One-year experience with implanon sub-dermal implants in Jos, Nigeria

To determine Implanon acceptance, the group of women accepting it, complications, indications for discontinuation; and report an initial experiencewith themethod. Thiswas a retrospective observational study of Implanon®, a single rod, long acting, reversible subdermal contraceptive implant system, containing the progestin etonogestrel, which was introduced in Jos, Nigeria, inMay 2006. Implanon capsules were accepted by 404 clients constituting 13.4% of acceptors of all contraceptive methods. The average age, parity and number of living children to the acceptors were 32.1 years, 3.6 and 3.3 respectively.About three-quarters (76.0%) of the women had secondary and tertiary education. Seventy-three (18.1%) of the women were taking a modern contraceptive method for the first time. There were 7 removals giving a high continuation rate of 98.3% in the first year. Menstrual disturbance was the commonest (57.1%) indication for removal. Implanon is an acceptablemethod of contraception among ourwomen  population.Keywords: Implant, Implanon, sub-dermal, Jos,Nigeria

Correlation between ultrasound estimated fetal weight in term pregnancy and actual birth weight amongst pregnant women in Jos

Background: High rate of perinatal mortality is still a major cause for concern in developing countries such as Nigeria. A large portion of this problem is related to birth-weight which remains the single most important parameter that determines neonatal survival. A simple and accurate method of estimating intrauterine fetalweight that can be easily applied to all pregnancies is thus an important means of reducing perinatal mortality and morbidity.Objective: To determine the correlation between ultrasound estimated fetal weight in term pregnancy and actual birth weight amongst pregnant women in Jos, North-Central NigeriaMethods: This research was a prospective cross-sectional hospital based study correlating sonographic estimated fetal weight at term with actual birth weight in Jos, North-Central Nigeria. Ultrasound estimated fetal weight was calculated using a combination of the biparietal diameter (BPD), abdominal circumference (AC), and femoral length (FL) usingHadlock formula, inbuilt in ALOKA SSD-4000 ultrasound machine fitted with 3.5MHz curvilinear transducer.Results: A total of 400 women were recruited for the study. The mean maternal age was 29.35 years, and the mean gestational age at delivery was 38 weeks and 6 days. The mean actual birth weight was 3209.31 ± 497.52g while the mean ultrasound estimated fetal weight was 3177.85 ± 533.01g.There was an overall strong correlation between ultrasound estimated fetal weight and actual birth weight (r=0.835) and the difference was not statistically significant (p>0.001.). Also, 75% of the estimates were within 10% of the actual birth weight.Conclusion: Ultrasound estimated fetal weight correlated strongly with actual birth weight especially for babies with normal birth weight. However, for babies at the extremes of birth weight, ultrasound estimated fetal weight would need to be correlated with physical examination (including clinical estimation) to avoid unnecessary obstetric intervention.Keywords: Correlation, ultrasound, fetal weight, actual weight, term pregnanc

Risk Factors for Placenta Praevia in Jos, North Central Nigeria

Background: Placenta praevia, a major cause of obstetric haemorrhage, is potentially lifethreatening to the mother and frequently results in high perinatal morbidity and mortality. Several epidemiological and clinical studies report disparate data on the risk factors associated with this condition. Although several studies on risk factors for placenta praevia have been published, data obtained from the sub-Saharan Africa remains scanty. Our objective is to describe the spectrum of risk factors for placenta praevia in Jos, North Central Nigeria. Methods: This was a retrospective cohort study of 96 women delivered form January, 1999 to December, 2002 at Jos University Teaching Hospital, Jos, Nigeria. Data on total number of deliveries, maternal age, parity, and past obstetrics history and abortion were carefully extracted from medical records and analyzed using the Epi Info 3.4.1 (CDC, Atlanta, Georgia). Results: The prevalence of placenta praevia was 0.89%. Previous uterine evacuation was documented in 35.4% of cases, while previous caesarean section scar occurred in 5.2% of cases. About half (44.8%) of the cases had no known risk factor. Conclusion: Uterine scaring following abortion management is an important risk factor for placenta praevia. However, majority of patients with placenta praevia in this work have no identifiable risk factor. Key Words: placenta praevia, antepartum haemorrhage, risk factors, North central Nigeri

Induced abortion; a continuing tragedy

Background: Induced abortion remains one of the gravest problems associated with women’s reproductive health in Nigeria. Induced abortion is commonly practiced in Nigeria with a prevalence ranging from 25-53% amongst adolescents in schools and 88-94% amongst out of school single women. It is a major contributor to maternal mortality and serious morbidity in Nigeria Objectives: The objectives of this review were to assess the socio-demographic characteristics of patients that procure induced abortions, determine the gestational age at which these abortions occurred, as well as to determine common complications associated with induced abortions Methods: This was a retrospective study of induced abortions that were seen at the Gynaecology Emergency unit of the Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos Nigeria between January 2001 and December 2003. The data were retrieved from the medical records department and analyzed using Epi-info version 3.2.2. Results: The mean age of the women was 22.1years (range 14-45years). More than half, 41 (56%) had secondary school education. Seventy five percent (54) of the patients were unmarried. Fifty four percent (39) of the patients were students. Doctors in private hospitals procured majority (34.7%) of the abortions. Retained products of conception, pelvic abscess, uterine perforation and gut injury were the common complications encountered. There were 4 mortalities in the study giving a mortality rate of 5.6%. Conclusion: Single and none working women were more likely to have induced abortions. The common complications following these procedures were retained products of conception, sepsis, gut injury, and maternal death.Key Words: Induced Abortion, single women, retained products of conception, Jos University Teaching Hospital

Indications for abdominal hysterectomy at the Jos University Teaching Hospital.

Objective: Abdominal Hysterectomy is an everyday procedure in the Department of Obstetrics and Gynaecology of the Jos University Teaching Hospital. There is, however, dearth of data on the indications for and, pattern of morbidity and mortality of this procedure from this centre. This prompted the review. Methodology: This was a retrospective study of all Abdominal Hysterectomies done in the Department of Obstetrics and Gynaecology of the Jos University Teaching Hospital (JUTH), Jos, Plateau state, North Central Nigeria over a four year period (2002-2005). Results: Abdominal hysterectomy accounted for 10.8% of all major gynaecological operations during the study period. The age group of 40-44 years accounted for 50% of the patients that had total abdominal hysterectomy. Uterine fibroid was the commonest indication, which accounted for 89.5% of cases. The morbidity rate was 33% and there was no mortality. Conclusion: Hysterectomy for Uterine fibroids was the commonest indication for l Abdominal Hysterectomy. Though postoperative morbidity was high (33%), there was no mortality.Key words: Abdominal Hysterectomy, Uterine Fibroids, morbidity, Jos  University Teaching Hospital