Evaluation of maternal serum levels of dehydroepiandrosterone sulphate and its association with successful labour outcome among parturients undergoing spontaneous labour at term

This study evaluated maternal serum levels of dehydroepiandrosterone sulphate (DHEAS) in spontaneous labour and its association with successful labour at term. A cross-sectional observational study was carried out on 140 parturients. Their blood samples were collected in active labour; allowed to clot, centrifuged, separated and stored at −20 °C before analysis for DHEAS was done using the ELISA method. Labour was termed successful when vaginal delivery was achieved. Serum DHEAS levels were higher among parturients with successful labour compared to women with unsuccessful outcome (p = 0.001). DHEAS level was also higher among parturients who did not require oxytocin augmentation compared with those who required it (p = .001). The odds ratio and incidence of successful labour increased significantly as DHEAS level increased above a critical value of 1.5 μg/ml (p = .001). The association between serum DHEAS level and successful labour remained significant after adjusting for other variables (p = .002)

An institutional survey of female genital mutilation in Lagos, South-West, Nigeria

Background: Female genital mutilation (FGM) as a procedure can have serious physical and psychological health consequences in girls and women.Objectives: To determine the prevalence of FGM and the socio-demographic factors which influence the practice among women in Lagos State.Methods: This was a cross-sectional descriptive study carried out at the Lagos University Teaching Hospital (LUTH) with eligible participants recruited by  consecutive sampling method. Relevant data were collected using a structured questionnaire and physical inspection of the external genitalia was performed on each respondent to confirm the presence and type of FGM. All quantitative data were entered in the computer and analysed using SPSS version 17 for windows.  Descriptive statistics were computed for all relevant data.Results: The prevalence of FGM in the study was 56.3% with the largest proportion of the respondents with FGM being women aged 60years and above. The Yoruba ethnic group had the lowest prevalence of FGM (44.2%), while the highest  prevalence was found among the Ibos (93.1%) (p=0.025). An almost similar  proportion of Christians (53.3%) and Muslims respondents (62.4%) had physical evidence of FGM (p=0.074). Higher levels of maternal education was significantly related to reduction in practice of FGM (p=0.002).Conclusion: There is an urgent need for a better analysis and understanding of the socio-demographic mechanisms sustaining the practice of FGM in Nigeria.Keywords: Complications, education, external genitalia, Ibo, prevalence, socio-demographic factor

A Review of Fetomaternal Outcome of Preterm Prelabour Rupture of Membranes in a Tertiary Hospital in Lagos, South-west, Nigeria

Preterm prelabour rupture of membranes(PPROM) is an important obstetric complication. It accounts for a third of all preterm deliveries with associated increased risks of fetomaternal and neonatal morbidity and mortality. To review the fetomatermal outcome of PPROM in a tertiary hospital in Lagos, South-west, Nigeria. This is a descriptive retrospective designin which cases of PPROM were identified from the Labour ward records and their case notes retrieved. Relevant information were extracted from those case notes and the neonatal unit records. Data was analyzed using Epi-info statistical software package. The rate of PPROM in this study was 2.2%. The mean age of the women was 31.3 ± 2.4years with the unbooked women constituting 50.2% of the cases and women with parity of 2 or less accounting/or 83.3% of them. The mean gestational age at delivery was 32. 7 ±2.4weeks. Caesarean section was the mode of delivery in 49.3% of cases, 8.1 % of the women had clinical evidence of choriamnionitis, 4.9% had puerperal sepsis while 1 maternal death was recorded. Ninety four percent (94%) of the births were livebirths while 6% were stillbirths. Low birth weight was noted in 79.1% and birth asphyxia was observed in 7.4%. Neonatal Unit admission was necessary in 72.5% of the livebirths. Perinatal mortality in this study was 17%. PPROM is an important cause of adverse fetomaternal outcome with increased perinatal and maternal morbidity and mortality. Adequate antenatal care should be advocated so that appropriate risk assessment can be done and intervention provided where applicable. Neonatal units should also be equiped to be able to render necessary care for these preterm neonates thereby reducing the morbidity and mortality asscociated with PPROM.Keywords: PPROM, preterm deliveries, fetomaternal outcom

Women's knowledge of cervical cancer and uptake of Pap smear testing and the factors influencing it in a Nigerian tertiary hospital

Background: Both the incidence and burden of cervical cancer have been drastically reduced in the developed world, due to the practice of regular cervical cancer screening with Pap smear. Unfortunately, the disease is still the most common gynaecological cancer, and the second leading cause of female cancer mortality in Nigeria, with up to 80% of women with cervical cancer ultimately succumbing to the disease. Objective: We examined the knowledge of cervical cancer and uptake of Pap smear screening among women attending obstetric and gynaecological outpatient clinics at the Lagos University Teaching Hospital in Lagos, Nigeria, and the factors that affect it. Methods: The study was a descriptive cross-sectional study derived from a cohort of 225 pregnant and non-pregnant women using a structured questionnaire to assess their knowledge of cervical cancer, uptake of Pap smear and factors that affect them. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results: The knowledge of women in this study regarding symptoms and risk factors of cervical cancer was very poor (40.0% and 15.6%, respectively), despite a 78.5% awareness rate. Likewise, the uptake of Pap smear was very low (22.9%), with an awareness rate of 55.1%. The major reasons for having a Pap smear were recommendation from doctors/nurses (89.4%) and fear of developing cervical cancer (23.4%), while the reasons for not having a Pap smear were lack of awareness (53.8%) and non-recommendation of the test by doctors/nurses (31.0%). Prior counseling by doctors/nurses and knowing someone with cervical cancer significantly increased the knowledge of cervical cancer and the uptake of Pap smear, while high level of education was significantly associated only with increased knowledge of cervical cancer and awareness of Pap smear, but not its uptake. Conclusion: Our study indicates that when healthcare providers supply regular health education and recommendation of Pap smear test, this will increase the knowledge of cervical cancer and its screening, and reduce the burden of the disease. Keywords: Knowledge of cervical cancer, Risk factors for cervical cancer, Symptoms of cervical cancer, Uptake of pap smear, Nigeri