Correlation between placenta and umbilical cord morphplogy and perinatal outcome in singleton deliveries at term in a Nigerian tertiary health centre

Context: The ability of the fetus to grow and thrive in-utero depends on a number of factors of which the placenta is a contributor. The umbilical cord is an essential organ connecting the fetus to the placenta and a healthy placenta is essential for good perinatal outcome.Objectives: The study aims at determining the relationship between the morphology of the placenta and umbilical cord and perinatal outcome in singleton deliveries at term in a Nigerian hospital.Study design:This is a cross-sectional study involving the analysis of placentae and umbilical cords of three hundred and five neonates delivered in the Federal Medical Centre, Owo who met the inclusion criteria. Immediately after each delivery, the umbilical cord was clamped and severed five centimetres from its attachment to the neonate. The rest of the umbilical cord from the cut end to its insertion on the placenta was measured in centimetres and five centimetres of the umbilical cord attached to the neonate was added to get the entire length of the umbilical cord. Other parametersinvolving the morphology of the umbilical cord and placentae were also noted.Outcome measures: Correlation between the morphological parameters of the umbilical cord, placenta and the neonatal factors such as Apgar scores, birth weight, length of the baby, admission into Neonatal Intensive Care Unit and its indication were determined.Results: Three hundred and five women had their babies' placentae and umbilical cords examined and also had other records complete. There were 270 umbilical cords out of the 305 recruited with normal coiling index range of 0.17-0.20 coils per centimetres giving an incidence of 88.5%. There was a positive correlation between birth weight and placenta weight (r = 0.466; p value <0.001); there was also a positive correlation between birth length and umbilical cord length (r = 0.130; p value <0.024); likewise there was a positive correlation between umbilical cord coiling index and some parameters of assessing perinatal outcome like the Apgar scores at first and fifth minute (r = 0.137; p value 0.024 and r = 0.84; p value 0.167 respectively) while it had a negative correlation with birth weight (r = -0.130;p = 0.024) .Conclusion: The findings from this study contribute significantly to knowledge and have also helped to establish the correlation between the intrauterine and extrauterine wellbeing

From traditional birth attendants to hospital: a maternal near-miss

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Social Meaning and Consequences of Infertility in Ogbomoso, Nigeria

Background: This study examined the meaning of infertility from layman's perspective, and experiences of women suffering from infertility among reproductive age women seeking care at the gynaecology unit of the Bowen University Teaching Hospital, Ogbomoso, Nigeria.Materials and Methods: It was a cross-sectional study. Quantitative and qualitative data collection methods were employed. Quantitative data collection was by the aid of a structured interviewer-administered questionnaire among 200 women seeking care for infertility at the hospital. Qualitative data collection was by Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs).Result: Approximately 40% and 60% of the respondents seeking care for infertility were suffering from primary and secondary infertility respectively. Perceived meaning and   etiologies of childlessness were multidimensional, but 33% of the respondents not sure of the causal factor. Seventy-nine percent   were under pressure to become pregnant. The high premium placed on fertility within marriage has placed   a larger proportion of them under pressure from their husbands (25%), their mother-in-laws (40%), and the community (14%).Conclusion: This study concluded that women regard infertility to be caused by multiplicity of factors. Most of these etiologies were unscientific and unverifiable. Fruitful expectations also put enormous burden on those women suffering from infertility including adverse psychosexual effects. The unceasing pressure due to infertility   in this group of patients calls for urgent intervention as most of these women become susceptible to high risk sexual behavior, depression and other severe consequences

Intrapartum prediction of birth weight using maternal anthropometric measurements and ultrasound scan

This prospective study was conducted at Federal Medical Centre, Owo, Nigeria, between April 1st and 31st of July, 2013 to predict birth weight in labour using four clinical methods and ultrasound scan independently and comparatively to determine which is closest to the actual birth weight. The four clinical methods are Ojwang's formula, Johnson's formula, 5% of maternal weight and 10% of maternal body mass index. A total of 100 women who fulfilled the inclusion criteria had their foetal weight estimated using the methods. Accuracy of the prediction was determined by mean weight difference, percentage error and proportion of estimates within 10% of actual birth weight.Tests of significant difference were done and the level of significance was set at 0.05.Correlation and regression analyses were carried out.Of the five methods used, ultrasound scan estimation had the highest correlation coefficient of 0.681(P<0.001) followed by Ojwang's rule with correlation coefficient of 0.675(P<0.001). The prediction using Johnson's method performed next to Ojwang's rule with correlation coefficient of 0.629(P<0.001).The methods using 5% maternal weight and 10% maternal BMI had correlation coefficients of 0.312(P<0.001) and 0.220(P<0.001) respectively. It was then concluded that there is positive significant correlation between the methods used and actual birth weight. The method using 10% maternal BMI is the least reliable while the ultrasound scan estimate was the most reliable. Ojwang's rule estimation performed next to ultrasound and should be considered first in settings where ultrasound machine or the expertise to use the machine is lacking.Keywords: Birth weight, Foetal weight, Ultrasonography, Pregnancy, Delivery, Prospective studie

Prevalence Of Human Immunodeficiency Virus & Hepatitis B Virus Co-Infection In A Population Of Apparently Healthy Pregnant Women In University Of Ilorin Teaching Hospital, Ilorin

No Abstract

Case report: From traditional birth attendants to hospital: a maternal near-miss

‘Maternal near-miss’ is defined as a woman who nearly died during pregnancy or following delivery but survived. The story of many women in sub Saharan Africa is that of an escape from death if they do eventually have a safe delivery.1This situation is not unconnected to several factors as it concerns these women, their families, the society and the choices they make

A Three-Year Review of Birth Weight Pattern Among Term Deliveries in Bowen University Teaching Hospital, Ogbomoso, Nigeria

Background: Birth weight is a commonly used indicator of newborn maturity and health and a reliable predictor of postnatal survival. There is a need to determine the birth weight pattern and maternal factors that influence the birth weight in babies delivered at term. Objective: To determine the birth weight pattern and maternal factors influencing the birth weight of babies delivered at term. Methods: In this retrospective, descriptive study, the hospital records of all pregnant women who had childbirth at term in Bowen University Teaching Hospital (BUTH), Ogbomoso, Nigeria, from 01 January 2018 to 31 December 2020, were retrieved. Data on birth weight and maternal obstetric factors were retrieved for analysis. Results: The mean age of the mothers was 30.52 ± 5.23 years. A total of 1072 deliveries were recorded during the study period. These consisted of 580 (54.1%) males and 492 (45.9%) females, with a male-to-female ratio of 1.18:1. The caesarean section rate was 37.7%. The mean birth weight was 3.15±0.56 kg, and male babies had a higher mean weight (3.186±0.535kg vs 3.14±0.493kg). Normal birth weight (NBW) was recorded among 90.3%, while low birth weight (LBW) and high birth weight (HBW) were 6.7% and 3.0%, respectively. Only maternal comorbidities (p = 0.0001) and number of gestation (p = 0.0001) were significantly associated with birth weight. Conclusion: Maternal and foetal factors influenced the birth weights of the babies. Implementing measures to minimise the risk of delivering babies with abnormal birth weights is essential to improve newborn survival