ABSTRACT
Background: Gynaecological disorders are a particularly common cause of morbidity and mortality among women of reproductive age and a common cause of hospital presentation/admission and surgery.Objective:This study sought to review gynaecological diagnoses and surgeries performed in a tertiary health facility from 2012 to 2017 and its implication for healthcare planning and budgeting.Methodology:This was a retrospective review of all gynaecological diagnoses and surgeries seen in the Rivers State University Teaching Hospital (RSUTH) from 2012 to 2017.Data were retrieved using a proforma comprising of year, gynaecological diagnosis and gynaecological surgeries. Data obtained was entered into Microsoft Excel for descriptive analysis.Results:The proportion of clinic attendees declined from an average of 23% in the first three years (2012-2014) to about 10% in the last three years (2015-2017). The most common gynaecological diagnosis were uterine fibroid (33.3%), infertility 28.1% (primary 5.7%, secondary 22.4%), PID (5.9%), ovarian tumour (4.2%), secondary amenorrhea (3.4%) and pelvic malignancies (3.4%). The commonest major surgeries were myomectomy 441(33.7%), salpingectomy 345(26.4%), hysterectomy 168(12.8%) and cervical cerclage 122(9.3%). The commonest minor surgeries were manual vacuum aspiration 314(41.0%), examination under anaesthesia and biopsy 110(14.3%) and adhesiolysis for synechiae 97(12.6%). The duo of uterine fibroid and infertility made up 50%-70% of all gynaecological diagnoses.Conclusion:This study showed that there has been a steady decline in gynaecological consultations over the years. However, the duo of uterine fibroid and infertility made up half to three-quarter of all gynaecological diagnoses over the 6 years. Infertility and uterine fibroids have a long cause and effect association. Healthcare policies and budgeting should be increased towards tackling these conditions, especially the setting up of a fertility center to provide assisted reproductive technologies and laparoscopy to improve practice and patient outcome
ABSTRACT
Background: Policies and programs aimed at giving access to healthcare free of charge for some segments of the population are increasingly being put in place by low and middle-income countries. The impact of such policies has so far been rather mixed.Objective:This study sought to determine the pattern of obstetrics clinic attendance, deliveries and neonatal outcome during and after a Free Medical Care (FMC) Programme. Was there any significant difference during and after the FMC programme? Methodology:This was a retrospective population-based study involving the three years of a free medical care programme (2012-2014) and the three years after the programme (2015-2017). Data on antenatal/postnatal clinic attendance, method of deliveries and neonatal outcome were retrieved from the hospital records. The Epi-Info 7 statistical software was used for analysis and statistical significance was set at p<0.05.Results:Mean antenatal attendance was 20763.67±6085.71 and 14269.00±1932.71 during and after the programme respectively, but this difference was not significant (P = 0.143). The mean postnatal attendance of 1457.7±447.69 during and 1025.7±193.52 after was not significant (P=0.200). There was more total number of deliveries during (8596) than after (5989) but this was not significant (P=0.171). There were more operative deliveries during (51.9%) than after (39.3%) and this was significant (P=0.0001). The CS rate was 43.1% with previous CS and CPD both responsible for over 40%. Livebirths were 8,272 (58.8%) duringand 5,796 (41.2%) after, which was significant (P=0.0001). There was significant difference (P=0.006) in the macerated stillborn (MSB) rate during (44.2%) and after (55.8%). The stillborn rate was 66.9 during and 98.2 after the programme.Conclusion: There were more clinic attendance and deliveries during the programme, but it was not statistically significant. There was however statistically significant increase in operative delivery, total births and livebirths, and reduced MSB rate during the programme
ABSTRACT
Background: Infection with hepatitis B (HBV) and human immunodeficiency virus (HIV) are global public health problems. These infections during pregnancy increase the risk of maternal morbidity and mortality, and also pose a risk to the fetus due to mother to child transmission.Objective:To determine the prevalence of seropositive HIV and HBsAg cases amongst pregnant women at the Rivers State University Teaching Hospital (RSUTH).Methodology:A retrospective review of hospital and laboratory records of all pregnant women booked at RSUTH in two years, from May 2017 to April 2019, was carried out. Data on patients’ age, parity and educational leveland reactivity of HIV and HBsAgtest at booking were retrieved Original Research Article using structured proforma and analyzed using Epi Info Version 7. Test for significance using Chi-square was set at a significant level of P<0.05.Results:3560 patients had HIV and HBsAg screening out of which 148 (4.2%) and9 (0.3%) respectively were positive. The comorbidity rate in this study was 0.06%. The mean age was 31.5±4.7 years and the mean gestational age at booking was 22.1±6.8 weeks. There was no significant relationship between their age (χ2 = 2.690, p-value=0.442) and parity (χ2 = 3.759, p-value=0.145) with HIV seropositivity, but these were significant for HBsAg (χ2 = 13.691, p-value=0.003) (χ2 = 13.121, p-value=0.001). Educational status was significant for HIV (χ2 = 16.188, p-value=0.000) but not for HBsAg (χ2 = 0.229, p-value=0.892).Conclusion: The seroprevalence rate of HIV and HBsAg in this study were low. HIV seroprevalence was significantly affected by lower education, while HBsAg seroprevalence was significantly affected by younger maternal age andnulliparity. Continued screening of pregnant women for these infections remains valuable and further community-based studies to identify risk factors are recommended