ORIGINAL ARTICLE Sonography in chronic distension of the abdomen and apparent pregnancy

Abstract Objective: To find out the causes of chronic distension of the abdomen in women who thought they were pregnant; and the role of sonography in their management. Method: A retrospective study Results: There were 394 patients in the study. The mean age was 36.2 ± 1.7. Uterine fibroids (42%) and ovarian benign tumours (11%) were the main findings. Cancer of the cervix (10%) cancer of endometrium 3.3%; cancer of ovary (3.6%) and medical conditions -obesity (6.3%), cirrhosis of liver 3.8% were also important findings. The sensitivity for using sonography in diagnosing fibroids, ovarian cancers and benign ovarian tumours was 90.4%; 66%; and 86% respectively. Conclusion: Sonography can exclude pregnancy and it is reliable in diagnosing many causes of chronic abdominal distension. Histopathology is mandatory in ovarian tumours

Sexual and reproductive health in Accra, Ghana

Objective: To describe sexual and reproductive health among women in Accra and explore the burden of sexual and reproductive ill health among this urban population.Design: Cross-sectional study.Methods: We analysed data from the WHSA-II (n=2814), a cross-sectional household survey on women’s health, and supplemental data from an in-depth survey (n=400), focus groups discussions (n=22) and in-depth interviews (n=20) conducted among a subsample of women which focused specifically on reproductive health issues.Results: Modern contraceptive use was uncommon. More than one third of women reported ever using abstinence; condoms, injectables and the pill were the most commonly reported modern methods ever used. The total fertility rate among this sample of women was just 2.5 births. We found a considerable burden of sexual and reproductive ill health; one in ten women reported menstrual irregularities and almost one quarter of women reported symptoms of a Sexually Transmitted Infection (STI) or Reproductive Tract Infection (RTI) in the past 6 months. Focus group results and indepth interviews reveal misperceptions about contraceptionside-effects and a lack of information.Conclusion: In urban Ghana, modern contraceptive use is low and a significant proportion of women experience reproductive ill health (defined here as menstrual irregularity or RTI, UTI, STI symptoms). Increasedaccess to information, products and services about for preventive care and contraception could improve reproductive health. More research on healthy sexuality and the impact of reproductive ill health on sexual experienceis needed

Prevalence of Obesity in Women of Accra, Ghana

The Women\'s Health Study of Accra, Ghana measured the burden of obesity and obesitylinked illnesses in urban women. This is a Cross-sectional community based study. 1328 adult women, age 18 years and older, were selected as a representative sampling of the women of Accra. A comprehensive medical history, physical examination and laboratory tests were performed. Overweight and obesity status was determined by calculating the body mass index (BMI) (kg/m2). BMI measurements are available for 1237 non-pregnant women. A total of 430 women (34.8%) were obese; 340 (27.4%) were overweight; 369 (29.8%) were normal weight; and 98 (8.0%) were underweight. Risk factors for obesity include age 50 to 70 years, OR 2.12 [1.72 -2.62], p 5 (p 34 years (

Clinic visits and cervical cancer screening in Accra

Objective: To determine the factors that increase the chances of a woman in Accra having a Pap smear and whether women who have recently visited clinics have higher chances of having had Pap smears.Design: A cross-sectional studyMethods: A representative sample of women in Accra, Ghana was interviewed and the clinical and demographic factors influencing cervical cancer screening was assessed.Results: Out of 1193 women with complete data, only 25 (2.1%) had ever had a Pap smear performed though 171 (14.3%) had their last outpatient clinic visit for either a gynaecological consultation or a regular checkup. Simple logistic regression showed that a high educational level, high socioeconomic status and a history over the past month of postmenopausal or intermenstrual bleeding significantly increased the odds of ever having a pap smear. Neither monthly income nor lastclinic visit for a gynaecological consultation or regular check up increased the odds of having a pap smear. Multiple logistic regression showed that a high educational level and experiencing postmenopausal or intermenstrualbleeding were the most important determinants of ever having a Pap smear.Conclusion: While we wait for a national program for cervical cancer screening, there is a need for clinicians to put more individual effort into ensuring that asymptomatic women are screened for cervical cancer

Association of maternal sleep practices with pre‐eclampsia, low birth weight, and stillbirth among Ghanaian women

ObjectiveTo assess sleep practices, and investigate their relationship with maternal and fetal outcomes, among pregnant Ghanaian women.MethodsIn a cross‐sectional study conducted at Korle Bu Teaching Hospital, Accra, Ghana, between June and July 2011, postpartum women were interviewed within 48 hours of delivery about sleep quality and practices during pregnancy. Interviews were coupled with a systematic review of participants’ medical charts for key outcomes including maternal hypertension, pre‐eclampsia, premature delivery, low birth weight, and stillbirth.ResultsMost women reported poor sleep quality during pregnancy. Snoring during pregnancy was independently associated with pre‐eclampsia (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.4–8.5; P = 0.007). The newborns of women who reported supine sleep during pregnancy were at increased risk of low birth weight (OR, 5.0; 95% CI, 1.2–20.2; P = 0.025) and stillbirth (OR, 8.0; 95% CI, 1.5–43.2; P = 0.016). Low birth weight was found to mediate the relationship between supine sleep and stillbirth.ConclusionThe present findings in an African population demonstrate that maternal sleep, a modifiable risk factor, has a significant role in pre‐eclampsia, low birth weight, and subsequently stillbirth.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135150/1/ijgo261.pd

Refugee and Migrant Women's Views of Antenatal Ultrasound on the Thai Burmese Border: A Mixed Methods Study

Antenatal ultrasound suits developing countries by virtue of its versatility, relatively low cost and safety, but little is known about women's or local provider's perspectives of this upcoming technology in such settings. This study was undertaken to better understand how routine obstetric ultrasound is experienced in a displaced Burmese population and identify barriers to its acceptance by local patients and providers.Qualitative (30 observations, 19 interviews, seven focus group discussions) and quantitative methods (questionnaire survey with 644 pregnant women) were used to provide a comprehensive understanding along four major themes: safety, emotions, information and communication, and unintended consequences of antenatal ultrasound in refugee and migrant clinics on the Thai Burmese border. One of the main concerns expressed by women was the danger of childbirth which they mainly attributed to fetal malposition. Both providers and patients recognized ultrasound as a technology improving the safety of pregnancy and delivery. A minority of patients experienced transitory shyness or anxiety before the ultrasound, but reported that these feelings could be ameliorated with improved patient information and staff communication. Unintended consequences of overuse and gender selective abortions in this population were not common.The results of this study are being used to improve local practice and allow development of explanatory materials for this population with low literacy. We strongly encourage facilities introducing new technology in resource poor settings to assess acceptability through similar inquiry

Sonography in chronic distension of the abdomen and apparent pregnancy

Objective: To find out the causes of chronic distension of the abdomen in women who thought they were pregnant; and the role of sonography in their management. Method: A retrospective study Results: There were 394 patients in the study. The mean age was 36.2 ± 1.7. Uterine fibroids (42%) and ovarian benign tumours (11%) were the main findings. Cancer of the cervix (10%) cancer of endometrium 3.3%; cancer of ovary (3.6%) and medical conditions - obesity (6.3%), cirrhosis of liver 3.8% were also important findings. The sensitivity for using sonography in diagnosing fibroids, ovarian cancers and benign ovarian tumours was 90.4%; 66%; and 86% respectively. Conclusion: Sonography can exclude pregnancy and it is reliable in diagnosing many causes of chronic abdominal distension. Histopathology is mandatory in ovarian tumours