Decision-Delivery Interval for Emergency Caesarean Section at the Rivers State University Teaching Hospital

Decision-Delivery interval when carrying out emergency caesarean section (EmCS) cannot be over-emphasized especially with regards to maternal and fetal outcome.There are variety of factors that may contribute to these intervals such as logistics, personal delay, delay in obtaining of informed consent, lack of blood, and availability of theatre space.Aim: To determine the decision-delivery interval and causes of delay in EmCS at the Rivers State University Teaching Hospital (RSUTH).Methods: It was prospective study conducted at the RSUTH between July 1, 2018 to January 31, 2019. Information was obtained using a self structured questionnaire and analyzed using version SPSS 25.Results: There were 481 patients admitted into labour ward for the period under review of which 71(14.8 %) had EmCS. The mean age was 31 years. The commonest indication for EmCS was Cephalopelvic disproportion (CPD) represented by 23 (32.4%) of the subjects.The average time for decision -delivery interval was 1 to 2 hours represented by 29 (40.8%). The shortest decision -delivery interval was less than 30 minutes 1(1.3%).The decision –delivery interval time greater than 5 hours were 9 (12.7%). The 3 commonest reasons for delay with respect to average decision –delivery intervals were personal delay 21 (20.8%), logistics 19 (18.8%) and lack of blood 13 (12.9%).Conclusion: The study revealed that the average decision -delivery interval was1 –2 hours represented by 40.5% of the subjects. This was relatively long when compared to developed countries of the world. The commonest reason for delay in carrying out EmCS was personal delay (20.8%). The commonest indication for EmCS was CPD (32.4%). Addressing the reasons for the decision –delivery interval will help improve our practice and reduce adverse effects to mother and baby

The Role of Pastors in the Prevention of Breast Cancer: Analysis of 176 Ante Natal Clinic Attendees at the Rivers State University Teaching Hospital

Introduction:Pastors and religious leaders have a role to play in the prevention of diseases, in this scenario prevention of breast cancer. Breast cancer is the leading cause of death globally in women between 44 –50 years.Aim:The role pastors and religious leaders play in the prevention of breast cancer exemplified by the analysis of 176 antenatal clinic (ANC) attendees at the Rivers State University Teaching Hospital (RSUTH).Methods:It was a prospective study of ANC attendees at the RSUTH. The information was coded and analyzed using SPSS version 25.Results:A total of 180 questionnaires were distributed and 176 questionnaires retrieved. The mean gestational age was 32.4 years. The modal parity was 1.As regards level of education, tertiary were 129 (73-3%), secondary 43 (24.4%) and primary 4 (2.3%). Those aware of breast cancer were 159 (90.3%). Means of information by the subjects for breast cancer prevention were media 96 (54.6%), hospital 39 (22.0%), religious house 3 (3.8%) and others 38 (19.6%) Antenatal mothers who carried out self breast examination for detection of breast lumps were 95 (54%). Subjects who were aware of mammogram were 42 (23.9%) while those who had mammogram in the past were 2 (1.1%). ANC attendees who had family history of breast cancer were 7 (4%). The relationship between breast cancer awareness and educational status tertiary 123 (69.9%), secondary 34 (19.3%), primary 2 (1.1%) and no information oneducational status 17(9.7%).Conclusion: Though the level of breast cancer awareness was high 90.3%, religious houses contributed to only 3%. In addition, preventive measures such as self breast examination (54%) and mammogram (1.1%) are still not encouraging

Prevalence of Diabetes Mellitus in Pregnancy amongst Antenatal Clinic Attendees at Booking at the Rivers State University Teaching Hospital

Background:The prevalence of diabetes mellitus (DM) havetripled from 1980 till date as a result of many factors of which obesity/excessive weight gain is a closely related factor of DM. There are many adverse challenges of DM in pregnancy with its associated fetal and maternal consequences.Aim:To determine the prevalence of DM in pregnancy amongst antenatal clinic (ANC) at booking at the Rivers State University Teaching Hospital (RSUTH).Methods: It was a cross sectional study of ANC attendees at booking at the RSUTH. Simple random sampling method was used. The Information was coded and analyzed using SPSS version 25.Results: A total of 99 pregnant women were recruited at booking in the ANC of the RSUTH. The mean age was 32.2 years and the modal parity was 1.0.The number of ANC attendees with weight equal to or greater than 90 Kg were 21 (21.2%), number with weight greater than equal to 90 Kg with glucose in urine were 10 (10.1%) Three (3.0%) of the subjects were known diabetic whereas 12 (12.1%) had family history of DM.Conclusion: The study revealed the prevalence of DM amongst ANC attendees at the RSUTH as 3.0%. There was corresponding glycosuria in 10.1% of the ANC attendees. ANC attendees had family history of DM were 12.1%. Advocacy is needed to educate the populace on the predisposing factors of DM and its adverse effect on maternal and child health.

The Role of Pastors: Attitude of 193 Ante Natal Clinic Attendees towards Caesarean Section at the Rivers State University Teaching Hospital

Introduction:Caesarean section (Cs) is a surgical procedure carried out to prevent adverse maternal and fetal outcome. Aversion to Cs may constitute a major obstacle to safe motherhood. Some for pregnant women not accepting Cs are socio-cultural, religious, ethnic or economical.Aim:Determine the attitude of the church in Nigeria and Pastors towards caesarean section, hence profer solution to the aversion to caesarean section. Methods:It was a prospective study of ANC attendees at the RSUTH. The information was coded and analyzed using SPSS version 25.Results:A total of 200 questionnaires were distributed and 193 retrieved. The mean age was 31 years. The modal parity was 2. As regards level of education; respondents with no formal education were 5 (2.6%), primary 6 (3.1%), secondary 88 (45.6%) and tertiary 94 (48.7%). Fifty seven (30%) of the antenatal mothers had aversion for CS. The reasons given were socio-cultural 25 (13%), religious 8 (4.1%), economic 7 (3.6), ethnic 4 (2.1%), combination of the above 17 (8.8%) and 132 (68.4%) did not respond.Conclusion:The study revealed that the aversion for CS was 30% amongst antenatal clinic attendees at the RSUTH. Religious in this scenario were all Christians was 4.1 %, non-respondents were 68.4%. Counselling and advocacy are needed to change the wrong perspective about CS by the Pastors to reduce maternal and perinatal mortality

A Study of the Awareness and Acceptabilty of Labour Epidural Analgesia amongst Antenatal Clinic Attendees in One Tertiary Hospital

Background: The benefits of Pain relief to parturientsin labour cannot be over-emphasized. However, in low middle income countries accessibility, availability and affordability these services are not optimum. This has made it near impossible for women in labour to benefit from epidural analgesia.Aim: This study was aimed to assess the knowledge of availability and level of acceptance of labour analgesia amongst antenatal clinic attendees at the department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital (RSUTH).Methods: The present observational study was conducted after informed consent was given by antenatal clinic attendees. Data was collected using a pretested questionnaire and analyzed using SPSS Version 25.Results: Response from 200 women with mean ± SD age and gestational age of 31.49 ± 4.89 years and 34.25 ± 4.75 weeks respectively. The modal Parity was 1. 56; while 106/200 (53%) were aware of pain relief in labour, 94/200 (47%) had no knowledge of pain relief in labour. Twenty eight (28/106) constituting 26.42% had knowledge of the pharmacological methods while 78 (73.59%) had non-specific ideas about pain relief in labour. Twenty six (26/28) (92.86%) of the respondents will accept epidural analgesia in labour.Conclusion: Knowledge of availability and acceptance of labour analgesia was poor. Lack of information is a major contributor for non-acceptance of labour analgesia. The inclusion and dissemination of information about labour analgesia by anaesthetists and obstetricians during antenatal classes would increase the knowledge about its availability and wide acceptance to these parturients

Thriving Traditional Birth Attendants in the Nigerian Church: Gate-way to Maternal and Perinatal Mortality - A Typical Example of Conflict in the Church. Review of Practices of Traditional Birth Attendants across the 23 Local Government Areas in Rivers State – South South Nigeria

Background: There is need to educate the pastors and the church congregation for the need for skilled birth attendants to handle pregnancy and labour related challenges in other to reduce maternal and perinatal mortality. This is because, in some “maternities” in Nigeria traditional birth attendants (TBAs) attend to pregnancy related cases and in some instances these unconventional practices are extended to the local churches.Aim: To determine cases of TBAs practicing in churches and help prevent these unconventional obstetrics practices thus preventing maternal and perinatal motality.Methods: It was a cross-sectional study of TBAs across all 23 local government areas of Rivers State in a lecture to prevent maternal death in the month of June 2019 in Port Harcourt, Rivers State Information was coded and analyzed using SPSS version 25.Results: Forty questionnaires were distributed and 37 retrieved. The mean age was 44 years. They were all females. All ofthem were Christians. Their modal age of practice was 1 –5 years. As regards TBAs educational status, those with no formal education were 4 (10.8%), primary 6(16.2%), secondary 20 (54.1%) and tertiary 7 (18.9%). Eleven (29.7%) of the TBAs have ante natal care in the church out of which 6 (16.2%) conducts delivery in the church. Perinatal and maternal deaths recorded by the TBAs in the past 1 year were 7 (18.9%) and 1 (2.7%) respectively.Conclusion: There is need for our Pastors and churches in Nigeria to recognize the place of skilled birth attendants in attending to pregnancy and labour in other to reduce maternal /perinatal mortality and discourage TBAs from practicing in the church. n addition, the study revealed that majority of the TBAs had secondary level of education (54.1%). There is need for churches to encourage their members to seek the pre-requisite training by emphasizing acquiring the necessary education to improve their vocation as birth attendants.

Access to Contraception amongst Female Adolescents: Rivers State Study

Introduction:The importance of contraception amongst adolescents cannot be over-emphasized especially as it concerns reproductive health. Globally, these group of persons are vulnerable and engage in high risk sexual behaviour with little or no access to contraception particularly in the developing countries of the world.Aim: To determine the access to contraception amongst female adolescents in Rivers State. Methods:It was a cross sectional study of female adolescents attending holiday camp in Port Harcourt, Rivers State. Questionnaires were distributed and information coded and analysed using SPSS version 22.Results:One hundred questionnaires were distributed and 89 retrieved. The mean age was 16 ± 2 years. Fifty seven (64.0%) were in secondary school while 32(36.0%) of the adolescents were undergraduates. Twelve (13.5%) were sexually active compared to 69 (77.5%) who were not sexually active, 8 (9%) were non respondents to this question. One (1.1%) of the adolescents had access to contraception while 85 (95.5%) had no access to contraception, 3 (3.3%) did not give any response as regards to access to contraception or not. The media was the most common means of information 25 (28%) on contraception.Conclusion: The study revealed that access to contraception amongst female adolescents in Port Harcourt was poor. Enlightenment programme is highly recommended to prevent unwanted pregnancies, sexually transmitted infections and other adverse effects on reproductive health.

Religion, Culture and Medicine Analysis of Female Genital Mutilation amongst 84 Antenatal Clinic Attendees at the Rivers State University Teaching Hospital

Introduction: Female Genital Mutilation (FGM) or Female Circumcision (FC) have been influenced by religion, culture and medicine. The practice of FGM havebeen associated with myriads of negative health consequences, resulting in its abolishment by the World Health Organization (WHO). This is unlike male circumcision which is well accepted by most religions of the world, culture and medically.Aim: To ascertain the influence of religion, culture and medicine as regards FGM amongst antenatal clinic (ANC) attendees at the Rivers State University Teaching Hospital (RSUTH). Methods: It was a cross sectional study of ANC attendees at The RSUTH. The Information was retrieved using a self structured questionnaire which was coded and analyzed using SPSS version 25.Results: A total number 84 ANC attendees were recruited for the study. The mean age was 30.7 years and the modal parity was 1. The mean gestational age was 15.8 weeks. Twenty (23.8%) respondents had FC, all of whom were Christians. Eighteen (21.4%) of the respondents were of the opinion that FGM was a good practice; while 66 (78.6%) respondents believed that FGM was a wrong practice. The 2 most common reasons for FGM were to prevent promiscuity 7 (8.3%) and cultural reasons 7 (8.3%). The commonest known complication by respondents following FGM was bleeding from the genital tract 24 (28.6%).Conclusion: The prevalence of FGM from the study was 23.8% amongst ANC attendees at the RSUTH. Religion, culture and medicine may play vital roles in the eradication of FGM in our sub-region as recommended by WHO

Obstructed Labour and Maternal Outcome at the Intensive Care Unit of the University of Port Harcourt Teaching Hospital: A Ten Year Review

ntroduction:Obstructed labour is a major cause of maternal mortality. Admissions into the intensive care unit (ICU) especially for post-delivery monitoring and treatment of patients with obstructed labour entails critical care for favourable outcome for the mother.Aim:To evaluate the maternal outcome of mothers admitted into the intensive care unit who had obstructed labour at the University of Port Harcourt Teaching Hospital (UPTH).Methodology:The study was a retrospective study of all the cases of obstructed labour admitted into the ICU of UPTH between 1stJanuary, 2007 to 31stDecember, 2016. Information were retrieved from the patients case note and analyzed using SPSS version 20.Results:A total of1549 patients were admitted into the ICU for the period under review, of which 218(14.1%) were obstetric admissions. One hundred and forty were unbooked mothers while 78 were booked. The mean age was 30 ± 2 years and the modal parity was 2. All the 64 cases of obstructed labour were unbooked mothers and comprised 29.4% of the obstetric admissions. The number of maternal deaths from obstructed labour were 23, which comprised of 10.6% of the obstetric admissions. Conclusion:The study revealed that the maternal deaths following obstructed labour admitted into the ICU was high. The reason is that these patients present late. There is therefore need for patients at risk of obstructed labour to register for antenatal care early and delivery conducted by skilledbirth attendant for improved outcome.

Awareness and Early Detection of Ante Natal Clinic Attendees towards Breast Cancer at a Tertiary Hospital in South – South Nigeria

Background:Breast cancer is the leading cause of death globally in women between 44 –50 years. As a result of poor awareness, late presentation is often times common amongst women with breast cancer in developing countries of the world as such outcome is poor. Aim:To determine the awareness and early detection of ante natal clinic attendees towards breast cancer at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria.Methods:This was a cross-sectional study of ANC attendees at the RSUTH. Simple randomized sampling method was used. A structured pre-test survey questionnaire The information was analyzed using SPSS version 25.Results:A total of 180 questionnaires were distributed and 176 questionnaires retrieved. The mean gestational age was 32.4 years. The modal parity was 1. With respect to the educational level, tertiary were 129 (73.3%), secondary 43 (24.4%) and primary 4 (2.3%). Those aware of breast cancer were 159 (90.3%). Means of information by the subjects for breast cancer prevention were media 96 (54.6%), hospital 39 (22.0%), religious house 3 (3.8%) and others 38 (19.6%) Antenatal mothers who carried out self breast examination for detection of breast lumps were 95 (54%). Subjects who were aware of mammogram were 42 (23.9%) whilethose who had mammogram in the past were 2 (1.1%). ANC attendees who had family history of breast cancer were 7 (4%). The relationship between breast cancer awareness and educational status were as follows, tertiary 123 (69.9%), secondary 34 (19.3%), primary 2 (1.1%).Conclusion:Though the level of breast cancer awareness was high 90.3%. Self breast examination for early detection of breast cancer was above average (54%), while the use of mammogram for early detection of breast cancer was still not encouraging represented by 1.1% of the respondents. The media was the commonest medium of awareness for the prevention of breast cancer represented by 54.6% of the ante natal clinic attendees