ABSTRACT
Background: There is a paucity of organized human biomonitoring, including that of carbon monoxide (CO) in the Niger Delta, Nigeria. The study aims to quantify the impact of maternal exposure to CO in the first trimester of pregnancy and its modification by maternal demographic and obstetric factors. Methodology: It was of cross-sectional design conducted at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. Four hundred and ninety consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Demographic, social, and obstetric characteristics were recorded. Maternal exhaled CO concentration (ECOC) and maternal and fetal carboxyhaemoglobin concentrations (MCOHC and FCOHC) were measured with the aid of a smokelyzer. Data were analyzed, using SPSS version 25.0 software. Ethical approval was obtained from the RSUTH Ethics Committee. Results: The mean values of ECOC, MCOHC, and FCOHC were 3.25±2.51 ppm, 1.15±0.40%, and 0.93±0.72% respectively and the severity (mild, moderate, and severe) of the impact was inversely proportional to the number of women affected. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in the following maternal characteristics: age, educational levels, BMI, gravidity, and parity. In the case of FCOHC, the measures of the differences were as follows: p:<0.019, <0.020, <0.0001, <0.0001, and <0.038 for age categories, educational levels, BMI, gravidity, and parity respectively. There were statistically significant positive correlations between the BMI and the mean values of ECOC, MCOHC, and FCOHC. Conclusion: The higher the severity of exposure to CO (mild, moderate, and severe), the lower the number of impacted pregnant women. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in women of different ages, educational levels, BMI, gravidity, and parity categories.
ABSTRACT
Background: The study was prompted by the high prevalence of hyperglycaemia first detected in pregnancy (HIP) which is classified into diabetes mellitus in pregnancy (DIP) and gestational diabetes mellitus (GDM). This study aimed to determine the usefulness of Glycosylated Haemoglobin (HBA1c) in the diagnosis of HIP in the first trimester of pregnancy. Methodology: The study was of a prospective cross-sectional design carried out between January 2020 and August 2020 at the University of Port Harcourt Teaching (UPTH) and Rivers State University Teaching Hospital (RSUTH). Three hundred and five consecutive pregnant women attending the antenatal clinic at 8 to 13 +6 weeks of pregnancy were recruited for the study. Patients' socio-demographic information, anthropometric measurements, and medical, obstetric, and gynaecological history were recorded on a predesigned proforma. Blood was taken for an oral glucose tolerance test (OGTT) and glycosylated haemoglobin (HBA1c) levels. Ethical approval for the study was obtained from the Research Ethics Committee of the UPTH and RSUTH. Results: The prevalence of DIP, GDM, and HIP in the study was 2.62%, 28.85%, and 31.48% respectively. The ROC curve for HbA1c in the study showed a significant area under the Curve (AUC) value of 0.653%, 95% CI = 0.59 - 0.72, p = 0.001. The Youden index reached 2.50 and the optimal cut-off for HBA1c for diagnosis of diabetes was 5.25%. The sensitivity, specificity, PPV, and NPV for HbA1c against the Gold standard OGTT in the diagnosis of GDM were 36.5%, 88.5%, 59.3, %, and 75.2% respectively. HbA1c had high specificity and moderately high NPV. Conclusion: Glycosylated haemoglobin was a fairly good tool for diagnosis of HIP in the first trimester, but it could not replace OGTT which is the gold standard.
ABSTRACT
Background: Vaginal infections constitute a significant health challenge for women and lead to long-term complications if not promptly and adequately treated. We aimed to determine the prevalent organisms in vaginal infections in our women and the antibiotic susceptibility of the offending organisms. Methodology: This was a prospective cross-sectional study of 635 consecutive women attending the Obstetrics and Gynaecology clinic of the University of Port Harcourt Teaching Hospital from 1st January 2017 to 31st December 2018. Data obtained were analysed using SPSS version 19. Results: Four hundred and eight (64.3%) of the women were gynaecological patients, while the remaining 227 (35.7%) were obstetric patients. One hundred and ninety-one(30.1%) out of the total 635 study population did not have any growth of the organisms tested for in the culture assay, while the remaining 444 (69.9%) had. One hundred and forty-four of the women(22.2%) had growth of candida Albicans, 130 (20.5%) had staphylococcus aureus, 78 (12.3%) - Klebsiella species (spp), 48 (7.6%) - Escherichia coli, 30 (4.7%) - Pseudomonas species, 8 (1.3%) - Proteus species and 6 (0.9%) of the women had Streptococcus species. The commonest pathogen involved in vaginal infections in women was Candida albicans. The commonest bacterial isolate was Staphylococcus aureus and then Klebsiella species. The bacteria were susceptible to Ceftriaxone, Cefpodoxime, Cefotaxime, Cefixime, Ciprofloxacin, Dorepenem and Ampicillin. They were mainly resistant to cefuroxime, ceftazidime, Augmentin, Erythromycin and Meropenem. Conclusion: Candida albicans is prevalent in our women. Staphyloccocus aureus is the commonest bacterial organism in women with vaginal infections. Empirical antibiotic treatment using Cetriazone, Cefpodoxime and Ciprofloxacin, available in our setting, may be beneficial while awaiting the culture results in women with suspected vaginal infections.
ABSTRACT
We reviewed the records of antenatal clinic attendees over a period of 9 years to determine the prevalence of anaemia at booking. The laboratory records of 8751 out of a total of 37,506 pregnant women who booked for antenatal care between 2004 and 2013 at the BMSH were reviewed. The effects of maternal age, educational status, parity, gestational age, haemoglobin genotype and infections on the prevalence of anaemia were investigated. The prevalence of anaemia at booking was 69.6%, most of whom had moderate anaemia. Anaemia was significantly prevalent in the 10-19 year age group, and in women with secondary education, in their 2nd trimester and with SS genotype. Anaemia also increased with gestational age, this however was not statistically significant. There was no statistical difference between those who are human immunodeficiency virus (HIV) positive and had anaemia and those who are HIV negative who also had anaemia. This study shows that anaemia in pregnant women is still unacceptably high considering the consequences and despite interventions on the ground to reduce prevalence. There is a need to review the intervention measures with emphasis on programmes that would increase awareness among pregnant women and the general public.
