Prevalence of hypocalcaemia and maternal complications among antenatal clinic attendees at the University of Port Harcourt Teaching Hospital

Background: Plasma Calcium level is not a routine laboratory test conducted during pregnancy. The role of calcium supplementation to prevent maternal complications of pregnancy such as pre-eclampsia and pregnancy induced leg cramps is conflicting. Objective: To determine the prevalence of hypocalcaemia and maternal complications among antenatal clinic attendees. Method: Ten milliliters of blood sample were taken from each of the 90 pregnant women that met the inclusion criteria for the study. The plasma isolated from each woman was analyzed for calcium and albumin using calcium-albumin kit (lab 7225 spectrophotometer set Bran Scientific and Instrument Company, England). The data was analyzed using SPSS version 16. Results: The prevalence of hypocalcaemia was 25.6% at recruitment and 40% in the third trimester. Sixty-five percent of the subjects who had hypocalcaemia in third trimester developed pre-eclampsia. In the hypocalcaemic group, the frequency of leg cramps was 23.3% and 27.8% at recruitment and at the third trimester respectively. Eight out of the 23(34%) subjects had pre-eclampsia in the normotensive group. Conclusion: The study revealed that high prevalence of hypocalcaemia was associated with advanced gestational age. In addition, there was a relationship between hypocalcemia, pre-eclampsia and pregnancy  induced leg cramps. Thus calcium supplementation is recommended for those at risk of hypocalcaemia.Key words; hypocalcaemia, maternal complications, pre – eclampsia, leg cramps.

Ruptured uterus: Fetomaternal outcome among unbooked mothers and antenatal care defaulters at the University of Portharcourt teaching hospital.

BACKGROUND: Unbooked emergencies are major reasons for the high maternal and perinatal mortality and morbidity in Nigeria. Rupture of the gravid uterus in women without antenatal care usually present late to hospital as unbooked emergencies with high perinatal deaths and very poor maternal outcome. AIM: To determine the factors implicated in the poor feto-maternal outcome with ruptured uterus amongst the unbooked mothers at the University of Port Harcourt Teaching Hospital(UPTH).METHOD: A retrospective analysis of case records of 82 consecutive patients without antenatal care who had ruptured uterus between January 2008 and December 2012.RESULT: There were 2133 deliveries among unbooked mothers at the University of Port Harcourt Teaching Hospital over this 5-year period. The incidence of ruptured uterus for the period under review was 3.8%. The mean age was 28.1years and the modal parity was 2. Abdominal massage and prolonged obstructed labor were the commonest predisposing factors, occurring in 43.9% and 34.1% of these women respectively. There were 80 perinatal deaths contributing to 12.2% of the perinatal mortality rate. There were 6 maternal deaths from ruptured uterus which was 10.9% of the maternal mortality ratio of 2578.5 per 100,000 live birth during the study period.CONCLUSION: Perinatal and maternal mortality rates from ruptured uterus were high. The major causes of uterine rupture are abdominal massage and prolonged obstructed labor, which are both preventable. Public enlightenment and condemnation of practices that promote these factors is advocated.KEYWORDS: ruptured uterus, feto-maternal outcome, unbooked, Port Harcourt

Urinary Screening for Detection of Asymptomatic Haematuria and Proteinuria in Children in Urban and Periurban Schools in Port Harcourt

In order to determine the prevalence of asymptomatic haematuria and proteinuria, a survey was carried out among pupils of two primary schools; one located in the urban area and the other in the periurban area of Port Harcourt Local Government Area. The prevalence rate of significant asymptomatic proteinuria was one percent and that for haematuria was 0.6 percent. There was no significant difference in the prevalence rate of asymptomatic proteinuria or haematuria between children in the periurban school when compared to those in the urban school. Although the yield from mass urinary screening was low, majority of those detected to have significant urinary abnormalities had persistence of those abnormalities when followed up. Urinalysis should therefore be done routinely as part of the school health programme in primary schools and children found to have urinary abnormalities should undergo further evaluation and follow up over a long period Keywords:Urinary screening, Asymptomatic haematuria, Asymptomatic Proteinuria. Nigerian Journal of Paediatrics 2003; 30:1-

Uptake of cervical cancer screening: awareness, willingness and practice among antenatal clinic attendees in Port Harcourt, Nigeria

Background: Cervical cancer remains the commonest genital tract cancer and yet it is preventable through cytologic screening with Pap smear. Awareness and willingness among target population is an imperative for uptake of screening services. Aim: To contribute to the existing knowledge base, and in particular, bridge the information gap on awareness, willingness and practice regarding uptake of cervical cancer screening in south-south Nigeria. Methods: A cross-sectional survey was conducted among a random sample of 335 pregnant women attending an antenatal clinic at the Braithwaite Memorial Hospital in Port Harcourt between October and November 2002. Level of compliance was 97.6%. Results: The mean age of the respondents was 27.6 ± 14.5 years; 185 (56.6%) possessed tertiary education, and 251 (84.4%) were married. Level of   awareness   of  cervical   cancer   was   60.9% (n=199), and 52.0% (n=170) for awareness of Pap smear. The level of awareness appeared to increase with level of education   (2 p-value =0.002). More than half, 226 (69.1%; 95%CI= 63.8-74.1) indicated willingness to screen for cervical cancer if given the opportunity. At the time of the study, 27 (8.3%; 95%CI=5.5-11.8) of the respondents had done a Pap smear test. This accounted for 15.9% (95%CI=10.7-22.3) of the 170 who were aware of Pap smear, and 11.9% (95%CI=8.0-16.9) of those who were willing to have a Pap smear. Conclusion: This study revealed a relatively high level of awareness and practice of cervical cancer screening compared to other regional figures in Nigeria.   Keywords: Cervical cancer, Pap smear, Antenatal care,  Port Harcourt,  Nigeri

Perceptions of Infertility - A Survey of Urban Residents in Port Harcourt

Objective: Societal influence on infertile couples usually stems from what is known or perceived about the causes, risk factors and treatment of infertility in the population. This study aimed to investigate perceptions of infertility among urban residents of Port Harcourt. Materials and Methods: A cross-sectional, household-based survey was conducted in the Borikiri area of Port Harcourt in 2003. A sample of 150 adults, aged 20 years and above was drawn by multi-staged random sampling involving the selection of streets, houses, households and finally individuals, as sampling units at different stages. Households were visited over a period of two days, and all eligible subjects were interviewed using a pre-tested, interviewer-administered, structured questionnaire. Results: Sixty (40.0%) of the respondents were females; 105 (70%) were 20-29 years; 58.7% were unmarried; and 66.7% possessed tertiary education. Only 48 (32.0%) correctly identified a three-fold medical definition of infertility (2=38.88, p-value=0.00). Between 88% and 100% were aware of a selection of factors perceived to increase the risk of infertility. About two-thirds (93, 63.3%) felt that a woman was more likely to be responsible for infertility. Majority, 106 (70.7%) were aware of In-vitro Fertilization, and 92 (61.3%) knew of Artificial Insemination by Husband and Artificial Insemination by Donor respectively. Over 80% were in support of Artificial Insemination by Husband and In-vitro Fertilization, but only about 25% and 10% supported Adoption and Artificial Insemination by Donor, respectively. Conclusion: Our study showed that most of Port Harcourt residents' perception of the definition of infertility differed from its commonly used medical context. However many recognized some known risk factors of infertility and were aware of assisted reproductive technologies. But they were selective in the options they support. Patients' level of knowledge and differences in perceptions between a biomedical and lay concept of infertility are important for health workers' management decisions. Keywords: Infertility, Perception, Urban subjects, Port Harcourt, Nigeri

Effect of Azidothymidine on CD4 Positive T Cells in HIV

The effects of Azidothymidine (AZT) on the level of CD4 positive T cells in seropositive HIV patients regularly visiting the University Teaching Hospital, Port Harcourt and Braithwaite Memorial Hospital were selected for this investigation. Treatment group consisted of patients that received AZT at doses of 5mg/kg orally whereas the control group received placebo. The result shows that AZT increased significantly ( P ≤ 0.01) CD4 + T cells level from 700 ± 3.00μl to 950±3.00μl while in the control group the significant decline (P ≤ 0.01) of CD4 + T cells continued. This is indicative of the protective effects of AZT in preventing the destruction of CD4 + T cells by the HIV virus. The increased CD4 + T cells levels in the AZT treated patients was followed by concomitant reduction of the frequencies and severity of the HIV disease symptoms such as opportunistic infections and Lymphadenopathy. The control group had increase in the frequency and severity of these symptoms. The results of this study indicate that the use of AZT in the treatment of HIV positive patients is justified and therefore recommended especially in blacks. Journal of Applied Sciences and Environmental Management Vol. 8 (2) 2004: 35-3

Addressing population growth in Nigeria and averting maternal mortality: Need for continuous research into male reversible contraception – male implants in perspective

No Abstract