Risk Factors and Pregnancy Outcome of Placental Abruption at the Niger Delta Unive rsity Teaching Hospital, Okolobiri, South-South Nigeria.

Aim: To determine the incidence, predisposing factors, clinical presentation and perinatal and maternal outcome of patients managed for abruptio placenta. Study Design: A retrospective review. Place and Duration of Study: Department of Obstetrics and Gynaecology, Niger Delta University Teaching Hospital, Okolobiri between January 2009 and December 2013. Materials and Methods: Data were collected from records of all patients presenting with abruptio placenta. Information extracted from the records included demographics, parity, gestational age, clinical presentation, risk factors for abruptio placenta, complications, and perinatal and maternal outcome. Data analysis was performed with Epi info version 6.04d. The results are presented as means with standard deviations, percentages, rates and proportions. Association between maternal age and selected obstetric and neonatal variables were assessed using the chi-square and the twotailed Fisher exact test. Results: A total of 40 cases of abruptio placenta were seen out of 2,736 deliveries giving an incidence of 1.46%. Age did not significantly affect the incidence of abruptio placenta in this study (p=0.13). High parity was significantly associated with abruptio placenta (p = 0.02). Unbooked status and Low socio-economic class were both significantly associated with abruptio placenta (p<0.001). Possible abdominal trauma due to traditional abdominal massage was documented in 26 (72.2%) cases and was significantly associated with abruptio placenta (p<0.01). There was one maternal death giving a case fatality rate of 2.8%. There were 19 perinatal deaths giving a perinatal mortality rate of 527.7 per 1000 births. Conclusion: Lack of antenatal care and traditional abdominal massage during pregnancy are major predisposing factors to abruptio placenta in our environment. Perinatal mortality associated with abruption placenta is high.

Factors Influencing Gestational Age at Booking at The University of Port Harcourt Teaching Hospital South-South Nigeria.

Aim: To assess the factors influencing registration for antenatal care in Nigerian pregnant women. Study Design: A cross-sectional study. Place and Duration of Study: The antenatal clinic of the department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital from January 2013 to June 2013. Methodology: A cross-sectional study involving 600 pregnant women attending the booking visit at the antenatal clinic in UPTH from January 2013 to June 2013 was undertaken using an interviewer administered structured questionnaire. Data management was done using Epi Info™ 7.1.4 statistical software. Results: The mean gestation age at first antenatal attendance was 18.7±6 weeks. Only 133 women (22%) booked before 14 weeks gestation, most of these (89.5%) were primigravidae Majority of the women [409(68%)] had their first visit between 14 weeks and 28 weeks. Primigravida were significantly more likely to book early in pregnancy (p=0.01). Age and educational status did not appear to influence the gestational age at booking. Distance of residence from the hospital also affected the gestational age at booking as those residing more than 10 km from the hospital were significantly less likely to register early (p=0.03). However availability of funds was a major determinant of when a pregnant would register for antenatal care. Conclusion: Majority of our women register for antenatal care later in pregnancy than the prescribed first trimester due to poverty.

The Pattern of Female Genital Mutilation in Port Harcourt, Southern Nigeria.

Aims: Female genital mutilation is a harmful traditional practice which is an infringement on the sexual and reproductive rights of women and girls and has profound psychosocial as well as reproductive health morbidities. This study aimed at measuring the change in the incidence of the female genital mutilation in Port Harcourt, South-South Nigeria. Study Design: A cross-sectional study. Place and Duration of Study: Department of ObstetricGynaecology of the University Port Harcourt Teaching Hospital (UPTH) between 1st January and 31st January 2009. Methodology: Five hundred clients were selected randomly and agreed to participate in the study. They were interviewed using a structured questionnaire and examined clinically. Data management was with SPSS 15.0 for Windows statistical software. Results: The prevalence of female genital mutilation (FGM) was 34%. Four hundred and eighty one (96.2%) were aware of female circumcision generally. Ninety five (55.8%) of those circumcised, had it done in infancy. Thirty seven percent of the practitioners of female circumcision were traditional birth attendants while 14.7% were trained health professionals. The commonest reason for female circumcision included reduction of sexual passion/promiscuity and conformity with tradition. Type 1 female genital mutilation was the commonest (58.2%). Among those clients aged 50 years and above, 78.8% had FGM while 9.1% of those aged 10 – 19 years had FGM. This showed a downward trend. Conclusion: Female circumcision is a harmful traditional practice which has remained a serious health problem. Its prevalence is still high in our environment. This study suggests that it is on a downward trend.