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

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 choice of contraceptives among women in Orlu, Nigeria

Background: Remarkable progress has been recorded in the turn of the century towards the development of more efficient and safer contraceptives. Previous studies from some parts of the country showed an increase in the percentage of clients changing from one contraceptive method to another. With the advent of the HIV/AIDS pandemic at the turn of the new millennium there may still be further changes in the choice of contraceptives in different parts of the world, Nigeria inclusive. Aim: To study the choice of contraceptive usage and the factors predictive of such choices in Orlu, southern Nigeria. Design:  A cross sectional study Setting: Imo state University Teaching Hospital, Orlu, Nigeria. Subjects:  Clients attending the family planning clinic. Main outcome variables: contraceptive choice, reason for choice, awareness and source of awareness about contraceptives. Results: Five hundred and three clients were reviewed. Ninety one percent knew at least one method of contraception. Their ages ranged between 18 and 52 years with majority in the 33-37 years age bracket. Most of the women were housewives (46.5%). Clients who had attained post secondary school education or more constituted 29.4%, majority were married (84.7%), in monogamous marriages (81.7%) and grandmultiparous (45.9%). The commonest contraceptive choice was the injectables (44.3%) while nurses and midwives formed the commonest source of knowledge about contraception and referral. Conclusion: The most commonly used contraceptive method in Orlu, Nigeria is the injectables. The HIV/AIDS pandemic may likely change or affect this trend.   Keywords: Contraceptive choice, Source of awareness, Referral, Orl

Knowledge and practice of cervical cancer screening at the Imo State University Teaching Hospital, Orlu

Aims: This study investigates the knowledge and practice of cervical cancer screening in randomly selected women attending various clinics in the Imo State University Teaching Hospital, Orlu as well as the determinants of take-up of cervical cytology screening. Methods: The subjects were 450 randomly selected women attending various clinics at the Imo State University Teaching Hospital Orlu, from May 1, 2005 to April 30, 2006. A pre-tested semi-structured self- administered questionnaire was used. This included questions on the socio-demographic characteristics of the patients as well as questions regarding their knowledge of cervical cancer and its prevention and their degree of utilization of Pap smear. Results: The mean age of the 450 respondents was 31.6 + 5.8 years. Singles constituted 26.1% while 73.9% were married. Those who were aware of cervical cancer were 13.6% as against 6% who were aware of Pap smear. Only 2.4% of the 450 respondents had ever had a cervical cytology performed on them. The most frequent reason given for not using the service was lack of physician referral. Culture was found to negatively impact on the take up of cervical cytology. Majority of the respondents would prefer a male doctor to perform a Pap smear on them if they were to have one. Conclusion: The study shows that there is poor awareness and knowledge of both cervical cancer and its prevention in our environment. The uptake of cervical cancer screening is also very poor. There is therefore the need to establish an organized cervical cancer screening in different parts of the country, but in the interim health care providers should improve on opportunistic screening. In our socio cultural settings, sexually active women, the community and the men folk should form the target of any awareness/enlightenment campaigns about cervical cancer, and should be actively involved in the planning and execution of any screening programmes. Keywords: Cervical cancer, Screening, Knowledge, Practice, OrluPHMJ Vol. 2 (2) 2008: pp. 145-15

Presentation and management fo uterine leiomyoma at Imo State University Teaching Hospital, Orlu, Nigeria

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Pregnancy complications and outcome following cervical cerclage operations at the University of Maiduguri Teaching Hospital,

Objective: To determine the Pregnancy Complications and Outcome following Cervical Cerclage Operations. Subject: The case records of 76 patients who underwent Cervical Cerclage Operation for Cervical incompetent at the University of Maiduguri Teaching Hospital between January, 1983 and December 1999 inclusive were reviewed. In all the patients the diagnosis of Cervical incompetence was made based on the history of two or more midtrimester abortions or preterm deliveries and ultra-sound finding of internal OS diameter of 16mm or more in the second trimester of Pregnancy. Result: The MacDonald (81%) and shirodkar (19%) techniques were the two forms of Cerclage employed. Preterm rupture of membranes vulvovaginitis and Urinary tract infection were the Common Post-insertion Complications encountered while antepartum haemorrhage, Perineal/Cervical tear and mal-presentations were the common associated labour complications. 65.3% of the deliveries were term births while preterm deliveries made up 23.1% of the births. The overall foetal salvage rate was 85.3%. There was no maternal death. The Peritanal mortality was 84 per 1000. Conclusion: The overall foetal salvage rate of 88.3% observed in this study is high and in a developing Country like Nigeria with inadequate neonatal facilities and a slim foetal survival between 24-28 weeks, any procedure like cervical cerclage that will prolong pregnancy until foetal maturity is still relevant and beneficial. KEY WORDS: Cervical incompetence, Cervical Cerclage, Pregnancy outcome, Maiduguri, Nigeria. [Nig J Clinical Practice Vol.5(1) 2002: 25-28