ABSTRACT
The fact that the integrity of the lower uterine segment (LUS) has not been routinely evaluated sonographically before deciding on the mode of delivery after caesarean section has deemed it fit that the lower uterine segment thickness (LUST) should be assessed. The authors carried out a scoping review in October 2023. Four databases were searched for peer reviewed articles that discussed evaluation of LUST and TOLAC. The year of publication, primary author抯 country of origin, sample size, study design, gestational age at ultrasonographic assessment, scanning route and key findings were extracted from the included articles. The articles identified were 625 while 250 were screened after removing duplicates and finally 30 articles were included in the review. The first authors of the included articles originated from 10 different countries and 30% of them were Indians. The most frequently used study designs in the articles were prospective cohort studies (63.3%). Majority of the key findings were as follow: Ultrasonography is the best modality for LUS assessment, LUST measurement is more reliable through vaginal scan; maternal age, body mass index and pregnancy related factors affect LUST and LUST of ?3.5 mm at term is safe for TOLAC. Maternal socio-demographic characteristics and past obstetric history affect the LUST and success of TOLAC. Ultrasonographic evaluation of the LUST at term is safe, needed before TOLAC and more reliable when conducted through vaginal route. The LUST influences the pregnancy outcome during TOLAC and a LUST cut-off value of ?3.5 mm is safe for TOLAC.
ABSTRACT
Gynecological bacterial infections (GBIs) are prevalent in our environment and as a result pose a number of physical, social and psychological consequences. These infections are acquired through several ways. Treating GBIs is a daunting task making its control the most important strategy to alleviating its physical and psychosocial consequences. To highlight the physical, social, and psychological consequences of gynaecological bacterial infections in our resource limited setting. To highlight the hugely unresolved challenges associated with the management of gynecological bacterial infections in our resource-limited setting. Several databases (Medline, Google Scholar, Pubmed, WHO’s Hinari and Wikipedia) and some selected websites were searched using the following keywords: gynecological infections, vaginal infections and discharges, vaginal flora, sexually transmitted infections, pelvic inflammatory disease, syndromic management and challenges, psychosocial consequences, alternative medicine. A total of 5470 relevant articles were obtained between 1947 and 2018. Out of these only 256 relevant articles on the topic were reviewed. However, 213 were dropped for having an incomplete submission. Forty-three (43) articles were fully accessed and referenced. The high prevalence of GBIs poses a lot of burden on the reproductive and socio-economic lives of our women. This should be matched by behavioral changes, prompt diagnosis and early treatment; facilitated by accessible and affordable health care through improved government funding.
ABSTRACT
Background: Human Immunodeficiency Virus sero-discordance is high among heterosexual couples in Africa. However, only few studies have explored the factors that are associated with the prevalence in sub-Saharan Africa. The aim of this study was to determine the prevalence of female sero-discordance among HIV positive pregnant women in Owerri and to assess its possible associated factors.Methods: A cross sectional study of pregnant women (and their partners) who tested positive to HIV I and II at the Prevention of Mother to Child Transmission (PMTCT) clinic from December 2015 to May 2016 in Federal Medical Center Owerri, Imo state, Nigeria.Results: A total of 106 HIV positive pregnant women (and their partners) were studied. The prevalence of female serodiscordance was 63.2% (67/106). Pre-marital serodiscordance contributed about 52.2% (35/67) female serodiscordance among couples in the study. Sero-discordance rate for the lower, middle, and upper classes were 50% (28/56), 76.1% (35/46) and 100% (4/4) respectively and was statistically significant (p<0.01). Condom use was significantly associated with female serodiscondance (P<0.01). CD4+ count of the female partner at booking was also found statistically significantly associated with female serodiscordance (P<0.01).Conclusions: There is high prevalence of female serodiscordance among HIV positive pregnant women in Owerri. Pre-marital serodiscordance contributed significantly to high level of female serodiscordance among couples. Higher social class, condom use and high female- partner CD4+ count are significantly associated with female sero-discordance.
ABSTRACT
Background: Acquired resistance to protein C in pregnancy has been established as one of the factors associated with thromboembolic phenomenon, an important cause of maternal mortality and morbidity. Objectives: To establish the mean levels of PCA ratio (measure of protein C resistance) of among our pregnant women since maternal mortality rate of the country is on the increase despite efforts to reduce this trend. Materials and Methods: A prospective study was carried out in a tertiary institution in Enugu State, Southeastern Nigeria over the 7 months period from May 2010 to November 2010. Two hundred pregnant women and 50 non pregnant female controls were recruited and PCA ratio, (coagulometric assay) were determined. Results: There was a non significant difference between the mean and standard deviation PCA ratio of the female non pregnant controls and pregnant women in 2nd trimester 4.32±0.4 and 4.30±0.4 respectively. A significant difference was noted between the controls and pregnant women in 3rd trimester 4.32±0.4 and 3.87±0.5 respectively also between the pregnant women in their 2nd and 3rd trimester 4.30±0.4 and 3.87±0.5 respectively. Conclusion: There is increased protein resistance C in our pregnant women. This may implicate thromboembolic disorders as one of the leading causes of increase maternal mortality despite a downward trend in the prevalence of post partum haemorrhage