Audit of emergency obstetric referrals at a tertiary center in Kano.

Introduction: Maternal and perinatal deaths could be prevented if functional referral systems are in place to allow pregnant women to get appropriate services when complications occur. Methodology: The study was a 1-year retrospective study of obstetric referrals in Aminu Kano Teaching hospital, from 1st January to 31st December 2019. Records of all emergency obstetrics patients referred to the hospital for 1 year were reviewed. A structured proforma was used to extract information such as sociodemographic characteristics of the patients, indications for referral, and pre-referral treatment. The care given at the receiving hospital was extracted from the patients' folders. An Audit standard was developed and the findings were compared with the standards in order to determine how the referral system in the study area perform in relation to the standard. Results: There were total of 180 referrals, the mean age of the women was 28.5 ± 6.3 years. Majority (52%) of the patients were referred from Secondary Centres and only 10% were transported with an ambulance. The most common diagnosis at the time of referral was severe preeclampsia. More than half of the patients (63%) had to wait for 30 to 60 minutes before they see a doctor. All the patients were offered high quality care and majority (70%) were delivered via caesarean section. Conclusion: There were lapses in the management of patients before referral; failure to identify high risk conditions, delay in referral, and lack of treatment during transit to the referral centre.

Résumé Introduction: Les décès maternels et périnatals pourraient être évités si des systèmes de référence fonctionnels étaient en place pour permettre aux femmes enceintes d'obtenir des services appropriés en cas de complications. Méthodologie: L'étude était une étude rétrospective d'un an sur les références obstétricales à l'hôpital universitaire Aminu Kano, du 1er janvier au 31 décembre 2019. Les dossiers de toutes les patientes en obstétrique d'urgence référées à l'hôpital pendant 1 an ont été examinés. Un formulaire structuré a été utilisé pour extraire des informations telles que les caractéristiques sociodémographiques des patients, les indications de référence et le traitement pré-référence. Les soins prodigués à l'hôpital d'accueil ont été extraits des dossiers des patients. Une norme d'audit a été élaborée et les résultats ont été comparés aux normes afin de déterminer comment le système d'aiguillage dans la zone d'étude fonctionne par rapport à la norme. Résultats: Il y avait un total de 180 références, l'âge moyen des femmes était de 28,5 ± 6,3 ans. La majorité (52%) des patients ont été référés depuis des centres secondaires et seulement 10% ont été transportés en ambulance. Le diagnostic le plus courant au moment de la référence était la prééclampsie sévère. Plus de la moitié des patients (63%) ont dû attendre 30 à 60 minutes avant de voir un médecin. Tous les patients ont reçu des soins de haute qualité et la majorité (70%) ont accouché par césarienne. Conclusion: Il y avait des lacunes dans la prise en charge des patients avant la référence ; incapacité à identifier les conditions à haut risque, retard dans la référence et absence de traitement pendant le transit vers le centre de référence. Mots-clés: Audit, Obstétrique, référence, Kano.

Comparative Study Between Hysterosalpingo-Contrast Sonography and Hysterosalpingography in Evaluating Tubal Patency at Aminu Kano Teaching Hospital, Kano.

Background: Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive, costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and radiation exposure. This study aimed to compare the effectiveness of Hysterosalpingo-contrast Sonography (HyCoSy) using a saline and air mixture to HSG in assessing tubal patency in infertility patients at Aminu Kano Teaching Hospital. Methodology: A cross-sectional study involved 50 consenting patients seeking fertility evaluation. The researchers used a semi-structured questionnaire to gather demographic information. HyCoSy with the saline and air mixture was performed between the 5th and 10th day of the menstrual cycle, followed by HSG within the next five days. The patency of each fallopian tube was assessed, and pain levels experienced during both procedures were recorded using a numerical rating scale. Results: The results indicated that 68.8% of patients had bilateral patent tubes according to HyCoSy, while 60.4% were found to have patent tubes with HSG. A comparison of findings for individual tubes showed an 89.6% concordance rate between the two tests, with a Kappa index of 0.73, indicating substantial agreement. Importantly, patients reported significantly less pain during the HyCoSy procedure (mean NRS score of 4.1) compared to HSG (mean NRS score of 7.1). Conclusion: This study demonstrated that HyCoSy using a saline and air mixture is highly comparable to HSG in assessing tubal patency. Notably, HyCoSy was preferred by patients due to its reduced pain and better tolerance, with minimal adverse effects. This suggests that HyCoSy may be a more patient-friendly and cost-effective alternative for tubal assessment in cases of infertility.

Audit of emergency obstetric referrals at a Tertiary Center in Kano

Introduction: Maternal and perinatal deaths could be prevented if functional referral systems are in place to allow pregnant women to get appropriate services when complications occur. Methodology: The study was a 1-year retrospective study of obstetric referrals in Aminu Kano Teaching hospital, from 1st January to 31st December 2019. Records of all emergency obstetrics patients referred to the hospital for 1 year were reviewed. A structured proforma was used to extract information such as sociodemographic characteristics of the patients, indications for referral, and pre-referral treatment. The care given at the receiving hospital was extracted from the patients' folders. An Audit standard was developed and the findings were compared with the standards in order to determine how the referral system in the study area perform in relation to the standard. Results: There were total of 180 referrals, the mean age of the women was 28.5 ± 6.3 years. Majority (52%) of the patients were referred from Secondary Centres and only 10% were transported with an ambulance. The most common diagnosis at the time of referral was severe preeclampsia. More than half of the patients (63%) had to wait for 30 to 60 minutes before they see a doctor. All the patients were offered high quality care and majority (70%) were delivered via caesarean section. Conclusion: There were lapses in the management of patients before referral; failure to identify high risk conditions, delay in referral, and lack of treatment during transit to the referral centre.

Clinical audit of the management and outcomes of preterm pre-labour rupture of membranes at Aminu Kano Teaching Hospital.

Introduction: preterm pre-labour rupture of membranes (PPROM) is one of the important causes of preterm birth that can result in high perinatal morbidity and mortality along with maternal morbidity. The purpose of the study was to audit the management of women presenting with Preterm pre-labour rupture of membranes in Aminu Kano Teaching Hospital (AKTH). Methods: this was a retrospective audit on patients admitted with PPROM in AKTH over a period of 24 months. Data was analysed using SPSS version 22 and presented using percentages and compared with the audit standard. Chi-squared test was used to test for association (p-value <0.05). Results: the mean gestational age was 33.27±2.42 weeks. Diagnosis was made on all patients through history and clinical examination. Almost all patients received a course of erythromycin (88%), corticosteroid (84%) and magnesium sulphate (86%). Vaginal delivery was achieved in 57%. About 60% of the neonates were premature, 78% had Apgar score >7 at 5 mins, 50% were admitted in the special care baby unit and 72% survived. Chorioamnionitis and puerperal sepsis occurred in 8% and 21.7% of the mothers. Prolonged PPROM of >24 hours was statistically significantly associated with puerperal sepsis (χ2=7.218; p = 0.007) and perinatal mortality (χ2= 11.505, p = 0.001). Conclusion: despite high fidelity to institutional clinical practice guidelines in Aminu Kano Teaching Hospital there seems to be poor maternal and neonatal outcome with high perinatal mortality. Thus the guidelines need to be reviewed in context of improving the outcome.

Family planning (KB) practices and the impact on Papuan women reproductive health.

OBJECTIVE: This study aims to describe and analyze KB or family planning practices and their impact on Papuan women. A case study was conducted in Waena Village, one of the Kampung KB in Jayapura City, Papua. METHODS: The research method used is descriptive qualitative using an ethnographic approach. The determination of the informants was done purposively by assigning one of the key informants. Data collection includes in-depth interviews and observation. Data analysis includes data reduction, data description, and interpretation. RESULTS: The results showed that women of childbearing age carried out the practice of KB by using various forms of birth control. Some use birth control pills and spiral birth control (intrauterine contraception). In addition, the family planning program has provided education to increase knowledge about reproductive health, types of diseases so that women feel more valued and cared for by men with the existence of KB program. Moreover, the existence of the Kampung KB program also has an impact on community social activities, such as educate adolescents and children to have a clean and healthy lifestyle oriented toward family welfare. CONCLUSION: The Kampung KB program in Waena Village has educated the public about reproductive health, which significantly affects community order.

Cervical cytopathological changes in pregnancy: An experience from a low resource setting.

Background: Cervical cancer is the leading cause of death among women in developing countries. It is preventable through effective cervical cancer screening program. However, in Nigeria, screening programs are opportunistic and coverage is insufficient to make an impact. Aim: This study assessed the cervical cytopathological changes among pregnant women at booking using liquid-based cytology (LBC) in Aminu Kano Teaching Hospital (AKTH). Methodology: This was a cross-sectional study that was carried out at the antenatal Clinic of AKTH, Kano, Nigeria. A total of 161 pregnant women who fulfilled the criteria and gave their consent were recruited into the study using systematic sampling technique at booking for antenatal care. LBC was employed using standard procedure and samples sent to histopathology department for analysis. Pro forma developed for the study was used to obtain the socio-demographic and reproductive characteristics of the women and the risk factors for abnormal cervical cytology. Results: Out of the 161 pregnant women that had cervical cytology screening using LBC on their first prenatal visit during the study, 22 had abnormal cervical cytology, giving a prevalence rate of 13.7%. Out of this, six (27.3%) were atypical squamous cells of undetermined significance, 3 (13.6%) were Atypical Squamous Cells, Cannot Rule Out HSIL (ASC-H), 11 (50.0%) were low-grade Squamous Intraepithelial Lesions while 2 (9.1%) were high grade squamous intraepithelial lesions. Negative smears were seen in 104 women (64.6%). Inflammatory and other conditions of the cervix which are technically negative smears made up the remaining 21.7%. There was a statistically significant association between cervical cytology results and advanced age (P < 0.01), increasing number of lifetime sexual partners since coitarche (P < 0.01), high parity (P < 0.01), absent previous Pap test (P < 0.027), previous history of sexually transmitted infections (P < 0.040), and positive HIV status (P < 0.001). Following binary logistic regression, advanced maternal age, increasing number of sexual partners, high parity, and positive HIV status stood out to be independent predictors of premalignant lesions of the cervix in pregnancy in this study. Conclusion: Advanced maternal age, increasing number of sexual partners, high parity, and positive HIV status stood out to be independent predictors of premalignant lesions of the cervix in the study. Routine cervical cytology screening using LBC should be offered to all antenatal clients in our setting to increase coverage and detection rate of preinvasive lesions of the cervix, and/or pregnant women with increased risk of abnormal cervical cytology from this study.

RésuméContexte: Le cancer du col de l'utérus est la principale cause de décès chez les femmes des pays en développement. Il est évitable grâce à un programme efficace de dépistage du cancer du col utérin. Cependant, au Nigéria, les programmes de dépistage sont opportunistes et la couverture est insuffisante pour avoir un impact. Objectif: Cette étude a évalué les changements cyto-pathologiques cervicaux chez les femmes enceintes lors de la réservation en utilisant la cytologie en phase liquide (LBC) à l'hôpital universitaire Aminu Kano (AKTH). Méthodologie: Il s'agissait d'une étude transversale qui a été réalisée à la clinique prénatale de 'AKTH, Kano, Nigéria. Un total de 161 femmes enceintes qui remplissaient les critères et ont donné leur consentement ont été recrutées dans l'étude en utilisant une technique d'échantillonnage systématique lors de la réservation pour les soins prénatals. LBC a été utilisé en utilisant la procédure standard et des échantillons envoyés au service d'histopathologie pour analyse. Le pro forma développé pour l'étude a été utilisé pour obtenir les caractéristiques sociodémographiques et reproductives des femmes et les facteurs de risque d'une cytologie cervicale anormale. Résultats: Sur les 161 femmes enceintes qui ont subi un dépistage cytologique cervical utilisant le LBC lors de leur première visite prénatale au cours de l'étude, 22 avaient une cytologie cervicale anormale, ce qui donne un taux de prévalence de 13,7%; six (27,3%) étaient des cellules squameuses atypiques de signification indéterminée, 3 (13,6%) étaient des cellules squameuses atypiques, ne peut exclure HSIL (ASC-H), 11 (50,0%) étaient des lésions intraépithéliales squameuses de bas grade tandis que 2 (9,1%) étaient des lésions intraépithéliales squameuses de haut grade. Des frottis négatifs ont été observés chez 104 femmes (64,6%). Les conditions inflammatoires et autres du col de l'utérus qui sont des frottis techniquement négatifs constituaient les 21,7% restants. Il y avait une association statistiquement significative entre l'âge avancé (P <0,01), un nombre croissant departenaires sexuels à vie depuis la coïtarche (P <0,01), parité élevée (P <0,01), absence de test Pap précédent (P <0,027), antécédents d'infections sexuellement transmissibles (P <0,040) et statut VIH positif (P <0,001). Suite à la régression logistique binaire, l'âge maternel avancé, le nombre croissant de partenaires sexuels, une parité élevée et un statut VIH positif se sont révélés être des prédicteurs indépendants des lésions prémalignes du col de l'utérus pendant la grossesse dans cette étude. Conclusion: L'âge maternel avancé, le nombre croissant de partenaires sexuels, la parité élevée et le statut VIH positif se sont révélés être des prédicteurs indépendants des lésions prémalignes du col de l'utérus dans l'étude. Un dépistage cytologique cervical de routine utilisant le LBC doit être proposé à tous les clients prénatals dans notre environnement pour augmenter la couverture et le taux de détection des lésions pré-invasives du col de l'utérus et / ou aux femmes enceintes présentant un risque accru de cytologie cervicale anormale de cette étude.

Family planning (KB) practices and the impact on Papuan women reproductive health

Objective: This study aims to describe and analyze KB or family planning practices and their impact on Papuan women. A case study was conducted in Waena Village, one of the Kampung KB in Jayapura City, Papua. Methods: The research method used is descriptive qualitative using an ethnographic approach. The determination of the informants was done purposively by assigning one of the key informants. Data collection includes in-depth interviews and observation. Data analysis includes data reduction, data description, and interpretation. Results: The results showed that women of childbearing age carried out the practice of KB by using various forms of birth control. Some use birth control pills and spiral birth control (intrauterine contraception). In addition, the family planning program has provided education to increase knowledge about reproductive health, types of diseases so that women feel more valued and cared for by men with the existence of KB program. Moreover, the existence of the Kampung KB program also has an impact on community social activities, such as educate adolescents and children to have a clean and healthy lifestyle oriented toward family welfare. Conclusion: The Kampung KB program in Waena Village has educated the public about reproductive health, which significantly affects community order. (AU)

CA125 levels in pregnancy: A case-control study amongst pregnant women in Aminu Kano teaching hospital, North-West Nigeria.

BACKGROUND: Induction of inflammatory response within the placenta in patients with pre-eclampsia triggers the expression of CA125, thus making CA125 a potential marker reflecting the severity of preeclampsia. OBJECTIVE: The study was aimed to assess and compare CA125 levels in pre-eclamptics and normotensives. SUBJECTS AND METHODS: A case-control design was used to study 83 each of the selected pre-eclamptics and normotensives women using a systematic sampling technique. Data were collected using interviewer-administered questionnaire; blood and urine samples were also collected and analysed in the laboratory. Data were summarised using frequencies, percentages, mean ± standard deviation (SD) or median, and range as appropriate. Inferential statistical measures were used to determine the relationship between the outcome and independent variables with a P value set to be statistically significant at ≤0.05. RESULTS: The ages of the pre-eclamptics and normotensives women were found to have a mean ± SD of 29.46 ± 6.92 and 29.70 ± 6.90 years, respectively. More than half 58 (69.9%) of the cases had proteinuria of 3+ (300 mg/dL). Significant difference was statistically (P < 0.01) found in mean serum CA125 levels between women with mild and severe pre-eclampsia with CA125 being more likely to be higher (>50 IU/mL) in severe pre-eclampsia than in mild pre-eclampsia. CONCLUSION: The study has shown that serum CA125 is elevated in pre-eclamptic pregnancies compared to normotensive pregnancies and the possibility of CA125 being a biomarker of severity and hence may provide information to make an informed choice in early-onset pre-eclampsia to consider conservative management and thus improve perinatal outcome.

Appropriate Documentation of the Timing of Events in the Management of Women with Postpartum Hemorrhage in Aminu Kano Teaching Hospital: A 2-Year Audit.

BACKGROUND: Appropriate documentation of the timing of events in the management of women with postpartum hemorrhage (PPH) is associated with better outcome. OBJECTIVE: To find out how best the Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, fares when compared with the Royal College of Obstetricians and Gynaecologists (RCOG) guidelines about appropriate documentation of the timing of events in the management of PPH. METHODOLOGY: It was a retrospective study based on findings obtained from the case folders of women who had PPH between January 2016 and December 2017. A structured pro forma was used to extract information such as personal data, type of PPH, vital signs of patients, sequence of events, administration of pharmacological agents, and timing of interventions. RESULTS: There were 5202 patients who presented to the labor ward, and 129 of them were cases of PPH giving an incidence of 2.48%. The mean age of the patients was 20.38 ± 1.13 years, and about half of them (47.6%) were multiparas. There was appropriate documentation in terms of initial assessment, resuscitation, and investigations as the percentages of standards achieved are 85%, 78.6%, and 85.7%, respectively. Sixty-one percent of the patients had treatment within the time recommended and 56% had treatment with appropriate uterotonics. Appropriate documentation of major surgeries according to the guidelines was achieved in 12% of cases. CONCLUSION: There was good performance in documentation of initial management of patients with PPH when compared with the RCOG guidelines but suboptimal performance in timing of major surgical interventions.

Awareness, acceptability and barriers to the utilization of modern methods of family planning among women attending antenatal clinic in Bayero University, Kano

Background: Contraceptive prevalence rate (CPR) is generally very low in Nigeria, but particularly lowest in northern Nigeria. Barriers to access and utilization have been variously studied, but there is need to consider specific contexts. Objective: The aim of this study is to determine the level of awareness, acceptability, and barriers to the utilization of modern methods of family planning in Bayero University, Kano, North-west, Nigeria. Methodology: This was a cross-sectional study conducted at the antenatal section of BUK staff clinic, among 152 pregnant women between May and October 2013. Ethical approval and informed consent were obtained. Descriptive statistics was used to report categorical variables. Results: Awareness of modern methods of contraception was high (86.18%) and the majority (86.19%) knew at least one method of family planning. The commonest methods known by the respondents were: Oral contraceptive pills (39.47%), injectables (22.37%) and condom (14.47%). Out of the152 respondents, 77(50.66%) accepted the use of modern methods of family planning and 39(25.65%) out of these number had ever used at least one method, while 38(25.00%) did not. Fear of side effects (42.11%), desire for more children (15.79%), and lack of awareness (13.82%), religious prohibition (10.53%) and opposition by male partners (7.89%) constituted the major barriers to the utilization of modern methods of family planning. Conclusion: The level of awareness was found to be high but acceptability and utilization were low, this is due to the existing barriers to utilization of modern methods of family planning. Effort should be made to allay the fear of side effects and to educate women on the implication of frequent childbirth

Antepartum Hemorrhage: A Retrospective Analysis from a Northern Nigerian Teaching Hospital.

BACKGROUND: Antepartum hemorrhage (APH) contributes significantly to maternal and perinatal morbidity and mortality globally, particularly in the developing world like ours. Prevention, early detection, and prompt management cannot be overemphasized to significantly reduce the morbidity and mortality associated with this condition. OBJECTIVES: The study is aimed at determining the prevalence, etiology, sociodemographic characteristics, and the fetomaternal outcome of pregnancies complicated by APH in Aminu Kano Teaching Hospital, Kano. MATERIALS AND METHODS: A 5 years retrospective study of all pregnancies complicated by APH at Aminu Kano Teaching Hospital, Kano, Nigeria, between January 1, 2009, and December 31, 2013, was conducted. RESULTS: A total of 224 cases of APH were recorded out of the 18,273 cases admitted for delivery during the study period, giving an institutional prevalence rate of 1.2%. Two hundred and eighteen folders were retrieved and analyzed giving a retrieval rate of 97.3%. The mean gestational age at presentation was 35.3 ± 2 weeks and the most common causes were abruptio placenta and placenta previa constituting 68.3% and 30.0%, respectively. Sociodemographic characteristics associated with the occurrence of APH included age, booking status, parity, and socioeconomic status. The peak prevalence of APH was observed in the 35-39 year age group accounting for 33.0%. There were 123 live births and 92 stillbirths. The cesarean section rate was 53.5%. Major complications were intrauterine fetal deaths in 42.8%, postpartum hemorrhage in 24.2% of cases, and anemia necessitating blood transfusion in 61.5%. There were three maternal deaths all due to abruptio placentae during the study period giving a case specific fatality rate of 2%. CONCLUSION: The prevalence of APH in our setting is high. The major causes were abruptio placenta and placenta previa. The major fetal complication was intrauterine fetal death, and the major maternal complications were postpartum hemorrhage and anemia with consequent high blood transfusion rate. Early detection, provision of antenatal care, and emergency obstetric care services can reduce the negative effects of APH.

Investigating antimalarial drug interactions of emetine dihydrochloride hydrate using CalcuSyn-based interactivity calculations.

The widespread introduction of artemisinin-based combination therapy has contributed to recent reductions in malaria mortality. Combination therapies have a range of advantages, including synergism, toxicity reduction, and delaying the onset of resistance acquisition. Unfortunately, antimalarial combination therapy is limited by the depleting repertoire of effective drugs with distinct target pathways. To fast-track antimalarial drug discovery, we have previously employed drug-repositioning to identify the anti-amoebic drug, emetine dihydrochloride hydrate, as a potential candidate for repositioned use against malaria. Despite its 1000-fold increase in in vitro antimalarial potency (ED50 47 nM) compared with its anti-amoebic potency (ED50 26-32 uM), practical use of the compound has been limited by dose-dependent toxicity (emesis and cardiotoxicity). Identification of a synergistic partner drug would present an opportunity for dose-reduction, thus increasing the therapeutic window. The lack of reliable and standardised methodology to enable the in vitro definition of synergistic potential for antimalarials is a major drawback. Here we use isobologram and combination-index data generated by CalcuSyn software analyses (Biosoft v2.1) to define drug interactivity in an objective, automated manner. The method, based on the median effect principle proposed by Chou and Talalay, was initially validated for antimalarial application using the known synergistic combination (atovaquone-proguanil). The combination was used to further understand the relationship between SYBR Green viability and cytocidal versus cytostatic effects of drugs at higher levels of inhibition. We report here the use of the optimised Chou Talalay method to define synergistic antimalarial drug interactivity between emetine dihydrochloride hydrate and atovaquone. The novel findings present a potential route to harness the nanomolar antimalarial efficacy of this affordable natural product.

Combined uterine and urinary bladder rupture: an unusual complication of obstructed labor in a primigravida.

BACKGROUND: Combined uterine and urinary bladder rupture following prolonged obstructed labor is indeed a momentous uro-obstetric emergency. The urinary bladder involvement is distinctly rare in the absence of factors that predispose the bladder to be adherent to the lower uterine segment and is quite unusual in a primigravida. OBJECTIVE: To report a rare case of uterine rupture involving urinary bladder secondary to a prolonged obstructed labor in a primigravida from a low resource setting. CASE: A 17-year-old married unbooked primigravida who presented with a 3-day history of spontaneous onset of labor at term that was initially managed at home and later in a primary health care center where she had fundal pressure and oxytocin augmentation, respectively. The labor was complicated by combined uterine and urinary bladder rupture with sepsis. She was resuscitated and had exploratory laparotomy with uterine and urinary bladder repair. The postoperative period was uneventful and she was followed-up at the gynecology and family planning clinics. CONCLUSION: There is a need for community reawakening on the inherent risks of teenage pregnancy, bad obstetric practices, and unsupervised pregnancy, labor, and delivery, particularly in the rural settings as in the index patient. A high index of suspicion and prompt appropriate intervention will reduce the sequel of morbidity and occasional mortality from this predicament.

An assessment of serum prolactin levels among infertile women with galactorrhea attending a gynecological clinic North-West Nigeria.

BACKGROUND: Galactorrhea is a common manifestation of hyperprolactinemia but may not always be present in women with hyperprolactinemia. This study was, therefore, undertaken to assess the serum prolactin levels of infertile women presenting with galactorrhea and to determine the prevalence of hyperprolactinemia among them. MATERIALS AND METHODS: This was a retrospective study of serum prolactin levels of 63 female partners of infertile couples attending the gynecological clinic of Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria, who were found to have galactorrhea from January 1, 2012, to December 31, 2013. Ethical clearance was obtained. Solid phase enzyme-linked immunosorbent assay was used to measure serum prolactin. Sociodemographic characteristics were determined. The data obtained were analyzed using SPSS version 17.0 statistical software. Absolute numbers and simple percentages were used to describe categorical variables. Similarly, quantitative variables were described using measures of central tendency (mean, median) and measures of dispersion (range, standard deviation) as appropriate. RESULTS: The average age of the women was 27.9 ± 5.6 years. In half of the cases (50%), galactorrhea was associated with menstrual disturbances, mainly amenorrhea (23.3%). Although most (63.3%) of the clients had normal serum prolactin level despite being galactorrheic, averagely there was a marked elevation in serum prolactin of as high as 40.3 ± 52.3 ng/mL. CONCLUSION: We conclude, therefore, that the prevalence of hyperprolactinemia in this study was low when compared with other studies and that galactorrhea does not always indicate raised serum prolactin levels.

Perceptions about Eclampsia, Birth Preparedness, and Complications Readiness among Antenatal Clients Attending a Specialist Hospital in Kano, Nigeria.

Background. Eclampsia is a reliable indicator of poor birth preparedness and complications readiness. We determined perceptions about eclampsia, birth preparedness, and complications readiness among antenatal clients in Kano, Nigeria. Materials and Method. A cross-sectional design was used to study 250 randomly selected antenatal clients. Data was analyzed using SPSS 16.0. Result. The mean age of the respondents was 26.1 ± 6.4 years. The majority perceived that eclampsia is preventable through good ANC (76.4%) and hospital delivery (70.8%). Overall, 66.8% had good perception about eclampsia. Having at least secondary school education and multigravidity were associated with good perception about eclampsia on multivariate analysis. About a third (39.6%) of the mothers was less prepared. On binary logistic regression, good perception about eclampsia and multigravidity were associated with being very prepared for birth. Up to 37.6% were not ready for complications. Half (50.4%) knew at least three danger signs of pregnancy, and 30.0% donated blood or identified suitable blood donor. On multivariate analysis, having at least secondary school education, being very prepared for birth, and multigravidity emerged as the only predictors of the respondents' readiness for complications. Conclusion and Recommendations. Health workers should emphasize the practicability of birth preparedness and complications readiness during ANC and in the communities, routinely review plans, and support clients meet-up challenging areas. The importance of girl-child education to at least secondary school should be buttressed.

Factors Responsible for Under-Utilization of Postnatal Care Services in Maiduguri; North-Eastern Nigeria

Background: In Maiduguri; the utilization of available postnatal care services is still very low. This may be influenced by demographic; socioeconomic; cultural; and obstetric factors among others. Objective: The aim of this study is to understand the current status of utilization of maternal postnatal health care services and identify factors responsible for under.utilization of available postnatal care services in Maiduguri. Materials and Methods: A. cross.sectional; questionnaire.based study was conducted involving 350 women in their reproductive age group. (15.49. years); who had delivered previously; residing in Maiduguri and who came to access any of the available maternal health care services at the State Specialist Hospital; Maiduguri over a 3.month period. The Chi.squared statistics and multivariate logistic regression analysis were used. Results: Out of the grand total of 350 questionnaires that were distributed during the study period; 18 questionnaires were excluded from analysis due to incomplete responses; 332 with complete responses were therefore analyzed; giving a response rate of 94.9. The results showed that only 16.9 of the respondents attended postnatal care services within 42. days after delivery. Most of the mothers. (60.9) were not knowledgeable about postnatal care services. A. very high proportion of participants. (69.4) did not attend antenatal clinics; and over. 70of the study population had delivered at home. The study has identified some factors that have an important influence on utilization of postnatal care services in Maiduguri. These included awareness of postnatal care services. (odds ratio. [OR] 12.04; 95 confidence interval. [CI]: 10.26; P =. 0.000); higher educational status of the woman. (OR 7.15; 95 CI: 5.19; P =0.000); lower parity. (OR 5.22; 95 CI: 3.21; P = 0.001) and marital status. (married woman.OR 3.44; 95 CI: 2.17; P =0.002). Educational attainment of the husband also significantly affected the respondents' seeking behavior of postnatal care. (OR 2.01; 95 CI: 1.13; P =0.042). Conclusion: Utilization of postnatal care services is quite low in Maiduguri. Socioeconomic and sociodemographic factors influenced the use of postnatal care services. Government should provide culturally acceptable health educational programs and expands maternal health care services into the communities for the better; effective and efficient health care delivery