vaginaux rassembl\ue9s de ces femmes ont \ue9t\ue9 examin\ue9es au microscope par les pr\ue9parations humides de b\ue2ti et bact\ue9riologiquement par des cultures. R\ue9sultat: Sur 360 femmes interview\ue9es pour des vaginalis de Trichomonas par la pr\ue9paration humide de b\ue2ti, et d'autres organismes par la culture, 40 (11,1%) \ue9taient positifs pour des vaginalis de Trichomonas, 6(1,7%), 48(13,3%) et 140(38,9%) \ue9taient positifs pour des gonorrh\ue9es de Neisseria, des vaginalis de Gadnerella, et des albicans de candida respectivement. La diff\ue9rence de la distribution sp\ue9cifique d'\ue2ge de Trichomoniasis \ue9tait statistiquement significative en utilisant la chi-carr\ue9 ((P&lt;0.01). Conclusion: la constatation des Co-infections des vaginalis de Trichomonase avec des vaginalis de G. (0.6%), des gonorrh\ue9es de N. (0,6%), et des albicans de C. (2,8%) dans cette \ue9tude sugg\ue8re son r\uf4le dans la pr\ue9disposition des porteurs d'autres infections sexuellement transmissibles s\ue9rieuses, y compris l'infection de VIH. Il y donc le besoin d'examen courant des femmes sexuellement actives pour le criblage des vaginalis de Trichomonase afin d'effectuer des efforts accrus de commande. En outre, l'isolement de .vaginalis de T dans les s\ue9cr\ue9tions g\ue9nitales devrait mener \ue0 une recherche d'autres organismes sexuellement transmissibles

Pelvic inflammatory disease

No Abstract.ABSUMSAJ Vol. 2 (1) 2000: pp. 6-

Is misoprostol a suitable alternative to the surgical evacuation of incomplete abortion in rural South-Eastern Nigeria?

Background: Research has demonstrated the effectiveness of misoprostol for treatment of incomplete abortion. However, few studies have focused on the feasibility of treating incomplete abortion with misoprostol at the rural clinic level in sub-Saharan Africa.Objective: To determine the effectiveness, safety and acceptability of misoprostol as an alternative to the surgical treatment of incomplete abortion at a rural clinic.Design: Open-label randomised controlled trial.Setting: A private clinic in Ekeakpara community, Osisioma Ngwa Local Government Area, Abia State, Nigeria.Subjects: Women of reproductive age presenting with incomplete abortion.Results: Regardless of treatment allocation, nearly all women had a complete uterine evacuation with either oral misoprostol or manual vacuum aspiration (misoprostol: 98.8%, MVA: 100%, P = 0.99). Misoprostol users were more likely to report that they were ‘very satisfied’ with the method (75.6% versus 45%, P&lt;0.001). In the 72 hours after treatment, women using misoprostol reported heavier bleeding but lower levels of pain than those treated with manual vacuum aspiration. Women in the misoprostolgroup were more likely to choose that treatment again (96.9 versus 55.6%; P&lt;0.001) and would recommend it to a friend.Conclusion: For treatment of first-trimester uncomplicated incomplete abortion at a rural facility, both MVA and 600 ìg oral misoprostol are safe, effective, and acceptable treatments. Depending on availability of each method and the desires of individual women, either option may be  presented to women for the treatment of incomplete abortion

Socio economic implication of septic abortion in Aba

No Abstract.JOMIP Vol. 5 2004: pp. 16-1