Progestogen-only injectable contraceptive: experience of women in Osogbo, southwestern Nigeria

Background: Progestogen-only injectable contraceptive is a long-acting contraceptive given intramuscularly to give protection against unwanted pregnancy for a period of 2 or 3 months; depending on the type. Alterations in menstrual pattern are a well known side effect of this effective contraceptive method. Objectives: To determine the characteristics of women accepting the method; complications and indications for discontinuation. Materials and Methods: This was a retrospective review of clients using progestogen-only injectable contraceptive between 1 st January; 2001 and 31 st December; 2009. Relevant information extracted from the case notes was analyzed. Survival analysis was carried out using Log-Rank Chi-square test to measure association over 12-month period of usage. Level of significance was set at P value less than 0.05.Results: A total of 1;967 women used contraception during the study period and 433 (22.1) made progestogen-only injectable their method of choice. 199(45.96) used NET-EN; while DMPA was used by234 (54.04) women. Many of the women (197; 45.5) used the method for terminal fertility control. Menstrual abnormality was the commonest (264; 71.4) complaint about progestogen-only injectable contraceptive; of which amenorrhea was experienced by constituted 176(66.7). Eighty-three (22.4) women had discontinued the contraceptive; and menstrual abnormality was the commonest reason for the discontinuation (68; 81.9). No pregnancy was reported among the women that came for follow up while on the method. Conclusion: Short duration of POIC use that is within 12 months is still high. However the main reason for discontinuation was found to be due to menstrual irregularities; hence the need for effective education of the women about this side effect; thus increasing the acceptance and continuation rate of the contraceptive method

Outcome of Breech Deliveries at a Tertiary Health Institution in Southwestern Nigeria

The aetiology of breech presentation is not clear, however, several factors had been found to be associated with increased risk of breech presentation. The mode of delivery of breech presentation for optimum neonatal outcome had been a subject of controversy over the years. The present study is a retrospective analysis of the outcome of singleton breech delivery at a tertiary health institution. The incidence of singleton breech delivery during the study period was 2.9%. The maternal age ranged between 16 and 44years with a mean age of 30.05±5.53; primiparous were 32(37.2%), while multiparous were 54(62.8%). External cephalic version was attempted, but failed in one case; assisted vaginal breech delivery was conducted in 19(22.0%) cases, 47(54.7%) were delivered by emergency Caesarean section, and 20(23.3%) had elective Caesarean section. Asphyxia was present in 14(77.8%), 31(66.0%)and 8(40.0%), of babies , delivered by assisted vaginal breech delivery, emergency Caesarean section, and elective Caesarean section, respectively (df = 2, p= 0.042). This study showed that elective Caesarean delivery gives the best neonatal outcome for breech presenting fetuses. Booking status positively impart fetal outcome, therefore provision and utilization of good quality antenatal care will go a long way to reduce the incidence of unbooked emergencies that significantly contribute to the poor neonatal outcome in breech deliveries

Knowledge and utilization of the partograph among obstetric care givers in South West Nigeria

This cross-sectional study assessed knowledge and utilization of the partograph among health care workers in southwestern Nigeria. Respondents were selected by multi-stage sampling method from primary; secondary and tertiary level care. 719 respondents comprising of CHEWS - 110 (15.3); Auxiliary Nurses - 148 (20.6); Nurse/Midwives - 365 (50.6); Physicians - 96 (13.4) were selected from primary (38.2); secondary (39.1) and tertiary levels (22.7). Only 32.3used the partograph to monitor women in labour. Partograph use was reported significantly more frequently by respondents in tertiary level compared with respondents from primary/secondary levels of care (82.4vs. 19.3; X2 = 214.6; p 0.0001). Only 37.3of respondents who were predominantly from the tertiary level of care could correctly mention at least one component of the partograph (X2 = 139.1; p 0.0001). The partograph is utilized mainly in tertiary health facilities; knowledge about the partograph is poor. Though affordable; the partograph is commonly not used to monitor the Nigerian woman in labour

Booking status and caesarean section outcome in LAUTECH teaching hospital, Osogbo

Background: To assess the clinical features; diagnosis; and treatment of patients having chronic otitis media (COM) with cholesteatoma seen in the ENT/Head and Neck Surgery Clinic at the University Clinical Center; Prishtina; Kosovo. Method: A systematic review of the medical records of all patients admitted to the ENT clinic having COM with cholesteatoma between January 1999 and December 2003. Results: During this period; 223 patients suffering from COM with cholesteatoma underwent surgical treatment. There were 123 (55) male and 100 (45) female patients. Their mean age was 30.7 years; ranging from youngest patient (7-year-old girl) to oldest (73-year-old lady). Thirty-three patients developed complications: 17 patients extracranial complications (EC) and 16 intracranial complications (IC). Leading pathogens in this series were Proteus mirabilis in 52of cases; Proteus vulgaris in 14and Staphylococcus aureus in 12. All patients underwent surgical treatment: 10 patients (4.5) a canal-wall up (CWU) procedure and 213 (95.5) a canal-wall down (CWD) procedure. No deaths occurred in this series. Conclusion: Because of possibility of developing life-threatening complications; patients with COM with cholestatoma must diagnosed in time and followed as soon as possible to the center that performs ear surgery; as only adequate treatment option for these patients

Pattern of contraceptives choice among the married women attending the family planning clinic of a tertiary health institution

Background: Rampant population growth is the most fundamental problem of our times. It affects adversely the advancement of nations and the wellbeing of all peoples. The fertility rate in Nigeria remains high at a national average of about 5.2 children per woman. When a woman effectively uses a modern method of contraceptive she is less likely to be exposed to the hazards of grand multiparity; and also unlikely to resort to dangerous illegal abortion. Method: This is a retrospective study; a review of the records of the family planning clinic of Ladoke Akintola University of Technology Teaching Hospital; Osogbo was undertaken. These were new clients coming for the first time to the family planning clinic of the institution from January; 2001 to December 2006. Result: A total of 1355 married women were coming for the first time to the family planning clinic within the study period; and their age range between 18 and 51 years with a mean of 33.5+6.1 years. 170 (12.5) were Para 1; Para 2-4 were 855 (63.1); while Para 5 and above were 330 (24.4). The clients source of information about family planning was: family planning clinic personnel 1039 (76.7); media (print and electronic) 152 (11.2); friends and relatives 127 (9.4); and community health workers 37 (2.7). Intrauterine contraceptive device was the most chosen method by the clients 1011 (74.6); while condom was the least chosen 3 (0.2); 264 (19.5); and 77 (5.7) clients chose injectables and pills; respectively. Conclusion: An increase in the level of knowledge on modern contraceptive methods through mass and interpersonal communications could be one of the key strategies to increase the utilization rate of modern contraceptive methods