Female reproductive tract infections: understandings and care seeking behaviour among women of reproductive age in Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>Reproductive tract infections (RTI's) are endemic in developing countries and entail a heavy toll on women. If untreated, RTI's can lead to adverse health outcomes such as infertility, ectopic pregnancy and increased vulnerability to transmission of the human immunodeficiency virus. It is also associated with adverse pregnancy outcomes. While RTI's and its sequelae abound in Nigeria, there is paucity of publications on the subject in the country. This study assessed the understandings and care seeking behavior with regards to RTI's among women of reproductive age in Lagos, Nigeria with the aim of improving awareness on the subject.</p> <p>Methods</p> <p>A descriptive cross sectional survey of women attending the gynaecological outpatient and family planning clinics of the Lagos State University Teaching Hospital was carried out between 1^stJune 2008 and 31^stAugust 2008 using a pre-tested questionnaire. Data was analysed using the Epi-Info 3.5 statistical software of the Centre for Disease Control and Prevention, Atlanta U.S.A.</p> <p>Results</p> <p>Most of the respondents (77.2%) had heard of RTI's. Toilet was the most perceived mode of contracting RTI's (44.6%), followed by sexual intercourse and poor hygiene. Vaginal discharge was the commonest symptom of RTI's named while inability to get pregnant was the commonest named complication. Majority of the respondent's demonstrated poor overall knowledge of symptoms and complications of RTI"s. 37.4% of the respondents had experienced symptoms of RTI's in the preceding six months. Vaginal discharge was the commonest symptom reported (21.8%) and the majority of those who reported symptoms sought medical treatment. Government health centres were the most visited health facilities for treatment.</p> <p>Conclusion</p> <p>Even though most of the respondents have heard of RTI's and sought treatment when symptomatic, they demonstrated poor overall understanding of the subject. There is need to educate women on preventive strategies, as RTI's are often assymptomatic.</p

Evaluation of blood reservation and use for caesarean sections in a tertiary maternity unit in south western Nigeria

<p>Abstract</p> <p>Background</p> <p>Haemorrhage from obstetric causes is the most common cause of maternal mortality in the developing world. Prevention of mortality from haemorrhage will necessarily involve prompt blood transfusions among other life saving measures. There are however limited stocks of fresh or stored blood in many health care facilities in Sub Saharan Africa. Caesarean section has been identified as a common indication for blood transfusion in obstetrics practice and its performance is often delayed by non availability of blood in our centre. An evaluation of blood reservation and use at caesarean sections in a tertiary maternity unit in Lagos, south western Nigeria should therefore assist in formulating the most rational blood transfusion policies.</p> <p>Methods</p> <p>Case records of 327 patients who had elective and emergency caesarian sections at the Lagos State University Teaching Hospital between 1^stOctober and 31^stDecember 2007 were reviewed. Data pertaining to age, parity, booking status, type and indication for Caesarean section, pre- and post-operative packed cell volume, blood loss at surgery, units of blood reserved in the blood bank, unit(s) of blood transfused and duration of hospital stay was extracted and the data analysed.</p> <p>Results</p> <p>There were 1056 deliveries out of which 327 (31%) were by Caesarean section. During the study period, a total of 654 units of blood were reserved in the blood bank and subsequently made available in theatre. Out of this number, only 89 (13.6%) were transfused to 41 patients. Amongst those transfused, twenty-six (54%) were booked and 31 (75.6%) had primary caesarian section. About 81% of those transfused had emergency caesarean section. The most common indication for surgery among those transfused were placenta praevia (9 patients with 21 units of blood) and cephalo-pelvic disproportion (8 patients with 13 units).</p> <p>Conclusion</p> <p>Even though a large number of units of blood was reserved and made available in the theatre at the time of operation, majority of the patients operated did not need blood transfusion. Provision of a mini- blood bank within the obstetric unit and careful patient categorization will ensure timely availability of blood for surgery without necessarily tying down stock in the central blood bank.</p

What Is The Optimum Maternal Haemoglobin Concentration Level For A Normal Birth Weight in Lagos?

Context: The level of maternal haemoglobin concentration necessary for normal birth weight may differ from that used to define anaemia. Objective: To estimate the optimum haemoglobin concentration in labour in relation to birth weight. Design: A cross-sectional study. Setting: The labour ward of Ayinke House, Ikeja General Hospital, Lagos, Nigeria. Subjects: One hundred consecutive booked patients presenting in established labour. Intervention: Estimation of haemoglobin concentration from venous blood samples of each patient. Main Outcome Measures: Relationship between haemoglobin concentration, mean birth weight and incidence of low birth weight. Results: The mean haemoglobin concentration was 122. 18g/L. The lowest incidence of low birth weight was found in the haemoglobin less than 100 g/L group. Mean birth weight fell when the haemoglobin concentration rose above 140 g/L. The incidence of low birth weight (birth weight lower than 2500g) also increased in the haemoglobin greater than 140g/L group. Conclusion: This study shows the possibility that the levels of haemoglobin concentration at which we diagnose anaemia in pregnancy in our environment may be higher than what is needed for normal neonatal birth weight, and that levels of maternal haemoglobin concentration above 140 g/L may be undesirable in our environment as far as birth weight is concerned. A larger study will be done to determine the optimal levels of maternal haemoglobin concentration. [Trop J Obstet Gynaecol, 2004;21:4- 6

Society of obstetrics and gynecology of Nigeria – Clinical practice guidelines: Guidelines for the prevention of cervical cancer

Clinical practice guidelines have been developed by professional societies globally. Each guideline although based on published scientific evidence reflected each country's socioeconomic peculiarities and unique medical environment. The Society of Obstetrics and Gynaecology of Nigerian has published guidelines in other clinical areas; however, this is the first edition of practice guidelines for the prevention of cervical cancer. The Guidelines Committee was established in 2015 and decided to develop the first edition of this guideline following Delphi pool conducted among members which selected cervical cancer prevention as the subject that guideline is urgently needed. These guidelines cover strategies for cervical cancer prevention, screening, and management of test results. The committee developed the draft guideline during a two-day workshop with technical input from Cochrane Nigeria and Dr. Chris Maske, Lancet Laboratories, South Africa. The recommendations for each specific area were developed by the consensus, and they are summarized here, along with the details. The objective of these practice guidelines is to establish standard policies on issues in clinical practice related to the prevention of cervical cancer

Bilateral Uterine Artery Ligation: An Effective Low-Technology Option in the Management of Symptomatic Uterine Fibroids

Objective: This pilot study was designed to determine the efficacy of uterine artery ligation by the vaginal route as a low-technology alternative to uterine artery embolisation in the management of symptomatic uterine fibroids. Methods: Both nulliparous and multiparous women who had symptoms of uterine leiomyomata such as menorrhagia, dysmenorrhoea and abdominal swelling were informed about a new approach for the treatment of fibroids and, after giving consent, were recruited for the study. Ultrasonic measurements of uterine and fibroid volumes were determined pre-operatively and at two, six, twelve and eighteen weeks after the procedure. The severity of menorrhagia, dysmenorrhoea and pelvic pain were documented pre-and post-operatively. All the patients had bilateral uterine artery ligation using the vaginal route. Results: Ten patients aged between 31 and 49 years of age were studied. The mean duration of surgery was 64 minutes. Mean duration of hospital stay was 48 hours. Mean estimated intraoperative blood loss was 262 millilitres. A 20.5% reduction in mean uterine volume was noted at six and twelve weeks post-surgery. The mean duration of menstrual flow was reduced from 23 days before surgery to 17.3 days at the immediate next cycle postoperatively. Subsequently, most patients noted more reductions, although one had a rebound increase. All patients had reduction in perceived pelvic pain and an improved sense of well-being. Conclusion: It is suggested that the favourable results documented from studies using uterine artery embolisation can be replicated using uterine artery ligation, which is a low-technology alternative. This is an ongoing study. Key Words: Uterus, Leiomyoma, Menstrual Loss, Artery Ligation. [Trop J Obstet Gynaecol, 2003, 20: 4-6