Correlates of exclusive breast feeding among nursing mothers attending child health clinic at a general hospital in Rivers State Nigeria

Background: Early initiation of breast feeding and feeding exclusively for six months have great implication for the survival, well-being and growth of new borne. Factors such as maternal age, occupation, religion, spouse age, spouse occupation, parity, antenatal care (ANC) attendance, mode of delivery (MOD) and birth order are significantly associated with exclusive breast feeding (EBF) Methodology: The study is a descriptive cross-sectional study conducted among nursing mothers attending child health clinic in General Hospital Bonny, in Bonny Island, Rivers State, Nigeria. All eligible nursing mother who presented at the clinic were enlisted for the study. Enlistment of eligible participants was done on every child welfare clinic day. Data was collected using a pretested, interviewer administered, structured questionnaire which was adapted and prepared in English Language. Categorical data was analyzed using multinomial logistic regression model with statistical significance set at 0.05. Result: Results from this study identified significant association between EBF and some maternal variables such as age, occupation and religion. Spouse age and occupation were significantly associated with EBF. ANC attendance, gestational age, MOD, parity and birth order were also significant variables associated with EBF. Conclusion: Maternal variables such as age, occupation, religion, parity, MOD, ANC attendance including spouse age and occupation significantly influence EBF of new borne.

Prevalence of cervical cancer in Ain Defla region (Algeria)

The high rate of cervical cancer in Algeria and the absence of organized screening programs are well shown in this study, which aims to determine the prevalence of cervical cancer and describe the risk factors associated with this alarming prevalence. This retrospective study is based on data collected from medical records and A questionnaire was developed to assess the risk factors (such as: parity, age at first marriage, smoking, oral contraceptive, and Hormonal status) of cervical cancer among the participants. Face to Face interview were conducted with the participants. The result obtained from this study revealed that cervical cancer occupies the fourth place of cancer in the Wilaya of Ain Defla (4,71 %); the results confirm the effect of several risk factors such as early marriage age (below 20 years: 46.66 %), multiparity (53.33%), menopause (66.66 %); taking contraception (53.33%) and smoking in the development of this pathology. The adoption of an early and annual screening program in our region would be very important to us. In addition, the interest of annual screening is to raise women's awareness of this pathology, particularly in isolated regions. (

The effects of maternal age and parity on the birth weight of newborns among mothers with singleton pregnancies and at term deliveries

Background: Birth weight is the most important factor determining the survival, growth and development of a newborn. Parity and maternal age have been shown to increase the risk of adverse neonatal outcomes, such as intra-uterine growth restriction (IUGR), low birth weight (LBW) and mortality. Objective of the study: The study was aimed at investigating the effects of maternal age and parity on the birth weight of newborns from singleton pregnancies and term deliveries. Materials and Methods: An institutional-based, retrospective, cross-sectional study design was employed at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia from April to July 2018. In total, 4,590 mothers with term delivery and singleton pregnancy from June 2015 to May 2017 were included in the study. Data on gestational age (GA), parity, history of ANC follow-up, source of referral and birth weight of the child was included. The collected data were analyzed using SPSS version 23 statistical package, and multiple logistic regression was carried out to determine the effect of maternal age and parity with respect to LBW. Results: Grand multiparous women (parity ≥5) have an adjusted odds ratio (AOR) of 3.89 with 95% confidence interval (CI = 2.19, 6.93) compared to multiparous women (p=2-4). Nulliparous women (p=0) have an AOR of 0.23 (95%CI = 0.19, 0.38) compared to multiparous women. Primiparous women (p=1) have an AOR of 0.22 (95% CI = 0.16, 0.30) compared to multiparous women. Women aged 40 and above have an AOR of 1.96 (95% CI = 1.22, 3.20) compared to women aged 30-34. The mean birth weight (MBW) of newborns was 3,075.41±569.58 grams (mean±SD). Conclusions: In this study, the risk of LBW was higher in grand multiparous women compared to multiparous women. Primiparous and nulliparous women have less risk of having an LBW baby compared to multiparous women. A maternal age of 40 and above were associated with a higher risk of delivering an LBW newborns compared to a maternal age of 30-34. Therefore, special attention should be given to deliveries at an advanced age and multiparous cases to reduce the incidence of LBW

Prevalence and predictors of Implanon uptake in Ugu (Ugu North Sub District) 2016/17

Background: The contraceptive implant (Implanon) has been recognised as one of the most effective family planning methods and is a healthier choice for women in Africa due to its efficacy and convenience. Despite the evidence of effectiveness and safety of the implant, the actual uptake for Implanon use in the Ugu district of KwaZulu-Natal is relatively low. The aim of the study was to determine factors associated with Implanon uptake in Ugu North Sub District 2016/17.Methods: An observational cross-sectional study with an analytical component using self-administered questionnaires to collectinformation from 385 participants using randomised systematic sampling was conducted at family planning clinics at GJ Crookes Hospital and seven surrounding primary health care clinics. The chi-square test and multivariate logistic regression was used to determine associations.Results: Some 16% (n = 60) of the participants utilised Implanon. Despite having the correct knowledge 65.7% (n = 220) were not willing to use Implanon if it were offered. In addition, 55% of participants (n = 177) believed Implanon had more side effects. Parity (< 4 children) was found to be a statistically significant protective factor against (p < 0.05) Implanon uptake.Conclusion: Implanon is a highly unattractive method of contraception for women residing in the Ugu North Sub District. Fear of side effects and invasive method of insertion were identified as the major barriers to Implanon use. Education and increased patient awareness are strategies to increase the desirability and uptake of Implanon

Does perineal body thickness affect faecal incontinence in multiparous patients?

Background. Obstetric trauma is the most common cause of faecal incontinence in multiparous women. The literature has shown that women with obstetric trauma to the anal sphincter have decreased perineal body thickness (PBT). Objective. To determine the role of PBT in the assessment of this type of faecal incontinence in multiparous patients. Methods. Forty-four women with faecal incontinence, and 36 asymptomatic women who had had two or more previous deliveries, were investigated with endoanal ultrasonography from January to December 2016. The patients were divided into three groups on the basis of PBT: <10 mm, 10 - 12 mm and >12 mm. The degree of faecal incontinence was measured using the Wexner faecal incontinence score. Sphincter angle defect was separately measured for each patient. Results. The mean (standard error) age of all of our 80 patients was 46.9 (1.3) years (range 26 - 77 years), and the mean PBT in incontinent patients was 8.78 (2.84) mm, and 12.65 (16.76) mm in asymptomatic subjects (p<0.001). The mean Wexner score was 8.6(range 2 - 20) in incontinent patients. External anal sphincter defect angles were negatively correlated with PBT (p=0.045). For 89% of the patients, there was a history of vaginal delivery, and 62.5% had undergone one or more prior episiotomies during delivery. A PBT <10 mm was associated with sphincter defect in most incontinent patients. Conclusion. PBT plays a significantly important role in faecal incontinence, so it is recommended that it should be one of the factors involved in anal incontinency evaluations

Comparison of 25 and 50 Microgram of Misoprostol for Induction of Labour in Nulliparous Women with Postdate Pregnancy in Port Harcourt

Background: Induction of labor for postdate pregnancy using misoprostol is one of the most common interventions in pregnancy. However; the optimal dose of misoprostol is yet to be determined with previous reports utilizing different dosages. Objective: The main objective of this study was to compare the effectiveness and safety of 25 ?g versus 50 ?g of intravaginal misoprostol for induction of labor in nulliparous women with postdate pregnancy. Methodology: This was a prospective study in which 88 nulliparous women with postdate pregnancy were randomly selected to receive either 25 ?g or 50 ?g of misoprostol for induction of labor. Student's t-test and Chi-square test were used to compare proportions. Results: There was no significant difference between the two groups with regard to the induction-vaginal delivery interval between the two doses. The proportion of women delivering vaginally with a single dose of misoprostol (11/40 vs. 23/43; P = 0.01) and vomiting were significantly greater in the 50 ?g group. However; there was no significant difference between both groups in terms of the need for augmentation of labor; caesarean section; tachysystole and hyperstimulation syndrome. Conclusion: Intravaginal administration of 25 ?g of misoprostol appears to be as effective; but safer than 50 ?g for induction of labor in nulliparous women with postdate pregnancy

Influence de l'age et de la parite de la mere sur le poids de naissance (Cas du Centre de Sante Shungu en RDC)

OBJECTIF:Cette etude avait pour objectif d'etablir la relation entre l'age; la parite de la mere d'une part et le poids a la naissance d'autre part MeTHODOLOGIE: Une etude transversale et descriptive; a ete menee sur un echantillon de 314 couples meres - enfants au Centre de Sante Shungu en RDC durant la periode allant du 1er Janvier 2010 au 31 Decembre 2011. Notre population d'etude concerne tous les cas des accouchements a terme durant la periode de l'etude. Les donnees ont ete recueillies a l'aide d'une grille a partir des registres de la maternite. Puis elles ont ete encodees; saisies; traitees et analysees a l'aide du logiciel SPSS (version 19). ReSULTATS L'analyse a revele que le poids moyen de naissance est significativement plus bas chez les primipares que chez les multipares et chez les meres de moins de 18 ans que chez celles de plus de 18 ans. Le risque d'accoucher d'un enfant de faible poids de naissance a ete 9 fois plus eleve chez les primipares que chez les multipares et 23 fois superieures chez les meres de moins de 18 ans que chez celles de plus de 18 ans. CONCLUSION : Le faible poids de la naissance est un probleme majeur de sante publique aussi bien dans les pays en voie de developpement que dans les pays developpes. La maitrise des facteurs maternels qui ont le plus d'influence sur le poids et sur lequel on peut agir tel que l'age; la parite; et l'etat nutritionnel est d'une necessite dans la lutte contre le faible poids de naissance

Predictors of vaginal delivery in nulliparous mothers

Background: Nulliparity is an obstetric high-risk group whose labor, compared with multiparae, are more likely to develop labor abnormalities that requires intervention. The aim of this report is todetermine factors that influence vaginal delivery in nulliparae. Materials and Methods: A prospective cross-sectional study was done on 286 eligible booked nulliparae in labor, to determine factors associated with vaginal delivery. Information about each patient's social demographic factors, and physical characteristics such as height and weight, events in labor and mode of delivery were recorded in the data sheet. Bivariate analysis was done using Chi square, while multivariate analysis was done using logistic regression. Level of significance was put at P < 0.05. Results: Of a total of 944 primigravidae delivered in the unit during the study period, 286 (30.3%) were eligible for the study. Vaginal delivery was achieved in 214 (74.8%) of the eligible parturient, while 72 (25.2%) had emergency caesarean delivery. Indications for the caesarean delivery were: failure to progress (46; 63.9%), fetal distress (20; 27.8%), maternal distress (5; 8.0%), and rapidly developing pre-eclampsia in labor (1, 0.3%). The birth weight of the baby ranged between 2.0 and 4.5 kg with mean weight of 3.1 ± 0.4 kg. Birth weight (odd ratio [OR] = 0.40, 95% confidence interval [CI] = 0.21-0.78), fetal head engagement in early labor (OR = 10.30, 95% CI = 1.35-78.69), and maternal body mass index (BMI) (odd ratio [OR] = 2.08, 95% confidence interval [CI] = 1.03-4.20) were found to be predictors of vaginal delivery. Conclusion: Normal range of maternal BMI, fetal head engagement and normal range of fetal birth weight were found to be the factors associated with vaginal delivery in nulliparae. Variations in these three factors may be the underlying reason for failure to progress, which is the most common indication for caesarean section among this population of parturient

Is Nulliparity a Risk Factor for Poor Obstetrical and Neonatal Outcomes in Rwandan District Hospital ? A Prospective Observational Study at Muhima District Hospital

Introduction: Nulliparity and multiparity are associated with different obstetrical and neonatal outcomes. The latter are well documented in the literature. What is not yet documented is whether such findings apply to Rwandan parturients. Objectives: The aim of this study was to determine whether the established differences in obstetrical and neonatal outcomes between nulliparas and non-nulliparas apply to Rwandan parturients.Methodology: It was a prospective; cross-sectional; analytical and case control study. Data were systematically collected from 608 parturients (300 nulliparas as study group and 308 multiparas as control; gestational age ? 28 weeks) at Muhima district hospital (Kigali City) from April 13th 2009 up to July 13th 2009. X2 test was used to compare observed proportions; and Student's t test to compare means.Results: The rate of spontaneous labour was significantly higher in multiparas than in nulliparas (96;7 vs 91;7; p = 0;008); and nulliparas had a significantly higher rate of induction of labour (8;2 vs 3;2 ; p = 0;008). The rate of cesarean delivery (28 vs 10;7; p 0;001) and the one of assisted vaginal delivery (1;6 versus 0;3 ; p 0;001) were significantly higher in nulliparas than in multiparas. Among indications of cesarean delivery; cephalo-pelvic disproportion (7versus 0;6; p

Grand multiparity: Obstetric performance in Aminu Kano Teaching Hospital; Kano; Nigeria

Objective: The objective was to review the obstetric performance of booked grand multiparae. Design and Setting: A 5-year prospective observational study of cases between January 1; 2002; and December 31; 2006; was conducted in Aminu Kano Teaching Hospital; a tertiary institution; in Kano; Nigeria. Materials and Methods: The antenatal complications and pregnancy outcomes among booked grand mulitparous women (pregnancy after fifth delivery); who delivered in our labor ward; were compared with those of the booked mulitparae (parae 1-4) who delivered immediately after a grand multipara. Outcome Measures: These were obstetric factors of maternal age and parity; antepartum hemorrhage; fetal malpresentations; and multiple pregnancy. Medical complications were gestational diabetes; hypertension; anemia; and heart disease. Pregnancy outcomes measured were gestational age at delivery; birth weight; mode of delivery; postpartum hemorrhage; and maternal and perinatal mortality. Results: The age range of the grand multiparae was between 22 and 43 years; with a mean age of 29.72 + 2.07 years. The parity range was between 5 and 15; with a mean parity of 7.78 + 0.63. There was increased occurrence of gestational diabetes mellitus (OR = 12.55; CI = 6.72-23.91); hypertension (OR = 3.07; CI = 2.07-4.59); heart disease (OR = 2.01; CI = 0.70-6.08); anemia (OR = 3.16; CI = 1.42-7.24); antepartum hemorrhage (OR = 2.18; CI = 1.22-3.92); fetal malpresentations (OR = 3.04; CI = 2.38-3.88); cephalopelvic disproportion (OR = 2.09; CI = 1.33-3.29); and fetal macrosomia (OR = 2.27; CI = 1.72-3.00) among the grand multiparae compared with multiparae. Conclusion: The effects of these complications were minimized by good antenatal care

Grand Multiparity: Obstetric Performance in Aminu Kano Teaching Hospital; Kano; Nigeria

Objective: The objective was to review the obstetric performance of booked grand multiparae. Design and Setting: A 5-year prospective observational study of cases between January 1; 2002; and December 31; 2006; was conducted in Aminu Kano Teaching Hospital; a tertiary institution; in Kano; Nigeria. Materials and Methods: The antenatal complications and pregnancy outcomes among booked grand mulitparous women (pregnancy after fifth delivery); who delivered in our labor ward; were compared with those of the booked mulitparae (parae 1-4) who delivered immediately after a grand multipara. Outcome Measures: These were obstetric factors of maternal age and parity; antepartum hemorrhage; fetal malpresentations; and multiple pregnancy. Medical complications were gestational diabetes; hypertension; anemia; and heart disease. Pregnancy outcomes measured were gestational age at delivery; birth weight; mode of delivery; postpartum hemorrhage; and maternal and perinatal mortality. Results: The age range of the grand multiparae was between 22 and 43 years; with a mean age of 29.72 + 2.07 years. The parity range was between 5 and 15; with a mean parity of 7.78 + 0.63. There was increased occurrence of gestational diabetes mellitus (OR = 12.55; CI = 6.72-23.91); hypertension (OR = 3.07; CI = 2.07-4.59); heart disease (OR = 2.01; CI = 0.70-6.08); anemia (OR = 3.16; CI = 1.42-7.24); antepartum hemorrhage (OR = 2.18; CI = 1.22-3.92); fetal malpresentations (OR = 3.04; CI = 2.38-3.88); cephalopelvic disproportion (OR = 2.09; CI = 1.33-3.29); and fetal macrosomia (OR = 2.27; CI = 1.72-3.00) among the grand multiparae compared with multiparae. Conclusion: The effects of these complications were minimized by good antenatal care

A Pilot Study of the Normal Sonographic Measurements of the Liver in Normal Pregnant Women in the University of Port Harcourt Teaching Hospital; South South Nigeria

Background: The liver is affected by the various processes that occur during pregnancy. Ultrasound assessment of the intra abdominal organs during pregnancy is done on a daily basis. We want to determine the normal length of the liver by ultrasound scan in normal pregnant women in the University of Port Harcourt Teaching Hospital thus establishing normal and reference values and also to study the effect if any of the gestational age; parity and body mass index on the liver size. Materials And Methods: One hundred and fifty normal pregnant women were evaluated. The dimensions of the liver were measured in the midclavicular line. Other parameters such as the gestational age; parity and body mass index were obtained and a test of variance carried out. Results: The average longitudinal diameter of the liver (midclavicular line) was 14.21+1.82cm (median; 14.2 cm; range; 8.0-18.9 cm). Results of the multivariate analysis showed a positive correlation between the liver length and body mass index but not with the parity and gestational age. Conclusion: This study will be of importance in the daily practice in the radiology and other clinical department in the assessment of the liver in pregnant women

The Experiences of First-Time Mothers with Colic Infants who Seek Help from Medical Professionals

The purpose of this study was to describe the experiences of first-time mothers with colic infants. The research design was qualitative; exploratory; descriptive and contextual. Data were collected by means of in-depth; semistructured; phenomenological interviews and a descriptive analysis was done. The results show that the real experience of having a baby did not meet mothers' expectations. Furthermore; colic babies were anxiety-provoking and mothers struggled with feelings of failure. They searched for an explanation for the colic; but felt disillusioned with the medical profession. Mothers exhibited a need for a containing figure. They also reflected on their relationship with their mothers. Mothers felt ambivalent towards their babies and marital relationships became strained. Lastly; mothers renegotiated their identity. Based on the results; suggestions for mental health professions were made with regard to providing parent-child therapy; support for the mother and strengthening the marital relationship. The importance of psychological interventions was emphasised as a source of support for these mothers

Non-protective immunity against tetanus in primiparous women and newborns at birth in rural and urban settings in Ibadan, Nigeria

Introduction: Nigeria remains among the few countries that are yet to achieve eradication of neonatal tetanus in the world despite the availability of an effective vaccine. This study investigated immunity against tetanus in primiparous mothers and neonates at birth, and identified associated factors.Methods: this cross-sectional study involved consecutive selection of 244 primiparous mother-neonate pairs (119 from rural areas, 125 from urban areas, 137 male neonates and 107 female neonates) delivered at primary healthcare facilities in Ibadan, Nigeria.. Socio-demographic characteristics, obstetric history, immunisation and birthweight were obtained from mothers by interview. A validated immunochromatographic rapid diagnostic test kit was used to test for immunity against tetanus. Positive and negative results were interpreted as protective immunity against tetanus (PIaT) and non-protective immunity against tetanus (NPIaT), respectively. Data were analysed using descriptive statistics, Chi-square and logistic regression at p = 0.05.Results: the mean age of mothers was 27.9±3.4 years (range: 20-33) and median birthweight was 2700g (range: 1760-3300). Of the 244 mothers, 198 (81.1%) received at least two doses of tetanus toxoid injection during pregnancy and prevalence of NPIaT and PIaT was 28.7% and 71.3%, respectively. The prevalence of PIaT was significantly higher among mothers in urban areas (n= 96; 80.7%) than rural (n=78; 62.4%), p<0.001. The prevalence of NPIaT among neonates was 36.5% (n= 89). Predictors of NPIaT among neonates were residence in rural LGA (OR = 2.22; 95% CI = 1.23-3.99) and maternal tetanus immunisation <2 doses (OR = 11.68; 95% CI = 4.05-21.75.Conclusion: lack of protective immunity against tetanus among neonates of primiparous women in Ibadan is prevalent and a more conscientious enforcement of routine tetanus prevention practices is needed

Particularites de la grossesse et de l'accouchement chez la grande multipare a Kinsangani

"L'analyse de 302 observations de grandes multipares ayant accouche a la maternite des Cliniques Universitaires de Kisangani de 1982 a 1992 confirme le caractere a ""haut risque"" des grossesses dans ce groupe de population. La frequence de la grande multipare est de 25;6 pour cent. On denombre un taux eleve d'anemie (47;4 pour cent); de placenta praevia (3;3 pour cent); des hemorragies de delivrance (5;0 pour cent); de prematurite (14;5 pour cent); des enfants de faibles poids (10;0 pour cent) et de mortalite perinatale (8;3 pour cent). La prevention de ces complications peut etre assuree par une surveillance prenatale obligatoire et une planification familiale efficace"

A 12-month lactation clinic experience in Uganda

A review of case histories of mother-infant pairs who attended a lactation clinic between January and December; 1989 is presented. The results show that the majority of mothers consulting the clinic perceive their lactation problems as 'insufficient breast milk production'. Factors which might have contributed to early lactation failure include: delayed initiation of breast feeding; use of prelacteal feeds; infrequent breast feeds by day and night; and early supplementation. The latter was especially common in this clinic sample: 69.6 per cent of infants were on regular supplementation by 4 months of age. The need is stressed for research into such breast feeding failures; revitalize community-based breast feeding support; as well as assessing the knowledge; attitude; and practices of health workers concerning breast feeding