Pattern and Determinants of Antenatal Booking at Abakaliki Southeast Nigeria

Background: Antenatal care is one of the pillars of SAFE Motherhood Initiative aimed at preventing adverse pregnancy outcome. Early antenatal booking is recommended for this benefit. Aim: The objective of this study was to determine the antenatal booking pattern of pregnant women and its determinants. Subjects and Methods: A cross-sectional survey of pregnant women attending the antenatal booking clinic at Federal Medical Centre Abakaliki Ebonyi State between April 6; 2011 to August 5; 2011 was undertaken. Epi info 2008 version was used for analysis. Results: The mean age of the respondents was 27.46 (5.81) years and the mean gestational age at booking was 24.33 (5.52) weeks. A total of 83.1 (286/344) of the pregnant women booked after the first trimester while the remaining 16.9 (56/344) booked early. Socio-biological variables and past obstetrics history did not contribute significantly to the gestational age at booking while sickness in index pregnancy; personal wishes; and financial constraint were statistically significant reasons given for seeking antenatal care. Majority of the pregnant women 37.2 (128/344) suggested that the second trimester was the ideal gestational age for booking while 18.3 (63/344) did not know the ideal gestational age for booking. Most pregnant women 81.1 ( 279/344) knew the benefits of early antenatal care even though they booked late 83.1 (286/344). Conclusion: Most pregnant women access antenatal care late at Abakaliki because of misconception and poverty. Health education and subsidization of cost of medical services will help in reversing the trend of late antenatal booking

Pattern and Determinants of Antenatal Booking at Abakaliki Southeast Nigeria

Antenatal care is one of the pillars of SAFE Motherhood Initiative aimed at preventing adverse pregnancy outcome. Early antenatal booking is recommended for this benefit. Aim: The objective of this study was to determine the antenatal booking pattern of pregnant women and its determinants. Subjects and Methods: A cross-sectional survey of pregnant women attending the antenatal booking clinic at Federal Medical Centre Abakaliki Ebonyi State between April 6; 2011 to August 5; 2011 was undertaken. Epi info 2008 version was used for analysis. Results: The mean age of the respondents was 27.46 (5.81) years and the mean gestational age at booking was 24.33 (5.52) weeks. A total of 83.1 (286/344) of the pregnant women booked after the first trimester while the remaining 16.9 (56/344) booked early. Socio-biological variables and past obstetrics history did not contribute significantly to the gestational age at booking while sickness in index pregnancy; personal wishes; and financial constraint were statistically significant reasons given for seeking antenatal care. Majority of the pregnant women 37.2 (128/344) suggested that the second trimester was the ideal gestational age for booking while 18.3 (63/344) did not know the ideal gestational age for booking. Most pregnant women 81.1 ( 279/344) knew the benefits of early antenatal care even though they booked late 83.1 (286/344). Conclusion: Most pregnant women access antenatal care late at Abakaliki because of misconception and poverty. Health education and subsidization of cost of medical services will help in reversing the trend of late antenatal booking

Risk Factors and Perinatal Outcome of Umbilical Cord Prolapse in Ebonyi State University Teaching Hospital; Abakaliki; Nigeria

Aim: The goal of this study was to identify risk factors associated with umbilical cord prolapse and to document the perinatal outcome of cases of cord prolapse. Materials and Methods: During the period of the study (from July 1; 2001 and June 30; 2007); forty-six cases of umbilical cord prolapse were identified from the labor ward record and analyzed retrospectively. Associations between cord prolapse and potential risk factors were evaluated by means of the odds ratio. Results: During the period of the study; 46 cases of cord prolapse were encountered out of 10;080 deliveries which was 0.46of all deliveries. Of the 46 fetuses with umbilical cord prolapse 32.6had a fetal weight of less than 2.5 kg compared with 15.2for fetuses in control group (P0.012). The umbilical cord prolapse occurred in association with breech presentation eleven times (23.9) and transverse presentation seven times (15.2). The occurrence of breech presentation among the control cases was 4.3(P0.00031); and that of transverse lie was 4.4(P0.02007). Among the women that had cord prolapse; 47.8had unbooked pregnancies compared with the control group with 14.5(P0.0000033). Multiparity accounted for 78.3in the cord prolapse cases and 68.1in the controls (P=0.19). The perinatal mortality rate was 413/1000. (41.3); compared to the perinatal mortality of 58/1000 for the control group. Conclusions: Our findings in this study has confirmed an association between increased risk of umbilical cord prolapse and abnormal fetal presentation; low birth weight and unbooked status. It is therefore suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care and this will enhance the early identification of these risk factors and an appropriate management instituted to reduce perinatal mortality

The Incidence; Pattern and Management Outcomes of Early Pregnancy Losses at the Ebony State University Teaching Hospital; Abakaliki

Background: Early pregnancy losses are a source of deep emotional trauma to any woman; her family and the attending Gynaecologist. This study evaluated the prevalence; pattern and management outcomes of such losses at a tertiary Health Institution. Methods: Data of all women who suffered early pregnancy losses between 1st January; 2002 and 31st December; 2004; were reviewed in a descriptive study. Information obtained from their case notes which related to the early pregnancy event; their socio demographics; obstetric history and management outcomes were collated. Univariate analysis was performed and frequency tables and figures were constructed where appropriate. Results: Early pregnancy losses comprised miscarriages; molar pregnancy and ectopic gestations accounted for 32.1of all gynaecological admissions during the period. Miscarriages were the commonest diagnosis and incomplete abortion constituted the bulk of this. Women of all parities were involved but rate of loss increased down the socio economic class strata. Majority were unbooked. A maternal mortality rate of 1.8attended all forms of early pregnancy losses during the period. Conclusion: Early pregnancy loss constitutes a major gynaecological problem in our centre. Health care providers must institute prompt and appropriate clinical management for a good clinical outcome

Menstruation in rural igbo women of South East Nigeria : attitudes, beliefs and practices

Many cultures hold on to different beliefs and retain community-defined restrictions for menstruating women. The Igbo society of southeast Nigeria is rich in culture, myths and superstitions but, surprisingly no documentation exists on menstrual beliefs and practices among the population. This questionnaire-based cross sectional study supplemented with in-depth interviews evaluated the beliefs, myths and traditional practices associated with menstruation within rural Igbo communities. It revealed that the menstrual egress is of great significance in Igbo culture and must be disposed of carefully to avoid exposure to witchcraft and rituals. Some respondents observed self-imposed restrictions on exercises, food items, visits and sex in order to maintain physical and spiritual cleanliness, lessen discomfort and avoid embarrassment. Gynaecologists working in this region should utilize the opportunities of clinical consultations to discuss menstrual health issues with their female patients and educate them on the physiology and significance of menstruation. (Afr Reprod Health 2008; 12[1]:109-115)

Age at menarche and the menstrual pattern of Igbo Women of South-east Nigeria

This study determines the age at menarche and menstrual pattern of an Igbo population in 12 randomly selected rural communities of Ebonyi State. Information on recalled ages at menarche, menstrual flow duration and cycle length was collected using a semi structured questionnaire over three months. 1209 women of reproductive age were interviewed. The mean age at menarche was 15.0 years and this declined over the years. The mean menstrual flow duration and cycle lengths were 3.3 days and 29.7 days respectively. Only 10.2% had a menstrual cycle length of 28 days. Account should be taken of the average length of 29-30 days in the rural Igbo population when calculating the expected date of delivery and in the family planning clinics. (Afr Reprod Health 2008; 12[1]:90-95)

Retained placenta aspect of clinical management in a tertiary health institution in Nigeria

Background: Retained placenta is a significant cause of postpartum haemorrhage; maternal morbidity and occasionally mortality. This study assessed the clinical presentation; management and outcomes of retained placenta at the Ebonyi State University teaching Hospital.Method: Analysis of records relating to retained placenta managed in the hospital over a three year period (August 2003 to July 20060. Results: The incidence of retained placenta was 0.22(1 in 456 vaginal deliveries). Eleven (32.4) patients were admitted with retained placenta following home delivery. Two (5.6) delivery in a peripheral hospital; 6(17.7) delivered in a Health center and 2(5.9)delivered in a maternity home. Preterm deliveries accounted for 17.7of the cases. Eighteen parturient were admitted in shock. One patient had hysterectomy for adherent placenta. Conclusion: Improved peripatum services; education on the dangers of unsupervised home deliveries; women empowernment and prompt referral for emergency obstetrics care will reduce the associated mortality and morbidity

Cancer of the Cervix at the University of Benin Teaching Hospital (UBTH); Benin City; Nigeria; in the Last Decade of the Last Millennium

Objective: To evaluate the incidence and clinical presentation of cervical cancer in a Nigerian tertiary health institution. Methods: A review of retrieved retrospective data relating to patients managed for cancer of the cervix at the University of Benin Teaching Hospital (UBTH); Benin City between January 1991 and December; 2000 was done and is presented as frequency tables. Results: Cancer of the cervix constituted 72.9of all gynaecological malignancies seen at the University of Benin Teaching Hospital (UBTH) and accounted for 4.8of all new gynaecological admissions. The mean age at presentation was 49.1+5.7 years; with a peak age of 41 years to 50 years. Commonest presenting feature was abnormal vaginal bleeding while the modal stage at presentation was IIIB. The squamous cell variety was commonly encountered. Conclusion: Cancer of the cervix is of Public health importance in Benin City; Nigeria. Late presentations render curative protocols ineffective. Public enlightenment targeting sexually active women in the lower socio economic strata to boost uptake of screening services should be undertaken