Knowledge, attitude and practice of cervical cancer screening - Papanicolaou test (Pap smear) among female health care providers in Port Harcourt

Background: Cervical cancer is the second most common malignancy affecting women globally and the commonest female genital cancer in Nigeria. It can be prevented through regular cytologic screening by Pap smear. The general public sees health care providers as models; therefore; their attitudes and actions would predictably influence societal health behaviour. Aim: To assess the knowledge; attitude and practices of female health workers in Port Harcourt; towards cervical cancer screening. Methods: A questionnaire-based survey of 133 female health care providers at the Braithwaite Memorial Specialist Hospital and the University of Port Harcourt Teaching Hospital; Port Harcourt; which evaluated the socio-demographic characteristics of respondents; knowledge of cervical cancer; attitude and utilization of cervical cancer screening service was carried out. The data were entered into SPSS version 11.0 which was used for analysis and results are presented as Frequency tables; percentages and means. The level of significance was set at p-value 0.05. Results: Up to 123 (92.2) respondents had knowledge of Pap smear as a screening tool for cervical cancer; and 96 (72.2) respondents recognized early sexual debut as a risk factor. Nine-three (70) respondents would be willing to have Pap smear. Only 17(12.8) had done a Pap smear previously. Conclusion: The high knowledge of cervical cancer screening and their positive attitudes towards it did not translate to service utilization by female health professionals in Port Harcourt.There is therefore need to improve uptake of Pap smear by health professionals in order to improve their effectiveness in encouraging the public to utilize this service

Post Operative Miscarriage Following Ruptured Appendix in Pregnancy

Acute appendicitis in pregnancy though rare; is the most common non- obstetric complication warranting emergency laparotomy. Gestational physiological changes make difficult the diagnosis and delay in diagnosis and surgery results in increased complications. We present a-24 year old primiparous lady at 16 weeks of gestation who was referred from a private hospital to the accident and emergency unit of the University of Port Harcourt Teaching Hospital with 6 days history of abdominal pain; fever and vomiting at an ultrasound gestational age of 16 weeks and managed as case of ruptured appendix in pregnancy. She had laparotomy and appendicectomy. Intraoperative findings were purulent peritoneal exudates; ruptured appendix with flakes of necrotic tissues and fecolith. She subsequently had post operative miscarriage 48hours after the surgery which was completed by manual vacuum aspiration. She did remarkably well and was discharged on the 7th post operative day. Delay in diagnosis of appendicitis in pregnancy and surgery correlates to a more advanced disease with an increased risk of appendiceal rupture; which may contribute to increased risk of further complications. Prompt surgical intervention should be performed when acute appendicitis is suspected during pregnancy

Perinatal Outcome of Macrosomic Births in Port Harcourt

Background: Macrosomic babies are at increased risk of adverse perinatal outcome and therefore constitute a high risk group of neonates and the incidence appears to be rising. The objective was to determine the incidence of fetal macrosomia; and the perinatal outcome of macrosomic babies; compare with matched term; appropriate weight neonates in the booked antenatal population of the UPTH. Methods: It was a- one year prospective study of the perinatal outcome of singleton babies whose birth weights were 4000g and above (macrosomia) delivered to booked antenatal mothers in UPTH between 1st October 2003 and 30th September 2004; comparing them with term appropriate (2500-3999g) weight babies. The birth weight; sex; perinatal and maternal complications documented from direct observations; questioning and other information extracted from patients' case notes; were entered into a personal computer; analysed and presented as frequency tables; percentages; Chi-square x2; calculated as appropriate using Epi info version 3.4.3 statistical soft ware. P 0.05 was considered statistically significant. Results: Fetal macrosomia occurred in 354 out of 2417 singleton term deliveries; giving an incidence of 1in 7 deliveries or 14.65.The birth asphyxia (7.90vs 2.60; p= 0.011); Neonatal admission (29.54vs 2.85; p= 0.001) and perinatal mortality (48/1000 vs 23/1000 births; p=0.001); caesarean delivery (55.70vs18.64; p=0.001) rates were significantly higher in the macrosomic than the control group. Conclusion: There is a high incidence of fetal macrosomia in Port Harcourt with associated relatively higher adverse perinatal outcome compared to singleton term normal weight babies