A 4-year audit of retained placenta at Ekiti State University Teaching Hospital, Southwestern Nigeria

Background:Retained placenta, with its attendant complications, remains a significant cause of maternal morbidity and mortality. Objective:  To determine the incidence of predisposing factors to and complications of retained placenta at the institution of study.Materials and Methods: At the Obstetric unit of the Obstetrics and Gynaecology Department of Ekiti State University Teaching Hospital (EKSUTH), Ado Ekiti, a 4-year retrospective, descriptive study was conducted between 1st of January, 2014 and 31st of December 2018.Version 20 of the Statistical Packages for Social Sciences (SPSS) software was used to process the data. For data analysis, descriptive statistics was used; continuous variables were summarized with mean, while discrete variables were summarized with numbers and percentages. Results: Out of a total deliveries of 3,314 during the study period, there were 60 cases of retained placenta, giving an incidence of 1.8%. Majority of those that had retained placenta 66.7% (40) were within 30- 39 years age bracket; and with grand multiparous women carrying the largest percentage 33.3% (20). Among the various identifiable risk categories, the major identifiable risk factors were previous history of dilatation and curettage (61.7%) and previous history of retained placenta (16.7%). PPH was recorded in 46.7% (28) of the parturients; there was no maternal mortality. Conclusion: To reduce the prevalence of D&C complications, efforts should be geared towards increasing contraceptive prevalence and proficiency in post-abortal care. There is a pressing need for training and retraining of skilled birth attendants in the various health institutions running maternity care services; coupled with proficiency in handling retained placenta. There should also be a burning desire and political will to capture both the poor and the rich under the National Health Insurance program (NHIS) covering maternity care services

Missed Opportunities in Comprehensive Response to Sexual Assaults in Ekiti State, Nigeria

Sexual assault referral centres were designed to provide comprehensive services to survivors to mitigate the physical and psychological consequences of rape. However, some of the survivors who reported at these centres did not benefit fully from these, thereby presenting as missed opportunities. We assessed the missed opportunities among the survivors who reported at Ekiti Sexual Assault Referral Centre, Ado-Ekiti, Nigeria from June 2020 to June 2022. Data were extracted from the records of the Ekiti Sexual Assault Referral Centre, Ado-Ekiti and the Department of Public Prosecution of Ekiti State Ministry of Justice, Ado-Ekiti. The missed opportunities for post-exposure prophylaxis for HIV, emergency contraception, economic empowerment and relocation/shelter services were 62.2%, 35.9%, 42.3% and 4.3% respectively. There were 18 convictions out of the 21 concluded cases. Delayed reporting and poor compliance with follow-up schedules appear to be common denominators in these missed opportunities. To improve on the effectiveness of these services, there is a need to understand the cascade of events leading to delayed reporting and poor compliance with follow-up schedules by the survivors. Mobilisation of adequate financial resources is also expedient for the effective delivery of these services