Ha Ugboma

Clinical Presentation of Infertility in an Outpatient Clinic of a Resource Poor Setting, South-East Nigeria

Aim: To identify the prevalence, common symptoms, signs, partner contribution, common diagnosis and outcome of infertility in a resource poor setting. Study Design: Descriptive retrospective study.

Gestational Diabetes: Risk Factors, Perinatal Complications and Screening Importance in Niger Delta Region of Nigeria: A Public Health Dilemma

Aim: The study identified the incidence of undiagnosed gestational diabetes and its consequences on maternal/neonatal mortality and highlighted screening importance in an African urban setting in the Niger Delta region in Nigeria. Study Design: Randomised study. Place and Duration of Study: Pregnant women attending antenatal clinics in one tertiary, six primary, six secondary, hospitals, and six maternity homes in the Niger delta area of Nigeria between May 2006 to May 2009. Method: A total of 1920 pregnant women were recruited into the study. While 956 received the oral glucose test and formed the study group, 964 declined from continuing in the study, and formed the control group. Results: Women with gestational diabetes were at increased risk for premature rupture of membranes, preterm birth; breech presentation and high birth weight adjusting for maternal age. Conclusion: The presence of gestational diabetes in pregnancy is predictive of poor pregnancy outcome as it remains undetected in conception resulting in unto wards maternal/neonatal complications.

Ruptured ectopic pregnancy: the long and tortuous journey to the theatre

Ectopic pregnancy is a common gynaecological emergency in Nigeria, West Africa. Here we present a case that brings to light some of the problems facing the health sector in reducing the high maternal mortality rate.

Determinants of Delivery Outcomes in Teenage Mothers at a University Teaching Hospital, South-Eastern, Nigeria

Aim: This study aims at identifying some delivery outcome determinants in teenage mothers and evaluating the effect of booking in light of these parameters. Study Design: A retrospective study. Place and Duration of Study: Teenage mothers who delivered in a teaching hospital in Nigeria over a 5-year period (between 1

Outpatient non -surgical management of unruptured ectopic pregnancy in a specialist hospital in Nigeria: a report of three cases

Background : Ectopic pregnancy is a major contributor to maternal morbidity and mortality in the first trimester of pregnancy especially when ruptured. Most patients with this condition present to the health facility with features of rupture, warranting the traditional approach of an emergency exploratory laparotomy which puts a burden on available infrastructure, causes distortion of family dynamics and reduces reproductive potentials. Aim : To report the successful outpatient medical management of three cases of unruptured ectopic pregnancy using multidose intramuscular methotrexate in a specialist health facility in Port Harcourt. Case report: We present three cases of unruptured ectopic pregnancy diagnosed early using serum β HCG and ultrasound scan managed successfully with multidose intramuscular methotrexate on an outpatient basis. Conclusion : Early confirmation of pregnancy immediately after a missed period and localization of gestation site will facilitate identification of patients suitable for medical management of extrauterine pregnancy using a readily available anti-folate, methotrexate, which can be performed as an office procedure. This modality of treatment will reduce surgical risk, reduce demand on the already stretched health system and improve reproductive outcome. Keywords : Unruptured ectopic, Methotrexate, Ultrasound scan, Serum β human chorionic gonadotrophin hormones

Caesarean section: the perspectives of women in Port Harcourt, Nigeria

Normal 0 false false false Background: The caesarean section rate in several health facilities in Nigeria is rising, even with the strong aversion to the procedure by women in Nigeria. This study is to explore the experiences and views of women on caesarean section, as to identify areas of conflicts with the medical perception. Methods: The study was carried out in Port Harcourt using a descriptive, cross-sectional study design, with a self - administered questionnaire and in-depth interviews as the study tools. The questionnaire was administered to pregnant women attending the antenatal clinics of the two public tertiary health institutions in Port Harcourt. The in-depth interviews were held with ten women that had antenatal care in a health facility, but had their delivery in private maternity homes, to further explore reasons why certain women could go to great length to avoid a caesarean section. Results: A total of 347 questionnaires were retrieved and analyzed. The average age of the respondents was 29.5 years and they were mainly Pentecostal Christians (55.3%) and of tertiary education (53.3%). The aversion of the respondents for caesarean section stem from its stigma factor (52.7%) its ability to limit the number of children a woman could have (68.0%), its cost (63.7%), and the likelihood of morbidity and mortality (51.0%). Some (25.1%) of the respondents felt doctors sometimes recommend the procedure for their own financial gratification, an opinion actively peddled by some private midwives. Conclusions: There are some differences between the medical indications for caesarean section and the expressed need for the procedure by women. This should be taken into consideration in reaching the decision for the procedure. Keywords: Caesarean section, Health system, Aversion, Customer demand