The 2011 Survey on Hypertensive Disorders of Pregnancy (HDP) in China:Prevalence, Risk Factors, Complications, Pregnancy and Perinatal Outcomes

Hypertensive disorders of pregnancy (HDP) are a group of medical complications in pregnancy and also a risk factor for severe pregnancy outcomes, but it lacks a large-scale epidemiological investigation in recent years. This survey represents a multicenter cross-sectional retrospective study to estimate the prevalence and analyze the risk factors for HDP among the pregnant women who had referred for delivery between January 1st 2011 and December 31st 2011 in China Mainland. A total of 112,386 pregnant women were investigated from 38 secondary and tertiary specialized or general hospitals randomly selected across the country, of which 5,869 had HDP, accounting for 5.22% of all pregnancies. There were significant differences in the prevalence of HDP between geographical regions, in which the North China showed the highest (7.44%) and Central China showed the lowest (1.23%). Of six subtypes of HDP, severe preeclampsia accounted for 39.96%, gestational hypertension for 31.40%, mild preeclampsia for 15.13%, chronic hypertension in pregnancy for 6.00%, preeclampsia superimposed on chronic hypertension for 3.68% and eclampsia for 0.89%. A number of risk factors for HDP were identified, including twin pregnancy, age of >35 years, overweight and obesity, primipara, history of hypertension as well as family history of hypertension and diabetes. The prevalence of pre-term birth, placental abruption and postpartum hemorrhage were significantly higher in women with HDP than those without HDP. The possible risk factors confirmed in this study may be useful for the development of early diagnosis and appropriate treatment of HDP

Contribution of indirect obstetric deaths to maternal mortality at Nnamdi Azikiwe University Teaching Hospital, Nnewi.

Introduction: Maternal death is unacceptably high in this center like in most centers in the developing world.Objective: To determine the maternal mortality ratio and the contribution of the direct and indirect obstetric complications to maternal deaths.Method: A retrospective review of all maternal deaths at Nnamdi Azikiwe University Teaching Hospital Nnewi, between January, 2003 andDecember 2007, a 5 year period. Maternal deaths, were identified from the labour ward, lying-in ward, sick prenatal ward, postnatal ward,gynaecology ward records and the medical records. The total number of births was gotten from the labour ward register.Results: There were 36 maternal deaths within the study period, and maternal mortality ratio of 1282 per 100,000 deliveries. The majority(64%) were due to indirect causes. The most common cause was pulmonary tuberculosis (25%). Anaemia contributed 14% and, viral hepatitis 11%. Cerebral malaria, intestinal obstruction and metastatic breast cancer caused 2.8% of maternal deaths each. The direct obstetrics causes contributed 36%, with preclampsia/eclampsia 19.4%, sepsis (Septic abortion and puerperal Sepsis) 8.4%, haemorrhage 5.6% and uterine rupture 2.8%.Conclusion: Indirect obstetric causes accounted for majority of the maternal deaths recorded within the study period

The pattern of cervical cytology in Obstetrics and Gynaecology clinics in Nnewi, South-Eastern Nigeria

Background: Cervical cytology screening has decreased the incidence of and mortality from invasive cervical cancer in developed and even some developing countries. The story is still different in Nigeria because there is no national screening programme in place.Objectives: The aim of this study was to evaluate the pattern of cervicalcytology and relate it to some known risk factors such as age, parity, age at coitarche, number of sexual partners and clinical presentation.Subjects and Methods: A total of 100 women were seen at two Obstetrics and Gynaecology clinics in Nnewi over a three month period (May-July 2005) were screened. Conventional method of staining was used. The first fifty sexually active women that consented to completing the study questionnaire in the two clinics were included.Main Outcome Measures: The work noted the pattern of reports in relation to some known risk factors and adequacy of the sampling.Results: Sampling adequacy was 93%; epithelial cell abnormality was reported in only one smear; 58 were reported as normal; 14 showed benign cellular changes (i.e. infective); and 18 reactive changes (i.e. atrophy). Conclusion: Now that infective aetiology has been established in cancer of the cervix, the co-factors may be some of these causes of benign cellular changes of the cervix.Keywords: A typical squamous cells, cancer, cervical, co-factors, Pap smea

Twin versus singleton pregnancies: the incidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital

NJ Obiechina1, VE Okolie1, GU Eleje1, ZC Okechukwu1, OA Anemeje21Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria; 2Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, NigeriaBackground: Twin pregnancy is associated with more pregnancy complications and poorer pregnancy outcome than singleton pregnancy. Hence periodic review is necessary to improve on the pregnancy outcome.Objective: To determine the incidence and compare pregnancy complications and obstetric outcomes of twin pregnancies and singleton pregnancies.Materials and methods: The twin pregnancies (study group) that were delivered at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-East Nigeria from 1st February 2005 to 31st January 2010 were compared with singleton deliveries (control group) that occurred in the same hospital during the same period.Results: A total of 3351 deliveries were conducted during the study period, of which 113 were twin deliveries, giving an incidence of 1:29.6 deliveries. Only 100 case files could be retrieved for analysis. The mean parities for the twins and singletons were 2.7 ± 2.33 weeks and 1.96 ± 1.87 weeks whereas the mean gestational age at delivery for twin and singleton deliveries were 34 ± 5.2 weeks and 38.7 ± 2.4 weeks respectively (P < 0.05). The mean birth weights were 3.14 ± 0.73 kg and 2.3 ± 1.0 kg for singletons and twins respectively (P < 0.05). Hypertensive disorders of pregnancy, cord prolapse, malpresentation, premature rupture of membranes, low Apgar scores, cesarean section rate, and perinatal death were significantly higher in twin pregnancies than in singleton.Conclusion: The incidence of twin pregnancy over the study period was high and was significantly associated with more pregnancy complications and poorer obstetric outcomes. Close antenatal and intrapartum care are needed in order to improve outcome and decrease complications.Keywords: twin pregnancy, singleton, low birth weight, perinatal deat

Teenage Pregnancies a Lingering Obstetric Problem in Nigeria

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