Human immunodeficiency virus prevalence in an unbooked obstetric population in the Niger Delta

Despite recent advances in the prevention of transmission of human immunodeficiency virus (HIV) infection from mother to child during pregnancy, infants continue to be born and infected with HIV, particularly in Africa. This study was undertaken to determine the seroprevalence of HIV infection among unbooked pregnant women in the Niger Delta of Nigeria. One hundred and eighteen consecutively recruited unbooked subjects presenting to the isolation ward at the University of Port Harcourt Teaching Hospital were screened for HIV. Among the 118 subjects studied, 30 (25.4%) were positive for HIV. HIV-1 was the predominant viral strain. Gestational age of subjects at presentation was 28–40 weeks and mean age was 35.04 ± 8.06 years. The majority of subjects were primigravidas 66 (55.9%), while 52 (44.1%) were multigravidas. The prevalence of HIV was significantly higher among unbooked pregnant women with less formal education: 14 (11.9%) compared with 9 (7.6%), 5 (4.2%), and 2 (1.7%) for those with primary, secondary, and tertiary education, respectively (P = 0.01). Among the occupational groups, the prevalence of HIV was significantly higher among traders 14 (11.9%) than in career women 5 (4.2%, P = 0.04). Multigravid women were more susceptible to HIV infection 17 (14.4%) than primigravid women. Perinatal mortality and emergency cesarean section was high among unbooked pregnant women. The prevalence of HIV observed amongst unbooked antenatal subjects in this study is significantly higher than those of booked patients in previous studies. These findings are very pertinent to health care delivery, because this pool of unbooked patients may not be benefiting from the Prevention of Maternal to Child Transmission program, thus increasing the pediatric HIV burden in our environment

The Indication for Cervical Cerclage and Pregnancy Outcome in a Teritiary Hospital in South-South Nigeria: A Five Year Review

Background: Cervical incompetence is a major cause of second trimester miscarriage. Recurrent pregnancy loss in the second trimester is associated with significant distress. However, there should be a justifiable indication before a cerclage is inserted. There is no documentation of the indication of cervical cerclage and pregnancy outcome in Yenagoa, southsouth Nigeria. Objectives: This paper focuses on documenting the indication and obstetric outcome following cervical cerclage insertion at the Federal Medical Center Yenagoa, Bayelsa State. Methodology: A 5 year retrospective study was carried out in women who had cervical cerclage for cervical incompetence in the Federal Medical Centre, Yenagoa. The study was conducted from the 1 st of January 2014 to 31st of December 2018. All the case files of patients who had cervical cerclage were retrieved and reviewed. Results: A total of 41 patients had cervical cerclage. The commonest indication for cervical cerclage insertion was history indicated cerclage 59.4%. This was followed by ultrasound indicated cerclage 28.1% and rescue cerclage accounting for 12.5%. All patients employed McDonald’s method of cervical cerclage. The position of the knot wasin 12 0’ clock position in 53.1% of the patients and in the 6 0’clock position for 46.9% of the patients. The success rate following insertion of cerclage was 79.3%. The mode of deliveries was vaginal in 90.6% of the patients and 9.4% had caesarean section. Conclusion: There may be concern about the diagnosis of cervical incompetence. However, findings from this study clearly showed that the application of cervical cerclage is associated with good obstetric outcome

Perception about COVID-19 vaccine among patients at the federal medical centre, Yenagoa, South-South Nigeria

Background: The severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) is the causative organism of the coronavirus disease 2019 (COVID-19), which is a respiratory disease that was first identified in December, 2019 in Wuhan, China. Objective was to determine the perception of the COVID-19 among patients at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.Methods: This study was carried out at the Federal Medical Centre, Yenagoa between 4th January and 15th February, 2021. It was a descriptive cross-sectional study. The study population consisted of 1,000 consecutive patients that presented to the various out-patients departments of the hospital. Written informed consent was obtained. The data were collected with a predesigned questionnaire, and were analysed using statistical software (SPSS for windows® version 23, SPSS Inc.; Chicago, USA).Results: Out of 1,000 participants, only a quarter of the participants (24.6%) indicated willingness to take the COVID-19 vaccine when available in Nigeria. About one-tenth of the participants have had loss of sense of taste and smell (11.7%), and think they possibly may have been infected with the COVID-19 (10.8%) in the recent past. Among those that were unwilling to take the COVID-19 vaccine, 14.2%, 9.0% and 7.5% thought that hydroxychloroquine, azithromycin and septrin respectively, are safe alternatives to the vaccine.Conclusions: Although it is known that hypothetical choices may not always reflect real life decision, it is important for policy makers and stakeholders to pay more attention on health education and campaign, targeted at addressing the misconception about COVID-19 vaccine

Serum uric acid: a biochemical prognostic indicator of pregnancy outcomes among pre-eclampsia patients at the federal medical centre, Yenagoa

Background: High levels of uric acid concentration over normal pregnant values have been reported previously in established preeclampsia, hence it was suggested to be a useful biochemical prognostic marker of the disease.Methods: This is a hospital based prospective case control study where 100 patients with preeclampsia were recruited consecutively as they were admitted. 100 non-pre-eclamptics were also recruited as control. The foetomaternal data, adverse perinatal outcomes, maternal serum uric acid levels as well as complications of preeclampsia were recorded into the protocol. Statistical analysis was done using SPSS 22.0. Level of significance was set at p<0.05.Results: The mean age in the study group was 28±6.7 years while in the control group it was 31±6.5 years. The difference in age was not statistically significant (p=0.53). The mean serum uric acid level was significantly higher amongst participants with preeclampsia than in those without preeclampsia (405.6±995 µmol/L versus 232.7±26.3 µmol/L, p=0.00). Uric acid was statistically associated with the occurrence of eclampsia (p=0.03), Severe hypertension (0.03) and birth asphyxia (p=0.01).Conclusions: The mean serum uric acid was higher in preeclampsia than non-preeclampsia patients. High levels of uric acid were found in eclampsia, severe hypertension and birth asphyxia. However, the prognostic accuracy for uric acid was low for most pregnancy outcomes

The use of NAAT- PCR to determine asymptomatic chlamydia and gonorrhoea infections in infertile patients undergoing hysterosalpingogram at the federal medical centre, Yenagoa, South-South Nigeria

Background: The roles of Chlamydia trachomatis and Neisseria gonorrhoeae in the aetiology of infertility due to tubal occlusion have been established by various studies. These organisms may lead to pelvic infection by ascending into the upper genital tract through any instrumentation like hysterosalpingography. The objectives were to determine the prevalence of asymptomatic chlamydial and gonorrhoeal infections of the genital tract among women being investigated for infertility referred for hysterosalpingography; the relationship of these infections with tubal pathologies; and if routine endo-cervical screening and prophylactic antibiotics be recommended for these patients.Methods: This was a descriptive cross-sectional study. The study population consisted of consecutive 220 infertile women that met the inclusion criteria for this study. Consent was obtained. Endo-cervical swab was taken for NAAT-PCR for Chlamydia trachomatis and Neisseria gonorrhoeae. Hysterosalpingography was carried out. Data was analyzed using SPSS (version 22).Results: Amongst the 220 women, 9 (4.1%) had asymptomatic chlamydia infection. None had gonorrhoea infection and 211 (95.9%) had none of these two organisms. Forty-eight (21.9%) of the 220 women had bilateral tubal blockage and 9 (18.8%) out of these 48 women had asymptomatic infection with Chlamydia trachomatis.Conclusions: There is a statistically significant association between tubal blockage and chlamydia infection (p = 0.00) [RR 4.31 (3.37-5.50)]. There was no evidence to recommend routine screening/antibiotics considering the low prevalence of microbes and the absence of post-HSG pelvic infection. Results from a multicenter randomized controlled trial will be more representative

Hypertensive disorders in pregnancy at the Federal Medical Centre, Yenagoa, South-South Nigeria: a 5-year review

Background: Hypertensive disorders complicate 5.2%-8.2% of pregnancies, and contribute significantly to perinatal and maternal morbidity and mortality worldwide. The objective of this study is to determine the incidence, clinical characteristics, maternal and perinatal outcomes of hypertensive disorders in pregnancy at the Federal Medical Centre, Yenagoa, Bayelsa State, South-South Nigeria.Methods: This retrospective study was conducted between 1 January, 2016 and 31 December, 2020. Relevant data was retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0.Results: Out of the 4,571 obstetric patients that were managed in our Centre in the period under review, 335 of them had HDP, giving an incidence rate of 7.32%. The most common HDP were pre-eclampsia (189, 56.4%) and eclampsia (82, 24.5%), while the least common was chronic hypertension (3, 0.9%). A little more than one-half (171, 51.0%) of the women delivered preterm, with a mean gestational age at delivery of 35.5 weeks. The most common route of delivery was emergency Caesarean section (205, 61.2%). There were three maternal deaths, giving a case fatality rate of 0.9%. Two of the maternal deaths were due to eclampsia, and one, from pre-eclampsia.Conclusions: Women should be adequately counseled to embrace preconception care, early booking and regular antenatal care visits, with proper monitoring of blood pressure and urine protein. Prompt diagnosis and management are key in preventing the maternal and perinatal morbidity and mortality that are associated with these disorders

Comparative evaluation of serum magnesium level in pre-eclamptic and non pre-eclamptic women in a tertiary hospital in southern Nigeria

Background: Magnesium is a micronutrient found in the human body whose major function is to maintain nerve and muscle function. Magnesium sulphate has been used over time as a prophylactic drug in pre-eclamptic women. There is paucity of studies on the role of serum magnesium level in preeclampsia in South-South Nigeria.Objective: The main objective of this study was to determine the serum levels of magnesium in cohorts of pre-eclamptic and non pre-eclamptic patients in a tertiary hospital in South-South Nigeria.Methodology: This was a comparative study in which 104 women who satisfied the eligibility criteria were enrolled for the study (52 pre-eclamptic and 52 non- pre-eclamptic women). Data analysis was done using statistical software (IBM SPSS® for windows version 21.0.) Data was analyzed for mean and standard deviation. Comparison of serum levels of magnesium between the two groups was performed by student t-test and P value &lt; 0.05 was considered as statistically significant.Results: The study showed that the serum magnesium level was not statistically different between the pre-eclamptic and non-pre-eclamptic women (1.79±0.24mg/dl vs. 1.88±0.37mg/dl respectively, p = 0.10). There was no correlation between serum magnesium level and the systolic and diastolic blood pressures in either group.Conclusion: This study showed that women with preeclampsia did not demonstrate reduced serum magnesium level. This support the hypothesis that hypomagnesaemia is not a possible aetiology of preeclampsia.Keywords: Pregnancy, Micronutrients, Hypertension, Primigravid