Antenatal Clinic Waiting Time, Patient Satisfaction, and Preference for Staggered Appointment-A Cross-Sectional Study.

Time spent in the antenatal clinic (ANC) is a major disincentive for pregnant women and constitutes a barrier to the utilization of ANC. Long waiting time and poor patient satisfaction may contribute to poor utilization. This study assessed waiting time, patients' satisfaction, and preference for staggered ANC appointments. A cross-sectional study was conducted; information obtained includes sociodemographic and obstetric characteristics, and time spent at ANC service points. Data were analyzed using International Business Machines (IBM) Statistical Products and Service Solutions (SPSS) software version 23. Descriptive statistics and chi-square test were conducted. Level of significance: P < .05. One hundred and twenty-two participants were interviewed. Mean age was 30.52 (±4.65) years, they were mostly multi-gravid, married, and with tertiary education. Mean time spent in ANC and waiting time were 191 min and 143 min, respectively. Waiting time was longest at doctor's consultation (59 min), laboratory services (38 min), and the cash pay-point (18 min). About 68.9% were satisfied with services and highest at doctors' consultation. Satisfaction was associated with waiting time of <45 min. Dissatisfaction was high at the cash pay-point (28.7%), followed by the laboratory (16.4%). About 56.5% preferred staggered appointments. Time spent in ANC should be reduced and staggered appointments may be a useful strategy to reduce waiting time and patient load.

SERUM TOTAL IgG AND TETANUS SPECIFIC IgG IN NIGERIAN HUMAN IMMUNODEFICIENCY VIRUS INFECTED PRIMIGRAVIDAE AND THE CORD BLOOD OF THEIR BABIES AT BIRTH.

BACKGROUND: HIV infection affects millions of women and children, particularly in sub-Saharan Africa. Tetanus also causes significant maternal and neonatal morbidity and mortality in developing countries. Since the main effect of HIV is immunosuppression, there is potential for a negative influence on the host immune response to tetanus in women with HIV. OBJECTIVE: This case-control study evaluated the effect of HIV infection on maternal tetanus antibody production and neonatal tetanus antibody levels. METHODS: Thirty registered primigravidae were recruited from the clinic;15 were HIV positive and 15 were HIV negative. Serum samples of maternal and cord blood were obtained from both groups at delivery. Maternal total IgG and cord blood tetanus-specific antibody were estimated by Enzyme Linked Immunosorbent Assay. RESULTS: There was no significant difference in the total IgG level of HIV positive mothers compared with HIV negative mothers. No significant difference in the tetanus-specific IgG level in the cord blood of babies of HIV positive mothers compared with cord blood of babies of the HIV negative mothers. CONCLUSION: HIV infection did not significantly reduce total IgG production in Nigerian primigravidae. Tetanus-specific IgG levels were above protective levels in neonates of HIV positive mothers suggesting adequate protection.

PREVALENCE OF MALARIA PARASITAEMIA AND THE USE OF MALARIA PREVENTION MEASURES IN PREGNANT WOMEN IN IBADAN, NIGERIA.

BACKGROUND: Malaria complicates up to 58.1% of pregnancies in Nigeria. Preventive measures include intermittent preventive treatment and consistent use of insecticide-treated nets. However, uptake of these interventions can often be sub-optimal. OBJECTIVE: This study aimed to assess the prevalence of malaria in pregnancy in peri-urban and rural communities of Ibadan, Nigeria and its association with the use of preventive measures. METHODS: In this cross-sectional study, pregnant women were recruited from selected primary health centres and blood films were taken for malaria parasites. Explanatory variables were the use of bed nets and chemoprophylaxis; the primary outcome was presence of peripheral malaria parasitaemia. RESULTS: Malaria prevalence was 4.3% (67 of 1570 participants); two-thirds of women with parasitaemia had malaria symptoms. Four hundred and thirty-eight (27.9%) used prescribed sulphadoxine-pyrimethamine prophylaxis, 784 (49.9%) women reported that they consistently slept under insecticide-treated nets, and 236 (15%) complied with both interventions. Bed net use appeared more protective than chemoprophylaxis. However, the protection from malaria in those who used preventive measures was not statistically significant (p=0.075). CONCLUSION: Malaria prevalence was low. No association was determined between malaria and the use of preventive measures; the lack of association may be due to the low prevalence.

A community-based surveillance of gastrointestinal helminthiasis among pregnant women in Ibadan, South West Nigeria.

BACKGROUND: : Intestinal helminthiasis is a major public health problem in Africa. Helminthic infection in pregnant women causes loss of appetite, poor nutrient absorption, gastrointestinal impairment, iron deficiency, and iron deficiency anemia resulting in low birth weights and preterm births. The main aim of this study is to assess the prevalence of helminthic infections in pregnant women in rural and peri-urban communities of Ibadan. MATERIALS AND METHODS: : A cross-sectional descriptive study was carried out at the antenatal clinics of 12 selected primary health centers and mission homes in Ibadan, Nigeria. Open- and closed-answer questionnaires were administered to 604 consenting pregnant women, who provided fresh stool samples for microscopy. Helminthic quantification was carried out by the Kato-Katz technique. Proportions were compared using Chi-squared with IBM® SPSS® Statistics 21 for analysis. Statistical significance was set at P < 0.05. RESULTS: : Eighty-nine stool samples (14.7%) were positive for helminthiasis. Most had roundworms (13.6%); 13 (2.2%) had hookworms. The mean arithmetic eggs per gram of feces were 2,124 and 248, respectively. No participant had a heavy intensity infection; nearly all were of low intensity. Participants (P = 0.005) and their husbands (P = 0.005) who had higher education were less likely to have helminthiasis. CONCLUSION: These communities are classified as Category III, having a low prevalence and low intensity infection. Therefore, prophylactic anti-helminthic treatment in pregnancy is not recommended. The inverse relationship with education may be a function of better living conditions. Better hygiene should be advocated.

Bioavailability of Cu, Zn and Mn from Mineral Chelates or Blends of Inorganic Salts in Growing Turkeys Fed with Supplemental Riboflavin and/or Pyridoxine.

An 84-day feeding trial was conducted in growing turkeys to measure the bioavailability of Cu, Zn and Mn from a commercial mineral chelate and corresponding inorganic salts in composite feeds containing supplemental riboflavin (B2) and/or pyridoxine (B6). A total of 320, 28-day-old British United Turkeys (BUT) were assigned to eight dietary treatments in a 2 × 4 factorial arrangement comprising two trace mineral sources: chelated trace mineral blend (CTMB) and its corresponding inorganic trace minerals blend (ITMB) fed solely or with supplements of vitamin B2 (8 ppm) or B6 (7 ppm) or 8 ppm B2 + 7 ppm B6. Each treatment was replicated four times with 10 turkeys each. It was observed that turkeys fed with diets supplemented solely with ITMB elicited higher (P < 0.05) Zn excretion than their counterparts fed with diets containing ITMB with supplements of vitamins B2 and/or B6. Manganese retention was lower (P < 0.05) in turkeys fed with diets supplemented solely with ITMB than those fed with diets containing vitamins B2 and/or B6 additives. Combination of CTMB or ITMB with B6 improved (P < 0.05) the concentration of Mn in the liver and Cu in the bone. It was concluded that the minerals in CTMB were more available to the animals than ITMB. Furthermore, vitamins B2 and/or B6 supplementation improved the bioavailability of the inorganic Cu, Zn and Mn in growing turkeys and tended to reduce the concentration of these trace elements in birds' excreta.

MATERNAL MORTALITY AUDIT IN A TERTIARY HEALTH INSTITUTION IN NIGERIA: LESSONS FROM DIRECT CAUSES AND ITS DRIVERS.

INTRODUCTION: Nigeria has the second highest number of maternal deaths in the world.The study aimed at determining the causes of and non-obstetric contributors to maternal mortality at a tertiary referral hospital. MATERIALS AND METHODS: It was a prospective audit of all consecutive maternal deaths in the hospital over a three-year period. Immediately after the death, information wvas retrieved via a data collection form. Data were analysed with SPSS-20. RESULTS: Seventy deaths were examined over the study period. Maternal mortality ratio was 1,265/100,000 live births. The annual ratio decreased steadily over the study period. Most of the deaths were of multiparous women who had not received any antenatal care, and were mostly postpartum,within 24 hours of delivery. Most of them were critically ill on admission to the hospital. Major causes of death were haemorrhage (36%), sepsis (17%) and hypertensive disorders (16%).Delays were identified in 34.3% of cases; most (70.1%) were Phase III delays. DISCUSSION: Direct causes of maternal mortality are consistent with those found in literature. Steps which the centre has been taken to counter direct and non-obstetric causes are discussed. Possible strategies to improve health financing and referral system are proffered.

Knowledge and use of emergency contraception by medical doctors on internship in a tertiary healthcare facility in Nigeria.

CONTEXT: Emergency contraception (EC) is widely used to prevent unwanted pregnancy and it is largely adopted in many countries as over the counter drug to improve access. AIMS: To determine and compare the correct knowledge, attitude and current use of EC among newly graduated medical doctors (MDs). SETTINGS AND DESIGN: A cross-sectional study conducted among 255 newly graduated MDs at the University College Hospital, Ibadan, Nigeria. MATERIALS AND METHODS: A pretested self-administered questionnaire was used to obtain data from consenting participants. STATISTICAL ANALYSIS USED: Descriptive, bivariate, and multivariable analyses were performed, and statistical significance was set at 0.05. Statistical Package for Social Science version 15.0 (Chicago, IL, USA) software was used. RESULTS: The mean age of the respondents was 27.2 years (standard deviation = 2.1). The commonest indication for emergency contraceptive use mentioned was rape-96.5%. About 70% support EC in Nigeria, while about a quarter (26.9%) routinely counsel women about ECP use. About 21% of respondents currently use EC. Logistic regression analysis revealed significant results for gender [odds ratio (OR) =3.64; 95% confidence interval (CI) OR = 1.31-10.01), religion (OR = 0.26; 95% CI OR = 0.11-0.630) and marital status (OR = 0.19; 95% CI = 0.07-0.56). CONCLUSION: The correct knowledge and professional disposition toward EC as a form of contraception is low. We recommend that in-service training should focus more on EC to improve the quality of their knowledge and attitude towards it.

Effectiveness of a structured checklist of risk factors in identifying pregnant women at risk of gestational diabetes mellitus: a cross-sectional study.

BACKGROUND: Gestational diabetes mellitus (GDM) is associated with increased risk of mortality and morbidity for pregnant women and newborns. Identifying pregnant women with risk factors for GDM based on the clinical suspicion is a popular approach. However, the effectiveness of the use of a structured checklist of risk factors is yet to be evaluated. This study assessed the effectiveness of a structured checklist of risk factors in identifying pregnant women at risk of GDM at the University College Hospital, Ibadan. MATERIALS AND METHODS: It was a comparative cross-sectional study implemented in two phases. The first phase (Group A) of the study was a prospective study that involved 530 pregnant women who presented at the booking clinic. A structured checklist containing risk factors was used to identify women at the risk of GDM. The second phase (Group B) was a retrospective study of 530 pregnant women managed 2 years previously who were selected by systematic random technique. RESULTS: The mean age, gestational age at booking, gestational age at delivery and birth weight were 30.2 ± 5.2 years, 21 ± 10.8 weeks, 38.7 ± 2.7 weeks and 3.1 ± 0.7 kg respectively. The prevalence of GDM in Group A and B were 4.9% and 1.6% respectively ( P < 0.05). There was about three fold increase in identification of women at risk of GDM by use of a checklist. CONCLUSION: Identification of women at risk of GDM was approximately 3-4 fold higher with the use of checklist of risk factors. Exhaustive clinical identification with a checklist of risk factors for GDM should be encouraged.

Viral infections among couples for assisted reproduction in a fertility clinic in Nigeria.

CONTEXT: The risk of laboratory cross-contamination may limit the availability of assisted conception for couples infected with chronic viruses. However, assisted conception is the standard of care for people living with human immunodeficiency virus (HIV) to minimize risk of transmission or reinfection. AIMS: To assess the burden of viral infection among couples that present for assisted reproductive technology (ART) with a view to evaluating implications for their care. SETTINGS AND DESIGN: A cross-sectional descriptive study carried out among 138 couples at a private fertility clinic in Nigeria. MATERIALS AND METHODS: Screening for HIV, hepatitis B virus (HBV) and hepatitis C virus were carried out among these clients. The males' seminal parameters were analyzed according to World Health Organization (WHO) criteria. STATISTICAL ANALYSIS USED: Statistical Package for Social Sciences was employed. Analysis was by Chi-square test; statistical significance was set at 0.05. RESULTS: Viral infections were found in 10/138 women (7.2%) and 15/138 (10.9%) men. The most prevalent infection was HBV. Twenty-one couples were sero-discordant. Two couples had concordant HIV and HBV infections, respectively. There was no significant association between sperm quality and chronic hepatitis infection. CONCLUSION: Nearly a fifth of the couples had at least one partner infected with a chronic virus - a proportion significant enough to demand attention. Apart from separate laboratory and storage facilities, basic principles to minimize transmission are recommended: HBV vaccination in sero-discordant partners of HBV carriers (and immunoprophylaxis for the baby) and antiretroviral therapy for HIV-positive partners to reduce the viral load before fertility treatment is commenced.

Knowledge of hepatitis B virus infection, access to screening and vaccination among pregnant women in Ibadan, Nigeria.

The knowledge of pregnant women about Hepatitis B virus infection at three different levels of healthcare and their access to screening and vaccination was evaluated by a questionnaire-based cross-sectional study. There were 643 respondents with a mean age of 30.2 ± 5.2 years and mean gestational age of 26.1 ± 8.4 weeks. The distribution of respondents was 55 (8.6%, primary), 204 (31.7%, secondary) and 383 (59.6%, tertiary) women. The majority of respondents were traders (36%) or civil servants/professionals (28.6%). Overall, 76% of all women had inadequate knowledge about hepatitis B infection; 19.5% had been screened, while 9.7% had been vaccinated. There was an increased likelihood of adequate knowledge, previous screening and vaccination among health workers (p = 0.00). Other positive predictors of knowledge and vaccination were tertiary education (p = 0.04) and tertiary care (p = 0.00). There is inadequate knowledge among pregnant women in Ibadan about Hepatitis B infection, with significant differences at the various levels of care, particularly in non-tertiary settings where screening and vaccination is also sub-optimal. Information dissemination, universal screening and vaccination services for pregnant women in Nigeria require urgent consideration.

Cervical ripening and induction of labour-awareness, knowledge and perception of antenatal attendees in Ibadan, Nigeria.

The levels of awareness, knowledge and the perceptions of women about cervical ripening and induction of labour were assessed in a cross-sectional questionnaire-based interview of 265 antenatal attendees of the University College Hospital, Ibadan, Nigeria from 1 March to 30 April 2009. Questions included evaluated sociodemographic data, obstetric history, awareness of both procedures and knowledge of specific methods. Data analysis was done using SPSS v.14.0 for Windows; frequency tables were utilised to determine proportions and significant variables from χ(2) analysis were entered into a logistic regression model. The majority of respondents were between 26 and 34 years; 56.4% were nulliparous. Awareness of cervical ripening and induction of labour was found in 71% of respondents. Knowledge of misoprostol and Foley's catheter however, was present in 25% and 13% of all women, respectively. Both procedures were perceived to prevent caesarean section or reduce burden of health workers in 16% of respondents. No significant predictor of knowledge was found but history of previous induction was a predictor of awareness (p < 0.05). Improved counselling is required to further increase knowledge of methods for induction and correct wrong perceptions, particularly in women at risk of labour induction.

Chlamydia Infection; Plasma Peroxidation and Obesity in Tubal Infertility

Background: Genital tract infections and obesity are both sources of oxidative stress. Alterations in immune and antioxidant parameters may arise from this or from an indeterminate autoimmune mechanism. Objective: This study aimed to investigate the association of Chlamydial infection; obesity and oxidative response with tubal infertility in Nigerian women. Methods: It was a case-control study of 40 women with tubal infertility and 32 fertile women; respectively; recruited from the Infertility and Family Planning Clinics respectively; of the University College Hospital; Ibadan; Nigeria. Anthropometric indices were measured in each subject and endocervical swabs were taken to screen for current genital tract infection. Antioxidant; hormonal and immunologic analysis were performed on serum. Results: None of the subjects had current genital tract infections. Chlamydia trachomatis IgG positivity was significantly higher in infertile than in fertile subjects [OR 4.33; 95CI (0.078-0.681)]. No significant variations were observed in the anthropometric indices; antioxidant parameters and hormones between infertile and the fertile women. Body mass index correlated positively with oxidative stress in infertile subjects. Waist and hip circumferences correlated negatively with oestradiol in women with tubal infertility. Conclusion: Chlamydial infection is associated with tubal factor infertility; however; obesity seems to increase oxidative stress and reduce fertility potential in women with tubal factor infertility

Human papilloma virus vaccination for control of cervical cancer: a challenge for developing countries.

Primary HPV prevention may be the key to reducing incidence and burden of cervical cancer particularly in resource-poor countries. Vaccination programmes are already established in several developed regions, but several grey areas stand in the path of similar success in developing countries. This review sought to identify challenges of HPV vaccination in developing countries and discuss vaccine use, pitfalls and controversies; areas requiring collaborative efforts were identified. A Pub Med search was done; key words included Human papilloma virus, HPV vaccine and sub-Saharan Africa. Other resources included locally-published articles and additional internet resources. The potential benefit of mass HPV vaccination appears enormous. However, the challenges of competing health demands, poverty, ignorance, religion, culture, weak health system, establishment of an effective intersectoral collaboration and underfunding must be overcome to make maximal vaccine uptake a reality. Education and effective communication is crucial in achieving successful immunization programmes.

Acceptability of counselling and testing for HIV infection in women in labour at the University College Hospital, Ibadan, Nigeria.

BACKGROUND: Many patients are referred to labour ward as emergencies, and therefore do not benefit from the antenatal HIV counselling and testing and treatment offered to registered patients. OBJECTIVE: To assess the acceptability and suitability of offering HIV counselling and testing to women of unknown HIV status presenting in labour. METHODS: A cross-sectional study comprising counselling and obtaining consent for HIV testing among 104 unregistered patients who presented in labour over a 3-month period. Rapid and enzyme-linked immunosorbent assay screening was performed for 90 consenting respondents. Reactive results were confirmed by Western blot. Appropriate therapy was instituted. RESULTS: Acceptance rate for HIV testing was 86.5%, prevalence of HIV was 6.7%. Women of lower educational status were more likely to accept testing in labour (OR: 0.3; 95% CI: 0.1-0.7; p=0.01); age, parity, occupation and knowledge of HIV had no influence. Most women (66.3%) had satisfactory knowledge of HIV. No one admitted to feeling coerced to test in fear of being denied care. Most refusals for screening were to avoid needle pricks (28.6%). Compared to ELISA screening test, specificity of the rapid test was 100%, sensitivity 85.7%, positive predictive value 100% and negative predictive value 98.8%. Attitude to testing was maintained on post-partum re-evaluation. CONCLUSION: The prevalence of HIV amongst unregistered parturients showed the importance of offering point-of-care HIV testing and intervention, especially in an environment where antenatal clinic attendance is poor. Rapid testing appeared to be acceptable and feasible in labour to prevent the mother-to-child transmission of HIV.

Chlamydial infection, plasma peroxidation and obesity in tubal infertility.

BACKGROUND: Genital tract infections and obesity are both sources of oxidative stress. Alterations in immune and antioxidant parameters may arise from this or from an indeterminate autoimmune mechanism. OBJECTIVE: This study aimed to investigate the association of Chlamydial infection, obesity and oxidative response with tubal infertility in Nigerian women. METHODS: It was a case-control study of 40 women with tubal infertility and 32 fertile women, respectively, recruited from the Infertility and Family Planning Clinics respectively, of the University College Hospital, Ibadan, Nigeria. Anthropometric indices were measured in each subject and endocervical swabs were taken to screen for current genital tract infection. Antioxidant, hormonal and immunologic analysis were performed on serum. RESULTS: None of the subjects had current genital tract infections. Chlamydia trachomatis IgG positivity was significantly higher in infertile than in fertile subjects [OR 4.33; 95%CI (0.078-0.681)]. No significant variations were observed in the anthropometric indices, antioxidant parameters and hormones between infertile and the fertile women. Body mass index correlated positively with oxidative stress in infertile subjects. Waist and hip circumferences correlated negatively with oestradiol in women with tubal infertility. CONCLUSION: Chlamydial infection is associated with tubal factor infertility, however, obesity seems to increase oxidative stress and reduce fertility potential in women with tubal factor infertility.

An audit of vaginal hysterectomies at the University College Hospital, Ibadan.

BACKGROUND: Cost reduction, less postoperative morbidity and absence of abdominal scars are advantages of vaginal hysterectomy. The study aimed to examine the rate, indications, and complications of vaginal hysterectomies performed at University College Hospital Ibadan to derive lessons for the immediate future. METHODS: An analysis of the records of all vaginal hysterectomies performed from 1995-2004. Information on the patients' epidemiological characteristics, indications and details of surgery performed, length of duration of surgery and postoperative course was retrieved. Data was analyzed with Stata-11 software. RESULTS: Vaginal: abdominal hysterectomy ratio was 1:9, the former constituting 2.3% of major gynaecological operations done. The mean age of patients was 56.6 +/- 12.9 years and most were grandmultiparous. Twenty-two cases (81.8%) were due to genital prolapse. No uteri were larger than 12 weeks' size. Most (78.1%) were performed by consultants. Complication rate was 63.0%; the most frequent was intra-operative haemorrhage. Mean hospital stay was 7.4 +/- 3.5 days. Post-operation anaemia was associated with longer hospital stay (p = 0.02). CONCLUSION: With increasing detection rate of CIN, lesser parities and the availability of the operating laparoscope at our centre, there is need to widen case selection beyond genital prolapse (in view of known benefits of vaginal hysterectomy) for renewed skill acquisition to reduce the high complication rates and for better training of resident doctors.

The learning curve of radical hysterectomy for early cervical carcinoma.

Cervical cancer remains a public health concern in developing countries that lack the wherewithal to cope with the associated challenges. Screening for premalignant cervical lesions and offering definitive care for early disease is the key to preventing the scourge. We conducted an audit of the radical hysterectomies performed on account of early cervical carcinoma at our centre between September 2006 and August 2008, following capacity-building by Operation Stop Cervical Cancer. Ten women aged 35 to 60 years were managed. All had type III radical hysterectomy. Three patients had adjuvant teletherapy (one was stage IIb, diagnosed intra-operatively). There was a linear reduction in the surgical blood loss and duration of surgery. Average blood loss was 1500 mls; four had blood transfusions. One case was complicated with rectovaginal fistula (the woman with stage IIb disease) and another had bilateral lymphoedema and left lower limb sensory neuropathy. There was no tumour recurrence on follow-up. Definitive surgery for early cervical cancer is feasible in developing countries despite limited resources. Audit of surgical care of cervical cancer will assist in strengthening the scarce skill. Determination of suitable cases during preoperative evaluation is crucial to the success of the surgery.

Male participation in pregnancy and delivery in Nigeria: a survey of antenatal attendees.

This was a cross-sectional study carried out on 462 pregnant women attending antenatal care in Ibadan, Nigeria. The study's aims were to assess the level of participation of Nigerian men in pregnancy and birth, the attitude of the women and likely targets for improved care delivery. Three hundred and forty-nine women (75.5%) were aware that husbands could participate in childbirth. Most women did not think it was their husbands' place to attend antenatal clinic (48.3%) or counselling sessions (56.7%). Nearly all husbands (97.4%) encouraged their wives to attend antenatal clinic - paying antenatal service bills (96.5%), paying for transport to the clinic (94.6%) and reminding them of their clinic visits (83.3%). Three hundred and thirty-five husbands (72.5%) accompanied their wives to the hospital for their last delivery, while 63.9% were present at last delivery. More-educated women were less likely to be accompanied to the antenatal clinic, while more-educated men were likely to accompany their wives. Yoruba husbands were less likely to accompany their wives, but Yoruba wives with non-Yoruba husbands were 12 times more likely to be accompanied. Women in the rural centre were less likely to receive help with household chores from their husbands during pregnancy, while educated women were more likely to benefit from this. Monogamous unions and increasing level of husbands' education were associated with spousal presence at delivery. It appears that male participation is satisfactory in some aspects, but increased attendance at antenatal services and delivery would be desirable.

An appraisal of retained placentae in ibadan: a five year review.

OBJECTIVES: To determine the frequency of retained placenta at the University College Hospital Ibadan (UCH). and to describe the socio-demographic characteristics of the patients and examine the risk factors predisposing to retained placenta. METHODS: This is a descriptive study covering a period of 5 years from January 1(st) 2002 to December 31(st) 2006. During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births. RESULTS: During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were available for analysis. The mean age was 29.37 ± 4.99 years. First and second Para accounted for 52 per cent of the patients. Majority of the patient were unbooked for antenatal care in UCH with booked patients accounting for 27.8 per cent of the cases. The mean gestational age at delivery was 34.29 ± 6.02. Three patients presented to the hospital in shock of which 2 died on account of severe haemorrhagic shock. Fifty-eight patients (64.8%) presented with anaemia (packed cell volume less than 30 per cent) and 35 patients (38.8%) had blood transfusion ranging between 1-4 pints. 1 patient required hysterectomy on account of morbidly adherent placenta. Eleven patients (12.2%) had placenta retention in the past, 28 patients (31%) had a previous dilatation and curettage, 14 patients (15.5%) had previous caesarean sections and 47 patients (41.3%) had no known predisposing factors. CONCLUSION: Retained placenta still remains a potentially life threatening condition in the tropics due to the associated haemorrhage, and other complications related to its removal. The incidence and severity may be decreased by health education, women empowerment and the provision of facilities for essential obstetric services by high skilled health care providers in ensuring a properly conducted delivery with active management of the third stage of labour.