Association between maternal lipid profile and gestational diabetes mellitus

Background: Dyslipidemia is the third component of metabolic syndrome and is a wellknown cardiovascular risk factor. However, the association of dyslipidemia with gestational diabetes mellitus is still a subject of ongoing research in Nigerian obstetric populations.Objective: To determine the relationship between second trimester maternal fasting plasma lipid constituents and gestational diabetes mellitus.Methods: This was a prospective nested case control study that enrolled 288 pregnant women out of which 36 women with GDM (cases) where matched with 72 without GDM (controls) following results of oral glucosetolerance testing and plasma fasting lipid profiles done between 24 28 weeks. The patients were followed up until delivery to document maternal and fetal outcomes. Data was analyzed using Statistical Package for Social Sciences (SPSS). Categorical variables were presented in percentages while continuous variables were expressed as means (±Standard Deviation). Student ttest and Chisquare test or Fishers exact test were used for comparing variables between the two groups. A value of <0.05 at 95%confidence interval was considered statistically significant.Results: The overall mean plasma lipid levels for the four lipid constituents in the study population were 187.9mg/dL, 163.5mg/dl, 49.1mg/dL and 108.1mg/dL for TC, TG, HDLc and LDc respectively. The mean plasma triglyceride was significantly higher in cases compared to the controls: 187.0±67.7mg/dL vs. 151.7±66.4mg/dL, (p = 0.01). Abnormaltriglyceride was significantly associated with GDM (AOR:4.8, 95% CI (1.6-14.4), (p= 0.005).Conclusion:Maternal dyslipidemia (abnormal triglyceride) was shown to be significantly associated with GDM in this study and it appeared to be causally related

Uterine rupture: trends and feto-maternal outcome in a Nigerian teaching hospital.

OBJECTIVE: To determine the trends, predisposing factors, maternal and fetal outcome of cases of uterine rupture managed at the University of Abuja Teaching Hospital. METHOD: A retrospective review of all cases of ruptured uterus managed at the University of Abuja teaching hospital, Gwagwalada, between January 2006 and December 2010 was conducted. RESULT: There were 9604 deliveries in the hospital during the period of review out of which 82 were cases ruptured uterus, giving an overall incidence of 0.85% or 1 in 117 deliveries. They were mainly women of low parity with a mean age of 31.8 years. The commonest predisposing factor was injudicious use of oxytocin occurring in 38.7% of cases and was followed closely by previous caesarean section scar (28.0%). Prolonged obstructed labour was the third commonest cause of uterine rupture (18.7%) and occurred only in the unbooked patients. There were 11 maternal deaths which gave a maternal case fatality rate of 14.7%. All the deaths occurred in women who had intrapartum care in places other than the teaching hospital. There were 68 perinatal deaths which gave a fetal case fatality rate of 90.7% and all the babies that survived were in patients that had intrapartum care in the teaching hospital. CONCLUSION: Ruptured uterus is a common obstetric emergency in Nigeria's Federal Capital territory and is associated with high maternal and perinatal morbidity and mortality. It is however preventable when the quality of antenatal care, intrapartum care and medical facilities are improved.

Knowledge and utilization of malaria preventive measures among pregnant women at a tertiary hospital in Nigeria's federal capital territory.

OBJECTIVE: To determine the knowledge and utilization of malaria preventive measures as well as barriers to the utilization of these measures by pregnant women. MATERIALS AND METHODS: The study was a prospective cross-sectional survey involving pregnant women at the booking clinic of the University of Abuja Teaching Hospital between May and August 2010. Close-ended pre-tested structured questionnaires were administered by interviewer method to 403 consecutive consenting women. RESULTS: The knowledge of malaria and its preventive measures in pregnancy was 71.5%. There was a statistically significant association between knowledge of malaria and educational status (X2 = 16.053, P = 0.035). Intermittent preventive treatment was used by 15.9% of the respondents. Insecticide-treated net ownership was 42.6%; however, its use declined from 28.5% before pregnancy to 24.6% during pregnancy. CONCLUSION: There is adequate knowledge about malaria and its preventive measures in pregnancy, but the utilization of these measures is poor. There is need for concerted efforts at addressing the barriers to utilization of these effective interventions.

Fetal outcome of twin gestations in a Nigerian teaching hospital.

BACKGROUND: Although twin gestation is associated with increased perinatal morbidity and mortality, optimal management of this high risk pregnancy is associated with improved outcome for the mother and her baby. Globally, Nigeria has the highest incidence of twinning. This makes studies on twin gestation important, especially on the outcome of the babies which is reflection of the type of care received during the antenatal and intrapartum period. STUDY OBJECTIVE: This study was designed to determine the fetal outcomes of twin deliveries in a tertiary hospital in Nigeria's Federal Capital Territory. METHOD: This was a retrospective study of babies following twin pregnancies delivered in the hospital from 1st January 1998 to 31st December 2007. RESULTS: Out of the 600 babies reviewed, 10.2% were still births giving a still birth rate of 102 per 1000 births. Majority of the stillbirths (73.8%) occurred amongst the unbooked mothers and was higher amongst the second twins. More of the booked mothers had their babies delivered at term compared to the unbooked ones, 115 (38.3%) Vs 66 (22.0%).There was a statistically significant association between gestational age at delivery and booking status of the paturients. (X2 = 16.257, P = 0.001). The mean fetal weight was 2.395 kg +/- 0.63. There was no statistically significant difference when the weights of the first and second twin were compared. (t = 0.343, P = 0.732). Out of the 539 babies born alive, 85.0% had good Apgar score of = 7 in5 minutes, 13.0% of the first twins had moderate birth asphyxia compared to 16.0% of the second twins. The female to male ratio was 1:1.1. CONCLUSION: Twin gestation is associated with low birth weights and high still birth rate in this centre. Fetal outcome is better in the first twin compared to the second twin. Outcome for babies whose mothers were booked were better compared to the unbooked. Quality antenatal care and intrapartum management will help improve fetal outcome.

Knowledge and utilization of malaria preventive measures among pregnant women at a tertiary hospital in Nigeria's federal capital territory

Objective: To determine the knowledge and utilization of malaria preventive measures as well as barriers to the utilization of these measures by pregnant women. Materials and Methods: The study was a prospective cross-sectional survey involving pregnant women at the booking clinic of the University of Abuja Teaching Hospital between May and August 2010. Close-ended pre-tested structured questionnaires were administered by interviewer method to 403 consecutive consenting women. Results: The knowledge of malaria and its preventive measures in pregnancy was 71.5. There was a statistically significant association between knowledge of malaria and educational status (X2 = 16.053; P = 0.035). Intermittent preventive treatment was used by 15.9 of the respondents. Insecticide-treated net ownership was 42.6; however; its use declined from 28.5 before pregnancy to 24.6 during pregnancy. Conclusion: There is adequate knowledge about malaria and its preventive measures in pregnancy; but the utilization of these measures is poor. There is need for concerted efforts at addressing the barriers to utilization of these effective interventions