Primary Caeserean Section In Grandmultiparae At Mater Misericordiae Hosptial Afikpo: A 5 Year Retrospective Study

To identify the common indications and the outcome of primary caesarian section in grandmultiparae at Mater Misericordiae Hospital Afikpo. The case notes of 69 grandmultiparae who had primary caesarean section at Mater MisericordiaeHospitalAfikpo between January 1999 toDecember 2003 inclusively.The information obtained included age, parity, occupation, height, educational status, booking status, indication for caesarean section, operative and post-operative complications, types of anaesthesia, types of uterine incision, mean blood loss, associated pelvic findings and foetal outcome. Eighty nine percent (89%) of 69 primary caesarean sections were done emergency procedure. The commonest indications for a caesarean section were dystocia (76.8%), antepartum haemorrhage (17.4%), essential hypertension (10.1%) Puerperal pyrexia (24.6%), haemorrhage (7.2%)wound dehiscence (4.3%) and anaemia (2.9%), were the commonest intra- and post operative complications encountered. The perinatal mortality ratewas 153/1000.Therewere twomaternal deaths (29 per 1000). Health education of the population coupled with better utilization of comprehensive maternity care and family planning facilities are advocated. Keywords: Caesarean Section, Grand multiparae. Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 368-37

Maternal hiv positive sero-prevalence at delivery at a tertiary hospital in south-eastern Nigeria

Background Key Words: Maternal HIV positive sero-prevalence, delivery, birth sex ratio,Orlu.: The duo of HIV/AIDS infection has become a Global public health problem. This study was conducted to determine the maternal HIV positive seroprevalence at delivery at the Imo State University Teaching Hospital, Orlu. Methods: A retrospective analysis of the case records of women (both booked and unbooked) who tested positive to Human Immune-deficiency Virus at delivery at the Imo State University Teaching Hospital (IMSUTH), Orlu from 1st May 2005 to 30th April 2010 was made. The biosocial, obstetric and fetal sex data were extracted and analysed. Results: The maternal HIV positive sero-prevalence at delivery was 6.9%. The highest sero prevalence rate of 42.4% occurred in the age group of 31-35years. Sixty three (68.5%) of the women were multiparous (para 1- 4). The male: female birth ratio was 1 : 1.42. Forty one (44.6%) of the women were unbooked. None of the women were symptomatic of Acquired Immunodeficiency Syndrome (AIDS) on presentation. Conclusion: There is high maternal HIV seroprevalence at delivery at IMSUTH, Orlu. There should be improvement on interventions to reduce this ugly trend. There should also be early booking and adequate antenatal care services

Antenatal Care Booking Pattern at a Tertiary Hospital in South- Eastern Nigeria

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Assessment of age at menarche and menstrual pattern among secondary school girls in Awka, Southeast Nigeria

Background: Menarche is an important physiological milestone in girls and this usually occurs during their secondary school years. The menstrual pattern may vary in these adolescents. This knowledge may assist in counselling the young girls on reproductive health issues.Methods: A cross-sectional study of female secondary school students from Kenneth Dike secondary school, Awka; Amaenyi girls’ secondary school and community secondary school, Okpuno, all in Awka, Anambra state of Nigeria. All together 545 students were selected following informed consent. The study instrument was a pre-tested, semi-structured and self-administered questionnaire. Data analysis was done with IBM SPSS 20 software. Tests of association between variables were done with Fisher’s exact test and the level of significance set at p≤0.05. Results: The mean age of the 545 respondents was 16.79±1.736 years and majority of them are of the Igbo ethnic group (90.5%). The average age at menarche was 12.77±1.159 years. There is a significant difference between the age at menarche and the father’s occupation. The modal duration of flow was 4 days (48.7%) while 95.2% had a normal cycle length of 21-35 days.Conclusions: The average age of menarche of secondary school girls in Awka was 12.77±1.159 years. Most of the students had normal menstrual flow duration of 2-7 days with a cycle length of 21-35 days

Desire to practice postpartum contraception among antenatal women at Awka, Southeast Nigeria

Background: Postpartum contraception enables the nursing woman recover from the effects of pregnancy and childbirth before embarking on another pregnancy. It also promotes child welfare. The assessment of the desire by pregnant women to take up postpartum contraceptive service will help the planning of good delivery of this service.Methods: A cross-sectional study of antenatal clinic attendees at Chukwuemeka Odumegwu Ojukwu Teaching Hospital, Awka was done using a pretested interviewer-administered questionnaire. Data was analyzed with IBM SPSS version 20 software and associations between variables were tested with Chi square. Level of significance was set at P ≤0.05.Results: A total of 262 antenatal women were interviewed. The mean age of the respondents was 29.1±6.1 years while the mean parity was 2.5±1.5. Two hundred and one of the study women (76.7%) had the desire to practice postpartum contraception after the index pregnancy while only 9 (3.4%) were unsure whether they had the desire or not. Multiparous women are more likely to desire postpartum contraception (P <0.01). Also, previous use of contraception (P<0.01), desired index pregnancy (P=0.01) and being married or single (P=0.02) are all significantly associated with the desire to practice postpartum contraception.Conclusions: There was a high level of desire to practice postpartum contraception among antenatal clinic attendees at Awka. Parity, marital status, desired index pregnancy and previous practice of contraception all influence this desire

Maternal death and obstetric care audits in Nigeria: A systematic review of barriers and enabling factors in the provision of emergency care.

Acknowledgements We would like to thank Yutaka Osakabe for co-ordinating the retrieval of full text articles. The John D. and Catherine T. MacArthur Foundation supported this study, grant number 12-100074-000-INPPeer reviewedPublisher PD

Gestational age at booking in Imo State University Teaching Hospital.

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Caesarean section related morbidity and mortality at the Imo State University Teaching Hospital Orlu

Background: There is a general aversion to Caesarean section among Nigerian women. However, with increasing safety of the procedure and better enlightenment, more women are beginning to accept the procedure. To maintain this increasing acceptability, Caesarean section related morbidity and mortality must be reduced to the barest minimal levels. Aim: To determine the incidence and the complications associated with Caesarean section at the Imo State University Teaching Hospital, Orlu. Methods: A four-year descriptive study from June 2004 to May 2008 from the Obstetrics Department of Imo State University Teaching Hospital, Orlu was conducted. All pregnant women that were delivered by Caesarean section were included. Results: There were 363 (33.2%) mothers who underwent Caesarean sections out of 1094 deliveries in the unit during the period under review. Postoperative complications occurred in 52 patients (14.5%). The complications cut across all reproductive age groups and parity. The commonest complications encountered were wound infection (71.9%), postpartum haemorrhage (63.2%) and anaemia (40.4%). The mortality rate was 1.2%. Conclusion: The Caesarean section complication rate of 14.5% is still high, even though it is less than the figures quoted for some environments. There is still the need to reduce this rate to the barest minimum for us to be able to sustain the gains of the recent past.   Key words: Caesarean section, Morbidity, Mortality, Orl

The prevalence of gynaecological diseases at the Imo State University Teaching Hospital, Orlu, Nigeria

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Experience with manual vacuum aspiration at the Imo State University Teaching Hospital, Orlu, Nigeria

Background: Criminal or illegal abortions and it's attendant complications contribute significantly to maternal morbidity and mortality in developing countries. Manual vacuum aspiration provides a cheap, safe and effective means of reducing this morbidity and mortality.Aim: To evaluate the usefulness of manual vacuum aspiration in the management of first trimester miscarriages in Orlu.Methods: The case notes of 324 patients with first trimester miscarriages managed with manual vacuum aspiration (MVA) over a 5-year period from June 2004 to June 2009 were retrieved. Information extracted included age, parity, gestational age at presentation, indication for MVA use and complications resulting from the procedure.Results: A total of&nbsp; 1672 gynaecological patients were seen during the study period out of which 324 had MVA procedure, giving a prevalence rate of 19.4% with a mean age of 24+2.3 years. The highest number of procedures were carried out on patients aged 26-30 years (23.5%). Grandmultiparous patients accounted for the highest number of cases (53.1%). Most of the procedures (46.3%) were carried out in patients whose miscarriages occurred between 9-10 weeks of gestation. Incomplete miscarriage (75.6%) was the commonest indication for the use of MVA while genital tract bleeding (46.4%) was the commonest complication encountered. Majority of the procedures (86.4%) were carried out on out patient basis. There was no maternal death or blood transfusion.Conclusions: Abortion and it's attendant complications with a prevalence&nbsp; rate of 22.1% appears to be fairly common in our environment. MVA is very effective in the management of first trimester miscarriages in our centre. Keywords: Manual vacuum aspiration, Miscarriage, Experience, Orl