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Background: Preeclampsia is a pregnancy specific multisystem disease and it is associated with increased maternal and perinatal morbidity and mortality. Any factor(s) which could reliably predict the likelihood of serious complications would be very valuable in predicting the associated adverse outcome. Objective of this study compare maternal and fetal outcomes of preeclamptic patients with normotensive control in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.Method: This was a 4-year retrospective case-control study of the pregnancy outcomes among preeclamptic and normotensive women managed in our facility between 1st January 2012 and 31st December 2015. Data analysis was done using Epi Info software 7.2.1.Results: During the study period there were 6,585 deliveries among which 92 of the patients were managed for preeclampsia. This gives a prevalence of 1.4% or 14 per 1000 deliveries. There was no difference in the age and parity of the control. Most of the preeclamptic patients managed over the study period were unbooked for antenatal care in the facility (p value <0.0001). Preeclamptic patients were more likely to be delivered preterm (p value was <0.0001), and by caesarean section compared to the control. They were also more likely to have babies with low birth weights and poorer fetal outcomes. There was no difference in maternal mortality between both groups.Conclusion: Preeclampsia is associated with the unbooked status and poorer perinatal outcome compared with normotensive women. There is need to encourage women to book for antenatal care for prompt identification and management of these women.
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Background:Threatened miscarriage is the commonest complication of pregnancy and has been aBackground: Threatened miscarriage is the commonest complication of pregnancy and has been associated with adverse pregnancy outcomes. Therefore, the aim of this study is to determine the association between threatened miscarriage and adverse maternal and perinatal outcomes.Methods: This was a retrospective case-control study undertaken at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The study involved 228 women presenting with threatened miscarriage in the first trimester and 228 asymptomatic matched controls. The statistical analysis was done using Epi info version 7.1.5, March 2015 (CDC, Atlanta, Georgia, USA).Results: Women with threatened miscarriage were more likely to have preterm delivery (OR = 7.1, 95% CI = 3.51-14.32, P <0.0001), placenta praevia (OR = 2.4, 95% CI = 1.13 - 5.26, P = 0.03), placental abruption (OR = 3.6, 95% CI = 1.40 - 9.03, P = 0.01) and retained placenta (OR = 2.9, 95% CI = 1.18 - 6.97, P = 0.02). Similarly, women with first trimester threatened miscarriage were more likely to develop postpartum haemorrhage (OR = 2.4, 95% CI = 1.17 - 5.06, P = 0.02). There was no significant differences in the stillbirth rate, Apgar scores at 5 minutes less than 7, admission into neonatal intensive care unit and early neonatal death. Threatened miscarriage was associated with intrauterine growth restriction (OR = 3.5, 95% CI = 1.77 - 6.88, P <0.0001) and low birth weight <2.kg (OR = 3.2, 95% CI = 1.33 - 7.69, P = 0.01).Conclusions: Women with threatened miscarriage in the first trimester are at increased risk of adverse pregnancy outcomes and the risk factors should be taken into consideration when deciding upon antenatal surveillance and management of their pregnancies.
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Background: Mother-to-child transmission (MTCT) of HIV accounts for over 90% of all pediatrics infection globally. Strict adherence to antiretroviral drugs is needed to achieve maximal reduction of HIV transmission in pregnancy. Objective: To determine the level of adherence among HIV infected pregnant women on Prevention of Mother to Child Transmission. (PMTCT) antiretroviral therapy and to establish the factors that contribute to poor adherence. Methods: A cross sectional study was conducted in which 268 HIV positive pregnant women were recruited by systematic sampling method from PMTCT clinic of Federal Teaching Hospital Abakaliki. Pre tested interviewer administered questionnaire was used for data collection. Information on socio-demographic characteristics, knowledge of PMTCT, barriers to PMTCT and obstetric characteristics were obtained. Knowledge on PMTCT was accessed and a score of <4 out of 5 indicated poor knowledge. Adherence Level was calculated using the respondent self-report using (3 day recall) and a value < 95% indicated poor adherence. Data were analyzed using descriptive statistics, Chi square and logistic regression (p ⤠0.05). Results: The mean age was 30.7 ± 4.2 years. Two hundred and nineteen (81.7%) of the respondents were married, 124 (46.3%) were traders and 141 (52.6%) had secondary education. The prevalence of good adherence was 89.2% and 227 (89.0%) had good knowledge of PMTCT. Fear of being identified as HIV positive (21%) pregnancy related illness (13.7%) and forgetfulness (12.5%) were the most common reasons for non-adherence. Partner's support (OR=.03, 95% CI=0.01-0.09, p=0.001), and duration of ART (OR=4.39, 95% CI=1.3- 14.5, p=0.019) at bivariate analysis were found to be significantly associated with good adherence. Partners support (OR=0.027, 95%CI=0.01-0.09) retained the association with good adherence after controlling for cofounders. Conclusion: The study identified that stigmatization and pregnancy related illnesses were related to poor adherence while having Partners support improve adherence to HAART
Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/transmission , Infectious Disease Transmission, Vertical , Medication Adherence , NigeriaABSTRACT
The tendo calcaneus is a vital structure in the bipedalic system of human propulsion. Its thickness (TCT) was assessed in an apparently healthy young adult population of Southeast Nigeria using ultrasound. The relationship between TCT and other anthropometric parameters was also evaluated. 120 young adults with age ranging between 19 and 30 years volunteered for the study and their TCT was assessed using B-mode ultrasound. Height, weight, foot length and midcalf circumference were measured while Body Mass Index (BMI) and Body Surface Area (BSA) were calculated for the sample population. Results show that the mean values of TCT were 6.26±0.56mm and 6.32±0.58mm for the right and left sides respectively. TCT correlated positively with all the anthropometric variables assessed except age and BMI. TCT also showed significant sexual dimorphism (P=0.000), laterality and bilateral asymmetry with the left being thicker (P=0.000). These findings will further emphasize the biomechanical relationships of the large tendon. The study is the first to report lateralization and significant sexual dimorphism in a young adult population.
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Background: Coma is a medical emergency; and optimal management; especially in a resource-poor setting; would depend on the knowledge of its etiology and predictors of outcome. This communication reviews the etiology and outcome of non-traumatic childhood coma in Ebonyi State University Teaching Hospital (EBSUTH); Abakaliki. Objective: To determine the incidence; etiology and outcome of non-traumatic coma in children seen at the EBSUTH; Abakaliki. Materials and Methods: This is a retrospective analysis of records of all children admitted to the children emergency ward of EBSUTH in coma of a non-traumatic origin between 1 st of January and 31 st of December; 2007. Results: Forty children presented with coma out of 673 children admitted during the study period; giving an incidence rate of 5.9. The majority of the children (62.5) were aged between 1 and 5 years of age; and 79.5of them were deeply comatose on admission. Most of the cases (85) of non-traumatic coma were due to infective causes; mainly cerebral malaria (47.5); pyogenic meningitis (17.5) and septicemia (10). Twenty-four (60) children recovered while 13 (32.5) died. Conclusion : Infections were the predominant causes of non-traumatic coma in EBSUTH. In view of the high mortality among this group of patients; efforts at the control of malaria and other infections would significantly reduce the incidence of non-traumatic coma in this study site