Risk factors and perinatal outcome of umbilical cord prolapse in Sagamu, Nigeria

Background: Umbilical cord prolapse is an obstetric emergency that threatens the life and well-being of the fetus and also increases maternal morbidity. Fetal survival in umbilical cord prolapse can be enhanced by prevention where risk factors are identified and prompt diagnosis and decisive intervention.Objective: The aim of this study was to determine the incidence, identify the risk factors associated with umbilical cord prolapse and document the perinatal outcome of cases of cord prolapse.Methods: This was a 13-year retrospective case-control study of cases of umbilical cord prolapse seen at the OOUTH, Sagamu, Southwestern Nigeria between January 1, 2000 and December 31, 2012.Result: During the study period, the incidence of umbilical cord prolapse was 1 in 122 deliveries (0.82%). The umbilical cord prolapse occurred in association with breech presentation five times (33.3%) and transverse lie eleven times (18.5%). The occurrence of breech presentation among the control cases was 8.6% (p<0.001) and that of transverse lie was 1.9% (p<0.001). There were also significant statistical differences between the cases of cord prolapse and controls in terms of prematurity, low birth weight, unbooked status and multiparity. The perinatal rate was 222/1000 (22.2%) compared to the perinatal mortality of 68/1000 (6.8%) for the control group.Conclusion: It is suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care as this will enhance early identification of the risk factors and appropriate management instituted to reduce perinatal mortality

Induced Abortion in Nigeria

Objective: To obtain information on societal attitude to the issues of family planning; unwanted pregnancy; abortion; adoption of children and laws relating to them. Design: Focused group discussions. Setting: Twelve subgroups in the urban and rural areas of Ogun State; Nigeria were identified; and focus group sessions held for each subgroup. Subjects: Males and females; with their ages ranging from 15 years to above 50 years drawn from different segments of the community. Intervention: A set of guidelines/questions for the FGD were developed; field-tested and used. Main outcome measures: Rich information on such relevant issues as family planning; unwanted pregnancy; abortion and adoption of children; and the laws relating to them. Results: Participants felt that there was high prevalence of unwanted pregnancy and abortion particularly among youths. They had high level of awareness of contraceptives and attributed its low use to negative side-effects; high cost and provider bias. More Christians than Muslims favoured planning of pregnancies. Majority of the respondents had negative perception of induced abortion. Some of them supported abortion if the education of the young girl would be disrupted; if paternity of pregnancy is in dispute; or if it would save the family from shame as in rape or incest. Participants supported the enactment of laws that would make adoption of unwanted children easier. Conclusion: There is a need for policymakers to address the issue of abortion and unwanted children; and enact acceptable abortion and adoption laws to protect the rights of women and children in Nigeria