Joseph D. Seffah

Association of maternal sleep practices with pre-eclampsia low birth weight and stillbirth among Ghanaian women.

To assess sleep practices, and investigate their relationship with maternal and fetal outcomes, among pregnant Ghanaian women.

Health of urban Ghanaian women as identified by the Women’s Health Study of Accra

The purpose of the Womens Health Study of Accra was to provide an assessment of the prevalence of communicable and non‐communicable illnesses.

Re-laparotomy after Cesarean section

The objective of the study was to find out the indications for management and the outcomes of reopening the abdomen during the puerperium after Cesarean section.

Interest in healthy living outweighs presumed cultural norms for obesity for Ghanaian women

BackgroundCultural norms indicate that obesity reflects increased wealth and prosperity. Yet obesity is linked to serious medical illnesses. The purpose of this study was to determine if Ghanaian women would change their body image if it meant a healthier life.MethodsA questionnaire was administered to 305 Ghanaian women waiting for clinic appointments at Korle Bu Teaching Hospital, Accra Ghana. This survey included questions on current health, selection of figural stimuli, decision making on health and social determinants and 5 questions on self-perception of health from SF-36. Anthropometric measures were taken and body mass index calculated. Women were also provided with health related information at the conclusion of the interview.ResultsThe majority of all women surveyed would reduce their current body image if it meant that they would have an overall healthier life and reduce the risks of obesity-linked illnesses and complications. Currently obese women were significantly more likely than non-obese women to reduce their body image to reduce the risk of hypertension (OR 2.03 [1.64 – 2.51],<0.001); cardiovascular accident (OR 1.96 [1.61 – 2.38],<0.001); diabetes (OR 2.00 [1.63 – 2.44],<0.001); myocardial infarction (OR 2.27 [1.80 – 2.86],<0.001); if requested by a spouse(OR 2.64 [1.98 – 3.52],<0.001); and to improve overall health (OR 1.95 [1.60 – 2.37], <0.001). There was no association with current body image and responses to SF-36. The decision to select a new body image was not influenced by education, income, marital status or parity. Age 50 years old and less was significantly associated with the body image size reduction to reduce the risk of hypertension, diabetes, and a cardiovascular accident.ConclusionThe Ghanaian women interviewed in this study are interested in living a healthy life and are willing to reduce their body size to reduce the risk of obesity-linked illnesses. The target group for any interventional studies and measures to reduce obesity appears to be women age 50 and younger.

Obstetric ultrasonography in low-income countries.

The major issues in obstetric practice in developing countries are the high rates of maternal and perinatal mortality. In most low-income countries health financing systems are not well established so most people pay for health services at the service delivery points. This causes cost-related issues to be of major concern. The main questions that therefore need to be addressed about obstetric ultrasonography in low-income countries is whether the practice improves maternal and neonatal outcomes and whether the service is within the means of most people in these countries. The indications for obstetric ultrasound, guidelines for the use of obstetric ultrasound and the benefits of obstetric ultrasound in low-income countries are discussed and the future of obstetric ultrasound in developing countries is also briefly considered.

Secular trends in menarcheal age among Ghanaian women in Accra

Summary The Womens Health Study of Accra is a population-based cross-sectional survey that was conducted between March and September 2003 to assess the burden of disease in women in Accra. In addition to data relating to general health and living conditions, data on age at first menstruation was collected during the survey. A retrospective cohort analysis of the reported age at menarche was conducted using data from 2,644 women aged between 18 and 100 years. The median age of first menstruation of the entire cohort was 15.5 years and the median age of first menstruation among those aged <20 was 14.5 years. There was a statistically significant difference in median age at menstruation among the different age and socioeconomic groups. Multiple linear regression showed a significant decline of 0.2 years per decade in the mean age at menarche among Ghanaian women.

Maternal and perinatal mortality and morbidity associated with transverse lie

Objective: The aim of this study of transverse lie in labor of patients admitted to Korle Bu Hospital between 1 January 1996 and 30 June 1998, was to identify the methods of delivery, the perinatal and maternal morbidities and mortalities, and to provide recommendations to improve the outcome. Methods: This was a retrospective study of 152 patients who presented at the labor wards with transverse lie. The data sources of this study were the antenatal records, the labor wards delivery record books, the postnatal records and the admission books at the Neonatal Intensive Care Unit. Results: One hundred and forty‐two cases (92.1%) had an emergency cesarean section. The rest had the external version followed by vaginal delivery. There were two maternal deaths resulting from hemorrhage, infections and difficult surgery. There were 25 stillbirths, and 37 of the neonates required hospital admission. Conclusion: Transverse lie carries a high rate of complications in labor. Delivery should be carried out without delay in a hospital well‐equipped for cesarean delivery and assisted vaginal delivery. The complications could be further reduced by early diagnosis during the antenatal period when associated risk factors, such as placenta previa could be diagnosed with the aid of the ultrasound scan. Elective deliveries could then be undertaken.

Antenatal ultrasonography for breech delivery

Objective: We studied the role of sonography in the management of 370 breech presentations ≥34 weeks maturity. Method: 185 cases had sonographic confirmation of breech presentation prior to the delivery at the Korle Bu Teaching Hospital. A control group of 185 cases did not have prior scanning. Results: Significantly more elective cesarean sections were done in the study group, while the control group had more emergency sections (P=0.008), and had more traumatic delivery. Birth asphyxia and perinatal mortality were significantly more common in the control group (P<0.05). Conclusion: Sonography done before delivery improved neonatal outcome in breech presentation ≥34 weeks maturity.

Maternal outcomes of hypertensive disorders in pregnancy at Korle Bu Teaching Hospital, Ghana.

To determine maternal outcomes of hypertensive disorders in pregnancy at Korle Bu Teaching Hospital (KBTH) in Accra, Ghana.

Sonographic findings in women with complications after hysterectomy

To study the role of abdominal ultrasound in the management of complications after emergency or elective hysterectomy.