Uptake and Discontinuation of Jadelle Implant Use in University of Calabar Teaching Hospital, Calabar, Nigeria

Background: Contraception is known to contribute to a reduction in maternal mortality rates directly. Jadelle implant is a long‑lasting, reversiblecontraceptive that is safe, highly effective, and convenient. Objectives: The objectives of this study were to determine the sociodemographic profile, side effects, and reasons for discontinuation among users of Jadelle in the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Methodology: This was a 5‑year retrospective study carried out at UCTH, Calabar, Nigeria. Case files of women who accepted and inserted Jadelle implant between January 1, 2013, and December 31, 2017, were retrieved, and data were extracted for the study. Descriptive and analytical statistics of the data using mean and standard deviation were done, and results were presented in frequency and percentage tables. Results: A total of 270 women accepted and inserted Jadelle implant during the period under review with a mean age of 33.0 ± 6.2. Majority of the clients were Christians 98.1%, and 85.9% had at least secondary school education. About half (49.6%) of these women had a desire for future fertility, whereas 49.7% have had four or more children. Sixty‑one percent (61.5%) of the clients had previously used a form of contraception. Menstrual irregularities were the most commonly reported side effect (55.0%) as well as the most common reason for removal and discontinuation of the implant (43.3%). Conclusion: Jadelle is a highly effective, safe, and reversible method of contraception. The most commonly reported side effect was menstrual irregularities, which was also the most common reason for discontinuation in the UCTH, Calabar, Nigeria. Keywords: Calabar, contraception, discontinuation, highly effective, Jadell

Prevalence and risk factors for stillbirths in a tertiary hospital in Niger Delta area of Nigeria: a ten year review

Background: Stillbirth is a silent but major cause of perinatal mortality and source of foetal wastage. Aim: To determine the prevalence of stillbirth, demographic characteristics and identify the possible risk factors in our Hospital.Methods: This was a ten year cross-sectional retrospective study of stillbirths between 1st January, 2004 and 31st December, 2013. All cases of stillbirths from 28 weeks of gestation or the foetal weight of at least 1000g were included in the study.Results: There were a total of 19,347 deliveries with 937 stillbirths, giving a stillbirth rate of 48.4/1,000 total births or 4.8%. Of the 937 stillbirths identified, only 582 (62.1%) case files could be retrieved and was used for analyses. There were 381(65.5%) macerated and 201(34.5%) fresh stillbirths. Stillbirth rate were higher among grand multiparous women, women with primary education and unbooked women. There were 309(53.1%) male stillbirths and 273(46.9%) female stillbirths. Male foetuses were higher among fresh stillbirth (54.9%) while female foetuses had more macerated stillbirths (48.8%) than fresh stillbirths (45.1%). The major causes of stillbirths were hypertensive disorders of pregnancy (18.9%), prolonged/obstructed labour (13.6%), anaemia in pregnancy (12.2%) and abruption placentae (9.3%). A total of 121(20.8%) of the stillbirths were unexplained.Conclusion: The prevalence of stillbirth in our environment is high. Identified factors such as grandmultiparity, low education, unbooked pregnancy, anaemia in pregnancy, obstructed labour and ruptured uterus are modifiable. Every effort directed at reducing these factors must be made by all healthcare givers including policy makers to reduce stillbirths.Key words: Stillbirth, miscarriage, perinatal mortality, anaemia in pregnancy, obstructed labour, uterine ruptur

Growth parameters of children in Calabar, a south-south Nigerian city: Are the CDC growth charts useful in clinical practice in this area?

Background: In countries that do not have national  growth charts, the WHO or CDC growth charts are often used for growth assessment. How  reliable or appropriate are these charts in monitoring growth of children in these countries?Methods: A cross sectional study of children, aged 6-18 years in Calabar, South-South Nigeria was randomly studied. Heights and weights were  measured using a portable stadiometer with a weighing scale. Body mass index (BMI) was then calculated. The data obtained was analyzed and plotted in the CDC growth charts.Results: The mean height for boys and girls was 0.79 and 0.86 SD scores respectively above the 50th percentile points on the CDC growth chart for ages 6-11 years for boys and 6-12 years for girls; but 0.75 and 0.37 SD scores respectively below the 50th percentile for ages 12-18 years for boys and 13 -18 years for girls. The mean weight for boys and girls was 0.67 and 0.63 SD scores respectively at or above the 50th percentile point on the CDCgrowth chart for ages 6-11 years (for boys) and 6-15 years (for girls) but 0.58 and 0.42 SD scores respectively below the 50th percentile for ages 12-18 years (for boys) and 16-17 years (for girls). The mean BMI values for boys and girls was 0.58 and 0.55 SD scores respectively above the 50th  percentile points on the CDC growth chart for ages 6-10 (for boys) and for all the ages studied for girls but 0.30 SD scores below it for boys 11-18 years.Conclusion: The growth parameters (height, weight and BMI) of children in Calabar, South-South Nigeria compares closely to that of the CDC  growth charts. The CDC growth charts can be used in this area for the assessment of children for growth and development. Key words: Height, Weight, BMI, Children, Adolescence, CDC growth chart