Ehigha Enabudoso

The prevalence of hepatitis B and C viral infections among pregnant women

Background: Viral hepatitis during pregnancy is associated with high risk of maternal complications and has become a leading cause of foetal death. Aims: This study aimed at determining the prevalence of hepatitis B and C viral infections among pregnant women attending the antenatal clinic of the University of Benin Teaching Hospital. Patients and Methods: This was a hospital based cross-sectional study that included 5760 pregnant women who attended the antenatal clinic of the hospital during the periods of October 2009 - October 2010. Relevant data was gathered and women having history of previous liver diseases, diabetes and pre-eclamptic toxemia were excluded from the study. Rapid diagnostic test kits were used to screen for Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus (HCV) antibodies. Results: 720 (12.5%) and 206 (3.6%) out of 5,760 pregnant women included in the study were found to be positive for Serum antibodies to hepatitis B and C respectively. 33 (0.57%) were found to have mixed infections of hepatitis B and C. None of the expected risk factors had significant outcome. Conclusion: This study showed that the prevalence of the Hepatitis B virus (HBV) among pregnant women in this study area is of intermediate endemicity (12.5%).

Ruptured uterus in a Nigerian community: a study of sociodemographic and obstetric risk factors

Background.  Ruptured uterus is a common obstetric emergency in Nigeria, associated with high maternal and perinatal morbidity and mortality. There is a need for definitive identification of the risk factors to guide effective interventions to curb its scourge.

Perception and attitude of women with previous caesarean section towards repeat caesarean delivery

Objective. To explore the perception and attitude of women with previous caesarean section towards repeat caesarean section. Method. Observational study of women with prior caesarean delivery using an anonymous semi-structured questionnaire. Information elicited include the socio-demographic characteristics, outcome of the last caesarean delivery, experience of complications or domestic violence, acceptance of repeat caesarean section if advised by the doctor and the reason for any refusal. Results. One hundred thirty-nine parturients participated in the study. Seventy-seven percent had 1 previous caesarean delivery while 24.46% will decline a repeat caesarean section. Major reasons for refusal were postoperative pain, cultural aversion, fear of death, and cost of caesarean delivery. The rate of acceptance was significantly higher amongst those with more than one prior caesarean section while the rate of refusal was significantly higher amongst those who experienced perinatal death in the last caesarean delivery. Twelve percent experienced domestic violence (almost entirely psychological) mainly from the spouse or his relatives. Conclusion. A significant proportion of women with previous caesarean delivery will decline a repeat caesarean section if medically indicated. There is need for bahavior change communication involving the community, improved postoperative pain management, and better counseling especially on safety of the procedure.

Determinants of patient satisfaction after cesarean delivery at a university teaching hospital in Nigeria

To assess the prevalence of satisfaction, and associated factors, among parturients who had recently delivered by cesarean.

Maternal autonomy on health in a community as assessed by signing of consent for caesarean section and its sociodemographic correlates

Objective: To assess the level of maternal autonomy in a Nigerian community using maternal preference to sign the consent for caesarean section as the assessment tool and to evaluate the sociodemographic and obstetric correlates. Methods: A cross-sectional survey of parturients 2–5 days after caesarean delivery in a tertiary health facility in Benin City, Nigeria using a pretested interviewer administered questionnaire to obtain information on whom they would prefer to sign the consent form for caesarean section. Results: A total of 197 parturients were interviewed. The consent form was signed by 177 (90%) of the respondents. However, 96 (48.7%) preferred their spouses to sign. Maternal attainment of tertiary level education and a higher mean maternal age was significantly associated with maternal preference to sign the consent form. Conclusion: The level of maternal autonomy on reproductive health issues based on this simple survey is less than satisfactory. However, this study has provided baseline data for surveillance and follow-up studies of this important variable.

Organizing an international-standard obstetric ultrasonography training program in a low-resource setting.

Obstetric ultrasonography plays a critical role in the reduction of maternal and perinatal mortality,1 rending the shortage of formally trained obstetric ultrasonographers in Africa, a crucial problem. Despite advocacy for continuous professional training to improve the quality of care,2 practitioners in lowresource settings can encounter costly fees, accreditation issues, and limited availability when attempting to access training opportunities. A potential solution to address training needs is the establishment of regional centers of excellence; another is the organization of indigenous, short, intensive training programs in alliance with established international organizations, with teaching delivered by internationally recognized experts in the field. A pilot workshop based on the latter idea was successfully implemented in Benin City, Nigeria, in June 2015, in the form of a 2week obstetric ultrasonography training program that was approved by the International Society of Ultrasound in Obstetrics and Gynecology and included 64 participants (www.beninfetaldiagnostics.org/workshop2015). Preparation for this 2015 workshop included the use of an interactive website for global publicity, online registration, and preworkshop preparation. Advertisements and strategic visits to hospitals and training centers were made within Nigeria. Sponsorship, primarily in form of ultrasonography equipment, was solicited from medical equipment manufacturers and distributors. The daily program of the workshop included lectures, demonstrations, discussions, videos, and handson sessions; these handson sessions were similar to those reported by Tolsgaard et al.2 that yielded good results. Training was largely focused on technical performance and image assessment, two of three key tenets of ultrasonography training,3 with the goal of improving participants’ approach to obstetric scanning. An anonymous semistructured questionnaire was distributed to participants on the last day of training to assess their rating of the program and their own improvement in knowledge. Data from completed questionnaires were analyzed using Microsoft Office Excel 2007 (Microsoft, Redmond, WA, USA). No sensitive information was collected so ethical approval was not sought. Informed consent was assumed through participants completing and returning the anonymous questionnaires. Several aspects of the workshop and improvements in participant knowledge were rated as good (Fig. 1). A particularly encouraging finding was that there were few belowaverage ratings received. Considering the novelty of the program and that it was indigenous in nature, this marks the program as a success. Although the present study was selfassessed, and therefore prone to subjectivity, it demonstrated that such programs can be performed successfully in

An international standard fetal ultrasound training programme organized in a low resource setting: The ISUOG-benin city experience

Objectives: To organise an indigenous, cost-effective, short, intensive fetal ultrasound training programme in a low-resource setting, in order to improve the quality and quantity of skilled professionals in the field of obstetric sonography in a low-income country. Methods: The course was implemented in two stages namely the pre-workshop preparations and workshop proper. The former stage involved achieving international accreditation, publicising the programme as well as participant registration. The latter stage was focused on the workshop training activities which included lectures, practical sessions, discussions and hands-on sessions. Results: A high level of satisfaction with the programme was demonstrated by participants following a questionnaire assessment. Registration process and communication before the workshop were mostly rated as excellent and good. Other parameters such as lectures, practical sessions, coverage of objectives, knowledge improvement and others, followed the same pattern. Conclusion: Short, indigenous, cost-effective training programmes can be successfully carried out in a low-resource setting and the simple model allows for easy imitation at other relevant locations.