Intraocular Pressure in Pregnant and Non-Pregnant Nigerian Women

A number of hormones are known to affect intraocular pressure. Of these, the female sex hormones are the predominant ones to cause variations in intraocular pressure. The aim of this study was to determine if variation in sex hormones in pregnancy affects intraocular pressure. This study was a longitudinal one. 117 pregnant women aged 20 to 35 years in their first trimester of pregnancy were followed longitudinally throughout the course of pregnancy, and six weeks post partum. One hundred non pregnant women with a regular menstrual cycle of 26-29 days were also recruited and examined for changes in intraocular pressure. Intraocular pressure was measured with the handheld Kowa applanation tonometer. Mean Intraocular Pressure (MIOP) was 14.7 ± 2.2 mmHg, 13.2 ± 2.0 mmHg and 11.0 ± 1.3 mmHg in the three trimesters respectively. There was thus a fall in Intraocular Pressure during pregnancy and this was highly statistically significant (P<0.0001). At 6 weeks postpartum MIOP increased to 14.2 ± 1.8 mmHg. The difference between the mean values of Intraocular Pressure in the third trimester and 6 weeks postpartum was also statistically significant P<0.0001. Intraocular pressure decreased as pregnancy advanced. Postpartum, there was increase in intraocular pressure to near pre pregnant level. The difference in mean IOP between the pregnant and non pregnant women was statistically significant (P<0.05)

Ocular changes in pregnant Nigerian women

Objective: Pregnancy results in a lot of hormonal changes in the body and the eyes are no exception. These ocular changes could be physiologic, pathologic or a modification of a pre-existing condition. The aim of this study was to determine physiologic ocular changes that are associated with pregnancy in healthy Nigerian women.Materials and Methods: A total of 100 women were followed longitudinally through out the course of their pregnancy and 6 weeks postpartum. The women were recruited at 8 weeks of pregnancy at the anti-natal clinic in the Department of Obstetrics and Gynecology, University of Benin Teaching Hospital, Nigeria. The women were aged between 20 and 35 years. Tests carried out included visual acuity, ophthalmoscopy, retinoscopy, and tonometry. The tests were carried out in each of the three trimesters of pregnancy and 6 weeks postpartum.Results: There was a fall in intraocular pressure across the trimesters and this was very significant (P<0.0001). Postpartum, the intraocular pressure began to rise. The difference between the third trimester and post-partum values was also statistically significant (P< 0.0001). The difference in visual acuity through out the pregnancy was not significant (P= 0.8477). Although, there was a fall in refractive error across the different trimesters, it was not statistically significant (P=0.3). There was also no difference in the third trimester and the 6 weeks postpartum values of both visual acuity and refractive error.Conclusion: Ocular changes associated with pregnancy are transient and most tend to resolve postpartum, with values returning to near pre-pregnant state

Huge Benign Granulosa Cell Tumour In A 61 Year Old Nigerian Grandmultipara With Late Presentation

Objective: To re-appraise clinicians that huge ovarian lesions with features of malignancies may still be benign and that late presentation is a problem in genital cancer management that should be addressed. Subject, material and method: A case report of a huge benign granulosa cell tumour in a postmenopausal woman is presented. Results: She presented as a case of a huge right ovarian tumour with weight loss, respiratory and abdominal discomfort one year after initial diagnosis was made because of fear of surgery. She had laparotomy, total abdominal hysterectomy and bilateral salpingoophorectomy. Histology revealed granulosa cell tumour of the benign type. Conclusion: Huge ovarian tumours in the elderly could be benign. In the absence of proper screening technique for ovarian cancers, laparotomy for histological purposes is required. Health education and proper counselling is imperative to reduce delays of patients to hospitals. Key Words: Huge, benign, granulosa cell tumour, 61 year old, Late presentation

Early onset pregnancy induced hypertension/eclampsia in Benin City, Nigeria

Pregnancy induced hypertension/eclampsia is a major cause of maternal and perinatal morbidity and mortality in Nigeria. There have been very few studies focussed on early onset pregnancy induced hypertension/eclampsia in Nigerian women To determine the incidence, clinical features and outcome of cases of early onset pregnancyinduced hypertension /eclampsia in a Nigerian tertiary hospital, and compare maternofetal outcome in early and late onset disease.: A retrospective study of all cases of early onset pregnancy induced hypertension/eclampsia seen over a five-year period in a tertiary hospital.: Severity of disease, rates of induction of labour, caesarean section rate, maternal mortality, abruptio placenta, still births, severe birth asphyxia and early neonatal deaths. : Early onset pregnancy induced hypertension/eclampsia contributed 6.3% of all cases of hypertensivedisorders in pregnancy with an incidence of 1:141 deliveries. Most cases presented at between 28-32 weeks gestation (78.3%) The disease was severe at presentation or rapidly progressive in 39 cases (84.8%) leading to delivery within 72 hours of presentation. Caesarean section was the mode of delivery in 58.7% of cases. The perinatal survival rate was 34.0%. Early onset pregnancy induced hypertension was associated withsignificantly higher risk of presenting with eclampsia, having induction of labour and worse perinatal outcome than late onset disease.: Most cases of early onset pregnancy induced hypertension in the study population presented with severe and rapidly progressive disease and were associated with significantly higher risk of obstetric intervention and worse perinatal outcome than late onset disease

Bilateral tubal ligation in a rural hospital in the Niger Delta, Nigeria

Background and Objective: To document bilateral tubal ligation (BTL) rate  and highlight the need to improve on the rates.Materials and Methods: A retrospective review of BTLs done in a five-year period from January 2000 to December 2004 constituted the study group.Results: There were a total of 103 BTLs, 58 were Caesarean BTLs, six were cases of BTL with repair of uterine rupture and 39 had BTL from mini-laparotomy. There were 937 Caesarean sections and 2,356 deliveries during the study period. BTL therefore constituted 0.044% of the total deliveries. The majority (51.7%) were above 35 years of age and grandmultiparity constituted 60.4% of BTL cases. The majority was in the low social Class 4 and 5 (41.3%). Grandmultiparity was the most common indication (60.4%). Previous Caesarean sections were more in the highest social class with a mean of 2.9 ± 1.21 while ruptured uterus had the lowest. Unbooked cases of BTL constituted 62.1% of BTL.Conclusions: Bilateral tubal ligation rate was low in this study with grandmultiparity being the commonest indication, the majority of patients were elderly parturient and largely unbooked. Social class was highest among those with previous Caesarean section

Intraocular pressure and visual acuity across the phases of the menstrual cycle in Nigerian women

Context: Available literature suggests that the pattern of variation in intraocular pressure (IOP) in different phases of the menstrual cycle is inconsistent. Results from studies on the effects of oestrogen and progesterone alone or in combination, on IOP have been conflicting.Aim: To determine the pattern of changes in IOP and visual acuity during the different phases of the menstrual cycle in healthy Nigerian women.Method: This was a cross sectional descriptive study. One hundred women aged 20 to 35 years, with a regular 27-29 days cycle were examined during the follicular, ovulation and luteal phases of the menstrual cycle. Thewomen were examined for three consecutive cycles and mean values were computed.Results: Intraocular pressure decreased in the follicular phase and rose in the luteal phase. Mean IOP during the follicular phase was 16.7 ± 1.6 mmHg. At mid-cycle, IOP was 15.0 ± 1.7 mmHg and during the lutealphase, IOP was 16.0 ± 1.5 mmHg. The difference in mean IOP during the follicular phase and mid-cycle period was significant ( p<0.05). Also, the difference in mean IOP between ovulation and the luteal phase wassignificant (p<0.05). There was no significant difference in mean visual acuity values across the different phases of the menstrual cycle, (p>0.05).Conclusion: Intraocular pressure increases during the luteal phase of the menstrual cycle in normal female subjects, an effect that could relate to mildly impaired vision and non-compliance with contact lens wear.Keywords: Pressure, acuity, vision, follicular, luteal

Perception Of Obstetrics And Gynaecology Resident Doctors Of Traditional Birth Attendants’ Practices

Background: Nigeria has one of the highest maternal and perinatal morbidity and mortality rates in the world and the practice of traditional birth assistants (TBAs) is a major contributory factor.Objective: To assess the perception of traditional birth attendants’ practices by resident Nigerian obstetriciangynaecologists.Materials and methods: A cross-sectional survey of Nigerian resident obstetrician-gynaecologists using selfadministered questionnaires.Results: Majority of the study population (63.1%) knew at least one traditional birth attendant. The vast majority of the residents (70.2%) felt that the practices of traditional birth attendants were mainly prevalent in the rural areas. Thirty five point seven percent suggested that more than half of the Nigerian obstetric population patronised TBAs while 17.9% felt less than a fifth of the pregnant population patronised them. The vast majority of the residents were convinced that the practices of traditional birth attendants led to increase in maternal morbidity and mortality. The residents were about equally split on whether TBAs should be trained to enhance their practices. Concerning roles for traditional birth attendants, 23.8% suggested they should be empowered to refer patients to hospitals while 21.4% were of the opinion that they should be trained to care for low risk pregnancies.Conclusion: Most of the resident doctors had good knowledge of the practices of traditional birth attendants in Nigeria and felt their practices were associated with increase in maternal mortality. There was no consensus on roles for traditional birth attendants.Keywords: resident doctors, traditional birth attendants, knowledge, maternal mortalit

Knowledge and use of contraception by rural in- school adolescents in delta state, Nigeria

Background: The high prevalence of sexual activity among adolescents leading to unwanted pregnancies and reproductive tract infections are major public health concerns in developing countries.Objective: To determine the level of knowledge and use of contraception by in-school adolescents in randomly selected rural secondary schools in Delta State, Nigeria.Methods: A cross -sectional questionnaire based survey of in-school adolescents from randomly selected rural secondary schools in Ethiope East Local Government Area, Delta State of Nigeria.Results: There were 233 respondents. The mean age was 15.9 years + 1.9 SD. Thirty six point one percent of the study population had had sex. The mean age at coitache was 15.1 years + 2.1 SD. Sixty four point three percent of the adolescents that had had sex (84) took measures to avoid pregnancy. Fifty four point eight percent of them used condoms with only 31.0% using it consistently; coitus interruptus was used by 39.3% while 25.0% relied on washing their “private parts” immediately after sex. Only 49.4% of the adolescents had 2 had previous access to information on how to avoid getting pregnant. The major sources of information on avoiding pregnancy were “nurses and doctors” (17.2%), school teachers (16.7%) and elder sisters/relatives (11.2 %).Conclusion: Over a third of the study population had had sex with poor utilization of modern contraceptive methods and most got contraceptive information from school teachers, relatives and medical and paramedical personnel. The findings suggest that school and community based contraceptive health promotion programmes are likely to be more effective than media based ones in these settings

The level of heat-stable alkaline phosphatase in serum of some Nigerian pregnant women

This study was conducted to monitor the changes in the level of heat-stable alkaline phosphatase, hsALP (principally secreted by placenta) in maternal serum during pregnancy, and to relate results to placental and birth weights. Sera samples used for the assay were collected at the 15-22, 23-30 and 31-37wk gestational age from the same set of 411 consenting ‘normal’ pregnant women in apparently good health. Two hundred and thirteen pregnant women with low mean corpuscular haemoglobin, MCH (< 27 pg) were included as control group. The subjects were drawn from seven tribal groups in Delta State. The results indicated that the percentage proportion of hsALP activity – the placental isotype in the maternal serum – was highest during the 31-37 gestational age (53%) when compared with the 15-22 (7.6%) and the 23-30 wk (40%) gestational values. The respective values for the low MCH group were 4.6%, 22.7% and 36.8%. Neonatal birth weight mean values (kg) for ‘normal’ and low MCH pregnancy are: M=3.4 + 0.6, F=3.0 + 0.8 vs M=2.7 + 0.7, F=2.6 + 0.6, respectively. For each parameter determined, tribal variations were minimal. The demonstrated trend suggests that changes in heat-stable alkaline phosphatase level support pregnancy. Thus, the established level of hsALP in maternal serum could be diagnostic in assessing foetoplacental development and maternal health among the Nigerian pregnant population. Keywords/phrases: Heat-stable alkaline phosphatase; Neonates; Nigeria Placenta; Pregnancy. Ethiop. J. Biol. Sci., 7(1): 85-93, 200