Role of national blood transfusion service (NBTS) in promoting emergency obstetrics care (EMOC)

Background: Obstetrics haemorrhage is one of the leading cause of maternal mortality in our settings, this was compounded by the non availability to safe blood in situation of need. Hence the prompt access and availability of blood can avert this preventable cause of maternal death. Objectives: to highlight the benefits of effective collaboration with NBTS in ensuring prompt availability of blood for emergency obstetric services requiring blood for transfusion. Material And Method: All obstetrics cases requiring blood transfusion in FMC Nguru from 1st stJanuary 2006 ­ 31 December 2011 were retrospectively reviewed. Trends and pattern of the st strequest and source of blood were looked at within the two periods (from 1 January 2006 ­ 31 st stDecember 2008 and 1 January 2009 ­ 31 December 2011). Records of 1634 obstetric patients requiring blood transfusion or received blood transfusion in the maternity units were retrieved from the medical records, maternity ward record and blood bank. Information pertaining to their age, parity, indication for the transfusion or requests and source of blood was obtained for analysis. Data was analysed using simple percentage. st st Results: Between 1 January 2006 and 31 December 2008 only 513 (56%) of the units requested st st907 units of blood were supplied, while between 1 January 2009 and 1 December 2011 1367 ( 87%) of the 1567 units of blood requested were supplied. Within the earlier study period the only available source were from willing relatives and commercial blood donors, however between 2009 and 2011 more than 2/3 (64.2%) were supplied from the north east zonal NBTS office in Maiduguri. In 2006 through 2008, donation from relatives and commercial donors accounted for 53.22% and 46.78% respectively, but in 2009 and 2011 donation from relatives and commercial donors were recorded as 23.9% and 11.6% respectively. The commonest indication for the requests were anaemia, obstetrics haemorrhage (PPH, APH) and emergency C/S. Conclusion: Ready available source of blood will significantly improve timely availability of blood in our setting. There is the need to encourage this collaboration in other regions to ensure prompt availability of blood to attend to emergencies requiring blood transfusion

The Effect Birth Interval on Fetal Outcome at the University of Maiduguri Teaching Hospital – A Cross Sectional Study.

Background: Birth spacing is a well-known and underutilized health intervention. Longer birth intervals are associated with multiple health benefits for both mother and the child. Aim: To determine the effect of birth interval on fetal outcome in our environment. Methods: A cross sectional study, conducted at the university of Maiduguri teaching hospital. The subjects were multiparous women carrying singleton pregnancy who come to deliver at the hospital Obstetrics and Gynaecology unit during the study period. A pretested questionnaire was used to obtain their sociodemographic and obstetric characteristics. The effect of birth interval on fetal outcome was determined using χ2 test. Results: During the study period, 530 women fulfilled the inclusion criteria out of which complete data was obtained in 500 women; a response rate of 94.3%. The mean age of the study population was 28.8±5.7 years and the mean birth interval was 32.3±18.1 months. The mean gestational age at delivery was 38.93±1.87 weeks and the mean birth weight was 3270±165 gram. There was significant association between short birth interval and preterm delivery (χ2 =18.45, P=0.005) as well as fifth minute Apgar score of less than 7 (χ2 =12.112, P=0.007). Conclusion: Short birth interval was significantly associated with preterm delivery and birth asphyxia.

Utilization of Insecticide Treated Nets among Pregnant Women Attending Antenatal Clinic in a Suburban Referral Hospital, North-East Nigeria.

Aim: The aim of this study was to assess the knowledge and usage of ITNs among pregnant women attending antenatal clinic in a referral health facility in Nigeria. Materials and Methods: This was a cross-sectional study carried out at the antenatal clinic of the Federal Medical Centre Azare, North-East Nigeria between October and December 2012. A structured questionnaire was administered on consenting consecutive pregnant women until the sample size was reached. Data obtained were analysed and associations were compared using 2 and Fisher’s exact test where applicable, with Pvalue <0.05 considered significant. Results: A total of 197 pregnant women were recruited and interviewed. The maternal age ranged from 17-45 years with mean age of 24.2±5.5 years while the parity ranged from 0-11 with multipara constituting 95 (48.22%) and grand multipara, 29 (14.72%). While only 31 (15.74%) of the respondents had tertiary level of education, 64(32.49%) and 15(7.61%) of them had secondary and primary levels of education respectively. Twenty five (12.69%) had no formal education. Majority of the clients, 162 (82.23%) were unemployed, 14 (7.11%) were civil servants and 17 (8.63%) were petty traders. Although most of the women, 189 (95.94%), had knowledge of ITNs, only 132 (67.01%) owned them and much less, 97 (49.24%), used them. Para 5 and above were significantly more likely to use ITNs than para 1-4 and para 0 (2=21.118; P=0.03). Age, educational status, occupation, ethnic groups and religion (2=1.084; P=0.30) did not influence the use of ITNs. Thirty two (32.00%) and 23 (23.00%) of the ITN non-users gave heat and poverty respectively, as reasons for non utilization. Conclusion: Only few of the clients studied utilized ITNs mainly because of heat and poverty. Education of pregnant women to correct the myths associated with the use of ITNs will improve compliance rate.

Methods of Induction of Labour at the University of Maiduguri Teaching Hospital, Maiduguri: A 4-Year Review

Background: Induction of labour is an important intervention in obstetrics. Misoprostol is increasingly being used for induction of labour in many obstetric units and it may replace the traditional Foleys catheter/oxytocin protocol. Method: This was a retrospective study of the 3 methods of induction of labour used at the University of Maiduguri Teaching Hospital (UMTH). A total of 468 women had induction of labour during the study period. Two hundred and twenty eight of them had induction with 50?g of misoprostol; 57 women had 100?g of misoprostol while 183 women had extra-amniotic Foleys catheter with oxytocin infusion. Result: Induction of labour constituted 6.6(468/7086) of all deliveries during the study period. The commonest indication for induction of labour was prolonged pregnancy in 46.8; followed by pregnancy induced hypertension in 33.5. There was no difference in the achievement of vaginal delivery between the 3 methods of induction of labour (x2=1.13; p=0.57). The mean induction delivery time was shortest for those induced with 100?g of misoprostol (6.38+2.25 hours); followed by 8.16+3.58 hours in those induced with 50ug of misoprostol and 9.73+4.32.43 hours in those induced with Foleys catheter/oxytocin (p