Delayed interval delivery in twin pregnancy without cerclage: Case Report

This report describes a patient-counselling approach and non-surgical management of a dichorionic, diamniotic twin pregnancy where the delivery of the second twin followed the delivery of the first by 59 days. An initial ultrasound scan at twenty and a half weeks gestational age suggested cervical dilatation with protruding amniotic membrane of a dead first twin, and a viable second twin. She aborted the dead fetus at 21 weeks’ gestation and delivered a healthy female infant weighing 1300g at twenty nine and a half weeks gestation. After the loss of the first foetus, delayed delivery in multiple pregnancies can be successful in selected cases as exemplified by the case presentation. In well prepared perinatal centers, with physically and psychologically balanced patients who are well informed about the risks and benefits of the procedure, delayed interval delivery in twin pregnancy without cerclage may be a reasonable strategy

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 (

Sensitivity of Capital Market Development to Public Debt in Nigeria

This article investigated the sensitivity of capital market development to public debt in Nigeria using descriptive statistic, regression analysis, and the Engle-Granger co integration techniques for the period ranging from 1981 to 2014. The estimates from the descriptive analysis showed that both the market capitalization and public debt series were not normally distributed at 5% significance level. The ADF unit root test showed that the market capitalization and public debt series were integrated of order one (i.e., I (1)). The results from the regression model provide evidence to show that capital market development is not sensitive to domestic debt at any conventional level, but it is sensitive to external debt at 10% significance level. The estimates of the Engle-Granger co integration tests show that capital market development is not co integrated with public debt. It is recommended that capital market and debt management authorities should formulate policies will enhance linkage between the markets

Contraceptive choices of women in rural southeastern Nigeria

No Abstract

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

Awareness and perception of vasectomy among antenatal women in a tertiary health facility in southeast Nigeria

Background: Vasectomy is a safe alternative to bilateral tubal ligation (BTL) in achieving permanent sterilization but not popular in developing countries. As part of the efforts to increase popularity as well as acceptance of vasectomy in the developing countries, its awareness among women needs to be assessed. The study was undertaken to determine the awareness and perceptions of vasectomy among antenatal attendees in a tertiary health institution southeast Nigeria.Methods: This was a questionnaire-based cross-sectional study in which pregnant women visiting University of Nigeria Teaching Hospital, Enugu (UNTH) antenatal clinic from 1st June – 30th November 2017 were recruited. Data was collected using structured questionnaire. Two hundred (200) self-administered questionnaires were completely filled and analyzed by means of descriptive and inferential statistics including means frequencies and x^2-tests at the 95% confidence level (CL).Results: Of the 200 respondents, 146(73%) were completely unaware of the existence of vasectomy while 54(27%) were aware. Of those who were aware, 41(75.9%) accepted its use as a family planning method for men. The commonest reason for acceptance was the fear of infidelity among their husbands, 17(41.5%). The intention to use was however low as 24(44.4%) of those who accepted vasectomy disapproved of its use by their husbands and the main reason for disapproval was “weakens husband’s sexual performance,” (33.3%). Tertiary level of education of the respondents was 5.3 times independently associated with the acceptance of vasectomy.Conclusions: The awareness is low and there are several misperceptions about vasectomy among the women in Enugu. Tertiary education of the women however improves the choice of vasectomy as a permanent contraceptive option. There is the need for educational programmes in line with the numerous advantages of vasectomy so as to counteract the misperceptions especially those regarding sexual relationship

Maternal and neonatal factors associated with mode of delivery under a universal newborn hearing screening programme in Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>Emerging evidence from a recent pilot universal newborn hearing screening (UNHS) programme suggests that the burden of obstetric complications associated with mode of delivery is not limited to maternal and perinatal mortality but may also include outcomes that undermine optimal early childhood development of the surviving newborns. However, the potential pathways for this association have not been reported particularly in the context of a resource-poor setting. This study therefore set out to establish the pattern of delivery and the associated neonatal outcomes under a UNHS programme.</p> <p>Methods</p> <p>A cross-sectional study in which all consenting mothers who delivered in an inner-city tertiary maternity hospital in Lagos, Nigeria from May 2005 to December 2007 were enrolled during the UNHS programme. Socio-demographic, obstetric and neonatal factors independently associated with vaginal, elective and emergency caesarean deliveries were determined using multinomial logistic regression analyses.</p> <p>Results</p> <p>Of the 4615 mothers enrolled, 2584 (56.0%) deliveries were vaginal, 1590 (34.4%) emergency caesarean and 441 (9.6%) elective caesarean section. Maternal age, parity, social class and all obstetric factors including lack of antenatal care, maternal HIV and multiple gestations were associated with increased risk of emergency caesarean delivery compared with vaginal delivery. Only parity, lack of antenatal care and prolonged/obstructed labour were associated with increased risk of emergency compared with elective caesarean delivery. Infants delivered by vaginal method or by emergency caesarean section were more likely to be associated with the risk of sensorineural hearing loss but less likely to be associated with hyperbilirubinaemia compared with infants delivered by elective caesarean section. Emergency caesarean delivery was also associated with male gender, low five-minute Apgar scores and admission into special care baby unit compared with vaginal or elective caesarean delivery.</p> <p>Conclusions</p> <p>The vast majority of caesarean delivery in this population occur as emergencies and are associated with socio-demographic factors as well as several obstetric complications. Mode of delivery is also associated with the risk of sensorineural hearing loss and other adverse birth outcomes that lie on the causal pathways for potential developmental deficits.</p

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

Postpartum maternal morbidity and mortality associated with retained placenta in South Eastern Nigeria

Objective: To determine the incidence and complications of retained placenta in Aba, Southeastern Nigeria.Methodology: An observational cohort study that included all women with retained placenta after a vaginal delivery and managed at the Abia State University Teaching Hospital between 1st January 2005 and 31st December 2011.Results: There were 102 cases of retained placenta and 5840 deliveries giving an incidence of retained placenta of 1.7%. The vast majority (81/102) were unbooked. Primary postpartum haemorrhage occurred in 40% of the women. There was a case fatality rate of 4%.Conclusion: Retained placenta is a cause of postpartum maternal morbidity and mortality in Aba, south-eastern Nigeria. There is therefore a need to train birth attendants in the appropriate management of delivery and third stage of labour to prevent retained placenta and postpartum haemorrhage.Keywords: Retained placenta, Maternal morbidity and mortalit