Perception of pregnant women about antenatal care in a cottage hospital in Port Harcourt, Nigeria.

Antenatal care gives opportunity for care of women during pregnancy, prevention and treatment of diseases as well as behavioral change interventions. The perception of users about services influences service utilization. This study was performed to assess user satisfaction with antenatal care services at the centre and to identify constraints at service points. Women attending antenatal care at a cottage hospital In Nigeria were administered questionnaires to evaluate their satisfaction with services and their views about services at various points of care. Data analysis was made using Statistical Package for Social Science version 15.0. Statistical significance was set at P < 0.5. Four hundred correctly completed questionnaires were analysed. The mean age of the respondents was 29 years (SD of 4) and their parity ranged from 0 to 5 (mean 2.5 ± 1.9). The overall satisfaction with care was 94 % and it was highest (95.8 %) with health talks and least with medical consultations (64 %). Attributes valued at service points were educating nature of health talks, prompt attention, and friendly and polite staff. Reasons for dissatisfaction were unfriendly attitudes of staff and delay at service points. Additional care packages women would want were: more staff employed 61 (15.3 %), better organized services 34 (8.5 %) and routine ultrasound scans 25 (6.3 %). Women valued antenatal care and were highly satisfied with services received at the centre. Health education forums should be used to address issues with service delivery. Constraints at service points should be addressed to enhance better service delivery.

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.

Perinatal outcome in pregnancies booked for antenatal care but delivered outside health facilities in Calabar, Nigeria.

Pregnancies that were booked for antenatal care but delivered outside the health facilities were studied. The aim was to determine the perinatal outcome of these pregnancies, and also to compare the outcome with that of pregnancies that were booked and delivered in the University of Calabar Teaching Hospital (UCTH). Birth asphyxia was the commonest perinatal morbidity in both the study (14.3%) and control (4.8%) groups and was significantly higher in the study group than in the control (P < 0.01-P < 0.05). Incidence of neonatal infection tetanus and birth trauma was also significantly higher in the study than in the control groups (P < 0.01-P < 0.05). The incidence of prematurity, neonatal jaundice and congenital abnormality did not show any significant difference in the two groups (P > 0.05). The risk of perinatal death was three times higher in the study group than in the control. Proper public enlightenment campaigns and the establishment of a national health insurance scheme which may strengthen the use of orthodox health facilities for delivery, may improve the poor perinatal outcome in our community.