Perinatal Mortality Among Twins In Lagos University Teaching Hospital : Associated Risk Factors

Background: Perinatal mortality rate is reported to be higher in twins than in singletons. More than two decades ago, Abudu and Agarin reported a twinning rate of 21.1/1000 maternities and perinatal mortality rate of 142.6/1000 among twins in Lagos. Objective: To determine the current perinatal mortality rate and risk factors that influence perinatal mortality among twins in Lagos University Teaching Hospital, Nigeria. Materials and Methods: Babies weighing >1000grammes delivered by twin pregnancy between January 1996 and December 2000 in Lagos University Teaching Hospital were retrospectively studied. Routinely collected data from nurses and doctors registers in the departments of Obstetrics and Paediatrics on all twin deliveries was analysed. Results: Out of 5,947 deliveries, there were158 set of twins' giving a twinning rate of 26.6/1000 for the institution. Fifteen of the babies weighed 1000g died perinatally giving a perinatal mortality rate of 89.7/1000. The significant risk factors for perinatal mortality identified in twins were lack of antenatal care (P=0.005), low gestational age and premature delivery (

X-linked Hydrocephalus (Bickers-Adams Syndrome) in a Nigerian Family

A male infant with isolated prenatal hydrocephalus whose clinical features and family history were consistent with the diagnosis of X-linked hydrocephalus (Bickers-Adams syndrome) is described. Clinical, serological and radiological evidence for other causes of congenital hydrocephalus were lacking in the infant. Since the identification of an x-linked hydrocephalus has important consequences for genetic counselling, analysis of the family history of any male infant with isolated hydrocephalus is very important. Nigerian Journal of Paediatrics 2001; 28:78. pp. 78-8

Maternal socio-biological factors associated with low birth weight in Lagos, Nigeria

No abstract Nigerian Quarterly Journal of Hospital Medicine Vol. 13(1-2): 32-3

Perinatal Mortality at the Close of the 20th Century in Lagos University Teaching Hospital

Objective: To determine the perinatal mortality rate in Lagos University Teaching Hospital at the close of the 20th century. Materials and Methods: Routinely collected data from the Departments of Obstetrics & Gynaecology and Paediatrics from January 1996 to December 2000, were analysed. The data included total deliveries, stillbirths and early neonatal deaths. Results: A total of 6,759 deliveries, including 163 multiple pregnancies, occurred during the period. There were 573 perinatal deaths comprising 471(69.7/1000) stillbirths and 102(16.2/1000) early neonatal deaths. Autopsy was performed on 115 of the 573 deaths resulting in a perinatal autopsy rate of 20.1 percent. The overall perinatal mortality rate was 84.8/1000 while the perinatal mortality rate for singletons was 83/1000. Analysis of the deaths by the Wigglesworth classification showed that 46.6 percent of the deaths were normally formed macerated stillbirths, 38.7 percent were due to asphyxial conditions and 8.9 percent were attributed to conditions associated with immaturity. Lethal congenital malformations accounted for 3.7 percent while other specific conditions were responsible for 2.1 percent of the deaths. Conclusion: These rates are still very high and strategies to decrease perinatal mortality will need to focus on antenatal and intrapartum obstetric care. All those involved in obstetric and neonatal care require regular education on the need for prompt identification of problems, early referral and prompt intervention. Key words: Perinatal mortality, antenatal and intrapartum obstetric care. Nigerian Journal of Paediatrics Vol.31(1) 2004: 14-1

Guidelines for the management of HIV/AIDS in infants and older children in Lagos University Teaching Hospital

No abstract Nigerian Quarterly Journal of Hospital Medicine Vol. 13(1-2): 8-1

Prevalence of Skin Diseases in Children with Human Immunodeficiency Syndrome Infection in Paediatric HIV Clinic of A Tertiary Hospital in Nigeria.

Background: HIV infection/AIDS being a multi-systemic disease affects the skin at various stages in course of the illness. A knowledge of the common skin diseases associated with HIV infection can lead to early detection, appropriate staging and commencement of appropriate care in the infected patients.Objective: The study was to document the prevalence and pattern of skin diseases in children with HIV infection seen at the Paediatric department of a tertiary centre in Nigeria.Methods: HIV positive children attending the PEPFAR HIV clinic of Lagos University Teaching Hospital, Nigeria were examined for the presence of skin lesions. Anthropometric measurements were also obtained. Blood samples were taken for CD4+ cell count, viral load and full blood count.Results: Two hundred and fourteen (214) patients were studied, consisting of 107 HIV infected children and 107 uninfected children as controls. Skin lesions were observed in 89 (83%) of the HIV infected patients, while only 72 uninfected controls had skin lesions. (p = 0.035). The predominant skin disease in the HIV infected children was Pruritic papular eruption (PPE) with a frequency of 25.9%, followed by fungal infections (24.6%). Herpes zoster was found only in HIV infected children (p = 0.041). There was a strong correlation between the degree of immunosuppression (as reflected by the value of age dependent CD4+ cell count/CD4+ percentage) and the prevalence of skin disease in the HIV infected patients. The presence of pruritic papular eruptions and Herpes zoster was associated with advanced immunosuppression.Conclusion: Skin diseases are common in HIV infection in our environment. Early detection of HIV infection can be made in the presence of skin diseases like Pruritic papular eruption and Herpes zoster.Keywords: HIV, kin diseases, prevalence, children, Nigeri

Perinatal outcome of obvious congenital malformation as seen at the Lagos University Teaching Hospital, Nigeria.

A retrospective review of major congenital malformations in 353 newborns delivered at the Lagos University Teaching Hospital during a 10-year period, (1981-1990) has revealed an overall incidence of 15.8 per 1000 total births, while the contribution of such malformations to perinatal mortality was 11.9 per cent. Gastrointestinal, central nervous and musculo-skeletal system malformations were the commonest seen with individual incidences of 3.9, 3.5 and 2.1 per 1000 total births, respectively. Unclassified congenital malformations had the highest case fatality while central nervous system malformations constituted the commonest cause of death among the malformed neonates. The pattern and incidence of congenital malformations at the hospital would appear to have remained substantially unchanged in the last three decades. Nigerian Journal of Paediatrics 2001; 28: 73. pp. 73-7