Cu Iklaki

Awareness of Birth Preparedness and Complication Readiness in Southeastern Nigeria

The aims of this study are to assess the awareness and intention to use maternity services. This was a multicentric study involving 800 women. Educational status was the best predictor of awareness of birth preparedness (P = 0.0029), but not a good predictor of intention to attend four antenatal clinic sessions (P = 0.449). Parity was a better predictor of knowledge of severe vaginal bleeding as a key danger sign during pregnancy than educational level (P = 0.0009 and P = 0.3849, resp.). Plan to identify a means of transport to the place of childbirth was related to greater awareness of birth preparedness (χ 2 = 0.3255; P = 0.5683). Parity was a highly significant predictor (P = 0.0089) of planning to save money. Planning to save money for childbirth was associated with greater awareness of community financial support system (χ 2 = 0.8602; P = 0.3536). Access to skilled birth attendance should be promoted.

Perinatal Outcome in Unbooked Teenage Pregnancies in the University of Calabar Teaching Hospital, Calabar, Nigeria

Background. Teenage pregnancy being a high risk condition requires skilled attention for good outcome. Objectives. To determine the influence of antenatal care on perinatal outcome in teenage pregnancies in Calabar. Materials and Methods. A review of patient records in Calabar was conducted between 1st January, 2006 and 31st December, 2010, to determine perinatal outcome in teenage pregnancy. Results. Teenage pregnancy accounted for 644 (6.5%) of the total deliveries with 245 (38.0%) booked while 399 (62.0%) were unbooked. Teenage mothers contributed significantly to the proportion of women who were delivered without prior antenatal care (χ 2 = 6.360; P < 0.05). The mean duration of labour in booked teenagers was 10.85 ± 4.2 hours, while unbooked teenagers was 23.31 ± 3.6 hours (t-value = 77.1039; P < 0.05). There was statistically more caesarean sections among unbooked teenage pregnancies than booked (χ 2 = 36.75; P < 0.05). Stillbirth was statistically significant (χ 2 = 27.096; P < 0.05) among unbooked teenagers than booked. However, early neonatal death was not significantly different between booked and unbooked teenage pregnancies(χ 2 = 0.512; P < 0.05). Conclusion. Unbooked teenage pregnancies were significantly associated with increased operative intervention and poor perinatal outcome.

Factors associated with contraceptive use and initiation of coital activity after childbirth

The aim of the study is to identify the factors influencing contraceptive use and initiation of sexual intercourse after childbirth. This was a cross-sectional descriptive survey involving 256 consecutive women who delivered between April and October 2007 presenting at the Immunization Clinic University of Calabar Teaching Hospital Nigeria in April 2008. Data was obtained using an interviewer-administered structured questionnaire. Women who had antenatal and postnatal counseling were significantly more likely to use contraceptives than those who did not have counseling (odds ratio (OR) 0.29; 95% confidence interval (CI) 0.14-0.59; P = 0.0002 and OR 0.18; 95% CI 0.08-0.38; P = 0.0000002 respectively). Other variables significantly associated with contraceptive use included education (P = 0.0470) and reproductive goal (P = 0.0303). Linear regression analysis showed direct relationship between caesarean section and episiotomy as modes of delivery and initiation of coitus (r² = 0.439 and 0.45 respectively). Concerning residence after childbirth staying at home and with in-laws showed direct relationship with initiation of coitus (r² = 0.208 and 10.750 respectively). The number of women abstaining from intercourse showed a decreasing trend with increasing months after childbirth. Initiation of coitus was significantly associated with resumption of menstruation (P < 0.0001) and non-contraceptive use (P = 0.0089). In conclusion this study shows the need for use of postpartum contraception before fecund women become susceptible to pregnancy.

Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use

Summary The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South–South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001–2005). A total of 4,990 womens records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status.

Haemoperitoneum following coitus with no associated vaginal injury

Postcoital haemoperitoneum resulting in shock rarely occur without evident vaginal injury. A 24 year old Para 0 ±4 women presented to the emergency unit in shock with a history of fainting attack and severe absominal pain of 6 hours duration. Pain was felt immediately after coitus and was so severe that the patient had a blackout. Ultrasound scan revealed a left adnexal mass and fluid in the peritoneal cavity. At laparatomy more than 2 litres of fresh blood was found in the peritoneal cavity. The left ovary was enlarged by a haemorrhagic cyst with 3 bleeding points. The left fallopian tube was slightly oedematous with 2 areas of haemorrhagic spots but no obvious bleedig. Left ovarian cystectomy was done. Haemostasis was secured. Mary Slessor Journal of Medicine Vol. 5(2) 2005: 70-72