9 research outputs found
Primary post partum haemorhage (PPH) at the university of Maiduguri teaching hospital (UMTH): A ten-year review
No full textObjective: To determine the incidence, risks and aetiological factors for Primary Post-Partum Haemorrhage (PPH) in UMTH. Design Retrospective descriptive study.Setting: University Of Maiduguri Teaching Hospital, Maiduguri, Nigeria.Methods: The case records of all recorded cases of primary PPH between1stJanuary 2000 and 31stDecember 2009 inclusive, who were managed in UMTH were retrieved and relevant data obtained and analyzed.Results: Three hundred and seventy sixwomen had primary postpartum haemorrhage during the period under review with an incidence of 1.9%. However, only three hundred and two were available for analysis.Close to half of the women who had primary postpartum haemorrhage were grandmultiparous136(45%). Uterine atony was the commonest cause of primary PPH which was closely followed by retained placenta 37.7% and 22.5% respectively. This is attributed to mismanagement of labour. Majority of the patients were unbooked (63.6%) and about one third of the women had home delivery. The maternal mortality during the period was 96out of which 4were due to postpartum haemorrhage. The contribution of primary PPH to maternal mortality was 4.2% during the study period.Conclusion: Primary PPH is a largely preventable condition. Uterine atony and retained placenta were major causes of the condition in our center. This is a reflection of mismanagement of third stage of labour. Identification of patients at risk during pregnancy and labour with prompt intervention to prevent blood loss is advocated.Trop J Obstet Gynaecol, 30 (1), April 201
Hysterosalpingography versus Laparoscopy in the Evaluation of Female Infertility in Maiduguri, Nigeria.
No full textObjective: To compare the results of hysterosalpingography and laparoscopic methylene blue test for assessment of tubal patency in patients with infertility.
Subjects and Methods: The case records of 124 patients who underwent both hysterosalpingography and laparoscopy as part of comprehensive infertility work-ups at the University of Maiduguri Teaching Hospital between January 1996 and December 2000, inclusive, were reviewed.
Results: There was a close correlation of both methods in 90.9% of the cases in the diagnosis of tubal patency. There was no statistical difference in the diagnosis of tubal occlusion using both hysterosalpingography and laparoscopy. However, there was a significant difference in the ability to make a diagnosis of peritubal adhesions for which laparoscopy was more useful (p < 0.001).
Conclusion: The results suggest that laparoscopy is a superior method in the investigation of tubal patency with a better potential for full appraisal of peritubal adhesions prior to tuboplasty. It is therefore recommended as an essential investigation in patients with infertility.
Key Words: Hysterosalpingography, Laparoscopy, Tubal Patency
[Trop J Obstet Gynaecol, 2003, 20: 20-23
Survey on the use of misoprostol for induction of labour amon obstetricians in the West African sub-region
No full textNo Abstract
Survey on the use of misoprostol for induction of labour among Obstetricians in the west African sub region
No full textContext: Wide spread use of misoprostol is increasingly commoner in our obstetrics and gynaecological practice, most especially for Induction of labour in spite of its serious associated risks of maternal and fetal complicationsObjective: To determine the use of Misoprostol for induction of labour among the Obstetricians in the West African sub region.Methodology and settings: During the October 2007 pre examination workshop of the West African College of Surgeons (FWACS), Faculty of Obstetrics and Gynaecology 42 examiners responded through structuredquestionnaires on the use of misoprostol for induction of labour (IOL) in their institutions of practice. Results: About 91 % admit using misoprostol for IOL with only half (50%) having written protocols for labour induction with misoprostol. Almost all (93%) prefer the vaginal route for the administration of misoprostol andabout 74% do not use misoprostol for those with Caesarean section scar compared to only 19% who do. Misoprostol is used for cervical ripening and control of post partum haemorrhage among 24.4% and 50% of theObstetricians respectively. The commonest complications encountered were Fetal distress, uterine rupture and uterine hyper tonus among 54.8%, 52.4% and 45.2% of the respondents.Conclusions: Misoprostol use was high with yet serious complication occurring among those using it for IOL. Despite the manufacturers and other regulatory agents warning against its use in pregnancy because of serious maternal and fetal complications, misoprostol use for IOL is widespread. A regulated use of this drug especially in pregnancy is advocated
Informal communication in the humanities: A qualitative inquiry
No full textThis study examined the informal communication patterns of humanities scholars. A qualitative inquiry based on in-depth interviews was conducted. Thirty-six scholars from three humanities disciplines--history, philosophy, and literature--participated in various stages of the study. The intent was to find out how humanists perceive informal communication, what impact it has on their research and how their research shapes their informal communication. Also explored were the differences and commonalities in the three disciplines.This study found most of the stereotypes about humanities scholars do not hold true any more. The perceived value of informal contacts was found to vary with a scholar's discipline, specialty or research orientation.Made available in DSpace on 2011-05-07T12:36:15Z (GMT). No. of bitstreams: 2
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Male Contribution to Infertility in Maiduguri, Nigeria
No full textContext: Infertility is a frequent reproductive health problem in this environment. Abnormalities of seminal fluid may be found in up to 60% of infertile couples. Various factors are known to be responsible for seminal fluid abnormalities. Local studies on this very important health problem are few.
Objective: The objective of this study was to determine the magnitude of male contribution to infertility in North Eastern Nigeria and the factors responsible.
Study Design, Setting and Subjects: A descriptive study of 704 males with abnormal seminal fluid profile who were investigated at a university teaching hospital over a 12-month period. Relevant past medical history, physical examination and investigation results were extracted from the patients' case records.
Results: A total of 1201 seminal fluid analyses were conducted during the study period. Abnormalities were detected in the seminal fluid of 704 (58.6%) patients. Male factors were the only identifiable cause of infertility in 70% of the cases. Azoospermia (12.8%) and oligozoospermia (26.8%) were the most frequent semen abnormalities found. Varicocoele (13.9%), previous groin surgery (16.8%) and chronic urethritis and/or male accessory gland infection (5.5%) were the main associated clinical findings in the patients.
Conclusion: Male factor contributes significantly to infertility in this environment. The treatment of infertility using conventional methods have very low success rates while recent technologies are expensive and not readily available in this environment. It is therefore necessary for us to understand the various factors that contribute to male infertility in our environment so as to develop preventive strategies.
(Tropical Journal of Obstetrics and Gynaecology: 2001, 18(2): 87-90
Prolactin Levels Among Infertile Women in Maiduguri, Nigeria
No full textObjective: The objectives of this study were to determine the manner of clinical presentation of women with unexplained infertility in Maiduguri, North-Eastern Nigeria and their plasma levels of prolactin.
Materials and Methods:The records of 104 females undergoing infertility investigation at the University of Maiduguri Teaching Hospital and for whom no organic cause had been found were scrutinised to extract the details of their modes of clinical presentation. All had plasma prolactin level assays.
Results: The patients were aged between 20 and 40 years (mean: 28.3 years). Thirty-three (31.7%) of them had primary infertility while 71 (68.3%) had secondary infertility. Of the 104 patients, 33 (31.7%) had abnormal plasma prolactin levels. The women with secondary infertility were more likely to have abnormal prolactin levels: 22 (21.1%) compared to only 11(10.6%) among patients with primary infertility. About one-third of the patients presented with amenorrhoea (2% with primary and 34.6% with secondary amenorrhoea). Among patients presenting with amenorrhoea only 13 (12.5%) had elevated prolactin levels. Twenty four (23.1%) of the patients had galactorrhoea, of whom only 10 (9.6%) had hyperprolactinaemia. Patients with secondary infertility were more likely to have galactorrhea (17.3%) compared to patients with primary infertility (5.8%). The association of hirsutism, amenorrhoea and hyperprolactinaemia was not a common finding in our patients.
Conclusion: The use of dopaminergic-agonist therapy in women with unexplained infertility requires careful consideration, ensuring that the plasma prolactin levels and the clinical mode of presentation are factored into the decision to prescribe the drugs.
Key Words: Infertility, Anovulation, Prolactin, Amenorrhoea
[Trop J Obstet Gynaecol, 2003, 20: 97-100
Reproductive health human rights : women's knowledge, attitude, and practices toward their reproductive health rights in Palestine
No full textDhaher E. Reproductive health human rights : women's knowledge, attitude, and practices toward their reproductive health rights in Palestine. Bielefeld (Germany): Bielefeld University; 2008.Reproductive health rights ensure that people are able to have satisfying and safe sex life and that they have the capacity to reproduce with freedom to decide, when and how often to do so. Reproductive health rights also include the access of women to high quality health care services that help in protecting women during pregnancy and childbearing and providing the couples with the best chances of having healthy. In addition, reproductive health rights might be an important indicator for women's health.
Studies that were conducted in Palestine before had not focused on assessing women's perception on their reproductive health rights while receiving the health care. Therefore, the main purpose of this study was to assess knowledge, perception, attitude, and practices of reproductive health rights among the Palestinian women of reproductive age (15-49). Specifically, the objective was to assess women's perception of their reproductive health rights while receiving their reproductive health care (in particular: reproductive health rights concepts and meaning, family planning, antenatal care, delivery care and postnatal care). In addition, the present study aimed to assess women's perception towards wife beating and the best marriage age for women.
In order to achieve this purpose, a cross sectional study was conducted in 2006 at three clinics that provide Mother and Child Health Care in the West Bank. The clinics were located in the three largest cities in the West Bank: Jenin in the north, Ramallah in the center, and Hebron in the south. A total of 450 women (150 women in each site) in reproductive age (15-49) were interviewed using a structured questionnaire. The questionnaire assessed several issues related to reproductive health such as: understanding of reproductive rights, knowledge and use of family planning methods, antenatal care, delivery care, postnatal care, attitudes towards domestic violence and age at first marriage. Response rate of the study was 99.4 percent.
Generally, the results of this study revealed that women had positive understanding of their reproductive health rights. Women mentioned the right to have good access to health care during and after the course of pregnancy as their first important right. The majority of women were able to identify the modern contraceptives and most women mentioned that they made the fertility decision together with their husbands. Women started antenatal care at a relatively early stage of their pregnancy (before 4-month pregnancy), and 78.2 percent of women made six or more antenatal care visits during their entire pregnancy. Almost all women delivered their last child in medical institutions and under medical supervision. Women were most likely more satisfied from the private health facilities than from the governmental facilities. Although the majority of women considered postnatal care necessary (66.1 percent), only 36.6 percent of women obtained postnatal care. Sixty-five percent of women agreed with at least one reason for wife beating. The mean age of first marriage among the 450 women was 20 years old and the median was 19, while half of the women perceived the best age of their daughter's marriage between 17 and 20 years old.
Based on the results of this study, it is recommended to consider these results when planning for any women's health programs and projects. In order to improve health care services based on women's needs and priorities, we also recommend setting new policies and regulations that protect women against violence and organizing public education programs to change women's perception towards intimate partner violence and age at first marriage. Empowering women through education and open employment opportunity might help women in making decisions regarding their fertility and taking an active role when they experience any reproductive health rights violation. Future research should expand to include Gaza Strip and to include men, adolescent, health care providers, health policy makers and key law and religious leaders
Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial.
No full textBACKGROUND: Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. FINDINGS: Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65-1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52-0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88-1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. INTERPRETATION: Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. FUNDING: London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation
