Perineal Hygiene in the Puerperium: The Niger Delta Experience

Background: The puerperium is the period after the delivery of the placenta up to end of six weeks. The postnatal mother is at high risk of morbidity and mortality from sepsis. Appropriate perineal hygienemay play a significant role in reducing the extent of the problem.Objectives: To evaluate the knowledge and practice of perineal hygiene among postnatal mothers admitted into the postnatal ward of University of Port Harcourt Teaching Hospital (UPTH).Methods: A cross sectional descriptive study among postnatal mothers admitted into the postnatal st wards of University of Port Harcourt Teaching Hospital between 1 July and 31st December 2006. A systematic random sampling method was used. Fishers Exact and Chi Square tests were used for data analysis.Results: A total of 224 questionnaires out of 250 were retrieved. Most (99.6%) of the respondents had some form of formal education. Most of the booked respondents (56.9%) used sanitary pads for perinealhygiene. The sanitary towels were mainly purchased from patent medicine stores/ open markets with burying and burning as dominating major modes of disposal. Majority of the booked respondents (90%)had knowledge regarding application of pad from vulva to anus and the cleaning of perineal area from front backwards. About 88% of the booked and 52% of the unbooked populations had knowledge and appropriate practice regarding cleaning of perineal area after each emptying of bladder/bowel. Most of the respondents (77.2%) never had any puerperal complications.Conclusion: Majority of the booked as opposed to the unbooked postnatal mothers in University of Port Harcourt Teaching Hospital had good knowledge and practice regarding perineal hygiene. Thus antenatal care and formal education may be regarded as sine-que-non in maintaining good perineal hygiene among postnatal mothers.Key Words: Perineal Hygiene, Puerperium, Niger Delt

Time of Passage of First Stool in Newborns in a Tertiary Health Facility in Southern Nigeria

Introduction: The first stool passed by the newborn, the meconium, is different from the ordinary stool both in its nature and its implication. Delayed or non.passage of the meconium may represent a number of clinical conditions. In this study, we sought to identify what should be considered delayed passage of meconium in our babies. Aims and Objectives: To investigate the timing of passage of first stool in Nigerian neonates and whether it is influenced by gender, birth weight, maternal age, and parity.Materials and Methods: A proforma was designed to obtain the following data: Maternal age, parity, mode of delivery, Apgar score at 1 min, birth weight, gender, and interval between delivery and passage of firststool among normal newborn babies delivered at the obstetrics department of our center in August and September 2010.Results: One hundred babies out of 393 delivered during the period of the study were included in the study. There were 63 (63%) males and 37 (37%) females. The interval between delivery and passage of meconium ranged from 0.5 to 54 h; mean, 16.2 (SD = 10.57). This was not  influenced by gender, weight, maternal age, and parity. Conclusion: Non.passage of meconium beyond 48 h of life could be considered delayed. We therefore, recommend that clinicians should re.evaluate newborns, for hitherto unrecognized conditions, if after 48 hthey have not passed first stool.  Keywords: First stool, meconium, nigerian newborns, timin

Contraceptive prevalence amongst women attending infant welfare clinic at the University of Port Harcourt Teaching Hospital

Background: Low contraceptive prevalence in Sub-Sahara Africa has increased the burden of unwanted pregnancies and continued population explosion thus hampering the economic development of the sub-region. This should not happen considering availability of modern family planning methods. Objectives: To determine the contraceptive prevalence, types of contraceptive used and factors affecting the latter amongst women attending infant welfare clinic at the University of Port Harcourt Teaching Hospital (UPTH). Methods: A cross sectional questionnaire survey of contraceptive prevalence amongst women attending the infant welfare clinic at UPTH. A systematic random sampling method was employed. Data collected was analyzed using SPSS version-11 and Microsoft Excel. Results: A total of 250 questionnaires were administered and 240 retrieved .The most commonly used contraceptive was the condom (28.4%). Majority (55.4%) of the respondents were aware of the oral contraceptive pill. About 41% of the respondents were informed of contraception via the health centres while the commonest reason for non -use was the fear of complications. Conclusion: The contraceptive prevalence rate amongst women attending the infant welfare clinic in the UPTH is low though higher than the national figure. Prompt education of eligible women and men on the use effectiveness of the most commonly used contraceptive should be encouraged. Keywords: Contraceptive prevalence, Women, Infant Welfare Clinic, Port HarcourtPort Harcourt Medical Journal Vol. 3 (1) 2008: pp. 42-4

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Contraception with combined oral contraceptive pills in Port Harcourt, Nigeria

Background: Millions of women worldwide use the combined oral contraceptive pill (COCP) as an effective form of contraception. This has contributed immensely to population control and improvement of maternal wellbeing.Aim: To determine the acceptability, efficacy and side effect of COCP in Port Harcourt and compare with the experience elsewhere.Methods: This was a retrospective study of all clients who accepted COCP between 1st   January 1997, and 31st  December 2006 at the Family Planning Clinic of University of Port Harcourt Teaching Hospital (UPTH). Information obtained included sociodemographic characteristics, side effects, reasons for discontinuing the method and source of information.Results: A total of 4,160 clients accepted contraception during the study period, out of which 360 used COCP, giving a prevalence rate of 8.7%. The mean age and parity of acceptors were  27.14 ± 4.68 years and 1.82±0.45 respectively. Among the clients, 99.4% had formal education while 66.1% were single and 49.7%% were students. Prevalent side effects were menstrual disruptions (47.9%), weight gain (33.7%), hypertension and headaches (5.4% each) amongst others. The common reasons for discontinuing COCP were weight gain (28.6%), menstrual disruptions (28.5%) and non-compliance (14.2%). Mass media was the commonest source of information, and one accidental pregnancy occurred (Pearl index 0.03 per 100 woman years). Conclusion: This study shows that combined oral contraceptives pills appear to be acceptable, safe and effective in Port Harcourt. This compares to world wide experience. Concerted effort should be made in improving information dissemination on COCP especially amongst students and single clients. Keywords: Contraception, Combined oral contraceptive pills, Port Harcour

The Agony of Unsafe Abortion in A Teenager: A Case Report

This report represents a rare case of omental prolapse through posterior vaginal fornix laceration following an induced unsafe abortion. Miss T.R, a 14 year old orphan and junior secondary school 3 student had three different attempts at termination of 15 weeks pregnancy by a medical doctor in a private clinic. Physical examination at presentation in our teaching hospital revealed a very ill teenager, pale, febrile and tachycardic with an irregular fleshy mass protruding from the introitus and arising from a transverse laceration in the posterior vaginal fornix. After appropriate resuscitation, she had an emergency exploratory laparatomy with excision of the omentum , repair of posterior vaginal fornix laceration and manual vacuum aspiration of retained products of conception. The uterus and appendages were intact. The post operative period was uneventful with satisfactory wound healing. She was discharged home by the seventh day on admission after adequate counseling on contraception and referral to the family planning clinic.Key words: Unsafe abortion, Teenager, Omental protrusion, Laparotomy

Emergency Contraception: Knowledge and Perception of Female Undergraduates in the Niger Delta of Nigeria

Objective: To evaluate the knowledge of, and perception of female undergraduates in the Niger Delta of Nigeria towards Emergency Contraception. Methods: Anonymous self administered questionnaireswere applied to randomly selected non-medical femaleundergraduates of the University of Port Harcourt inMay 2005.Results: Six hundred questionnaires were retrieved out of 610 distributed. The respondents were between 17- 30 years. Those reported to have ever had sex were 85.3%; most of whom (98.4%) have previously usedsome forms of contraception. About 50.7% of 600 respondents were aware of emergency contraception; amongst which reports of friends/peers as the source of knowledge ranked highest (33.55%). About 88.2% ofthose that are aware of Emergency Contraception knew the correct timing. More than half (57.9%) did not know correct dosage of the available post-coital pill. While half (50.7%) of those having knowledge of postcoitalpills agree to the efficacy; only a third (35.53%) agreed to have actually used it.Conclusion: The awareness and use of Emergency Contraception amongst female undergraduates in Niger Delta region of Nigeria is low. Prompt education of this group of students in Emergency Contraceptionshould be encouraged with emphasis on available methods and correct timing of use