Neonatal Blood Pressure and Anthropometric Indices in Newborns of Pre-Eclamptic and Normal Mothers in Jos, Nigeria.

BACKGROUND AND OBJECTIVES: Preeclampsia is a significant public health problem associated with increased risk of hypertension for offsprings. We compared the blood pressure and presence of hypertension between neonates born to women with preeclampsia and those with normal pregnancy as well as its relationship to anthropometric indices. METHODS: This is a comparative cross-sectional study of 40 neonates born to women with preeclampsia and those born following normal pregnancy in four tertiary health facilities located in Jos, Nigeria. Anthropometric and blood pressure values were measured within 6-12 hours of delivery using standard protocols. SPSS version 25 was used in all analyses. Statistical significance was taken at p <0.05. RESULTS: The mean birth weight for neonates of preeclamptic women was 2,476.1±810.8 grams, compared with 2,994.2±529.6 grams in babies of normal pregnancy (p=0.002). The mean birth length for neonates of preeclamptic women was 45.4±6.2 cm compared with 49.8±3.1 cm in babies of normal pregnancy (p<0.001). The mean ponderal index (PI) in neonates of preeclamptic women was 2.6±0.6 g/cm3 compared with 2.4±0.4 g/cm3 in babies of normal pregnancy (p=0.17). The mean systolic blood pressure in neonates of women with preeclampsia was 74.53±16.99 mmHg compared with 75.26±15.20 mmHg in neonates following normal pregnancy (p=0.85). The mean diastolic blood pressure in neonates born following preeclampsia was 47.52±15.76 mmHg compared with 45.12±16.9 mmHg in those following normal pregnancy (p=0.46). Six (16%) of the neonates born to women with preeclampsia had systolic hypertension compared with 3(8%) of neonates of women with normal pregnancy. Similarly, 5(14%) of neonates born to women with preeclampsia had diastolic hypertension compared with 2(5%) of neonates of women with normal pregnancy. No significant association between neonatal hypertension and anthropometric indices. CONCLUSION: Newborns of women with preeclampsia have associated higher odds of elevated blood pressure. Elevated blood pressure has no significant relationship to birthweight, length or ponderal index. Early infant blood pressure surveillance is advocated in order to monitor and hence prevent complications ensuing in later life.

Sociodemographic profiles and use-dynamics of Jadelle (levonorgestrel) implants in Jos, Nigeria.

BACKGROUND: Contraceptive implants (including Jadelle) are highly effective, safe, and easy to use and have a long duration of action. They do not interfere with intercourse with immediate return to fertility after removal. However, disruption of the menstrual bleeding pattern is almost inevitable and coercive prescription may be a problem because insertion and removal of implants are provider dependent. The objective of this study was to determine the sociodemographic profiles of acceptors of Jadelle and the reasons for discontinuation in Jos, Nigeria. MATERIALS AND METHODS: This was a 6-year retrospective chart review carried out at the Jos University Teaching Hospital. RESULTS: About 1401 women accepted Jadelle with a mean (±standard deviation) of 33.4 ± 5.9 years. About 88% of the women were Christians and almost three-quarters (73.5%) had at least secondary school education. The means of parity and number of children still alive at the time of accepting Jadelle were 4.1 and 3.8, respectively. Half of the women (49.5%) were breastfeeding and over half (55.9%) had future fertility desires at the time of commencing Jadelle. About 82% had previously used other contraceptives (mostly short-acting methods such as injectables, pills, and condoms), with only 18% starting Jadelle as the first-ever contraceptive method. About 90% of the women had regular menstrual cycles. The major reason for discontinuation of Jadelle was desire for pregnancy although menstrual pattern disruption was the most common reason for removal in the first 6 months of use. CONCLUSION: The main reason for discontinuation of Jadelle was to have more children although menstrual pattern disruptions accounted for earlier discontinuation.

BODY WEIGHT CHANGES IN WOMEN USING IMPLANON IN JOS, NIGERIA.

BACKGROUND: The fear of weight gain is one of the adverse events that make women to discontinue Implanon® (etonorgestrel) contraceptive. Black women are more prone to gain weight with the use of such progestogen-only contraceptives than women of other racial groups. The weight of women is also an important consideration since it influences the concentration of the active drug and may predispose to failure at a higher weight profile.Information on weight changes with the use of etonorgestrel implant is scarce in our sub-region. We therefore explored the direction and extent of weight changes among women in different weight categories and determined the predictors of the final body weight during use of Implanon®. MATERIALS AND METHOD: This was a retrospective study of all women that accepted implanon at the Family Planning Unit of the Jos University Teaching Hospital, Jos Nigeria from March 2007 to March 2014. Data analysis was carried out using Stata version 12.1. The socio-demographic data and reproductive histories were extracted from the records and the duration of use of the implant, reasons for discontinuation and the initial weight and at follow up were analysed. RESULTS: Over 99% of the women who had Implanon® were parous and the commonest contraceptive they had used previously was the injectables. However, almost a quarter (22.8%) were accepting Implanon® as their first ever contraceptive method. The mean baseline weight was 64.4 ± 12.1 kg and the median weight was 63.0 kg. The average months of use of Implanon® in this study was 27 months and there was a mean increase in body weight of 2.5 kg during the study. However, there was a broad variability in the individual change in body weight with about 38.6% losing weight or not having any net weight change. Over three-fifths (61.4%) of the women had a net weight gain while using Implanon®. Of these women, 36.0% gained 1-5 kg, 19.2% gained 6-10 kg, 4.2% gained 11-15 kg and 2.0% gained more than 16 kg with the maximum gain at 26 kg. The mean weight changes were 0.8 kg, 1.6 kg, 3.2 kg and 3.3 kg respectively for the first, second, third and fourth years of Implanon® use respectively. Implanon® was removed on account of weight gain in 3.8% of those women who had removed the implant. There was no statistically significant difference in weight gain among the different weight categories: women who had an initial weight above 90 kg gained less than 1 kg compared to those who had normal weight (for this study <70 kg) at the baseline that gained on average more than 2.0 kg. The most significant predictor of the final body weight with Implanon® use was the initial body weight which predicts it in 83.5% of the time (p-value 0.000, CI 0.99, 1.05). CONCLUSION: There was a broad variability in weight changes with the use of Implanon® and the initial body weight is the most significant predictor of the final body weight. Therefore implanon can be used by women of all weight categories including those considered to be obese.

Pattern of contraception among HIV positive women in Jos University Teaching Hospital.

BACKGROUND: Prevention of unintended pregnancies among HIV positive women is a key strategy in preventing the spread of the disease. Contraception is crucial to achieving this and consistent use of condom provides the dual advantage of prevention of pregnancy and reinfection with HIV and other sexually transmitted infections. The purpose of the study is to determine the contraceptive awareness among these women, the types of contraception being used as well as the prevalence and compliance with barrier contraception. METHOD: A cross-sectional survey using an interviewer-administered proforma among HIV positive women within the reproductive age group receiving prevention of mother to child transmission (PMTCT) in Jos University Teaching Hospital. RESULT: A total of 140 questionnaires were administered and retrieved. One hundred and thirty nine women (99.3%) had contraceptive awareness. Ninety eight of them (70%) were using contraception, among which 95(96.9% of contraceptive use) were using condom. The condom prevalence rate in the whole population was 67.8% The pattern of contraception showed that 46 (46.9%) used condom alone, 49 (50%) used condom with other methods; among which condom and injectables constitutedthe largest group (41 women, 41.8%). Out of those using condom, 43 (43.2%) were using it consistently. CONCLUSION: The prevalence of contraception, the use of barrier contraceptive and the rate of the combined use of condom with other contraceptive method, underscores the contraceptive awareness of these women as a means of preventing unplanned pregnancies and prevention of re-infection with HIV and other sexually transmitted infections.

Ultrasonographic biometry: Biparietal Diameter of Nigerian foetuses.

BACKGROUND: Foetal biparietal diameter has been studied previously in Nigerian foetuses but populations have been too small to make categorical conclusions regarding the reference values/data. MATERIALS AND METHODS: In a cross sectional study, the foetal biparietal diameter (BPD) of 13,740 foetuses in Jos were measured with grey ultrasound machine in 13,740 Nigerian women during normal pregnancy and the mean BPD values for each week of pregnancy between 12 and 42 weeks were determined. RESULTS: The mean biparietal diameter value was 29.4mm at 14 weeks, 49.4mm at 20 weeks, 78.4mm at 30 weeks, 91.5 at 37 weeks and 95.6mm at 40 weeks. There was a positive relationship between gestational age and biparietal diameter with correlation coefficient of R(2) = 0.9996 (P < 0.001), and with fetal weight. The increase in BPD with increasing age in the study population showed a curve similar to that of Europeans. CONCLUSIONS: Ultrasonographic measurement of biparietal diameter in Nigerian fetuses showed a linear correlation exists between BPD and gestational age, as well as BPD and foetal weight in normal foetuses.

Embryonal rhabdomyosarcoma of the cervix.

Embryonal rhabdomyosarcoma (sarcoma botyroides) of the cervix, which is rare, is described in a 16-year-old. The combined use of chemotherapy, radiotherapy and surgery has markedly improved survival in those with this condition. However, our patient did not benefit from this treatment modality due to late presentation and loss to follow-up.

Stillbirths at the Jos University Teaching Hospital: incidence, risk, and etiological factors.

INTRODUCTION: Death of a fetus in-utero or intrapartum is both devastating to the couple and of concern to the clinician. Identifying the etiological and risk factors of stillbirths will help in the prevention or reduction of its occurrence. MATERIALS AND METHODS: This was a prospective observational study of all stillbirths over a 16-month period (from January 2006 to April 2007) at the maternity Unit of Jos University Teaching Hospital. Information on maternal socio-demographic details, history of antenatal complications of the index pregnancy, and maternal medical history were obtained by personal interview of all mothers who had a stillbirth. For each stillbirth, information was obtained on the type of stillbirth, estimated gestational age at delivery, sex of baby, and the mode of delivery. These characteristics were subjected to analysis. Etiological causes were assessed using the clinico-pathological approach advocated by Baird-Pattinson. RESULTS: There were a total of 3,904 deliveries with 158 stillbirths during the study period, giving a stillbirth rate of 40.5 per 1,000 total births. There were 84 (53.2%) macerated and 74 (46.8%) fresh stillbirths. Of the 3,904 total deliveries, there were 2,022 (51.8%) males and 1,882 (48.2%) females. There were 84 male and 74 female stillbirths, giving stillbirth rates of 41.5 per 1,000 and 39.3 per 1,000 total deliveries for male and female deliveries, respectively, which was not statistically significant (X2 = 4.6865, P < 0.3564). The major causes were abruptio placentae (17.7%), hypertensive disorders of pregnancy (12.7%) and maternal HIV infection 10.7% of stillbirths. Other causes were cord accidents (7.0%), placenta praevia (3.8%), and anemia in pregnancy (3.8%). Forty-six (29.1%) of the stillbirths were unexplained. The main risk factors identified were lack of antenatal care, poor antenatal clinic attendance, home delivery, and late presentation of complicated labor to the facility. CONCLUSION: The stillbirth rate in our centre is high, major causes being abruptio placenta and maternal medical conditions. Maternal HIV infection has emerged as a major contributor to stillbirths in this study.

Analysis of cases of rape as seen at the Jos University Teaching Hospital, Jos, North Central Nigeria.

OBJECTIVE: Women are at a higher risk of being sexually harassed. There is a need to document the clinical findings of this crime and its outcome in order to improve the quality of care the victims receive. MATERIALS AND METHODS: Case notes of patients who presented with alleged rape at Jos University Teaching Hospital between January 2001 and December 2003 were retrieved and analyzed. RESULTS: During the study period, 2,135 patients were seen in the Gynaecological Emergency Unit. A total of 120 were for alleged rape, representing 5.6% of the total cases seen. However, only 105 case notes were available for analysis. Of these, 63.8% of the alleged rapes were in children, with the infantile age group accounting for 26.7%. 36.2% of the victims had experienced some form of sexual exposure prior to the rape. A previous relationship with the rapist was established in 77.4% of the cases. Most cases delayed in presenting to hospital. Thirty six percent of the cases did not have a human immunodeficiency virus screening test done. Candida albicans (13.3%) accounted for most of the infectious agents. Emergency contraception was administered to the victims when indicated. CONCLUSION: Women under 16 years of age were at an increased risk of being raped, possibly because they are defenseless and vulnerable. Three quarters (3/4) of the assailants had some form of relationship with the victims, which may account for the delays in reporting. Children and young adolescents were more at risk than adults to be raped.

Stillbirths at the Jos University Teaching Hospital: Incidence; Risk; and Etiological Factors

Introduction: Death of a fetus in-utero or intrapartum is both devastating to the couple and of concern to the clinician. Identifying the etiological and risk factors of stillbirths will help in the prevention or reduction of its occurrence. Materials and Methods: This was a prospective observational study of all stillbirths over a 16-month period (from January 2006 to April 2007) at the maternity Unit of Jos University Teaching Hospital. Information on maternal socio-demographic details; history of antenatal complications of the index pregnancy; and maternal medical history were obtained by personal interview of all mothers who had a stillbirth. For each stillbirth; information was obtained on the type of stillbirth; estimated gestational age at delivery; sex of baby; and the mode of delivery. These characteristics were subjected to analysis. Etiological causes were assessed using the clinico-pathological approach advocated by Baird-Pattinson. Results: There were a total of 3;904 deliveries with 158 stillbirths during the study period; giving a stillbirth rate of 40.5 per 1;000 total births. There were 84 (53.2) macerated and 74 (46.8) fresh stillbirths. Of the 3;904 total deliveries; there were 2;022 (51.8) males and 1;882 (48.2) females. There were 84 male and 74 female stillbirths; giving stillbirth rates of 41.5 per 1;000 and 39.3 per 1;000 total deliveries for male and female deliveries; respectively; which was not statistically significant (X2 = 4.6865; P 0.3564). The major causes were abruptio placentae (17.7); hypertensive disorders of pregnancy (12.7) and maternal HIV infection 10.7of stillbirths. Other causes were cord accidents (7.0); placenta praevia (3.8); and anemia in pregnancy (3.8). Forty-six (29.1) of the stillbirths were unexplained. The main risk factors identified were lack of antenatal care; poor antenatal clinic attendance; home delivery; and late presentation of complicated labor to the facility. Conclusion: The stillbirth rate in our centre is high; major causes being abruptio placenta and maternal medical conditions. Maternal HIV infection has emerged as a major contributor to stillbirths in this study

Postpartum Maternal Morbidity in Jos; North-Central Nigeria

Introduction: Postpartum maternal morbidity is a serious public health problem. Major acute and long-term obstetric morbidities affect the life and reproductive career of women. Objective: To determine the incidence; pattern and associated factors of postpartum maternal morbidity in the Jos University Teaching Hospital (JUTH) and offer suggestions on various interventions to reduce this postpartum morbidity. Materials and Methods: This was a 3-year prospective observational study at the JUTH between April 2005 and March 2008. All patients who delivered or were treated in the hospital for postpartum morbidity were recruited for the study. Results: A total of 9056 women delivered; of which 246 (2.72) were treated for postpartum morbidity. Most of the patients (32.9) were between 25 and 29 years old. A majority of the women (58.5) were of Parity 2 to 4. House officers and senior house officers supervised most (43.5) of the deliveries. The most common postpartum maternal morbidity was primary postpartum hemorrhage (35.4). This was followed by hypertensive disorders (24.8) and genital tract sepsis (16.7). There was a statistically significant relationship between accoucher and postpartum maternal morbidity. Conclusion: The incidence of postpartum morbidity was high; with hemorrhage; hypertensive disorders and genital tract sepsis being common problems. It is hoped that supervision of deliveries by skilled medical personnel and active management of the third stage of labor will reduce the incidence of postpartum hemorrhage

Analysis of Cases of Rape as Seen at the Jos University Teaching Hospital; Jos; North Central Nigeria

Objective: Women are at a higher risk of being sexually harassed. There is a need to document the clinical findings of this crime and its outcome in order to improve the quality of care the victims receive. Materials and Methods: Case notes of patients who presented with alleged rape at Jos University Teaching Hospital between January 2001 and December 2003 were retrieved and analyzed. Results : During the study period; 2;135 patients were seen in the Gynaecological Emergency Unit. A total of 120 were for alleged rape; representing 5.6of the total cases seen. However; only 105 case notes were available for analysis. Of these; 63.8of the alleged rapes were in children; with the infantile age group accounting for 26.7. 36.2of the victims had experienced some form of sexual exposure prior to the rape. A previous relationship with the rapist was established in 77.4of the cases. Most cases delayed in presenting to hospital. Thirty six percent of the cases did not have a human immunodeficiency virus screening test done. Candida albicans (13.3) accounted for most of the infectious agents. Emergency contraception was dministered to the victims when indicated. Conclusion: Women under 16 years of age were at an increased risk of being raped; possibly because they are defenseless and vulnerable. Three quarters (3/4) of the assailants had some form of relationship with the victims; which may account for the delays in reporting. Children and young adolescents were more at risk than adults to be raped

Risk factors for placenta praevia in Jos, north central Nigeria.

BACKGROUND: Ptacento pro via, a major cause of obstetric haoemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. Several epidemiological and clinical studies report disparate data on the risk factors associated with this condition. Although several studies on risk factors for placoenta praevia have been published, data obtained from the sub-Saharan Africa remains scanty. Our objective is to describe the spectrum of risk factors for placenta praevia in Jos, north central Nigeria. METHODS: This was a retrospective cohort study of 96 women delivered form January, 1999 to December, 2002 at Jos University Teaching Hospital, Jos, Nigeria. Data on total number of deliveries, maternal age, parity, and past obstetrics history and abortion were carefully extracted from medical records and analyzed using the Epi Info 3.4.1 (CDC, Atlanta, Georgia). RESULTS: The prevalence of placenta praevia was 0.89%. Previous uterine evacuation was documented in 35.4% of cases, while previous caesarean section scar occurred in 5.2% of cases. About half (44.8%) of the cases had no known risk factor. CONCLUSION: Uterine scaring following abortion management is an important risk factor for placenta praevia. However, majority of patients with placenta praevia in this work have no identifiable risk factor.

Experience with Norplant at a Nigerian teaching hospital.

OBJECTIVES: To determine the acceptance of Norplant implants while it was in use and share our experience with other Norplant providers. DESIGN: Retrospective descriptive study. SETTING: The family planning clinic of the Jos University Teaching Hospital, Jos, Nigeria. RESULTS: During the 21-year period, January 1985 to December 2005, a total of eighteen thousand, two hundred and ninety one (18,291) new clients accepted various modern contraceptive methods in the family planning clinic of Jos University Teaching Hospital, Nigeria. Norplant was accepted by 1,333 clients (4.9%) as against the intrauterine devices (IUDs) 25.4%, and Oral Contraceptive Pills (OCP) 22.9%. Female sterilisation was a contraceptive method of choice in 21.2%, the injectables in 13.9%, and the male condom in 9.3%. Failure rate was 0.37% and continuity rate was high among users. The Norplant contraceptive implant was accepted by women of mean age of 29.6 years and women of all parity. The acceptance pattern demonstrated a multi-nodal pattern from the time of introduction in 1985 to December 2005 when supply came to an abrupt stop. The greatest barriers to Norplant use were non- availability and high cost of the commodity. CONCLUSION: Norplantimplants provided contraceptive protection with high reliability, safety, independence from user compliance, rapid return of pre-existing fertility after removal, good tolerability, and relatively simple and quick insertion and removal. The capsules will definitely be used as a reference for similar contraceptive products in the contraceptive market.

Indications for removal of etonogestrel implant within two years of use in Jos, Nigeria.

BACKGROUND: Implanon is a new long-term and reversible sub-dermal contraceptive implant in Nigeria. It is a single rod containing 68mg of etonogestrel meant to offer contraception for three years and marketed by Organon. OBJECTIVE: To determine the indications for removal of Implanon rods from clients within a two-year period. DESIGN: A retrospective review of 30 consecutive Implanon removals within the study period. SETTING: The fertility regulation unit of the department of obstetrics and gynaecology of the Jos University Teaching Hospital, North-Central Nigeria. RESULTS: A total of 30 clients requested for and had their Implanon rods removed out of 669 insertions constituting 95.5% crude continuation rate in the second year. The clients were of mean age 31.4 +/- 6.2 years, mean parity 2.9 +/- 1.8 and mean number of living children 2.7 +/- 1.6. There was an average weight gain of 1.9 kg. The most common indication for removal was menstrual disruption (33.3%). Desire for another pregnancy closely followed (30.0%). Weight gain was another indication for discontinuation (13.3%). Two women were pregnant at insertion of the implant. There was one failure of the method with pregnancy as a result. Spousal disapproval was an indication for removal in two cases. CONCLUSION: Like all progestin-only contraceptive methods, menstrual disruption was the most common indication for removal of implants. Inadvertent insertion of implants with existing pregnancy is of concern and should be avoided as much as is possible. In doubtful cases at insertion, this insertion should be deferred or serum beta-HCG should be assessed to exclude chemical pregnancy.

Risk Factors for Placenta Praevia in Jos; North Central Nigeria

Background: Placenta praevia; a major cause of obstetric haemorrhage; is potentially lifethreatening to the mother and frequently results in high perinatal morbidity and mortality. Several epidemiological and clinical studies report disparate data on the risk factors associated with this condition. Although several studies on risk factors for placenta praevia have been published; data obtained from the sub-Saharan Africa remains scanty. Our objective is to describe the spectrum of risk factors for placenta praevia in Jos; North Central Nigeria. Methods: This was a retrospective cohort study of 96 women delivered form January; 1999 to December; 2002 at Jos University Teaching Hospital; Jos; Nigeria. Data on total number of deliveries; maternal age; parity; and past obstetrics history and abortion were carefully extracted from medical records and analyzed using the Epi Info 3.4.1 (CDC; Atlanta; Georgia). Results: The prevalence of placenta praevia was 0.89. Previous uterine evacuation was documented in 35.4of cases; while previous caesarean section scar occurred in 5.2of cases. About half (44.8) of the cases had no known risk factor. Conclusion: Uterine scaring following abortion management is an important risk factor for placenta praevia. However; majority of patients with placenta praevia in this work have no identifiable risk factor

Ectopic pregnancy in Jos Northern Nigeria: prevalence and impact on subsequent fertility.

BACKGROUND: Ectopic pregnancy remains a major gynaecological problem in contemporary gynaecological practice. Not only do women die from this disease, but also of greater clinical importance is the indirect morbidity of poor fertility prognosis and adverse outcome in subsequent pregnancies. We were interested in documenting the prevalence of ectopic pregnancy and its impact on subsequent fertility. METHODOLOGY: This retrospective descriptive study was done at the Jos University Teaching Hospital. The case notes of all patients who had tubal ectopic pregnancy managed in JUTH between January 1997 and December 2000 were retrieved. Subsequent fertility and reproductive outcome were assessed among women who reported back for follow up fora minimum period of twelve months post surgery. The data was analyzed using frequencies. RESULTS: During the study period, January 1997 and December 2000 a total of 168 ectopic pregnancies were managed and 9,638 deliveries occurred during the same period. This gives a prevalence rate of 1.74%. Of the 168 cases of ectopics, 130 case records containing relevant information were retrieved (77.4%) and this constituted the sample population for the study. Majority (53.8%) of the women were between 20 and 29 years. Majority of the women were either nulliparous or primiparous (23.8% and 20.0% respectively). Tubal rupture occurred in 86.9% of the women at the time of laparotomy. Total salpingectomy was the surgical modality in 77.7% of the cases. The right fallopian tube was affected in 66.2% and the left 33.8% of the cases. The contralateral fallopian tube was grossly normal in 73.1% of cases. Of the 64 women who were followed up for a minimum of 12 months, 40.6% achieved viable intra uterine pregnancies, 6.3% had a repeat ectopic pregnancy in the contra lateral tube and 53.1% were unable to achieve pregnancy. CONCLUSION: Ectopic pregnancy is prevalent in our environment affecting mainly young women of low parity who desire future pregnancies. The subsequent impact on future fertility of these women could be improved if efforts are focused on early diagnosis to prevent tubal rupture. Early diagnosis prior to rupture offers opportunity for medical management and conservative surgical procedures that are proven to improve future fertility prognosis.

Overview of contraceptive use in Jos University Teaching Hospital, north central Nigeria.

BACKGROUND: Modern contraceptive methods accepted by 17,846 new clients in Jos University Teaching Hospital, a tertiary health institution, over two decades are presented. METHODS: This was a review of the contraceptive trend in new clients who used the various methods of contraception over an 18-year period, 1985-2002. RESULTS: The accepted methods were the intrauterine device (26.1%), oral contraceptive pills (23.5%), female sterilization (21.7%), the Injectable (14.2%), male condom (9.5%), Norplant implants (4.9%) and vasectomy (0.1%). Reversible methods were used by 78.2% and the permanent forms by 21.8%. The women were the acceptors of the methods in 90.5%, while men contributed only 9.5% of the new acceptors. Ten men only had vasectomy over the period of study. CONCLUSION: The Intrauterine device was the leading method of contraception accepted by the women and male vasectomy was the least accepted by men. There is the need for increased male involvement in contraceptive issues.

Implanon sub-dermal implants: a 10-month review of acceptability in Jos, North-Central Nigeria.

OBJECTIVE: To determine the acceptance of Implanon so far, the group of women accepting it, insertion complications and immediate post insertion problems, if any, and report our initial experience with the method. METHODOLOGY: This was a retrospective review study of all cases of Implanon acceptors between 1st May and 28th February 2007. Demographic and social factors were collated. Insertion and post-insertion complications were evaluated. RESULTS: A total of 2,608 clients accepted contraceptive methods out of which 350 clients had Implanon capsules inserted within the study period (13.4%). One hundred and ninety-one (54.6%) of the acceptors desired more children, and therefore using it to space pregnancies, 154 (44.0%) would not want more children, but opted for the temporary long term method, and 5 (1.4%) were uncertain whether to have more children in the future or not. The mean age and parity of acceptors were 32.4 years and 3.6 respectively. The mean number of living children to the women was 3.4. All the women were married. About three-quarters (75.8%) of the women had secondary and tertiary education. Seventy-two (20.6%) of the women were taking a modern contraceptive method for the first time. The rest 278 (79.4%) had used one or more methods of contraception, and were only switching over to Implanon sub-dermal implants. The patients weighed between 40 and 122 kg with an average of 62.4 kg. Post-insertion complications like infection, expulsion, bruising and induration were not reported. Four women discontinued the method for varying reasons. CONCLUSION: Women are accepting the new method. Over three-quarters of the clients are switching from other methods to Implanon. The method appears to have good continuation rate and therefore a promising long term sub-dermal contraceptive method amongst our women.