Background: Antenatal depression (AD) is prevalent and associated with adverse pregnancy, materna... more Background: Antenatal depression (AD) is prevalent and associated with adverse pregnancy, maternal and child outcomes, yet no study has addressed its magnitude and predictors in early pregnancy in Nigeria.Aim: To determine the prevalence and factors associated with AD in first half of pregnancy.Setting: Multicentric health facilities in Southern Nigeria.Methods: A multicentric health-facilities-based cross-sectional study was conducted from January to July 2018. Using pretested structure interviewer-administered questionnaires, antenatal depressive symptoms were assessed amongst 511 pregnant mothers with the Edinburg Postnatal Depressive Scale tool. Socio-demographic, socio-economic, clinical, family and social factors were also measured. Descriptive statistics, bivariate and multivariable logistic regression analyses were employed to describe and identify factors associated with AD.Results: The prevalence of antenatal depressive symptoms in early pregnancy in this study was 29.4% (...
Aim: To examine the outcome of gynaecological consultations for infertility in a tropical Teachin... more Aim: To examine the outcome of gynaecological consultations for infertility in a tropical Teaching Health facility. Material and Methods: This is a cross-sectional study of infertility cases seen at the Bowen University Teaching Hospital, Ogbomoso over a year (16 October, 2010 to 15 October, 2011). The patients were followed up for twelve months thereafter. Data collection was done using a designed profoma. All patients coming for gynaecological consultations because of infertility within the study period were included in the study after giving their informed consents. Patient information recorded in the profoma included age, parity, educational status, occupation, duration of infertility, investigations, modality of treatment and treatment outcome. Outcome was measured by the number of live births amongst treated patients. Results: A total of 195 patients presented for gynaecological consultations during the one year period; infertility was one of the commonest reasons for gynaecol...
Objective: The main purpose of this study is to derive a dating formula for the Nigerian obstetri... more Objective: The main purpose of this study is to derive a dating formula for the Nigerian obstetric population, quantify its prediction error, and compare its performance with existing published formulae. Materials and Methods: The crown-rump length (CRL) of 322 fetuses without risk for fetal growth restriction were plotted against menstrual age to obtain a scatter plot from which we derived the best-fit fractional polynomial regression model for estimating gestational age (GA). The accuracy of the formula was compared with that of existing formula in another data set of 88 fetuses. Results: The scatter plot yielded a best-fit equation for the estimation of GA (in weeks) from CRL (in mm) as GA=−0.0008 (CRL2) + 0.168 CRL + 5.397, (R2=0.8017). The mean prediction error was 0.13 for our formula, and 0.16 and 0.20 for Nelson′s, and Robinson′s formulae, respectively. Conclusion: Our dating formula locally derived was more favorably applicable for the Nigerian population. This has implication for prenatal diagnosis in Nigeria.
This study was carried out to evaluate the efficacy and safety of membrane stripping at term in r... more This study was carried out to evaluate the efficacy and safety of membrane stripping at term in reducing the incidence of post-term (41 weeks or greater) pregnancies. One hundred and thirty-seven pregnant women at 38 weeks gestation were randomised to receive either membrane stripping (69) or gentle cervical examination (68). Women who received stripping had earlier delivery (4.8 vs. 12.1 days; P<0.001) and less incidence of delivery at 41 weeks or greater (3% vs. 16%; P=0.009). No statistically significant difference was noted in incidence of premature rupture of membranes, clinical evidence of chorioamnionitis, intrapartum characteristics and perinatal outcome. We conclude that membrane stripping is a safe method to reduce the incidence of post-term pregnancy.
The aim of this randomised trial was to determine the effect of the policy of active management o... more The aim of this randomised trial was to determine the effect of the policy of active management of labour in all its components on the rate of caesarean section in a Nigerian district hospital setting. Two hundred and twenty-one nulliparous women fulfilling selected inclusion criteria were randomised to receive active management of labour, and 227 control women received routine labour management. Labour was significantly shortened by over 2 hours with active management of labour, and caesarean section reduced (9% vs. 16%, RR 0.57, 95% CI 0.34-0.95). There were no significant differences in maternal infectious morbidity, uterine hyperstimulation syndromes, ruptured uterus or neonatal Apgar scores between the two groups. We conclude that active management of labour shortens primigravid labour and reduces caesarean risk.
We set out to compare a policy of two-layered postpartum perineal repair leaving the skin unsutur... more We set out to compare a policy of two-layered postpartum perineal repair leaving the skin unsutured with a policy of three-layered repair, which involved skin closure. Parturients who sustained a second-degree tear or an episiotomy in four Nigerian centers were randomised to have either a two-layered repair (417 women) or a three-layered repair (406 women). Fewer women in the two-layered group reported perineal pain at 48 hours (57% vs. 65%, relative risk [RR] 0.87, 95% confidence interval [CI] 0.78-0.97) and 14 days postpartum (22% vs. 28%, RR 0.77, CI 0.61-0.98). The two-layered repair was also associated with reduced risk of suture removal (6% vs. 10%, RR 0.62, CI 0.39-0.99), and less superficial dyspareunia at 3 months (6% vs. 12%, RR 0.52, CI 0.33-0.81). The rates of wound healing were similar between the two groups. Leaving the skin unsutured during postpartum perineal repair reduces perineal pain and dyspareunia.
Our objective was to study the pregnancy outcomes among teenagers in a rural Nigerian setting. Si... more Our objective was to study the pregnancy outcomes among teenagers in a rural Nigerian setting. Single births to 1394 nulliparous mothers aged <or=19 during 1996-2001 at three district general hospitals were studied retrospectively. The outcome of pregnancy was compared with that of 1488 older nulliparae aged 20-24 years who delivered during the study period. Compared with women aged 20-24 years, patients of 15 years or less were at higher risk for anaemia, premature labour, low birth weight, and operative deliveries. However, the older teenagers (16-19 years) were less at risk. When women with inadequate prenatal care were removed from analysis, the risks in younger teenagers were not significantly different from those of older mothers. This calls for action to make prenatal care more available to teens, particularly those less than 15.
This study was conducted at three teaching hospitals in South-Western Nigeria. Paturients were ex... more This study was conducted at three teaching hospitals in South-Western Nigeria. Paturients were examined to find out if they had had female genital mutilation. Those who did were given a self-administered questionnaire. Results show that all the patients had either Type I (69%) or Type II (31%) mutilation (using WHO classification). The average age at which the procedure was performed was 6.9+/-2.9 years, with 4% of women having the procedure performed in pregnancy. The majority of the procedures were performed by medically untrained personnel (89%). Up to 67% of the women reported complications following the procedure. Severe pain and bleeding were the most common (69%) of the complications reported. The most common reason given for the procedure is cultural/traditional (63%). About a fifth of the women want their female child to undergo female genital mutilation. This study highlights the need for further interventions aimed at discouraging the practice of female genital mutilation.
Our objective was to compare oral misoprostol with intramuscular oxytocin in the prevention of po... more Our objective was to compare oral misoprostol with intramuscular oxytocin in the prevention of postpartum haemorrhage. Four hundred and ninety-six women were randomised to receive either 600 microg misoprostol orally or 10 IU oxytocin intramuscularly after delivery. There were no significant differences between the misoprostol and oxytocin groups with regard to the incidence of postpartum haemorrhage (1% vs. 0% respectively, relative risk (RR) 3.02, 95% confidence interval (CI) 0.32-28.88) or drop in haemoglobin concentration (0.71 g/dl vs. 0.68 g/dl, respectively, P = 0.699). The length of the third stage of labour and the percentage of women requiring manual removal of placenta, further oxytocics or blood transfusion were also similar. Shivering was significantly higher with misoprostol (57% vs. 14%; RR 4.06, CI 2.93-5.62), but there were no differences in other side effects. We conclude that oral misoprostol can replace intramuscular oxytocin in reducing postpartum haemorrhage in low-risk women, in developing countries, especially as it is administered orally and it is thermostable in tropical conditions.
Our objective was to evaluate the association between clinical chorioamnionitis following preterm... more Our objective was to evaluate the association between clinical chorioamnionitis following preterm pre-labour rupture of membranes (PPROM) and adverse neonatal outcome. We compared retrospectively, adverse neonatal outcome of singleton pregnancies with documented PPROM who developed chorioamnionitis (cases) with those who did not (controls). Our result showed that poor neonatal outcome was significantly associated with chorioamnionitis (34% vs 13%; p = 0.008). This association was found on multiple logistic regression analysis to be independent (p < 0.05) of other risk factors for poor neonatal outcome, viz: latency period (p = 0.002) and gestational age at delivery (p < 0.001). We conclude that chorioamnionitis complicating PPROM worsen neonatal outcome. The implication of this on expectant management of PPROM is discussed.
Background: Antenatal depression (AD) is prevalent and associated with adverse pregnancy, materna... more Background: Antenatal depression (AD) is prevalent and associated with adverse pregnancy, maternal and child outcomes, yet no study has addressed its magnitude and predictors in early pregnancy in Nigeria.Aim: To determine the prevalence and factors associated with AD in first half of pregnancy.Setting: Multicentric health facilities in Southern Nigeria.Methods: A multicentric health-facilities-based cross-sectional study was conducted from January to July 2018. Using pretested structure interviewer-administered questionnaires, antenatal depressive symptoms were assessed amongst 511 pregnant mothers with the Edinburg Postnatal Depressive Scale tool. Socio-demographic, socio-economic, clinical, family and social factors were also measured. Descriptive statistics, bivariate and multivariable logistic regression analyses were employed to describe and identify factors associated with AD.Results: The prevalence of antenatal depressive symptoms in early pregnancy in this study was 29.4% (...
Aim: To examine the outcome of gynaecological consultations for infertility in a tropical Teachin... more Aim: To examine the outcome of gynaecological consultations for infertility in a tropical Teaching Health facility. Material and Methods: This is a cross-sectional study of infertility cases seen at the Bowen University Teaching Hospital, Ogbomoso over a year (16 October, 2010 to 15 October, 2011). The patients were followed up for twelve months thereafter. Data collection was done using a designed profoma. All patients coming for gynaecological consultations because of infertility within the study period were included in the study after giving their informed consents. Patient information recorded in the profoma included age, parity, educational status, occupation, duration of infertility, investigations, modality of treatment and treatment outcome. Outcome was measured by the number of live births amongst treated patients. Results: A total of 195 patients presented for gynaecological consultations during the one year period; infertility was one of the commonest reasons for gynaecol...
Objective: The main purpose of this study is to derive a dating formula for the Nigerian obstetri... more Objective: The main purpose of this study is to derive a dating formula for the Nigerian obstetric population, quantify its prediction error, and compare its performance with existing published formulae. Materials and Methods: The crown-rump length (CRL) of 322 fetuses without risk for fetal growth restriction were plotted against menstrual age to obtain a scatter plot from which we derived the best-fit fractional polynomial regression model for estimating gestational age (GA). The accuracy of the formula was compared with that of existing formula in another data set of 88 fetuses. Results: The scatter plot yielded a best-fit equation for the estimation of GA (in weeks) from CRL (in mm) as GA=−0.0008 (CRL2) + 0.168 CRL + 5.397, (R2=0.8017). The mean prediction error was 0.13 for our formula, and 0.16 and 0.20 for Nelson′s, and Robinson′s formulae, respectively. Conclusion: Our dating formula locally derived was more favorably applicable for the Nigerian population. This has implication for prenatal diagnosis in Nigeria.
This study was carried out to evaluate the efficacy and safety of membrane stripping at term in r... more This study was carried out to evaluate the efficacy and safety of membrane stripping at term in reducing the incidence of post-term (41 weeks or greater) pregnancies. One hundred and thirty-seven pregnant women at 38 weeks gestation were randomised to receive either membrane stripping (69) or gentle cervical examination (68). Women who received stripping had earlier delivery (4.8 vs. 12.1 days; P<0.001) and less incidence of delivery at 41 weeks or greater (3% vs. 16%; P=0.009). No statistically significant difference was noted in incidence of premature rupture of membranes, clinical evidence of chorioamnionitis, intrapartum characteristics and perinatal outcome. We conclude that membrane stripping is a safe method to reduce the incidence of post-term pregnancy.
The aim of this randomised trial was to determine the effect of the policy of active management o... more The aim of this randomised trial was to determine the effect of the policy of active management of labour in all its components on the rate of caesarean section in a Nigerian district hospital setting. Two hundred and twenty-one nulliparous women fulfilling selected inclusion criteria were randomised to receive active management of labour, and 227 control women received routine labour management. Labour was significantly shortened by over 2 hours with active management of labour, and caesarean section reduced (9% vs. 16%, RR 0.57, 95% CI 0.34-0.95). There were no significant differences in maternal infectious morbidity, uterine hyperstimulation syndromes, ruptured uterus or neonatal Apgar scores between the two groups. We conclude that active management of labour shortens primigravid labour and reduces caesarean risk.
We set out to compare a policy of two-layered postpartum perineal repair leaving the skin unsutur... more We set out to compare a policy of two-layered postpartum perineal repair leaving the skin unsutured with a policy of three-layered repair, which involved skin closure. Parturients who sustained a second-degree tear or an episiotomy in four Nigerian centers were randomised to have either a two-layered repair (417 women) or a three-layered repair (406 women). Fewer women in the two-layered group reported perineal pain at 48 hours (57% vs. 65%, relative risk [RR] 0.87, 95% confidence interval [CI] 0.78-0.97) and 14 days postpartum (22% vs. 28%, RR 0.77, CI 0.61-0.98). The two-layered repair was also associated with reduced risk of suture removal (6% vs. 10%, RR 0.62, CI 0.39-0.99), and less superficial dyspareunia at 3 months (6% vs. 12%, RR 0.52, CI 0.33-0.81). The rates of wound healing were similar between the two groups. Leaving the skin unsutured during postpartum perineal repair reduces perineal pain and dyspareunia.
Our objective was to study the pregnancy outcomes among teenagers in a rural Nigerian setting. Si... more Our objective was to study the pregnancy outcomes among teenagers in a rural Nigerian setting. Single births to 1394 nulliparous mothers aged <or=19 during 1996-2001 at three district general hospitals were studied retrospectively. The outcome of pregnancy was compared with that of 1488 older nulliparae aged 20-24 years who delivered during the study period. Compared with women aged 20-24 years, patients of 15 years or less were at higher risk for anaemia, premature labour, low birth weight, and operative deliveries. However, the older teenagers (16-19 years) were less at risk. When women with inadequate prenatal care were removed from analysis, the risks in younger teenagers were not significantly different from those of older mothers. This calls for action to make prenatal care more available to teens, particularly those less than 15.
This study was conducted at three teaching hospitals in South-Western Nigeria. Paturients were ex... more This study was conducted at three teaching hospitals in South-Western Nigeria. Paturients were examined to find out if they had had female genital mutilation. Those who did were given a self-administered questionnaire. Results show that all the patients had either Type I (69%) or Type II (31%) mutilation (using WHO classification). The average age at which the procedure was performed was 6.9+/-2.9 years, with 4% of women having the procedure performed in pregnancy. The majority of the procedures were performed by medically untrained personnel (89%). Up to 67% of the women reported complications following the procedure. Severe pain and bleeding were the most common (69%) of the complications reported. The most common reason given for the procedure is cultural/traditional (63%). About a fifth of the women want their female child to undergo female genital mutilation. This study highlights the need for further interventions aimed at discouraging the practice of female genital mutilation.
Our objective was to compare oral misoprostol with intramuscular oxytocin in the prevention of po... more Our objective was to compare oral misoprostol with intramuscular oxytocin in the prevention of postpartum haemorrhage. Four hundred and ninety-six women were randomised to receive either 600 microg misoprostol orally or 10 IU oxytocin intramuscularly after delivery. There were no significant differences between the misoprostol and oxytocin groups with regard to the incidence of postpartum haemorrhage (1% vs. 0% respectively, relative risk (RR) 3.02, 95% confidence interval (CI) 0.32-28.88) or drop in haemoglobin concentration (0.71 g/dl vs. 0.68 g/dl, respectively, P = 0.699). The length of the third stage of labour and the percentage of women requiring manual removal of placenta, further oxytocics or blood transfusion were also similar. Shivering was significantly higher with misoprostol (57% vs. 14%; RR 4.06, CI 2.93-5.62), but there were no differences in other side effects. We conclude that oral misoprostol can replace intramuscular oxytocin in reducing postpartum haemorrhage in low-risk women, in developing countries, especially as it is administered orally and it is thermostable in tropical conditions.
Our objective was to evaluate the association between clinical chorioamnionitis following preterm... more Our objective was to evaluate the association between clinical chorioamnionitis following preterm pre-labour rupture of membranes (PPROM) and adverse neonatal outcome. We compared retrospectively, adverse neonatal outcome of singleton pregnancies with documented PPROM who developed chorioamnionitis (cases) with those who did not (controls). Our result showed that poor neonatal outcome was significantly associated with chorioamnionitis (34% vs 13%; p = 0.008). This association was found on multiple logistic regression analysis to be independent (p < 0.05) of other risk factors for poor neonatal outcome, viz: latency period (p = 0.002) and gestational age at delivery (p < 0.001). We conclude that chorioamnionitis complicating PPROM worsen neonatal outcome. The implication of this on expectant management of PPROM is discussed.
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