Prevention of unintended pregnancies in Nigeria; the effect of socio-demographic characteristic on the knowledge and use of emergency contraceptives among female university students

Background: The proportion of unintended pregnancy remains high in developing regions due to unmet need for contraception and inconsistent use of modern contraceptives. Practice of emergency contraception is particularly important because of the high rates of unintended pregnancy. The aim was to assess the practice of emergency contraception among female students.Methods: A cross-sectional study was conducted among 5,233 female university students in Nigeria.Results: About 25.4% of the students had ever had sex while 64.3% had heard about emergency contraceptives. About half (49.6%) had good knowledge while 70% thought that emergency contraceptives are effective and easy to access and use. Good knowledge about emergency contraceptives was predicted by dwelling urban or suburban areas (AOR=1.750 and 1.817; P<0.05), being single (AOR=2.597, P=0.001), being in the fourth year (AOR=2.096, P<0.001) and having ever had sex (AOR=1.449, P<0.001). Having ever used emergency contraceptive is predicted by good knowledge (AOR=1.852, P<0.001) and perception that emergency contraceptives are effective (AOR=139.774, P<0.001) and easy to access and use (AOR=8.429, P<0.001).Conclusions: Despite a significant risk of unintended pregnancy among female university students, the usage rate of emergency contraceptive is very low. There is a need to actively promote emergency contraception along with other contraceptive methods with the involvement of health workers and the media.  

Assessment of Tumor markers, C-reactive Protein, Cortisol and Total Plasma Peroxides Levels in Uterine Leiomyoma Patients

Objective: The pathophysiology of uterine leiomyoma is yet to be fully understood. This study determined the status of cortisol, C-reactive protein, total plasma peroxide and selected tumor markers in uterine leiomyoma patients. Materials and Methods: Forty-eight individuals (aged 25-45 years) with uterine leiomyoma (nodules=1-4; size=5-120mm) were recruited for this study. Forty apparently age-matched normal individuals without uterine leiomyoma served as controls. The patients and controls were selected after confirmation of the status of uterine leiomyoma by ultrasound imaging technique. The plasma levels of total plasma peroxides(TPP), cortisol, carcino-embryonic antigen(CEA), alpha fetoprotein (AFP), carbohydrate antigen 125(CA125) and C-reactive protein(CRP) were determined in them using spectrophotometry, enzyme linked immunosorbent assay and single radial immunodiffusion (Maccini) methods respectively. Results: The result shows significantly higher levels of TPP (p0.05) changes in the plasma levels of cortisol, CEA and AFP in the leiomyoma patients when compared with the controls. Significant (r=0.521, p=0.03) correlation existed between the number of myoma nodules and the levels of CRP in the leiomyoma patients. The size of the nodules correlated significantly (r=0.47, p=0.04) with the plasma levels of TPP. Conclusion: Elevated levels of CRP and TPP could indicate oxidative stress and inflammatory response in uterine leiomyoma patients. The induced inflammation and oxidative stress may increase with increase in number and size of the myoma nodules respectively. Higher level of CA125 could be a feature of uterine leiomyoma

Family planning and contraceptive practices among parturients in a cottage hospital in south-west Nigeria

Background: Family size predetermination and birthing according to schedule is a strong determinant of family stability as it allows proper resource allocation and management.Aims: To determine the family planning practices among parturients and determine the factors that can influence the uptake of contraceptives in the semi urban and rural population.Methodology: This is a cross-sectional quantitative, structured questionnaire based study of consecutive parturients in a cottage hospital.Results: Seventy five percent of the respondents had a birth interval of between 1-2years and the mean birth interval was about two and half years (Standard Deviation = 1year 3months). The pregnancy was anticipated in 101/131 (77.1%) of the cases and 90/131(68.7%) of them planned the number of children they want to have.Sixty two (47.3%) of the respondents have ever used a contraceptive while the knowledge of contraception was 88.5% (116/131). History of discontinuation was found in about forty percent (25/62) of the respondents and the main reason for discontinuation was desire for conception. Over half of the respondents (57.3%) opined that the major influencers to accept contraceptives are husbands influence; personal desire and if there are incentives attached.There was a significantly positive correlation between parity and number of children alive (r=0.89; p=0.01)Conclusion: The high parity among women is a consequence of low child survival. Increasing inter-pregnancy interval and increasing uptake of contraceptives might improve pregnancy outcome and improve the health of the woman. Male involvement in contraceptive services will improve significantly contraceptive uptake.Keywords: Choice of Contraception, Determinants, Infant Mortality, Family Siz

Isolated Giant Vulval Neurofibroma: A Case Report

A case of isolated giant vulval neurofibroma in a 34 year old para 1 lady is reported. She presented with a large vulval swelling involving labia majora, minora and the clitoris preventing her from having sexual intercourse. She had vulval biopsy sent for histopathological examination and it was diagnosed as “chronically inflammed neurofibroma of the vulval”. Because of the large size, simple vulvectomy was performed and she recovered well postoperatively. Literature on vulval neurofibroma regarding the presentation and management was revieved. Key Words: Vulva Neurofibroma, Vulvectomy [ Trop J Obstet Gynaecol, 2004;21:190-192