2 research outputs found
Rising trend and indications of caesarean section at the university of Maiduguri teaching hospital, Nigeria
Objective : To determine the trend and indications for the use of
caesarean delivery in our environment. Method : A retrospective review
of the caesarean sections performed at University of Maiduguri Teaching
Hospital from January 2000 to December 2005 inclusive. Results :
During the study period, there were 10,097 deliveries and 1192
caesarean sections giving a caesarean section rate of 11.8%. The major
maternal indications were cephalopelvic disproportion (15.5%), previous
caesarean section (14.7%), eclampsia (7.2%), failed induction of labor
(5.5%), and placenta previa (5.1%). Fetal distress (9.6%), breech
presentation (4.7%), fetal macrosomia (4.3%), and pregnancy complicated
by multiple fetuses (4.2%) were the major fetal indications. The
caesarean section rate showed a steady increase over the years (7.20%
in 2000-13.95% in 2005), but yearly analysis of the demographic
characteristics, type of caesarean section, and the major indications
did not reveal any consistent changes to account for the rising trend
except for the increasing frequency of fetal distress as an indication
of caesarean section over the years, which was also not statistically
significant (\u3c7[2] =8.08; P=0.12). The overall perinatal mortality
in the study population was found to be 72.7/1000 birth and despite the
rising rate of caesarean section, the perinatal outcomes did not
improve over the years. Conclusion : Trial of vaginal birth after
caesarean section in appropriate cases and use of cardiotocography for
continuous fetal heart rate monitoring in labor with confirmation of
suspected fetal distress through fetal blood acid--base study are
recommended. A prospective study may reveal some of the other reasons
for the increasing caesarean section rate
A Shortened versus Standard Matched Postpartum Magnesium Sulphate Regimen in the Treatment of Eclampsia: a Randomised Controlled trial.
Magnesium sulphate is currently the most ideal drug for the treatment
of eclampsia but its use in Nigeria is still limited due its cost and
clinicians inexperience with the drug. The purpose of this study was to
determine whether a shortened postpartum course of magnesium sulphate
is as effective as the standard Pritchard regimen in controlling fits
in eclampsia. Between January and June 2011, 98 eclamptic mothers
presenting at the labour ward of the University of Maiduguri Teaching
Hospital were randomised to receive either the standard Pritchard
regimen of magnesium sulphate or a shortened postpartum course in which
only two doses of intramuscular magnesium sulphate is given four hours
apart. The maternal and fetal outcomes were compared. The primary
outcome measure was recurrence of fits. The recurrence of fits and
other maternal complications were similar in the two groups. The total
dosage of magnesium sulphate in the shortened group was reduced by 40%
in 66% of patients. The shortened postpartum course of magnesium
sulphate is as effective as the standard Pritchard regimen in the
management of eclampsia.Le sulfate de magnésium est actuellement le médicament le
plus idéal pour le traitement de l'éclampsie, mais son
utilisation au Nigeria est encore limitée en raison de son
coût et des cliniciens inexpérience avec la drogue. Le but de
cette étude était de déterminer si un cours du
post-partum raccourcie de sulfate de magnésium est aussi efficace
que le traitement standard de Pritchard dans le contrĂ´le unique de
l'éclampsie. Entre janvier et juin 2011 98 mères
éclampsie qui se présentent à la salle de travail du
Centre Hospitalier de l’Université de Maiduguri ont
été randomisés pour recevoir soit le traitement de
Pritchard standard de sulfate de magnésium ou d'un cours du
post-partum raccourci dans lequel seulement deux doses de sulfate de
magnésium par voie intramusculaire sont données quatre heures
d'intervalle. Les résultats maternels et foetaux ont été
comparés. Le critère de jugement principal était la
récurrence de crises. La récurrence des crises et autres
complications maternelles Ă©taient similaires dans les deux
groupes. La dose totale de sulfate de magnésium dans le groupe
raccourci a été réduite de 40% à 66% des patients.
Le cours du post-partum abrégée du sulfate de magnésium
est aussi efficace que le traitement standard de Pritchard dans la
gestion de l'Ă©clampsie