Tropical Journal of Obstetrics and Gynaecology最新文献

{"title":"Risk factors for hypertensive disorders of pregnancy in Abuja, Nigeria: A prospective case-control study","authors":"M. Ayogu, G. Akaba, R. Offiong, N. Adewole, B. Ekele","doi":"10.4103/tjog.tjog_88_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_88_19","url":null,"abstract":"Background: Hypertensive disorders of pregnancy (HDP) are an important cause of maternal and perinatal morbidity and mortality throughout the world, particularly in developing countries like Nigeria. The study determined the risk factors for the development of HDP among women who booked early for antenatal care. Materials and Methods: This was a prospective case-control study conducted from March 2015 to March 2016 involving pregnant women with gestational age less than 20 weeks at booking and were followed up until delivery and 6 weeks postpartum. Information on gestational age at recruitment, at diagnosis of HDP, mode of delivery, and fetal outcome were recorded. Risk factors for HDP were compared between women who developed HDP (cases) and those who did not develop HDP (controls) by Fisher's exact test, Chi-square, and student's t-tests. Univariate and multivariate logistic regression analysis was used to test the relationship between certain risk factors and the development of HDP. A P value of less than 0.05 was considered statistically significant. Results: The prevalence of HDP in the study was 19.4%. Family history of preeclampsia (OR: 5.339, 95% CI: 1.149–24.818, P = 0.033); previous history of preeclampsia (OR: 10.819, 95% CI: 3.570–32.792, P < 0.001); multifetal gestation (OR: 13.275, 95% CI: 2.899–38.127, P = 0.010); chronic hypertension (OR: 3.431, 95% CI: 1.778–8.710, P < 0.001) and diabetes; (OR: 2.846 95% CI: 0.460–17.584, P < 0.251) were the risk factors associated with the development of HDP among the study population while nulliparity (OR: 0.726, 95% CI 0.366–1.440, P = 0.395); body mass index (BMI) (mean ± SD), (OR: 0.405, 95% CI: 0.173–0.945, P < 0.037);and low educational level (OR: 0.582, 95% CI: 0.070–4.857, P = 0.613) were not. Conclusion: The prevalence of HDP in the study group was high. Risk factors for HDP included family history of hypertension, previous history of preeclampsia, multifetal gestation, and chronic hypertension.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41419429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of hepatitis B virus infection among pregnant women attending antenatal clinic in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State","authors":"Emmanuel Ogbe, R. Bello, E. Audu, B. Okwaraoha","doi":"10.4103/tjog.tjog_107_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_107_19","url":null,"abstract":"Context: Hepatitis B virus (HBV) infection is a cause of chronic liver disease, causing cirrhosis and hepatocellular carcinoma, and pregnant women are not spared. Perinatal transmission is a significant way that the disease is spread from mother to children who will eventually become adults and chronic carriers. This study sought to determine the burden of the disease among pregnant women. Aims: To estimate the prevalence and investigate possible factors associated with HBV infection among pregnant women attending antenatal clinics in DASH, Lafia. Settings and Design: A hospital-based descriptive cross-sectional survey conducted at the Obstetrics and Gynecology Department of DASH, Lafia, Nasarawa Methods and Material: Around 200 pregnant women who attended the ANC clinic were consecutively enrolled, their venous blood samples collected, and hepatitis B profile was carried out using commercially available rapid chromatographic kits Statistical Analysis Used: Data were collected by trained data collectors using a proforma, then entered into a predesigned program in the Epi-info version 3.5.4 (CDC, Atlanta, Georgia, USA) and analyzed. Results: The seroprevalence of HBV infection was high (8%) and there were no statistically significant associations between the infection and the investigated sociodemographic and other risk factors. Conclusions: The study showed that HBV is hyperendemic in this region, and antenatal screening for this virus is desirable to avert its sequelae in both mothers and their newborn babies.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42854730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriateness of antimicrobial prophylaxis practices according to the guidelines in two common gynaecological surgeries","authors":"Junaid Khan, Asghar Khan, Sohail Kamran, M. Jamal, S. Sherwani, Z. Khan","doi":"10.4103/tjog.tjog_85_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_85_19","url":null,"abstract":"Background: Most postsurgical infections can be prevented through the effective use of antimicrobial. This study was conducted to investigate the antimicrobial prophylaxis practices and adherence to guidelines in gynecological surgeries. Methods: An audit based prospective study was carried out between February and April 2019 in the gynecological ward in a teaching hospital, Peshawar, Pakistan. This study included women who had two common surgical procedures (caesarean surgery and hysterectomy), did not undergo any previous surgery and having no infection at the time of surgery. The indication, choice/selection, timing and pattern of antimicrobials were the main evaluated parameters. The required information was collected from medical records through standardized data collection proforma. Observed prescribing practices were compared with antimicrobial prophylaxis guideline. Results: A total of 264 patients (caesarean surgery n = 173 and hysterectomy n = 91) with mean age: 32.6 ± 6.3 years were recruited in the analysis. Antimicrobial was prescribed to 241 patients (91.3%). The selection and timing of antimicrobial were adhered to guidelines in 40.7% and 56.4% cases, respectively (optimal value 100%). There was a statistically significant difference between guideline recommendations and antimicrobial practice in surgical procedures (P = 0.000).The commonly prescribed antimicrobials were ceftriaxone (22.4%) and cefazolin (22%).The combination usage of antimicrobial was also observed. Conclusion: Inappropriate use of antimicrobial prophylaxis and low adherence to standard guidelines was observed. Periodic audit and awareness about standard guidelines are required for the judicial use of antimicrobials in surgery.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43880842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conscious sedation for oocyte retrieval: Experience at a tertiary health facility in North-Central, Nigeria","authors":"L. Omokanye, A. Olatinwo, K. Durowade, A. Panti, Ganiyu Salaudeen","doi":"10.4103/tjog.tjog_22_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_22_19","url":null,"abstract":"Background: A variety of anesthetic techniques have been used to make transvaginal oocyte retrieval (TVOR) safe and efficient. The optimal anesthetic technique during TVOR should provide safe, effective analgesia, few side effects, a short recovery time, and be nontoxic to the oocytes that are being retrieved. The concept of conscious sedation is widely accepted for the short-term management of pain. Objective: This study assessed patient's perception of pain using conscious sedation and in-vitro fertilization (IVF) outcomes. Materials and Methods: A cross sectional study of 71 eligible patients that underwent assisted reproduction program in our facility. All clients were treated with antagonist protocol for controlled ovarian hyperstimulation. Self-administered questionnaires were used as the research instrument. Pain was assessed using a 10 cm visual analogue scale (VAS), while client's overall satisfaction was rated using Likert scoring system. Results: Client aged 33.2 ± 4.2 years. Most of them had primary infertility with mean duration of 4.5 ± 2.9 years. Unexplained infertility was the commonest cause of infertility. The pregnancy rate per embryo transfer was 47.9%, miscarriage rate was 5.6%, while the live birth rate was 42.3%. The mean VAS scores at 1 h, 6 h, 24 h and at embryo transfer were 4.9 ± 1.7, 2.5 ± 1.2, 1.3 ± 0.9, and 0.5 ± 0.6, while the Likert score was 3.8 ± 1.1. Conclusion: Conscious sedation with Midazolam and Pethidine is a safe, effective, and acceptable method of analgesia/anesthesia for TVOR. However randomized prospective studies with larger sample sizes are recommended.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44306715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographic detection of umbilical cord presentation before induction of labor or labor admission: Presentation of 4 cases","authors":"S. Hemmanur, Sneha Bandlapalli","doi":"10.4103/tjog.tjog_108_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_108_19","url":null,"abstract":"Umbilical cord prolapse is a serious obstetric emergency that endangers the life of the baby. Perinatal mortality is as high as 44% when it occurs outside a well-equipped hospital. Women with malpresentations and positions, multifetal pregnancies, and polyhydramnios are at risk of developing this complication. Detection of cord presentation by transvaginal sonography before induction of labor, or at the time of labor admission, can prevent this potentially fatal obstetric emergency. We present successfully managed four cases of cord presentation at our institution.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44448025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Torsion of an Ovarian Cyst in Pregnancy","authors":"S. Bello, K. Tunau, B. Bello, K. Abdullahi, B. Ugege, E. Ukwu","doi":"10.4103/tjog.tjog_83_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_83_19","url":null,"abstract":"Torsion of the ovary is the partial or total rotation of the ovary over its pedicle. It is unusual for it to occur in the second trimester. We report a case of a 35year old G10P9+0A7 at 17weeks gestation who presented with acute severe abdominal pain. She was found to have an ovarian cyst in pregnancy. She had Exploratory Laparotomy where a huge gangrenous cyst was found and Salpingoophorectomy was performed. The pregnancy continued without any problems. The histology report showed a Simple Cyst.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45678663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preeclampsia and cancer antigen 125 in women attending antenatal clinic in Usmanu, Danfodiyo University Teaching Hospital, Sokoto","authors":"Y. Aremu-Kasumu, E. Nwobodo, I. Ango, M. Abdulrahman, Fatusin Joel, Fatusin Betty","doi":"10.4103/tjog.tjog_89_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_89_19","url":null,"abstract":"Background: Preeclampsia is a hypertensive disorder of pregnancy that is characterized by the development of elevated blood pressure and proteinuria after 20 weeks of conception in a previously normotensive and non-proteinuric patient. It is one of the leading and most important causes of maternal and perinatal morbidity and mortality and it occurred in about 6% of human pregnancies. In Usmanu Danfodiyo Teaching Hospital Sokoto, preeclampsia and its complications were the leading causes of death in the year 2016. Preeclampsia has many suggested biomarkers, some of which are not well-defined. It has been assumed that failure in trophoblastic invasion and induction of an inflammatory process within the placenta in patients with preeclampsia may trigger the expression of CA-125 antigen. This study established a definite association between CA-125 and preeclampsia. Aims: This study was conducted to determine the relationship between cancer antigen 125 and preeclampsia and its correlation with severity. Settings and Design: Hospital-based study, comparative cross-sectional study. Methods and Materials: Ninety-seven pregnant women with preeclampsia were recruited as cases while 97 pregnant women without preeclampsia were similarly recruited as controls. In both groups (cases and controls), only women with singleton pregnancies at ≥32 weeks' gestational ages were recruited. Sociodemographic characteristics, obstetric history, family history, and clinical data were obtained using a standard interviewer-administered questionnaire. Anthropometric measurements were taken. Blood samples were taken for measurement of serum cancer antigen 125. Mean arterial pressure (MAP) was used as an indicator of the severity of the disease. Statistical Analysis Used: SPSS computer statistical software version 22, percentages, Chi-square, mean, Pearson correlation test. Results: The age range of the respondents was between 16 and 45 years. The mean age for the control was 28.6 ± 5.9 years, 27.9 ± 7.5 and 28.7 ± 7.2 years, for the control and severe preeclampsia groups, respectively. The mean level of CA-125 in the preeclampsia group was significantly higher than the control (36.13 ± 23.02 vs 24.53 ± 9.42). The mean levels of CA-125 in severe preeclampsia were significantly higher than mild preeclampsia (45.68 ± 23.38 vs 21.94 ± 13.18), P = 0.001. The MAP in mild and severe preeclampsia was 112.82 ± 3.55 mmHg and 130.63 ± 12.87 mmHg respectively. A negligible positive correlation was observed between the MAP and CA-125 in the mild preeclampsia group (r = 0.01, P = 0.48), while a positive correlation, that was statistically significant was observed between the MAP and CA-125 in the severe preeclampsia group (r = 0.62, P = 0.001). Conclusions: This study found a significant association between preeclampsia and CA-125. In addition, a positive relationship between the level of CA-125 and the severity of preeclampsia was established.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49043215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of Couvelaire uterus with coagulation dysfunction saved successfully with SR PPH suction cannula","authors":"H. Ram, D. Swetha","doi":"10.4103/tjog.tjog_73_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_73_19","url":null,"abstract":"Couvelaire uterus is one of the complications associated with placental abruption, and the incidence is around 1%. Blood seeps into the uterine musculature and reaches beneath the serosa. The uterus shows the signs of ecchymosis, flabby, cannot contract and retract and results in atonic post partum hemorrhage (PPH). As this uterus likely to bleed in postoperativee period, the treatment of choice is obstetric hysterectomy. In such cases, the women lose their fertility function. In this case, we have successfully used samartha ram post partum hemorrhage (SR PPH) suction cannula to achieve contraction and retraction and saved the uterus.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42003177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factor V Leiden mutation and acquired activated protein C resistance in Indian women with recurrent fetal loss","authors":"P. Sinha, M. Sikka, S. Sharma, K. Guleria, P. Gogoi","doi":"10.4103/tjog.tjog_106_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_106_19","url":null,"abstract":"Objectives: To study the prevalence and association of factor V Leiden (FVL) mutation and acquired APC resistance (APCR) in women with recurrent fetal loss (RFL). Patients and Methods: Fifty women with two or more RFLs and 50 age-matched controls with no history of fetal loss and at least one live birth were included in the study. Complete blood counts and screening tests for coagulation (PT, APTT), APCR, and FVL (PCR) were done in all women. Results: Age of the patients ranged from 20–42 years with a mean ± SD of 27.4 ± 4.8 years. Prolonged PT and APTT were observed in 2% and 8% cases, respectively. None of the controls had prolonged PT/APTT. APCR was observed in 8% cases and 2% controls. The prevalence of APCR was higher in women with first-trimester fetal loss (24.2%) as compared to women with the second trimester (13.3%) fetal loss. FVL was not observed in any of the cases or controls. Conclusion: This study indicates that FVL mutation is not associated with RFL in the Indian population while APCR is observed in Indian women with RFL.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43451710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic splenic rupture in pregnancy with favourable pregnancy outcome: Case report","authors":"A. Agboola, Peter Osuala, O. Afuwape, A. Omigbodun","doi":"10.4103/tjog.tjog_84_19","DOIUrl":"https://doi.org/10.4103/tjog.tjog_84_19","url":null,"abstract":"Trauma complicating pregnancy is one of the causes of deaths that are not captured in the maternal mortality ratio, yet it occurs in about 1 in 15 pregnancies. This is a report of a case of splenic rupture occurring after a vehicle hit a pregnant woman who was a pedestrian. Splenectomy was done and, in spite of having a hemoperitoneum of about 2 litres, she recovered without further complication and was able to sustain the pregnancy to term, with the delivery of a healthy female infant. Clinicians should seek to exclude splenic rupture in cases of blunt trauma to the abdomen during pregnancy because of the risk of severe haemorrhage, shock, and possibility of pregnancy loss.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44498382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}