RESUMO
Background: In-vitro fertilization (IVF) is associated with increased multiple pregnancy and its attendant complications. This study evaluates the attitude and acceptance of single embryo transfer (SET) and multifetal pregnancy reduction (MFPR) by clients assessing assisted reproduction in this region.Methods: A cross sectional survey of patients selected for IVF was conducted. Information on demography, knowledge of IVF procedure and their perception, attitude and acceptability of multiple pregnancy as well as their knowledge, attitude and perception to single embryo transfer and multifetal pregnancy reduction were extracted for statistical analysis.Results: Seventy-three women participated in the study. The mean age was 39 years and mean duration of infertility was 8.6 years. Only 3 (4.1%) respondents agreed to have SET as the overwhelming majority (70) 95.9% preferred 2 or more and they felt the more number of embryo transferred the better the chances of achieving pregnancy. Similarly most respondents, 38.4% (28) did not accept MFPR. Most respondents considered age (63%) and duration of infertility (78.1%) as major influencing factor for rejecting SET. Over 75% of respondents said they will still accept multiple embryos transferred despite knowledge of the possible complications.Conclusions: While most infertile women in our sub region appear to recognize the risks with multiple pregnancy, they are less interested in SET or MFPR because they perceive more embryos transferred as a means to maximize treatment outcome. Government funding, client education and a blastocyst transfer protocol may improve acceptability as well as overall preference for less number of embryos transferred in our environment.
RESUMO
Pregnancy induced hypertension/eclampsia is a major cause of maternal and perinatal morbidity and mortality in Nigeria. There have been very few studies focussed on early onset pregnancy induced hypertension/eclampsia in Nigerian women To determine the incidence; clinical features and outcome of cases of early onset pregnancy induced hypertension /eclampsia in a Nigerian tertiary hospital; and compare maternofetal outcome in early and late onset disease. : A retrospective study of all cases of early onset pregnancy induced hypertension/eclampsia seen over a five-year period in a tertiary hospital. : Severity of disease; rates of induction of labour; caesarean section rate; maternal mortality; abruptio placenta; still births; severe birth asphyxia and early neonatal deaths. : Early onset pregnancy induced hypertension/eclampsia contributed 6.3of all cases of hypertensive disorders in pregnancy with an incidence of 1:141 deliveries. Most cases presented at between 28-32 weeks gestation (78.3) The disease was severe at presentation or rapidly progressive in 39 cases (84.8) leading to delivery within 72 hours of presentation. Caesarean section was the mode of delivery in 58.7of cases. The perinatal survival rate was 34.0. Early onset pregnancy induced hypertension was associated with significantly higher risk of presenting with eclampsia; having induction of labour and worse perinatal outcome than late onset disease. : Most cases of early onset pregnancy induced hypertension in the study population presented with severe and rapidly progressive disease and were associated with significantly higher risk of obstetric intervention and worse perinatal outcome than late onset disease