Awareness and perception of vasectomy among antenatal women in a tertiary health facility in southeast Nigeria

Background: Vasectomy is a safe alternative to bilateral tubal ligation (BTL) in achieving permanent sterilization but not popular in developing countries. As part of the efforts to increase popularity as well as acceptance of vasectomy in the developing countries, its awareness among women needs to be assessed. The study was undertaken to determine the awareness and perceptions of vasectomy among antenatal attendees in a tertiary health institution southeast Nigeria.Methods: This was a questionnaire-based cross-sectional study in which pregnant women visiting University of Nigeria Teaching Hospital, Enugu (UNTH) antenatal clinic from 1st June – 30th November 2017 were recruited. Data was collected using structured questionnaire. Two hundred (200) self-administered questionnaires were completely filled and analyzed by means of descriptive and inferential statistics including means frequencies and x^2-tests at the 95% confidence level (CL).Results: Of the 200 respondents, 146(73%) were completely unaware of the existence of vasectomy while 54(27%) were aware. Of those who were aware, 41(75.9%) accepted its use as a family planning method for men. The commonest reason for acceptance was the fear of infidelity among their husbands, 17(41.5%). The intention to use was however low as 24(44.4%) of those who accepted vasectomy disapproved of its use by their husbands and the main reason for disapproval was “weakens husband’s sexual performance,” (33.3%). Tertiary level of education of the respondents was 5.3 times independently associated with the acceptance of vasectomy.Conclusions: The awareness is low and there are several misperceptions about vasectomy among the women in Enugu. Tertiary education of the women however improves the choice of vasectomy as a permanent contraceptive option. There is the need for educational programmes in line with the numerous advantages of vasectomy so as to counteract the misperceptions especially those regarding sexual relationship

Secondary Amenorrhoea and Haematometria Following Emergency Caesarean Section

Objective: To call attention to a rare cause of curable haematometria and secondary amenorrhoea. Case Report: A 28 year old primaparous patient developed cyclic abdominal pains and secondary amenorrhoea 9 months after an emergency Caesarean section for prolonged obstructed labour. Examination revealed that the os cervix was covered by a thick avascular membrane with a bluish apex. Sonography confirmed haematometria. Incision of the membrane was curative and restored normal menstrual flow. Conclusion: The haematometria and resultant secondary amenorrhoea followed puerperal sepsis. The causative inflammatory membrane was at the os cervix and, as there were no intrauterine adhesions, incising the membrane was curative. Key Words: Secondary Amenorrhoea, Haematometria, Caesarean Section Orient Journal of Medicine Vol.16(1) 2004: 21-2

ELECTIVE ABDOMINAL HYSTERECTOMY: INDICATIIONS AND COMPLICATIONS IN ENUGU, EASTERN NIGERIA.

A six-year review of hysterectomies at the University of Nigeria Teaching Hospital, Enugu, Nigeria, was undertaken to determine the rate, indications and complications of the operation. There were 14 hysterectomies per 100 gynaecological in-patients. In a decreasing order of frequency, the main indications for the 199 elective abdominal hysterectomies during the study period were: uterine fibroids (66.7%), ovarian tumour (12.1%) and cervical malignancy (11.6%). The sub-umbilical midline incision was used in 166 (83.4%) of the cases. Moderate to severe intra-pelvic adhesions were found in 59 (29.6%) of the patients. The uterine size was greater than 12 weeks gestation in 133 (66.8%) of the women. Appendicectomy was the most frequent incidental operation; it was performed on 56 (28.1%) of the subjects. Complications were recorded in 55 women, a complication rate of 27.6%. Approximately two-thirds of the complications involved the urinary tract or the abdominal incision wound. We conclude that although the hysterectomy rate in Enugu, Nigeria, is lower than in advanced countries, the indications and complications of the operation are similar to those from the latter countries. Suggestions are offered on how to minimise complications during hysterectomies. Key words: Abdominal hysterectomy, indications, complications, Enugu. (Global J Med Sci: 2002 1(1): 49-53

Domestic Violence Against Pregnant Nigerian Women

Context:Domestic violence against women is known to be common and violence against pregnant women can create an adverse outcome both for the mother and the fetus. Objectives: To estimate the prevalence of domestic violence against pregnant women in Enugu, Nigeria and to identify the risk factors promoting such violence. Study Design, Setting and Subjects:Trained personnel administered a self-reporting domestic-abuse questionnaire to 409 women attending antenatal clinics at the University of Nigeria Teaching Hospital between May and August 2000. Results:A total of 424 women were attending antenatal clinics at the time of the study, of whom 409 agreed to participate in the study. One hundred and fifty two (37.2%) had a previous history of abuse. Fifty-three women (13.0%) had been abused in the preceding twelve months and 45 (11.0%) during the index pregnancy. Eleven women (2.7%) had been sexually abused in the preceding one year, while 3.4% reported being afraid of their husbands. The risk factors for being the victim of domestic abuse, in descending order of magnitude, were financial problems (17.7%), having only female children (11.1%), unplanned pregnancy (8.8%), unemployment (4.4%) and previous caesarean section (4.4%). Conclusion:Prevalence of domestic violence was high among Nigerian pregnant women. Routine screening of prenatal women for domestic violence should be introduced during antenatal care. Key Words: Domestic Violence, Pregnancy, Partners, Screening [Trop J Obstet Gynaecol, 2003, 20: 116-118

Attitude of antenatal patients in Enugu toward HIV screening

Objective: To assess attitude towards antenatal Human Immuno Deficiency Virus (HIV) screening in Enugu, Nigeria.Method: A self-report questionnaire was administered to two hundred and nine women attending antenatal booking clinics at the University of Nigerian Teaching Hospital, Enugu. Results: The mean age was 29.7 years. One hundred and sixty three patients 78.0% were aware of HIV Screenng before booking while 22.0% were not aware at the time of booking. A total of 123 women (58.9%) had previous HIV Screening while the rest (41.1%) accepted the screening for the first time. Educational Level has a significant effect on uptake of HIV test 2 = 8.97, p = 0.003 df = 2 and on the perceived benefit of HIV Screening x2 = 16.6, p = 0.00005 df = 3 but has no significant effect on the awareness of vertical transmission x2 = 0.62, p = 0.43, df = 2. The reason for declining HIV Screening was that AIDS has no known cure, followed by fear of positive result. Conclusion: The awareness and attitude of Nigeria pregnant women towards HIV Screening and uptake of the test is good. Educational level has a significant effect on the uptake and perceived benefit of the test. Antenatal women should be offered routine voluntary counseling and testing. Keywords: antenatal, HIV screening, NigeriaTropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 156-15

Stérilisation à travers la minilaparotomie au sud-est du Nigéria

The study aimed to assess the trend in acceptance and characteristics of acceptors of female sterilization between January 1999 and December 2006 at the University of Nigeria Teaching Hospital, Enugu, South-Eastern Nigeria. There were a total of 20,485 new clients, with 212 (1.0%) accepting sterilization between January 1999 and December 2006. There was an initial rise in acceptance from 0.4% in 1999 to 3.0% in 2004, then a decline. 108 (50.9%) were between 35-39 years. 169(79.7%) had more than five living children. 69 (32.5%) and 76 (35.9%) had secondary and higher education respectively. Health workers were the main source of information. Completed family size was the reason for choosing sterilization in 185 clients (87.3%). 120 (56.6%) were in occupational social class 3. 106 (50.0%) did not practice any form of family planning prior to the procedure. 184 (86.8%) had interval sterilization and the rest (13.2%) postpartum. Acceptance of tubal sterilization is still low in our community (Afr J Reprod Health 2009; 13[4]:105-111).L’étude avait pour objectif d’évaluer la tendance de l’acceptation et les caractéristiques des accepteuses de la stérilisation féminine entre janvier 1999 et décembre 2006 au Centre Hospitalier Universitaire d’Enugu, au sud-est du Nigéria. Il y avait au total 20,485 nouvelles clientes dont 212 (1,0%) ont accepté la stérilisation entre janvier 1999 et décembre 2006. il y avait une hausse initiale dans l’acceptation de 0,4% en 1999 jusqu'à 3,0% en 2004, puis un déclin. 108 (50,9%) étaient âgés d’entre 35 et 39 ans. 169 (79,7%) avaient plus de cinq enfants encore vivants. 69 (32,5%) et 76 (35,9%) ont fait des études secondaires et supérieures respectivement. Les membres du personnel soignant ont été la source principale d’information. Ayant eu le nombre d’enfants désiré constituait la raison pour laquelle 185 clients (87,3%) ont choisi la stérilisation. 120 (56,6%) appartenaient à la classe sociale professionnelle 3, 106 (50,0%) n’avaient pratique aucune forme de la planification familiale avant la procédure. 184 (86,8) ont eu une stérilisation par intervalles et le reste (13,2%) avaient le post-partum. L’acceptation de la stérilisation tubaire est encore faible dans notre communauté (Afr J Reprod Health 2009; 13[4]: 105-111)

Leiomyomatosis peritonealis disseminata in a Nigerian woman

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition. A 48‑year‑old multiparous woman was referred because of an incidental ultrasound finding suggestive of LPD. She had a 6‑year past history of use of combined oral contraceptive pills. LPD was also suspected at laparotomy and confirmed by histology. She had total abdominal hysterectomy, bilateral salpingo ophorectomy and infracolic omentectomy. Patient was being followed‑up. LSD is a rare gynecological condition which can pose a diagnostic challenge. Removal of estrogen sources as was done for the patient is the mainstay of treatment. Patient follow‑up is very important because of the risk of malignant transformation.Keywords: Laparatomy, leiomyoma, leiomyomatosis peritonealis disseminata, Nigeria, ophorectomyNigerian Medical Journal | Vol. 53 | Issue 3 | July-September | 201

The outcome of complementary and alternative medicine use among pregnant women in South-East Nigeria: a multi-centre prospective study

There is a global increasing trend of complementary and alternative medicine (CAM) use among pregnant women. This study aimed at determining the maternal and perinatal outcome of CAM use among the pregnant women in South-East Nigeria. This was a prospective study in which self-administered semi-structured questionnaires were used to collate information from the consenting pregnant women who use CAM and those who did not use CAM from the gestational age of 36 weeks at four hospitals in South-East Nigeria. Both groups were matched for age, parity and address. Every participant was followed up until delivery. Data were analysed using SPSS version 23 (SPSS Inc., Chicago, IL). This study’s ethical clearance number was NHREC/05/01/2008B-FWA00002458-1RB00002323 and it was obtained at UNTH and on February 15 2019. CAM use in pregnancy was associated with low haemoglobin concentration, maternal complications, high caesarean section rate, low birth weight, low APGAR score, large placental weight and high hospital admission of babies when compared with non-CAM users (p value= <.05). In conclusion, CAM use in pregnancy was associated with poor maternal and perinatal health indices, hence the need to implement policies aimed at reversing them.Impact Statement What is already known on this subject? There is an increasing trend of CAM use among pregnant women in the world. Pregnancy is associated with certain conditions that predispose women to CAM use. The clinical indications for CAM use by the pregnant women are nausea and vomiting, labour pain, induction of labour, pedal oedema and waist pain. What the results of this study add? CAM use in pregnancy was associated with low haemoglobin concentration, maternal complications, high caesarean section rate, low birth weight, low APGAR score, large placental weight and high hospital admission of the babies when compared with non-CAM users. What the implications are of these findings for clinical practice and/or further research? CAM use in pregnancy was associated with poor maternal and perinatal health indices, hence the need to implement policies aimed at reversing them