Ej Udoma

Perinatal outcome in pregnancies booked for antenatal care but delivered outside health facilities in Calabar, Nigeria ☆

Pregnancies that were booked for antenatal care but delivered outside the health facilities were studied. The aim was to determine the perinatal outcome of these pregnancies, and also to compare the outcome with that of pregnancies that were booked and delivered in the University of Calabar Teaching Hospital (UCTH). Birth asphyxia was the commonest perinatal morbidity in both the study (14.3%) and control (4.8%) groups and was significantly higher in the study group than in the control (P < 0.01-P < 0.05). Incidence of neonatal infection tetanus and birth trauma was also significantly higher in the study than in the control groups (P < 0.01-P < 0.05). The incidence of prematurity, neonatal jaundice and congenital abnormality did not show any significant difference in the two groups (P > 0.05). The risk of perinatal death was three times higher in the study group than in the control. Proper public enlightenment campaigns and the establishment of a national health insurance scheme which may strengthen the use of orthodox health facilities for delivery, may improve the poor perinatal outcome in our community.

Profile Of Intrauterine Contraceptive Device Acceptors At The University Of Uyo Teaching Hospital, Uyo, Nigeria

BACKGROUND Use of modern contraceptive methods has been shown to reduce unwanted pregnancy, high parity and maternal mortality. Intrauterine contraceptive devices which are among the safest and most effective reversible contraceptives available, are particularly suitable for women in developing countries as they are affordable, convenient to use, do not require re -supply visits and are very cost-effective. The aim of this study is to determine the socio-demographic characteristics of intrauterine contraceptive device acceptors, the pattern of insertions and complications at the University of Uyo Teaching hospital, Uyo. METHOD The record cards of all clients who had intrauterine contraceptive device inserted at the family planning clinic over a six-year period were reviewed. RESULTS During the study period, there were 852 new contraceptive acceptors out of which 39.7% accepted the intrauterine contraceptive device. The modal age group of the clients was 25-29 years (32.5%). Acceptance of intrauterine contraceptive device was most common among multiparous clients (65.1%). Majority of the acceptors were married (90.0%), Christians (98.8%) and 72.8% had at least secondary school education. Clinic personnel (65.7%) and friends/relatives (21.3%) were the most common sources of information on contraception. Most (93.5%) of the clients had their intrauterine contraceptive devices inserted within 7 days of menstruation. Lower abdominal pain (5.5%) and vulval/vaginal itching (5.3%) were the most common complications. CONCLUSION The acceptors of intrauterine contraceptive devices in our center were young, multiparous and educated women. Increasing mass media involvement in the dissemination of accurate information about intrauterine contraceptive devices to the general populace, the introduction of postpartum and post-abortal intrauterine contraceptive device insertions and the encouragement of our grandmultiparous women to accept intrauterine contraceptive device would lead to an increase in its acceptance and use.

Maternal mortality from obstructed labor in south-eastern Nigeria: the role of spiritual churches

Obstructed labor and its sequelae, continue to be one of the major obstetric complications in w x Nigeria and other developing countries 1 . Eradication of illiteracy among our women by providw x ing them with compulsory, free education 2 , and Ž . training of traditional birth attendants TBAS w x 3 , are some of the recommendations designed to reduce maternal morbidity and mortality. The contribution to maternal morbidity and mortality in Nigeria by spiritual churches where w x they are actively involved in obstetric care 4 , has not previously been investigated. They are a popular primary resort for pregnant women, and women in labor, and only reluctantly release cases of obstetric complications to conventional health Ž . centers CHC when the cases have reached a state of disrepair. They see their work as a divine gift from God, thus making it difficult to alter their practices and rely strongly on the efficacy of prayers for the conduct of delivery and managew x ment of complications 4 .

Post-partum practices among women in Calabar, Nigeria.

We carried out a study on post-partum practices amongst women in Calabar at the maternal and child health clinic at University of Calabar Teaching Hospital between 1March and 31 May 2002. Three hundred women were interviewed. One hundred and ninety-three (64.3%) resumed coitus prior to 6 weeks of puerperium. There was no significant difference in parity (P=0.20) and educational status (P=0.10) between women who resumed coitus earlier than 6 weeks and those who resumed later. One out of every 10women resumed coitus without any contraception. The majority [212 (70.7%)] sat in hot water (sitz bath) to aid perineal wound healing and improve vaginal tone.

Reasons for gynaecological consultations in children in Calabar, South Eastern Nigeria

Childhood gynaecological disorders as seen in the University of Calabar Teaching hospital (UCTH), Calabar, Nigeria, over a 10-year period were studied. The aim was to establish the incidence and pattern of presentation of these disorders. Childhood gynaecological disorders constituted 3.1% of gynaecological admissions in UCTH. Vaginal laceration following rape was the most common disorder accounting for 54.8% of the cases. This was most common in the 8 to 11-year age group (52.2%). Vaginal bleeding was the most common presenting symptom (63.1%) and repair of vaginal laceration the most common procedure performed (54.8%).

Hysterectomies amongst teenagers in Calabar, Nigeria.

A 10-year retrospective study of hysterectomies performed on teenagers in Calabar was carried out.

Bacterial contamination of women in labor supervised by traditional birth attendants.

Most pregnant women in Nigeria prefer to be delivered at home in a spiritual setting and by traditional birth attendants. For this reason many arrive very late at the hospital when they experience obstruction of labor usually with intrauterine infections because traditional birth attendants do not observe aseptic procedures during vaginal examinations. After delivery these women commonly develop genital sepsis wound infection or peritonitis and effective treatment requires pathogen characterization and sensitivity to antimicrobial agents. (excerpt)

Effect of upgraded emergency services on obstetric case fatality at a Tertiary Hospital in Cross River state, Nigeria

Context: Maternal mortality is still a major problem in sub-Saharan Africa. Majority of these deaths are however preventable. Objectives: To assess the impact of the prevention of maternal mortality (PMM) programme carried out in the University of Calabar Teaching Hospital in 1994. Materials and Methods: A retrospective analysis of maternal mortality records in the University of Calabar Teaching Hospital during the pre-intervention years (1992-1994) and the post-intervention years (1995-1997). Results: There were 10,887 deliveries and 116 maternal deaths giving a maternal mortality ratio of 1,070 per 100,000 deliveries. The main causes of death were obstetric haemorrhage (25%), septic abortion (12.1%) and ruptured uterus (10.3%). These interventions were assessed as effective based on at least a 50% reduction in the case fatality rate (CFR) and were effective for obstetric haemorrhage (81.9% reduction in CFR, OR = 5.5), obstructed labour(80.5% reduction in CFR, OR =5.6), ruptured uterus (74.8% reduction in CFR, OR = 4) and eclampsia (54.2% reduction in CFR, OR = 2.2). Conclusion: Access to prompt and affordable emergency obstetric care by all pregnant women will result in a reduction in our high maternal mortality rates.