Effect of training on the knowledge and use of the partograph for low risk pregnancies among health workers in a tertiary hospital in Lagos State, Nigeria

Background: Partogram use is important for early recognition of deviations in labour. This study assessed the effect of training on the knowledge and use of the partogram in low-risk pregnancy (LRP).Methods: This is an analytical before and after study at the Lagos University Teaching Hospital. Fifty-two health personnel who conduct deliveries in the labour ward were assessed before and after a training on the proper utilization of the partogram which used WHO recommendations on the integrated management of pregnancy and child birth. Comparison of knowledge and utilization of the partogram before and after the training was estimated using the chi square test. The level of significance was p<0.05.Results: Thirty-two (61.5%) of the respondents were resident doctors while 38.5% were midwives. Only 27% of them had had any formal training on partogram use in the three years preceding the intervention. Training significantly improved knowledge of the partogram by improving standard records for cervical dilatation, uterine contraction and fetal descent; reducing substandard records for uterine contraction and fetal descent and no records, (p=0.0001). Training only significantly affected the utilization of the partogram in reference to blood pressure readings. There was a significant increase in substandard records and a reduction in standard records, (p=0.001)Conclusion: Training improved knowledge, but not the use of the partogram by health workers. Greater emphasis should be placed on the use of the partogram in monitoring labour progress in women with low risk pregnancies.Keywords: Partogram; Training; Labour management; Intrapartum car

A case report of a successfully managed advanced abdominal pregnancy with favorable fetomaternal outcomes

An abdominal pregnancy can be regarded as a form of an ectopic pregnancy where the embryo or fetus is growing and developing outside the uterus but within the abdominal cavity. While it is a very rare occurrence, abdominal pregnancies have a higher chance of maternal mortality, perinatal mortality, and morbidity compared to normal and ectopic pregnancies, but on occasion, a healthy viable infant can be delivered. We presented the case of a 40‑year‑old gravida 8 para 4+3 (4 alive) woman with intra‑abdominal pregnancy who was first seen at 29 weeks’ gestation with a history of abdominal pain and ultrasonographic findings of a live intra‑abdominal fetus. She was managed conservatively till 34 weeks’ gestation and was subsequently delivered by laparotomy with favorable maternal and fetal outcomes. The case is reported to highlight the successful outcome in spite of the difficulties in diagnosis and management in a low‑resource setting.Keywords: Ectopic pregnancy; laparotomy; perinatal mortalit