ABSTRACT
Background: Asymptomatic Bacteriuria (ASB) in pregnancy is associated with potential urinary and obstetric complications. The diagnosis and management of ASB in expectant mothers is in keeping with safe motherhood initiative. Aim: To determine the prevalence and pattern of ASB among HIV-positive and HIV-negative pregnant women in Enugu State, South Eastern Nigeria. Methods: This was a comparative analytical study among HIV-positive and HIV-negative pregnant women at the University of Nigeria Teaching Hospital, Enugu State. ‘Clean catch’ urine samples of these women collected and analysed. Statistical analysis was performed using the Chi-square and student’s t tests as appropriate. A P-value of less than 0.05 was considered statistically significant. Results: Among the two hundred and forty HIV-positive women, (23.3%) had significant ASB while (10.4%) of an equal number of HIV-negative women had significant ASB. The difference was statistically significant (p=0.013). A higher proportion of HIV-positive women, (22.5%) with CD4 cell count of ≤ 500/mm3 had significant ASB (p=0.015). Escherichia coli was the commonest isolate in both groups of women. The isolates were generally sensitive to amoxicillin-clavullanic acid, nitrofurantoin and cefuroxime in the two groups. The sensitivity to sulfametoxazle-trimethoprim was low; HIV positive (21.5%), HIV negative (16.0%). Among those treated, none had overt UTI in pregnancy. Conclusion: Screening, treatment and follow up for ASB in pregnancy are necessary especially in HIV positive women with CD4 cell count less than 500/mm3. This should be included during counselling in all antenatal protocols.
ABSTRACT
Background: Pelvimetry is a poor predictor of obstetric outcome. The predictive value of clinical pelvimetry remains limited except in extreme pelvic contracture or an excessively large fetus. Objective: To determine the attitudes of primigravidae to routine clinical pelvimetry. Subjects and Methods: This was a cross-sectional study of primigravidae at the University of Nigeria Teaching Hospital (UNTH), Enugu between January 1st and December 31st, 2009. Selfadministered, structured, and pre-tested questionnaires were distributed to the consenting selected women by trained medical interns. Data was analyzed using SPSS version 16. P< 0.05 was considered statistically significant. Results: A total of 195 primigravidae were selected at random for this study. One hundred and thirty eight primigravidae (138/195, 70.77%) were aware of clinical pelvimetry while 29.23% (57/195) were not aware of clinical pelvimetry. One hundred and twenty five primigravidae (90.58%, 125/138) desired clinical pelvimetry to continue while thirteen (9.42%, 13/138) did not desire clinical pelvimetry to continue. There was statistically significant difference between those who were aware and unaware of pelvimetry in their desire for pelvimetry [X2=18.903, p=0.0001, OR 5.2, 95% confidence interval=2.20 to 12.44]. Conclusion: There is profound awareness and the desire to continue clinical pelvimetry among primigravidae at the UNTH, Enugu, Nigeria, where majority of the women showed strong preference for it.