Perinatal outcome in unbooked teenage pregnancies in the university of calabar teaching hospital, calabar, Nigeria.

Background. Teenage pregnancy being a high risk condition requires skilled attention for good outcome. Objectives. To determine the influence of antenatal care on perinatal outcome in teenage pregnancies in Calabar. Materials and Methods. A review of patient records in Calabar was conducted between 1st January, 2006 and 31st December, 2010, to determine perinatal outcome in teenage pregnancy. Results. Teenage pregnancy accounted for 644 (6.5%) of the total deliveries with 245 (38.0%) booked while 399 (62.0%) were unbooked. Teenage mothers contributed significantly to the proportion of women who were delivered without prior antenatal care (χ(2) = 6.360; P < 0.05). The mean duration of labour in booked teenagers was 10.85 ± 4.2 hours, while unbooked teenagers was 23.31 ± 3.6 hours (t-value = 77.1039; P < 0.05). There was statistically more caesarean sections among unbooked teenage pregnancies than booked (χ(2) = 36.75; P < 0.05). Stillbirth was statistically significant (χ(2) = 27.096; P < 0.05) among unbooked teenagers than booked. However, early neonatal death was not significantly different between booked and unbooked teenage pregnancies(χ(2) = 0.512; P < 0.05). Conclusion. Unbooked teenage pregnancies were significantly associated with increased operative intervention and poor perinatal outcome.

Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use?

The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South-South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001-2005). A total of 4,990 women's records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status.

Clinical presentation and complications in patients with unsafe abortions in University of Calabar Teaching Hospital, Calabar, Nigeria.

BACKGROUND: Unsafe abortion still contributes significantly to high maternal morbidity and mortality particularly in developing countries despite concerted efforts being made to reduce it. Our objective is to determine the incidence, mode presentation and complications of Unsafe abortion. METHOD: This prospective study was carried out by directly interviewing patients managed for unsafe abortion over one and half years period (1" June 2003, to 31st' December, 2004) in Maternity Annex of the University of Calabar Teaching Hospital Calabar, Nigeria. RESULTS: Incidence of Unsafe abortion of 27.6% of all gynaecological admissions was established. Most Patients (55.7%) were age 20 30 years while 25.4% were teenagers. There were 33(27.1%) students, 38.2% were single women and 38.5% had secondary education. The major reasons given for terminating the pregnancy included completion of education (25.4%), fear of parental action (18.8%) and in 17.2% the father of the pregnancy was unknown. Medical officers (32.8%) performed majority of the abortions while 10.7% were self induced by the patients themselves. Main complications encountered included retained product of conceptions, haemorrhage, sepsis, injuries to genital tracts and intra-abdomal organs. CONCLUSION: Unsafe abortion and it complications occurs in all socioeconomic groups. Efforts directed at reducing unintended pregnancy by comprehensive family planning programs and effective emergency post abortal care services will reduce the problem while the legal status of abortion is being debated.

Clinical Presentation and Complications in Patients with Unsafe Abortions in University of Calabar Teaching Hospital; Calabar; Nigeria

Background: Unsafe abortion still contributes significantly to high maternal morbidity and mortality particularly in developing countries despite concerted efforts being made to reduce it. Our objective is to determine the incidence; mode presentation and complications of Unsafe abortion. Method: This prospective study was carried out by directly interviewing patients managed for unsafe abortion over one and half years period (1st June 2003; to 31st December; 2004) in Maternity Annex of the University of Calabar Teaching Hospital Calabar; Nigeria. Results: Incidence of Unsafe abortion of 27.6of all gynaecological admissions was established. Most Patients (55.7) were age 20 30 years while 25.4were teenagers. There were 33 (27.1) students; 38.2were single women and 38.5had secondary education. The major reasons given for terminating the pregnancy included completion of education (25.4); fear of parental action (18.8) and in 17.2the father of the pregnancy was unknown. Medical officers (32.8) performed majority of the abortions while 10.7were self induced by the patients themselves. Main complications encountered included retained product of conceptions; haemorrhage; sepsis; injuries to genital tracts and intraabdomal organs. Conclusion: Unsafe abortion and it complications occurs in all socioeconomic groups. Efforts directed at reducing unintended pregnancy by comprehensive family planning programs and effective emergency post abortal care services will reduce the problem while the legal status of abortion is being debated

Socio demographic profile and presentations of patients with ruptured gravid uterus in Calabar Nigeria.

BACKGROUND: To study the Socio-demographic profiles and mode of clinical presentations of with uterine rupture in pregnancy in Calabar, Nigeria. METHOD: Medical records of 67 patients managed for ruptured gravid uterus over 10 years in Maternity section of the University of Calabar Teaching Hospital Calabar, Nigeria were reviewed. RESULTS: An incidence of 1 in 213 of all deliveries during the period was established. Majority (49.2%) were aged between 31 to 40 years and 43.3% had no formal education. Unemployed patients were 29.9%, 42.3% did not book for antenatal care while 32.8% were attended to by traditional birth attendants (TBA) and in the churches. The Commonest clinical presentations were fetal heart rate abnormalities (52.2%) and maternal collapse (46.3%). Majority (50.7%) resulted from neglected obstructed labour. CONCLUSION: Ruptured uterus is a problem of ignorance among women of low socioeconomic group with most of them having unskilled and substandard care during pregnancy and delivery. Improvement in Socio-economic conditions and modification of some harmful cultural practices against women generally will reduce the problem of rupture uterus in our society.

Risk factors associated with sexual assault in Calabar south eastern Nigeria.

BACKGROUND: Sexual assault inflicts significant physical and psychological trauma in the victims. Interventions to prevent this violent crime against women are a major public health concern. The aim of this study is to identify the risk factors for sexual assault as seen in victims presenting in our hospital. METHOD: Twenty-two case records of sexual assault victims treated at the University of Calabar Teaching hospital were reviewed for this study. RESULTS: The incidence of reported sexual assault in this study was 2.1% with a rising trend observed. Age range was from 4 to 23 years. Six (27.3%) victims were primary school pupils. Twelve (54.5%) victims had not attained menarche, and 20 (90.9%) cases were single. Recorded place of assault was commonly along a bush track (36.4%) and a nearby cemetery (22.7%). Time of assault was mainly in the evening (50.0%). Identity of the assailant was known in 7 (31.8%) cases. Commonest weapon used by the assailant was a knife (36.4%). CONCLUSION: Concerted effort is required to curb the rising trend of reported sexual assault. Interventions aimed at creating public awareness of the possible risk factors may reduce the incidence of this detestable event in the community.

Trauma related to sexual assault in Calabar, south eastern Nigeria.

BACKGROUND: A woman who is sexually assaulted experiences intense anxiety and fear. The associated stigmatization often results in under reporting and management difficulties. The aims of this study are to document the types of injuries seen in victims of sexual assault and to highlight problems in management of cases. METHOD: Twenty-two case files of sexual assault victims between January 1998 and December 2001 were reviewed for age, types of injuries sustained and treatment received. RESULT: Age range of all victims was 4 to 23 years. The knife was used by the perpetrator in 8 (36.4%) cases. Time interval between assault and presentation to hospital was up to 12 hours in 13 (59.1%) cases. Superficial abrasions, bruises, and lacerations were observed in 12 (54.6%) cases. Six (27.3%) victims paid for human immunodeficiency virus screen and the results were non-reactive. Ten (45.5%) victims had primary repair of perineal tear. CONCLUSION: Sexual assault is associated with multiple bruises, lacerations, and perineal tears. Commercialization of medical services was a hindrance to proper management of cases.

Spousal communication in contraceptive decisions among antenatal patients in Calabar, south eastern Nigeria.

BACKGROUND: The objective of this study was to determine how many women in Calabar urban community actually discuss with their spouses about family planning, how their spouses view family planning and how that affects their usage of family planning facilities. METHOD: The study was conducted using a structured questionnaire which was administered by house officers and medical students on one thousand consecutive patients who attended antenatal care during the study period Seven hundred patients met the inclusion criteria for the study. RESULT: Fifty six percent of the respondents in the study have never discussed family planning with their spouses. About 15% of the respondents have the same view on family planning with their husbands while 11% of the women themselves do not want family planning even though their husbands wanted it. CONCLUSION: Communication between couples about family planning should be encouraged. Whereas women have common meeting points like antenatal clinics to learn more about contraceptives and family planning, the men rarely have such opportunities. They will therefore benefit from discussing with their spouses who are opportuned to learn from the various clinics. Spousal communication should therefore be emphasized in these clinics where contraception and family planning are taught.