13 research outputs found
Ruptured tubal pregnancy: predictors of delays in seeking and obtaining care in a Nigerian population
No full textPurpose: Morbidity and mortality from ruptured tubal pregnancies (RTPs) have been linked with delays in seeking and receiving care. Evaluation of the reasons for these delays and their contributions to maternal deaths is rarely done for women with RTPs in resource-constrained settings.Patients and methods: This was a 3-year retrospective review of the case records of women with tubal pregnancies managed at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Clinical and sociodemographic parameters were obtained, including information on onset of symptoms and intervals between the symptoms and when help was sought and obtained at the hospital.Results: There were 92 cases of tubal pregnancies, giving an incidence of 18 per 1,000 births. Most of the patients were married (74.7%), parous (64.9%), and urban dwellers (76.9%), and 11% were severely anemic on arrival. The case-fatality rate was 1.1% and 74.7% had delay in seeking care, while 82.4% of the women spent more than 2 hours after admission before surgical intervention. Rural dwellers (adjusted odds ratio 2.96, 95% confidence interval 1.08–8.36) and those without formal education (adjusted odds ratio 6.39, 95% confidence interval 1.06–67.30) had delays in seeking help, while problems with funds (?2=7.354, P=0.005) and initial misdiagnosis (?2=5.824, P=0.018) predicted delay in obtaining help at the hospital.Conclusion: RTPs are common gynecological emergencies in our environment that are often associated with delayed decisions to seek help and obtain care. Efforts should be geared toward women’s education and financial independence, improved hospital accessibility, and better diagnostic skills
Baird-pattinson aetiological classification and phases of delay contributing to stillbirths in a Nigerian Tertiary Hospital
No full textPurpose. This study aims to identify triggers of stillbirth in the study setting and to make suggestions to reduce the prevalence. Method. A three-year retrospective case-control study of stillbirths at Ekiti State University Teaching Hospital. Results. The stillbirth rate was 33 per 1000 births. Based on Baird-Pattinson classification of the primary obstetric causes of stillbirth, adverse intrapartum events, hypertensive diseases, and unexplained intrapartum fetal deaths were topmost causes of stillbirths. In comparison with the controls, other identified predictors of SB were grand multiparity (p = 0.016), delays in seeking medical care and/or in receiving treatment (p = 0.0001), wrong initial diagnosis (p = 0.0001), inadequate intrapartum monitoring (p = 0.0001), and inappropriate clinical management (p = 0.0001). Conclusion. Stillbirth rate remains high in our setting. Elimination of obstacles to accessing care, effective management of hypertensive disorders in pregnancy, updated health facilities, improved dedication to duty, and retraining of health workers will reduce the prevalence
Awareness and practice of emergency contraception at a private university in Nigeria
No full textThe pursuit of formal education now causes many people in developing countries to marry later in life, thereby leading to increased premarital sex and unintended pregnancies. Efforts have been made to characterize awareness and use of emergency contraception (EC) among undergraduate students in public universities in Nigeria; however, it is not known if students in private tertiary institutions adopt different practices or if having an affluent family background plays a role. This pilot study therefore aimed to assess the awareness and use of EC among students at a private Nigerian university toward assisting education planners in developing strategies in improving students’ reproductive well-being.ResultsOut of 94 female students, 42 (44.7%) had sexual experience, but only 32 (34.0%) were currently sexually active. Six students (6.4%) had had unwanted pregnancies, of which all but one were terminated. Fifty-seven respondents (60.6%) were aware of EC, though only 10 (10.6%) ever practiced it. The greatest source of EC information was from health workers and peers; the lowest source was family or relatives. Most respondents desired orientation and availability of EC on campus. EC awareness among the students was predicted by upper social class background (adjusted odds ratio [OR], 2.73; 95% confidence interval [CI], 1.06–7.45) and upbringing in the Federal Capital Territory (adjusted OR, 4.45; 95% CI, 1.56–14.22).ConclusionsThough awareness of EC was higher among the private university students in this study than at most public universities, there was no difference in EC usage. A high pregnancy termination rate was observed; dilatation and curettage were mainly adopted. In Nigeria, youth-friendly reproductive health information and access should not be limited to government-owned tertiary institutions but also extended to private ones.<br/
Antenatal drug consumption: the burden of self-medication in a developing world setting
No full textThis institutional-based cross-sectional study examines the burden of self-medication during pregnancy in a middle-income country setting and the impact on fetal wellbeing. Using a blend of open-ended and indication-oriented questionnaires, 346 pregnant women at term were interviewed about their pregnancy complaints and drug intake. Inferential statistical data analysis was employed with level of significance (?) set at 0.05. Excluding routine supplements and vaccinations, 251 (72.5%) women used medicines, of whom 79 (31.5%) had self-medicated. Consuming drugs without prescription was associated with increased US Food & Drug Administration (FDA) risk category (?(2)?=?8.375; P?=?0.015). There is therefore a need to scale up efforts towards educating women about the dangers of self-medication, while also introducing effective restrictive policies on over-the-counter drug sale
Clinical suspicion, management and outcome of intrapartum foetal distress in a public hospital with limited advanced foetal surveillance
No full textObjectives: To determine the basis for the clinical suspicion of foetal distress, the instituted managements and delivery outcome in a tertiary hospital in sub-Saharan Africa with limited capability for advanced foetal monitoring.Methods: It is a 3-year retrospective analysis of all the obstetrics cases with intrapartum foetal distress.Results: There were 301 cases reviewed. The birth asphyxia incidence rate was 233/1000 live births and the perinatal death rate was 47/1000 live births. Suspicion of foetal distress was premised on the presence of persistent tachycardia or bradycardia during intermittent auscultation. Main resuscitative measures were left lateral repositioning of patient, fast saline infusion, intranasal oxygen administration and discontinuation of oxytocin infusion, if any. Only 124 (41.2%) of all the cases had delivery achieved within 2?h of diagnosis. Mean decision-delivery interval by caesarean section was 2.93?±?2.05?h. Socio-demographic factors (p=?0.001) and pregnancy risk category (p?=?0.002) influenced incidence of birth asphyxia.Conclusion: To reduce subsisting high perinatal morbidity and mortality in sub-Saharan Africa, it is best that at the least referral hospitals should have advanced facilities for foetal monitoring and shortened surgical intervention time
Resumption of intercourse after childbirth in southwest Nigeria
No full textOBJECTIVE:To determine the history of resumption of intercourse after childbirth and associated contraceptive practices among women in the southwest region of Nigeria.METHODS:A cohort of 181 women with live births was followed up for 6 months after delivery. Enquiry about the time of first intercourse after childbirth, associated dyspareunia, use of contraception, etc was made during the postnatal clinic visits and/or by telephone contact.RESULTS:Fifty (27.6%) had coitus within six weeks of childbirth, it increased to 115 (63.3%) at three months and 127 (70.2%) by six months post-delivery. Prevalence of dyspareunia was 36.2%. Eighty three (65.4%) of sexually active women practiced contraception which was predominantly use of male condom and withdrawal method. Co-habitation with husband (adjusted OR: 6.30; 95% CI: 2.56-17.01; p = 0.001) and mode of delivery (adjusted OR: 2.45; 95% CI: 1.30-4.73; p = 0.006) were strong predictors of commencement of sexual intercourse within six months postpartum. Significantly fewer women who had Caesarean section resumed coitus within six months when compared with those who had vaginal deliveries (59.2% versus 78.4%). Perineal injury did not predict resumption of coitus or experience of dyspareunia.CONCLUSION:In contrast to the norm, more women in southwest Nigeria are resuming coitus soon after childbirth. It is imperative to scale up counselling on postpartum sexuality and contraception within the maternal health services in this region
Role of second‐trimester uterine artery Doppler indices in the prediction of adverse pregnancy outcomes in a low‐risk population
No full textPrevalence of and risk factors for gestational diabetes using 1999, 2013 WHO and IADPSG criteria upon implementation of a universal one-step screening and diagnostic strategy in a sub-Saharan African population
No full textAlcohol Consumption Patterns and Associated Factors in Ekiti State, Nigeria: a State-wide, Cross-Sectional Study
No full textAim: The study aimed to determine the prevalence, pattern, and factors associated with alcohol use among adults in Ekiti State. Subjects and Methods: The survey was a cross-sectional, household-based, using a four- stage, multistage sampling technique. Using the Geographic Information System, 5000 adults were selected and interviewed using the WHO STEPS Instrument on mobile tablets and Open Data Kit (ODK). Results: More than 50 % of the 4894 participants recruited for the study were between the ages of 18 and 44 years. About three-quarters of the participants were females (74.1 %). Approximately 24 % of the respondents reported ever taking alcohol, with men accounting for a higher proportion of lifetime and current use (52.1 % and 38.5 %, respectively) than women (14.1 % and 7.2 %, respectively). Daily consumption was higher among males (7.6 %) compared to females (3.9 %). In comparison to women, more than 10 percent of men admitted to abandoning their social responsibilities due to alcohol consumption. The prevalence of early morning alcohol consumption is much higher among men (13.3 %) than among women (1.9 %). About 2.2 % of respondents quit alcohol consumption for health reasons, with men being more likely to do so than women (6.7 % versus 1.2 %, respectively). Conclusion: The prevalence of alcohol use is high in Ekiti state, particularly among males. Men are also more likely to consume alcohol daily, in larger quantities, and are more likely to stop alcohol consumption due to health issues
