Obstetric Outcome in Grandmultiparous Women in Jos University Teaching Hospital

Background: The grandmultipara is traditionally regarded in Obstetrics as a high risk in pregnancy. However, some authors believe that if matched for age and socioeconomic status in a setting of satisfactory health care conditions, grandmultiparity should not be considered dangerous. This study determined the maternal morbidity and mortality and perinatal outcomes associated with grandmultiparity among women who came to deliver in Jos University Teaching Hospital.Method: This hospital based prospective case control study was carried out between June 2008 and January 2009 in the labour ward of the maternity unit of Jos University Teaching Hospital among 250 consecutive grandmultiparous women and another 250 consecutive women of parity 2 to 4 who were matched for age and socioeconomic status.Result: The 250 grandmultiparous women and their matched multiparous group had an average age of 32.9 ± 4.6 years. Grandmultiparous women were significantly more likely to develop hypertensive disease in pregnancy, have malpresentaion and develop postpartum haemorrhage. Their fetuses were significantly more likely to have fetal distress in labour, to be low birth weight babies and be admitted to the special care baby unit (SCBU).Conclusion: In the developing countries where the health care delivery system is still facing a lot of challenges, the grandmultipara should still be considered a high risk in pregnancy

How much do antenatal care attendees in a tertiary hospital in Jos, north central Nigeria know about gestational diabetes?

Background-The increasing prevalence of GDM has attracted global concern. The associated hyperglycaemia is a source of perinatal morbidity and mortality. Knowledge of GDM is known to prevent complications to mother and baby through adoption of life style modification behaviour and good health seeking behaviour.Methodology- It was a cross sectional study conducted over a 3 month period. Women were recruited into the study from the antenatal clinic. A structured questionnaire was used to extract information from the respondents. Data was analyzed with EPI INFO 3.5.4 CDC Atlanta, USA.Results- The response rate was 96.2%. The mean age of the respondents was 29±6 years. Only 2% had no formal education while 46.6% had tertiary education. Most of the women (55.3%) were unemployed and 53.0% of the women were multiparous. The respondents generally have a good knowledge of GDM with an average score of 9±3. The awareness on GDM and its risk factors and awareness on screening and treatment were good. Only 41.5% of the women knew GDM resolves after pregnancy. Knowledge on the other  consequences of GDM was good. Health professionals and friends and family served as source of information on GDM in 80.9 and 60.1% of the women respectively.Conclusion- the knowledge of antenatal women in our centre is good. Continuous training of health workers and women empowerment are strategies that can maintain and improve this knowledge. Key words: Gestational diabetes, Antenatal care attendees, Knowledg

Alleviation of maternal mortality and morbidity in the new millennium: Time for change? - The First John Bateman Lawson Memorial Oration

(Tropical Journal of Obstetrics and Gynaecology, 2001, 18(1): 43-46

In-Vitro Fertilization: Awareness and perception among infertile women at the Jos University Teaching Hospital

Background: The prevalence of infertility is high in the developing world, sub-Saharan Africa inclusive with its attendant medical and social consequences. Tubal factor and male factor are responsible for the majority of cases of infertility in this environment. In-Vitro fertilization (IVF) is the treatment of choice for these cases. Though the services are available in some parts of the country including Jos, the uptake appears to be low. We sought to assess the awareness and willingness to accept IVF services among infertile women inJos University Teaching Hospital. Method: A cross-sectional descriptive study involving 149 patients from the Gynaecological clinic of the Jos University Teaching Hospital was carried out. Data were obtained using a pretested questionnaire and analyzed using SPSS version 21.0. Results: The mean age of the respondents was 30+6 years. Only 45.6% had heard about IVF. The information they had on IVF was inaccurate in 52.9% of respondents. The majority (77.9%) of the respondents had no idea of the success rate of IVF but believed the process guaranteed pregnancy. Most respondents (74.5%) preferred to have multiple pregnancies if given a choice, however, the majority (72.7%) were unaware of the complications associated with multiple pregnancies. Conclusion: Efforts to improve the awareness about IVF should be adopted to increase the uptake of the IVF services. Keywords: IVF, awareness of IVF, infertility, Nigeri

A 10-year audit of gynaecological surgeries performed in the paediatric age group at the Jos University Teaching Hospital

Background: Surgeries performed for gynaecological conditions in children and adolescents are not common in our environment. Adequate facilities and the skill to perform the required procedures may also be lacking. We were interested in reviewing the practice of paediatric gynaecological surgery in our facility. Patients and Methods: A retrospective study of case files and theatre records of children below the age of 16 years who had surgeries at the Jos University Teaching Hospital over a 10 year period was undertaken. Results: A total of 89 surgeries were performed in this age group during the period under review. Twenty-eight (33.4%) of the patients were below the age of 11. The most common surgical procedure was for the management of septic abortion (21.3%). Correction of congenital malformations of the genital tract accounted for 21.4% (19) of the surgeries performed. Fourteen (15.7%) laparotomies were performed for ovarian cysts. Conclusion: Though the number of surgeries performed on children for gynaecologic reasons may appear small, the skills required to manage them should be enhanced and the requisite facilities provided

A Review of hysteroscopy in a private hospital in Jos, Nigeria

Background: Examination of the uterine cavity is an imperative gynaecology for the detection and treatment of intrauterine abnormalities. Hysteroscopy is considered to be the gold standard for this purpose Identification and subsequent treatment of intrauterine leisons may improve pregnancy rates in Invitro fertilization(IVF).Methods: Medical records of patients who had hysteroscopy between May 2016 and April 2017 at Kauna Specialist Hospital were analysed. Indications for hysteroscopy, findings and complications were noted.Results: A total of 82 hysteroscopies were performed during the period under review. The commonest indication was preparation for IVF in infertile patients (58.1%). Other indications included infertility (27.2%), menorrhagia (9.9%) and hypomenorrhoea (2.4%). Intrauterine abnormalities were detected in 59.3% Patients. Intrauterine adhesions were found in 30.9% of the patients . Endometrial polyps (13.7%), fibroids(4.9%) and irregular endometrial lining(4.9%) were also observed. A large proportion (42.7%) of patients who had recurrent IVF failure had intrauterine abnormalities.Conclusion: Hysteroscopy is an invaluable tool in the detection and treatment of intrauterine leisons. Its wider use is advocated in gynaecological practice in Nigeria.Key words: Hysteroscopy; Infertility; In Vitro fertilization, intrauterine abnormalitie

Factors influencing utilisation of delivery services at the Jos University Teaching Hospital (Juth), Jos

Background: A preliminary unpublished review of two-year antenatal and labour ward records revealed that of the 4537 women seen at the antenatal clinic of Jos University Teaching Hospital (JUTH) per year, 2318 (51.1%) delivered in the labour ward per year. There is thus a gap between antenatal clinic attendance and hospital delivery in JUTH. Objectives: To determine the choice of place and its determinants for delivery among women attending antenatal clinic in JUTH. Study design: A cross-sectional design was used to study the proportion of pregnant women who booked for antenatal care in JUTH and delivered of the index pregnancy in the same institution. Results: A total of 347 women were recruited. The women′s place of delivery included JUTH (33.1%), home (31.1%), private health institutions (13.5%), primary health care centers (10.1%), other public hospitals (5.8%) and nursing homes (6.3%). Lack of privacy (22.4%) and long waiting-time (20.2%) were the main reason for non-utilization of the delivery services in JUTH. The other reasons included far distance (17.7%) and family members′ preference (11.6%). The utilisation of delivery services in JUTH was influenced by women′s education (p < 0.05) and first trimester booking in the index pregnancy (p < 0.05). Conclusion: Many women who booked for ANC in JUTH delivered by choice outside the institution. We recommend that pregnant women be given health education on the benefits of hospital delivery, particularly, in institutions where their antenatal history is known. This will ultimately reduce maternal morbidity and mortality

Awareness of antimullerian hormone assay and its relevance in in-vitro fertilization among laboratory scientists

Background: infertility is a challenging medical disorder affecting 1 in every 6 couples. In-Vitro fertilization(IVF) offers hope for couples to actualize their dreams of procreation. Success with IVF is determined by several factors including ovarian reserve which can be determined by measuring serum levels of Antimullerian hormone (AMH).We evaluated the level of awareness of laboratory personnel on AMH and IVF in our environment.Methods: A self-administered questionnaire was administered to laboratory scientists at an annual conference of laboratory scientists.Result: A total of 174 questionnaires to 87 males and 87 females. Most of the participants were classified as senior staff (44.8%) while 8.6% were administrators/ directors. Our study revealed that 80.5% of the respondents had never heard of AMH although 70.1% had knowledge of IVF. The least commonly requested laboratory test for infertility evaluation was AMH (9.1%) while semen analysis was the commonest test (28.7%). Most respondents were of the opinion (98%) that both male and females should be evaluated when managing infertile couples.Conclusion: The awareness of AMH and its use in evaluating infertile patients is low among scientists in our environment. The educational system should be involved in revising curriculums especially in areas of current methods for successful IVF treatment.Key words: Antimullerian hormone, In Vitro Fertilization, Infertility, Laboratory scientis