Pregnant Nigerian women’s view of cesarean section

Objective: Cesarean section (C/S) is still being perceived as an abnormal means of delivery by many antenatal women in Nigeria. This study aims to determine the perceptions of antenatal clients in the southeastern Nigeria on C/S.Materials and Methods: The study was conducted using a structured questionnaire administered to 300 consenting pregnant clients attending the antenatal clinic. The data were analyzed and presented in a simple frequency table.Results: The average C/S rate in the hospital was 16.6%. Only 4 (1.4%) viewed C/S as very good and elected to undergo C/S. Thirty-four (12.3%) considered C/S as bad and would reluctantly undergo the procedure. Two hundred and twenty-five (81.2%) would accept C/S if their life or that of their fetus is in great danger.Conclusion: This study affirms previous suspicion that a significant proportion of antenatal clients are averse to C/S and the negative cultural perception of the people to C/S reinforced this aversion

A 20-year Review Of Twin Births At Mater Misericordiae Hospital, Afikpo, South Eastern Nigeria

Objectives: To provide information on twin deliveries among Igbos in a rural/semi-urban community of South-Eastern Nigeria, and compare the twinning rate with data from the other two major tribes. Methods: An analysis of the records of deliveries conducted over a 20-year period in a rural/semi-urban community of South-Eastern Nigeria. Results: The twinning rate of the community was 1:24, and increased with increasing maternal age, and generally with birth rank. Twin births were associated with a MMR of 895/100,000, and PMR of 213/1000 maternities, figures 3.4 and 1.7 times those of the total maternal and perinatal mortalities respectively. Ninty percent of the twin mothers delivered vaginally, 2% with the aid of symphysiotomy. Caesarean section rate was 10.6%. Conclusion: The twinning rate within Nigeria may probably be dictated by location rather than ethnicity. The maternal and perinatal mortalities associated with twin pregnancies in this study appear higher than for singleton births. Keywords: Twin Births, Rural Community, Eastern Nigeria. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 231-23

Implementing The NewWHO Antenatal Care Model: Voices From End Users In A Rural Nigerian Community.

Context: The recommended WHO antenatal focused visits with reduced number of visits and tests is yet to be implemented in many communities in rural Nigeria. Aim: This paper evaluated the attitude of antenatal clients in a rural mission hospital to the new antenatal model. Study Design: Focus group discussions were carried out bi-weekly for 12weeeks with consenting booked antenatal clients. The topic guide was developed following interactions with prenatal clients at a referral tertiary center. Results: One hundred and forty-four clients were interviewed. Prior to discussion, none had heard of the new antenatal care model. More than half of them will prefer the traditional policy with multiple visits to the new model. The traditional visit was said to be more reassuring and provides the clients time away from their routine chores/occupations and afford them the opportunity to interact with other expectant mothers and get acquainted with the health care providers. Conclusion: To realize the goals of the new WHO recommended antenatal model in rural Nigeria, mass enlightenment and education must precede its gradual and cautious introduction. Keywords: Antenatal Care, Clients, Rural, WHO. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 260-26

Evaluation of Vesicouterine Fistula with Ultrasonography in a Resource-constrained Setting

Objective: To determine the role of ultrasonography in the evaluation of patients with vesicouterine fistula. Methodology: This was a retrospective study conducted at the National Obstetric Fistula Centre, Abakaliki, South-East Nigeria between January 2015 and November 2016. Ethical clearance was obtained from Ethics and Research Committee of the National Obstetric Fistula Centre, Abakaliki, Nigeria. A total of 25 patients had vesicouterine fistula during the study period. The records of 22 patients who had pelvic ultrasonography were reviewed and formed the basis of this study. Results: The mean age of the study population was 30.1±6.2 years. Pelvic ultrasonography revealed a communication between the uterus and the bladder in 19 (86.4%) of patients which is suggestive of vesicouterine fistula. Three patients (13.6%) had normal sonographic assessment. All patients were successfully repaired. Conclusion: Ultrasonography appears to be a useful, cheap, quick and readily available means of evaluating vesicouterine fistula in a resource-constrained setting. It provides an added advantage to clinical diagnosis in the evaluation of vesicouterine fistula. Keywords: Vesicouterine fistula, urogenital fistula, ultrasonography

Management of Rectovaginal Fistulas at the National Obstetric Fistula Centre, Abakaliki over a 5-year Period

Objective: To share our experience in the management of rectovaginal fistula. Methods This was a retrospective study conducted at the National Obstetric Fistula Centre, Abakaliki, South-East Nigeria. The case folders of patients that had rectovaginal fistula between January 2012 and December 2016 were reviewed. Data was analyzed using the Statistical Package for Social Sciences, version 21. Results The records of 21 out of 26 patients who had rectovaginal fistula were available for review. The mean age was 31 ± 9 years. Majority (95.24%) were Christians. Twenty (95.24%) of  the cases were low rectovaginal fistula. The risk factors for rectovaginal fistula were mainly episiotomy, perineal tears during labour and prolonged obstructed labour Two (10%) out of the 20 patients that had surgery had minor complications. There was no mortality. The success rate after the first repair was 85% for those that were offered surgery. Conclusion The study suggests a good outcome for the patients reviewed with minimal complications. Keywords: Rectovaginal fistula, episiotomy, perineal tear

Rural-urban differences on the rates and factors associated with early initiation of breastfeeding in Nigeria: further analysis of the Nigeria demographic and health survey, 2013

Background This study investigates and compares the rates and factors associated with early initiation of breastfeeding (EIBF) within one hour of birth in rural and urban Nigeria. Methods Data from the 2013 Nigeria Demographic and Health Survey (NDHS) were analyzed. The rates of EIBF were reported using frequency tabulation. Associated factors were examined using Chi-Square test and further assessed on multivariable logistic regression analysis. Results The rates of EIBF were 30.8% (95% confidence interval [CI] 29.0, 32.6) and 41.9% (95% CI 39.6, 44.3) in rural and urban residences, respectively (p < 0.001). The North-Central region had the highest EIBF rates both in rural (43.5%) and urban (63.5%) residences. Greater odds of EIBF in rural residence were significantly associated with higher birth order (Adjusted Odds Ratio [AOR] 1.29, 95% CI 1.10, 1.60), large birth size (AOR 1.33, 95% CI 1.10, 1.60), and health facility delivery (AOR 1.46, 95% CI 1.23, 1.72). Rural mothers in the rich wealth index, not working and whose husbands obtained at least a secondary school education had significantly higher odds of early initiation of breastfeeding. Regardless of residence, greater odds of EIBF were significantly associated with non-cesarean delivery (Rural AOR 3.50, 95% CI 1.84, 6.62; Urban AOR 2.48, 95% CI 1.60, 3.80) and living in North-Central (Rural AOR 1.84, 95% CI 1.34, 2.52; Urban AOR 4.40, 95% CI 3.15, 6.15) region. Also, higher odds of EIBF were significantly associated with living in North-East (Rural AOR 1.48, 95% CI 1.05, 2.08; Urban AOR 3.50, 95% CI 2.55, 4.83), South-South (Rural AOR 1.51, 95% CI 1.11, 2.10; Urban AOR 2.84, 95% CI 2.03, 3.97) and North-West (Urban residence only AOR 2.08, 95% CI 1.54, 2.80) regions. Conclusions Rural-urban differences in the rates and factors associated with EIBF exist in Nigeria with rural residence having significantly lower rates. Intervention efforts which address the risk factors identified in this study may contribute to improved EIBF rates. Efforts need to prioritize rural mothers generally, (particularly, those in rural North-West region) as well as mothers in urban South-West region of Nigeria

Radiological Assessment Of The Uterus And Fallopian Tubes In Infertile Women At Abakaliki, Nigeria.

Objectives: This study is aimed at determining the pattern of abnormalities in the Hysterosalpingograms of patients who attended the Radiology Unit of Ebonyi State University Teaching Hospital, Abakaliki. Method: The 188 hysterosalpingograms conducted between January 2002 to December 2005 were analysed. Results: The mean age in this study was 31years. Forty-one (21.8%) Hysterosalpingograms were normal. Abnormality of the Fallopian tubes constituted 54.6% of all abnormalities recorded, uterine 33.6% and cervical 11.8%. Cornual occlusion and hydrosalpinx were the leading abnormalities of the Fallopian tube, 32.2% and 20.3% respectively, while beading of the Fallopian tubes was the least tubal abnormality recorded in 1.4%. Uterine fibroid was the leading uterine abnormality in the study (44.5%), and uterine unicornis unicollis and bicornuate uterus were the least abnormalities of the uterus recorded with 0.8% respectively. Cervical synechiae was the only cervical abnormality recorded in the study (11.8%). Conclusion: Hysterosalpingogram is relevant in outlining abnormalities of the fallopian tube and uterus especially in patients with infertility. The study suggests that abnormalities of the Fallopian tube are probably still a prominent contributor to infertility in our community. Keywords: Hysterosalpingogram, abnormality, infertility. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 211-21

Pattern of gynaecological tumours at the mater misericordiae Hospital, Afikpo, South-Eastern Nigeria (1990-2005)

No Abstract. Ebonyi Medical Journal Vol. 5 (2) 2006: pp. 57-6