Prevalence of hypocalcaemia and maternal complications among antenatal clinic attendees at the University of Port Harcourt Teaching Hospital

Background: Plasma Calcium level is not a routine laboratory test conducted during pregnancy. The role of calcium supplementation to prevent maternal complications of pregnancy such as pre-eclampsia and pregnancy induced leg cramps is conflicting. Objective: To determine the prevalence of hypocalcaemia and maternal complications among antenatal clinic attendees. Method: Ten milliliters of blood sample were taken from each of the 90 pregnant women that met the inclusion criteria for the study. The plasma isolated from each woman was analyzed for calcium and albumin using calcium-albumin kit (lab 7225 spectrophotometer set Bran Scientific and Instrument Company, England). The data was analyzed using SPSS version 16. Results: The prevalence of hypocalcaemia was 25.6% at recruitment and 40% in the third trimester. Sixty-five percent of the subjects who had hypocalcaemia in third trimester developed pre-eclampsia. In the hypocalcaemic group, the frequency of leg cramps was 23.3% and 27.8% at recruitment and at the third trimester respectively. Eight out of the 23(34%) subjects had pre-eclampsia in the normotensive group. Conclusion: The study revealed that high prevalence of hypocalcaemia was associated with advanced gestational age. In addition, there was a relationship between hypocalcemia, pre-eclampsia and pregnancy  induced leg cramps. Thus calcium supplementation is recommended for those at risk of hypocalcaemia.Key words; hypocalcaemia, maternal complications, pre – eclampsia, leg cramps.

Ruptured uterus: Fetomaternal outcome among unbooked mothers and antenatal care defaulters at the University of Portharcourt teaching hospital.

BACKGROUND: Unbooked emergencies are major reasons for the high maternal and perinatal mortality and morbidity in Nigeria. Rupture of the gravid uterus in women without antenatal care usually present late to hospital as unbooked emergencies with high perinatal deaths and very poor maternal outcome. AIM: To determine the factors implicated in the poor feto-maternal outcome with ruptured uterus amongst the unbooked mothers at the University of Port Harcourt Teaching Hospital(UPTH).METHOD: A retrospective analysis of case records of 82 consecutive patients without antenatal care who had ruptured uterus between January 2008 and December 2012.RESULT: There were 2133 deliveries among unbooked mothers at the University of Port Harcourt Teaching Hospital over this 5-year period. The incidence of ruptured uterus for the period under review was 3.8%. The mean age was 28.1years and the modal parity was 2. Abdominal massage and prolonged obstructed labor were the commonest predisposing factors, occurring in 43.9% and 34.1% of these women respectively. There were 80 perinatal deaths contributing to 12.2% of the perinatal mortality rate. There were 6 maternal deaths from ruptured uterus which was 10.9% of the maternal mortality ratio of 2578.5 per 100,000 live birth during the study period.CONCLUSION: Perinatal and maternal mortality rates from ruptured uterus were high. The major causes of uterine rupture are abdominal massage and prolonged obstructed labor, which are both preventable. Public enlightenment and condemnation of practices that promote these factors is advocated.KEYWORDS: ruptured uterus, feto-maternal outcome, unbooked, Port Harcourt

Photovoltaic performance prediction in Northern Nigeria using generated typical meteorological year dataset

Relevant meteorological files are needed by simulation software to assess the energy performances of buildings or efficiency of renewable energy systems. This paper adopts the Sandia method to generate typical meteorological year (TMY), using a 35-year hourly measured meteorological dataset from four stations in the northern region of Nigeria. The cumulative distribution function (CDF) for each year was compared with that of the long-term composite of all the years in the period for the seven major weather indices made up of relative humidity, wind speed, minimum temperature, global solar radiation, precipitation, mean temperature and maximum temperature. The 12 typical meteorological months (TMMs) selected from the different years were used for formulation of a TMY for the zone. In addition, performance assessment of a 72-cell polycrystalline solar PV module using the generated TMY and long-term (LT) values was also conducted. Two statistical indicators, the mean percentage error and the root mean square error, were adopted to evaluate the performance of each TMY with the LT mean, and also that of the PV energy system. Findings show that the TMMs are evenly spread within the data periods across the sites while closest fit between the long-term mean and TMY are obtained with the global solar radiation followed by the mean temperature in all the sites especially in Bida and Minna. From the energy system analysis carried out, it was found that TMY data are able to predict the performance of the PV system to within 5% of the LT data

Anaesthetic management of a super morbidly obese patient for total abdominal hysterectomy: a few more lessons to learn

Background: The prevalence of obesity is on the upward trend world-wide. This epidemic has challenging implications for anaesthetists, following the anthropometric changes associated with the disease. Objective: To highlight some of the challenges, the management and the lessons learnt during the management of this patient. Methods: This is a case report of a 52-year old super morbidly obese, diabetic, and hypertensive patient that presented for total abdominal hysterectomy. Surgery was carried out under a single-shot spinal anaesthesia with bupivacaine/fentanyl. Results: Under bupivacaine/fentanyl anaesthesia, she became very drowsy and had moderate to severe respiratory depression. She was arousable but had an obstructive sleep apnoea. Surgery was carried out successfully Conclusion: A better understanding of the pathophysiology and complications that accompany obesity is needed to manage an obese patient under anaesthesia

Addressing population growth in Nigeria and averting maternal mortality: Need for continuous research into male reversible contraception – male implants in perspective

No Abstract

Effect of routine preoperative fasting on residual gastric volume and acid in patients undergoing myomectomy

Background: Preoperative fasting of patients aims to reduce the residual gastric volume (RGV). The magnitude of this reduction is yet to be ascertained in the Nigerian population.Aim: To compare the RGV and pH of patients fasted for 6–12 h with those allowed oral intake of fluid up to 2 h preoperatively.Subjects and Methods: This randomized study involved 90 American Society of Anesthesiologists physical status I–II patients booked for abdominal myomectomy under general anesthesia. The patients were randomized into three groups. Preoperative fasting from midnight (Group F, n = 30) was fasted from midnight to the operation time. Carbohydrate‑rich drink group (Group C, n = 30) received 800 mL of oral carbohydrate solution in the evening before surgery (22:00 h). An additional 400 mL was given 2 h before anesthesia. Placebo drink group (Group P, n = 30) received water in the same protocol as Group C. The Student’s t‑test was used to analyze RGV and pH postoperative satisfaction and postoperative nausea and vomiting (PONV) were compared on a visual analog scale.Results: The RGV and pH were similar for all groups (P = 0.45 and 0.90, respectively). Antiemetic consumption and PONV scores were lower in Group C compared with Groups F and P (P = 0.01). Patients’ in Group C had higher satisfaction (P < 0.001).Conclusion: Preoperative carbohydrate or water intake up to 2 h before surgery is safe with better satisfaction when compared to overnight fasting.Keywords: Fasting, myomectomy, pH, residual gastric volum

Letter to the Editor: Obstetricians and Gynaecologists as Advocates for Better Reproductive Health in the Nigerian Context

No Abstrac

Ruptured uterus: fetomaternal outcome among unbooked mothers and antenatal care defaulters at the University of Port Harcourt Teaching Hospital

Unbooked emergencies are major reasons for the high maternal and perinatal mortality and morbidity in Nigeria. Rupture of the gravid uterus in women without antenatal care usually present late to the hospital as unbooked emergencies with high perinatal deaths and very poor maternal outcome. To determine the factors implicated in the poor feto-maternal outcome with ruptured uterus amongst the unbooked mothers at the University of Port Harcourt Teaching Hospital (UPTH). A retrospective analysis of case records of 82 consecutive patients without antenatal care who had ruptured uterus between January 2008 and December 2012. There were 2133 deliveries among unbooked mothers at the University of Port Harcourt Teaching Hospital over this 5-year period. The incidence of ruptured uterus for the period under review was 3.8%. The mean age was 28.1 years and the modal parity was 2. Abdominal massage and prolonged obstructed labor were the commonest predisposing factors, occurring in 43.9% and 34.1% of these women respectively. There were 80 perinatal deaths contributing to 12.2% of the perinatal mortality rate. There were 6 maternal deaths from ruptured uterus which was 10.9% of the maternal mortality ratio of 2578.5 per 100,000 live birth during the study period. Perinatal and maternal mortality rates from ruptured uterus were high. The major causes of uterine rupture are abdominal massage and prolonged obstructed labor, which are both preventable. Public enlightenment and condemnation of practices that promote these factors is advocated.Keywords: ruptured uterus, feto-maternal outcome, unbooked, Port Harcour