Tropical Journal of Obstetrics and Gynaecology最新文献

{"title":"Patient safety in maternity: The Nigerian context","authors":"O. Badejoko","doi":"10.4103/TJOG.TJOG_102_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_102_19","url":null,"abstract":"Background: The death of Folake Oduyoye at the Lagos University Teaching Hospital (LUTH), Nigeria on 13th December 2014 triggered a protest march against the hospital, by a coalition of civil society organizations and human rights activists, and a legal suit was instituted against the government. Although a Federal High Court ruled in 2018 to overturn Oduyoye's case on a technicality, this ruling is currently being appealed. Objective: To perform a sociological analysis of the Oduyoye/LUTH case and another managed in OAUTHC Ile-Ife; as a means of providing insight into the current state of patient safety in maternity, in Nigeria. Methodology: This sociological analysis was conducted using secondary data, sourced from a combination of detailed online searches of published literature, news items, and social media posts; along with personal observations and reviews of patient's records. Results: Patient safety issues in maternity are prevalent in Nigeria. Responsible macrosociological factors include lack of clarity regarding the political economy of healthcare in Nigeria, dubious justiciability of citizens' right to healthcare, poor resource allocation to healthcare, and dismal coverage of national health insurance, along with poor regulation of health services, and nonintegration of healthcare with partner social institutions. At the mesosociological and microsociological levels are lack of public confidence in Nigerian healthcare, gross infrastructural decay from chronic neglect, understaffing and inadequate training of personnel, lack of institutional risk management and clinical governance. Conclusion: The state of patient safety in maternity in Nigeria is quite worrisome. Various sociological factors were identified and viable solutions proffered.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46721175","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":"Correlation of abnormal umbilical artery Doppler Indices and mode of delivery in intrauterine growth restriction","authors":"S. Ganju, B. Dhiman, N. Sood","doi":"10.4103/TJOG.TJOG_79_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_79_19","url":null,"abstract":"Background: Elevated impedance to blood flow in the placenta is reflected by abnormal umbilical artery (UA) indices as seen in intrauterine growth restriction (IUGR). Aims: To correlate abnormal UA Doppler velocimetry parameters with birth weight and mode of delivery in IUGR. Material and Methods: A prospective study was conducted in Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child, IGMC Shimla HP, over a period of one year from August 2017 to July 2018. The study included a total of 120 consecutive clinically suspected cases of singleton IUGR pregnancies, at 34–40 weeks of gestation. Umbilical artery (UA) Doppler indices including systolic/diastolic (S/D) ratio, pulsatility index (PI), and resistive index (RI) were measured. The decision regarding mode delivery was based on absent or reversal of diastolic flow, abnormal fetal heart tracing, and other maternal and fetal conditions, e.g., preeclampsia or abnormal biophysical profile. The birth weight, mode of delivery, and the reasons for emergency cesarean section were noted. Statistical analysis was performed using Statistical Package for Social Sciences, version 16.0 and a P value <0.05 was considered statistically significant. Results: Abnormal UA PI (>1.42) was seen in 24 fetuses. Among these, 69% (n = 16) underwent a cesarean delivery, and 91% (n = 22) had a birth weight less than 2.5 kg. Statistically significant association was noted with abnormal UA PI (P-value: <0.01), abnormal UA RI (P-value: <0.001), and abnormal UA S/D (P-value: <0.001) and cesarean delivery. The main indication for cesarean section was fetal distress. Conclusion: Abnormal UA Doppler indices are significantly associated with cesarean deliveries and low birth weight babies.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47520175","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":"Suicidality among Nigerian postpartum women: Prevalence and correlates","authors":"T. Opakunle, O. Aloba, O. Opakunle","doi":"10.4103/TJOG.TJOG_43_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_43_19","url":null,"abstract":"Background: Postpartum suicidality is a major public health concern that has been identified as one of the major contributors to the global mortality burden. It poses a profound risk to women in the postpartum and the community in general. Aim: To determine the prevalence and correlates of suicidality among Nigerian postpartum women. Subjects and Methods: This is a cross-sectional descriptive study involving 347 Nigerian women recruited during the postpartum period. They completed a study-specific sociodemographic and pregnancy-related questionnaire, the Edinburgh Postpartum Depression Scale, Suicidal Behaviors Questionnaire-Revised, and the Brief version of the World Health Organization Quality of Life Questionnaire. Results: The prevalence of lifetime suicidal ideation, plans, and attempts was 10.4%, 2.9%, and 1.7% respectively. In addition, 5.2% of the respondents reported suicidal ideation in the past year, while 4.0% of the respondents indicated the likelihood of suicide attempts in the future. Depression, lower quality of life, preterm delivery, complications during pregnancy, poor support from the husband and the in-laws, stressful infant care, and baby's hospitalization were significantly associated with suicidality. Conclusion: Suicidality is relatively common among Nigerian postpartum women. Therefore, postpartum women should be routinely screened for suicidal behaviors.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42764750","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":"Analysis of vaginal and rectal sampling methods for maternal group B streptococcal isolation","authors":"V. Sharmila, T. Babu","doi":"10.4103/TJOG.TJOG_36_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_36_19","url":null,"abstract":"Background: Group B streptococci (GBS) is considered as an important cause of neonatal morbidity and mortality. The Centers for Disease Control and Prevention (CDC) recommends recto-vaginal sampling of pregnant women and the use of selective broth medium for GBS isolation. This study was done to evaluate the GBS yield from only vaginal, only rectal, and both rectal and vaginal swabs collected. In addition, the drawbacks of using the selective broth mediums for GBS isolation were also analyzed. Methodology: This was a prospective study that was done to screen 300 pregnant women for vaginal and rectal GBS colonization. Vaginal and rectal swabs were inoculated separately in Todd Hewitt Broth and later subcultured on blood agar for GBS isolation. Results: The GBS detection rates from both vaginal and rectal swabs were 42.9%, indicating heavy colonization in these women. In addition, our study noted certain drawbacks with the use of selective Todd Hewitt Broth medium used for GBS isolation. Conclusion: GBS isolation rate was higher when both rectal and vaginal swabs were collected. Our study also concluded that there was a need to develop alternative culture media for GBS isolation in view of the drawbacks encountered with the selective Todd Hewitt Broth medium.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44375666","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":"Does genital Chlamydia trachomatis cause spontaneous miscarriage in black women?","authors":"R. Aliyu, A. Adesiyun, S. Aliyu","doi":"10.4103/TJOG.TJOG_75_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_75_19","url":null,"abstract":"Background: Chlamydia trachomatis (Ct) is the commonest bacterial sexually transmitted disease worldwide and is now being considered as an emerging “obstetric pathogen”. It is an enemy to the human reproductive system causing infertility, adverse pregnancy and perinatal outcomes but its role in causing spontaneous miscarriage is still unclear. Objective: To assess the association between genital Chlamydia trachomatis and spontaneous miscarriage in black women. Materials and Methods: Eighty three women with spontaneous miscarriage (case group) were compared with 83 women with on-going pregnancy beyond 28 weeks' gestation (control group). Sera of both groups were tested for the presence of Chlamydia trachomatis Immunoglobulin G (IgG) antibody using ELISA. Results: Seroprevalence of IgG to Ct was 8.4% and 3.6% among women with spontaneous miscarriage and on-going pregnancy, respectively. Ct IgG seropositivity was not significantly different between the two groups (P = 0.192; OR = 0.41, CI 0.10 – 1.63). Conclusion: Chlamydia trachomatis IgG seropositivity is not associated with spontaneous miscarriage in this study. However, multicentre study with larger sample size and using polymerase chain reaction as a diagnostic technique is recommended.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46294477","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":"Knowledge and perception of postmenopausal symptoms among postmenopausal women presented at the gynecological clinic of a tertiary health institution in Abakaliki","authors":"C. Ibo, L. Ajah, Johnbosco Ifunanya Nwafor, K. Ekwuazi, O. Okoro, C. Obi, J. Mamah","doi":"10.4103/TJOG.TJOG_61_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_61_19","url":null,"abstract":"Introduction: As life expectancy increases, most women spend a larger part of their lives in the postmenopausal state. This period is associated with other medical comorbidities which affect the quality of life. Knowledge and perception of postmenopausal symptoms could help them cope with such a situation. Aim: To determine the knowledge and perception of postmenopausal symptoms among postmenopausal women presented to the gynecological clinic of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Methods: This was a cross-sectional study carried out at the Gynecological clinic of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Around 408 women were administered structured questionnaires. The information obtained was analyzed using SPSS version 20. Results: Majority (50%) of the respondents were 50–54 years age group and the least (6.9%) were 55–59 years. The commonest menopausal symptom reported was hot flushes by 300 (73.5%) respondents. Tiredness and vaginal dryness were reported by 188 (46.1%) and 180 (44.1%) respondents, respectively. The knowledge of hormone replacement therapy was low (7.8%). The study showed that 356 (87.3%) women have no knowledge of hormone replacement therapy. Conclusion: There is a need for educating women in the clinics regarding menopause and hormone replacement therapy which would further enable women to make informed choices about their health postmenopause.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43799635","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":"Comparison of performance of shock index and conventional vital sign parameters for prediction of adverse maternal outcomes following major postpartum hemorrhage in Abakaliki, Southeast Nigeria","authors":"Johnbosco Ifunanya Nwafor, V. Obi, B. Onwe, D. Ugojis, V. Onuchukwu, C. Obi, C. Ibo","doi":"10.4103/TJOG.TJOG_60_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_60_19","url":null,"abstract":"Background: Despite advances in care, postpartum hemorrhage has continued to contribute disproportionately to maternal morbidity and mortality in developing countries due to delayed and/or substandard care in the diagnosis and management of hypovolemic shock. Aim: To compare the performance of the shock index with conventional vital signs for prediction of maternal outcome following postpartum hemorrhage and to establish alert thresholds for use in low-resource settings. Materials and Method: This is a 7-year retrospective cohort study of 289 women treated for primary postpartum hemorrhage at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The data for systolic and diastolic blood pressure, mean arterial pressure, pulse pressure, heart rate, and shock index measured at the time of diagnosis of postpartum hemorrhage were analyzed. Adverse maternal outcomes such as intensive care unit admission, blood transfusion ≥5 units, hemoglobin level <7 g/dL, surgical interventions, end-organ failure, and death were reviewed. The area under the receiver operating characteristic curve (AUROC) for each vital sign was used to predict adverse maternal outcomes. Sensitivity, specificity, and negative and positive predictive values were calculated to determine the thresholds of the best predictor. Results: Shock index had the highest AUROC to predict invasive surgical procedures (0.70 for SI [95% CI 0.66–0.80] compared with 0.69 [95% CI 0.61–0.76] for pulse rate). Shock index was a consistent superior predictor for other outcomes. Shock index (SI) ≥0.9 had 100% sensitivity (95% CI 74.6–100) and 46.7% specificity (95% CI 34.9–56.5) for prediction of intensive care admission, and SI ≥1.7 had 46.9% sensitivity (95% CI 19.8–62.8) and 98.9% specificity (CI 91.1–100) for prediction of maternal death. Conclusion: Shock index is a consistent superior predictor of adverse maternal outcomes following postpartum hemorrhage when compared with conventional vital signs. SI <0.9 provides reassurance, whereas SI ≥1.7 indicates a need for urgent intervention to prevent maternal mortality.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43965029","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":"Role of blood transfusion in obstetrics","authors":"L. Reshma, S. Sreelatha","doi":"10.4103/TJOG.TJOG_68_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_68_19","url":null,"abstract":"Blood transfusion in obstetrics should be administered to save the patient's life. Severe blood loss could lead to hypovolemic shock which requires an immediate blood transfusion to prevent organ failure and death. Transfusion of blood and blood components must be approached like the use of medicines. They must be used only after weighing the benefits against the risks as well as in the right dose, right indication, and schedule. This review article deals with preparation, indications, administration of blood components, and its complications in obstetrics.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43785037","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":"Low uptake of human papillomavirus vaccination and cervical cancer screening among female undergraduates of a Nigerian University","authors":"E. Afolabi, O. Ogunsanwo, S. Oyebamiji, O. Ani","doi":"10.4103/TJOG.TJOG_96_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_96_19","url":null,"abstract":"Background: Cervical cancer is a public health problem affecting women all over the world. Persistent infection with high-risk types of human papillomavirus (HPV) is a key risk factor for the development of cervical cancer. Besides, HPV vaccines and cervical cancer screening have been established as the primary and secondary preventive measures, respectively, yet studies have documented low uptake of these preventive measures. This study was designed to identify factors associated with uptake of HPV vaccination and cervical cancer screening among female undergraduates in Obafemi Awolowo University, Ile-Ife, Nigeria. Methods: This is a cross-sectional descriptive study employing a semi-structured, self-administered questionnaire to elicit information from 240 female undergraduates on sociodemographics and factors associated with uptake of HPV vaccines and screening for prevention of cervical cancer. The data collected was analyzed using the statistical package for social sciences (SPSS) version 20.0. Descriptive statistics were used to present data in tables and frequencies. Results: Findings from the study revealed that 80% of the respondents have heard of cervical cancer; however, only 48.3% and 41.7% have information about HPV vaccination and cervical cancer screening, respectively. The key factors identified for low uptake of HPV vaccination and cervical cancer screening were inadequate information about HPV vaccines (96.7%) and lack of detailed information about cervical cancer screening (94.6%), respectively. However, the least identified factors for low uptake of the primary and secondary preventive measures were some of the respondents considered their age too young to receive HPV vaccines (15%) and lack of time (42.1%) for the uptake of cervical cancer screening. Conclusion: There is a high level of knowledge about cervical cancer, but does not translate to high uptake of the prevention services. Thus, there is a great need to put in place measures to improve the uptake of HPV vaccination and cervical cancer screening services among the target population.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47451160","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":"Awareness, knowledge, and perception about Sayana press® contraceptive technology in Nigeria","authors":"F. Eremutha, V. Gabriel","doi":"10.4103/TJOG.TJOG_81_19","DOIUrl":"https://doi.org/10.4103/TJOG.TJOG_81_19","url":null,"abstract":"Background: Access to modern contraception can save lives. Sayana Press® is a 3-month injectable contraceptive that has a small needle and comes in a prefilled syringe, which makes it easy to use and less painful. Subjects and Methods: A mix method cross-sectional study was carried out in the Federal Capital Territory (FCT) and 3 states chosen across Nigeria: Nassarawa, Benue, and Oyo states. Quantitative data were collected using an interviewer-administered questionnaire while the qualitative data were collected using focus group discussions with selected youths, teachers, family planning service providers (caregivers), and parents. Results: Despite its years of introduction into the family planning market, Sayana Press® awareness was low, with 37.7% (43) of the 114 respondents in the quantitative study being aware of its existence as a new family planning method. The qualitative data also reinforced the crucial role of contraceptive knowledge (benefits and side effects) and cost on the uptake of Sayana Press®. Conclusion: Government and donor support for centralizing the procurement and distribution of contraceptives is a key determinant of Sayana Press® awareness and uptake.","PeriodicalId":23302,"journal":{"name":"Tropical Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70848369","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}