A Study of Caesarean Section in a Secondary Health Care Facility in Uyo; South-South Nigeria

Background: The rising caesarean section (CS) rate in Nigeria has been reported by several studies. But while these studies were mainly conducted in tertiary health institutions; the experiences in the secondary health care facilities who are also actively involved in providing maternity care and caesarean delivery are rarely reported.Aim: To study the rates and indications for caesarean section in a secondary health facility in Uyo; Nigeria to provide alternate source of information on caesarean section. Methods: This was a five-year retrospective study of all cases of caesarean section in St Luke's hospital; Anua; Uyo; Nigeria covering the period of January 2000 to December 2004. Information on the socio-demographic characteristics of patients; number and types of CS and their indications were obtained from the delivery register; theatre register and other ward records. These were analyzed using simple percentages. Results: There were 10;190 deliveries in the period under review. Of these; 1384 were by caesarean sections giving a caesarean section rate of 13.6. The nullipara accounted for 36.6of cases of caesarean sections. There were similar rates of caesarean section among booked and unbooked patients. However; there were more emergency procedures among the unbooked patients.The major indication for caesarean section was fetal distress followed by repeat caesarean sections.Documentation and record keeping was a major challenge observed.Conclusion: Caesarean section rate observed in the study is lower than what obtains from most tertiary centres and falls within the recommended rates of 5-15

Haemoglobin Genotypes: A Prevalence Study and Implications for Reproductive Health in Uyo; Nigeria

Background: Haemoglobinopathies are among the most common genetic disorders worldwide; inherited as autosomal recessive disorders from healthy-carrier parents. The most common are the sickle cell disorders and the thalassaemias; occurring in people of African; Asian; South European and Middle Eastern descent. The University of Uyo Teaching hospital (UUTH); Uyo; Akwa Ibom state; Nigeria is a tertiary health institution providing the health needs of the host and neighbouring states in South-south and South East Nigeria. There is currently paucity of data on the haemoglobin genotype distribution in Akwa Ibom state; hence the need for this study; considering its importance in medical diagnosis; patient management; genetic information and counselling. Methods: This is a retrospective study. Registers and results of all haemoglobin genotype investigations carried out in the department of Haematology; University of Uyo Teaching Hospital; Uyo between January; 2003 and December; 2007 were extracted; reviewed and analyzed using simple percentages. Results: Eight thousand and ninety seven Haemoglobin genotype tests carried out over a five year period were analysed: 6376 (78.7) of these were HbAA; 1580 (19.6) HbAS; 121 (1.5) HbSS; while HbAC and SC accounted for 16 (0.2) and (0.04) respectively. The ratios of Hb AA to Hb AS; HbAAto HbSS andHbAAtoHbAC were 4:1; 52:1 and 400:1 respectively. Of the 8097 subjects; 6723(83.0) were females; 1152(14.2) were males. Among the females; 4.8of HbSS and HbSc were in children under 15 years while only 0.3were in those 15 - 44 years. Conclusion: While HbAA is the predominant genotype in our environment; there is also a significant number of the abnormal haemoglobin genes. Withmany children with sickle cell disease now surviving to adulthood due to advances in medicine; a larger number of women with sickle cell disease in pregnancy with all the attendant challenges it poses should be expected in our environment. It is necessary therefore; to keep abreast with developments in the area of its management in order to cope with the challenges