Determinants of contraceptive use by women in the central senatorial zone of Bayelsa State, Nigeria: A cross-sectional survey.

BACKGROUND: Contraceptives are known to contribute to maternal health and well-being as well as improve child survival. Due to the multiethnic nature of Nigeria, it is known that the factors that influence contraceptive use may vary from one location to another and as such a blanket policy by the federal government on improving contraceptive use may not take into account the subtle differences in sociocultural practices that may influence contraceptive use. The aim of the study was to determine the contraceptive prevalence and explore factors that determine the use of contraceptives among women of Bayelsa Central Senatorial Zone. MATERIALS AND METHODS: A cross-sectional survey of 210 women aged between 18 and 49 years who completed a close-ended questionnaire was carried out. Descriptive analysis was done for sociodemographic data, and tests of significance were done using SPSS version 20. RESULTS: The prevalence of modern contraceptives in the Central Senatorial Zone of Bayelsa State was 36.8%. Condoms were the most common type of contraceptives used. Education, religious beliefs, and knowledge of fertile days were factors that significantly predicted contraceptive use. Age and number of children influenced the type of contraception a woman used. CONCLUSION: The contraceptive prevalence in this study is high. The factors that determine contraceptive use such as education and religion have been identified and can be leveraged upon to increase its use.

Effect of Age on Childbearing in Port Harcourt, Nigeria.

OBJECTIVES: To determine the effect of maternal age on pregnancy outcomes in women aged 40 years and above at the University of Port Harcourt Teaching Hospital. METHODS: A retrospective comparative study was conducted on women aged ≥40 years (n=249) and a control group aged 20-29 years (n=249) who delivered at ≥28 weeks gestation between January 1, 2008 and December 31, 2012. The medical records of the patients were analyzed using Epi Info 6.04d. Association between maternal age and selected obstetrical variables were assessed using the chi-squared and the two-tailed Fisher exact test. Differences were considered statistically significant when p≤0.05. RESULTS: The mean age of the women in the study group was 41.2 ±1.75 versus 26.10 ± 2.37 in the control group. Advanced maternal age was associated with a significantly higher rate of hypertensive disorders of pregnancy (p=0.01), diabetes mellitus (p<0.01), abnormal lies/presentation (p=0.04), caesarean deliveries (p<0.01) and low birth weight (p=0.04). CONCLUSION: Older parturients have a higher risk of medical disorders of pregnancy. They are more likely to deliver by caesarean section and have low birth weight babies than their younger counterparts.

Abnormal cervical cytology among HIV-positive women in Nigeria.

OBJECTIVE: To determine the prevalence of abnormal cervical smears and high-grade lesions among HIV-positive and HIV-negative women, and to assess the relationship between severity of disease and CD4 count. METHODS: In a prospective cross-sectional comparative study, 250 HIV-positive and 250 HIV-negative women attending the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, were enrolled between January and March 2012. Cervical smear samples were collected from participants, examined, and reported via the Bethesda system. Data management and analysis was done with SPSS. Differences between the 2 study groups were determined by χ2 test and Student t test. RESULTS: The prevalence of abnormal cervical smears was significantly higher among HIV-positive women (34.4%) than among HIV-negative women (20.2%) (P<0.01). The proportion of high-grade lesions was significantly higher among HIV-positive women (23.5%) than among HIV-negative women (8.2%) (P=0.025). HIV-positive women with a CD4 count below 500 cells/mm3 had significantly more abnormal cervical smears (28.3%) compared with those with a CD4 count of 500 cells/mm3 or more (6.1%) (P=0.04). CONCLUSION: HIV-positive women were found to be at significantly greater risk of developing abnormal cervical cytology and high-grade lesions compared with HIV-negative women.

The prevalence of serum immunoglobulin g antibody to Chlamydia trachomatis in subfertile women presenting at the university of port harcourt teaching hospital, Nigeria.

OBJECTIVES: This study was undertaken to assess the prevalence of IgG antibody to Chlamydia trachomatis in subfertile patients at the University of Port Harcourt Teaching Hospital and to determine associated factors between this and infertility. STUDY DESIGN: This case controlled study was conducted among 100 women presenting for infertility consultation at the University of Port Harcourt Teaching Hospital. One hundred women with normal intrauterine pregnancies attending the antenatal clinic were used as controls. A questionnaire was used to obtain information on their socio-demographic data, sexual and obstetric history administered to them. 2mls of venous blood was collected, labelled and sent to the laboratory. The presence of IgG antibody to Chlamydia trachomatis was determined. Hysterosalpingography was performed on all infertile women to assess tubal patency. Data management was with SPSS 15.0 for Windows(®) statistical software. RESULTS: The mean age of the subjects was 30 ± 3.1 years, median parity 0.5 and average life time sexual partner 3.7 ± 2.8. All the participants in the study were married. 62% of subjects had tertiary education. The Chlamydia trachomatis IgG antibody prevalence in the subfertile population was 74% and 51% in the control group, P<0.001. Tubal occlusion occurred in 58 (78.4%) of cases positive for chlamydia antibody. Pelvic inflammatory disease and mucopurulent discharge were the most common presentating symptoms among Chlamydia antigen positive infertile women, P<0.001. There was an association between subfertility and the number of life time sexual partners. There was an association between subfertility and non usage of condoms. CONCLUSION: The prevalence IgG antibody to Chlamydia trachomatis was significantly higher in women with subfertility compared to women with proven fertility. There was a strong association between Chlamydia antibody positivity and tubal occlusion. In a resource-poor country such as Nigeria, enzyme immunosorbent assay for chlamydial IgG antibodies may be substituted for HSG for the detection of tubal occlusion.

Induced abortion amongst undergradute students of University of Port Harcourt.

BACKGROUND: Induced abortion is the termination of pregnancy through a deliberate intervention intended to end the pregnancy. This practice is widespread in Nigeria despite the restrictive abortion laws in Nigeria. Many women still undergo induced abortion every year and endanger their health and lives as induced abortion can only be procured illegally in Nigeria. We hope to determine the proportion of undergraduate students who had induced abortion in the past and the contributing factors. To determine the proportion of the undergraduate students who support the restrictive abortion laws in Nigeria. METHOD: A cross sectional questionnaire survey of undergraduate students of the University of Port Harcourt was done through a cluster sampling method along with focus group discussion with some of the respondents. 451 out of 500 administered questionnaires were retrieved and analyzed. RESULT: The incidence of induced abortion amongst the respondents was 47.2%. About 40% had never used an effective form of contraception in the past and 13% were unaware of contraception. 77.9% of the induced abortion was by dilation and curettage and 1% by manual vacuum aspiration. Up to two third of the respondents were against legalization of abortion. CONCLUSION: Up to 47% of these undergraduates had performed abortion in the past. Protecting educational career was the single most important reason for this. Although most of these undergraduates are against legalizing abortion, they highly patronize unsafe abortion. Improving contraceptive awareness and usage will reduce unwanted pregnancy and induced abortion. This option appears next to total abstinence in reducing the morbidity and mortality from induced abortion in this country.

Perinatal outcome of babies delivered to eclamptic mothers: a prospective study from a nigerian tertiary hospital.

BACKGROUND: Eclampsia is a leading cause of maternal and perinatal mortality in Nigeria. Preventive and interventional measures have been shown to reduce maternal mortality and morbidity with no significant beneficial effect on neonatal outcomes. The aim of this study is to assess the perinatal outcome of eclampsia at the University of Port-Harcourt Teaching Hospital (UPTH). MATERIALS AND METHODS: This prospective, cross-sectional study was conducted on 88 consecutive patients presenting with antepartum eclampsia at the UPTH between 1(st) January 2007 and 31(st) December 2008. A protocol was developed and used to collect information about socio-demographic characteristics, mode of delivery, perinatal complications and outcome. Data collected was entered into a spread sheet using SPSS 15.0 for Windows(®) statistical software which was also used for analysis. Chi square was used to test relationship between variables. P value<0.05 was considered statistically significant. RESULTS: There were a total of 5488 deliveries at the University of Port-Harcourt Teaching Hospital from January 2007 to December 2008. Of these, 5,310 were live births while 404 were perinatal deaths giving perinatal mortality rate of 73.6 per 1000 live births. Eighty eight (1.6%) of the mothers were eclamptic. Eight (9.1%) were booked, 80 (90.1%) were unbooked. The mean gestational age at delivery was 35.1 ± 4.2 weeks. The main mode of delivery was by emergency caesarian section in 49 (55.7%) of the patients. Others were spontaneous vertex delivery (34.1%), assisted vaginal breech delivery (6.8%) and instrumental vaginal delivery (3.4%). Fifty four babies (61.4%) were admitted into the Special Care Baby Unit. Indications for admission include prematurity (n=23), low birth weight (n=10), severe birth asphyxia (n=12), neonatal jaundice (n=4) and neonatal sepsis (n=5). There were 37 perinatal deaths giving a perinatal mortality rate of 411 per 1000 live births. Of the mortalities, 19 were intrauterine foetal deaths, while 18 were early neonatal deaths. Causes of death include severe birth asphyxia (n=6), respiratory distress syndrome (n=4), prematurity (n=4), neonatal jaundice (n=1) and sepsis (n=3). CONCLUSION: Eclampsia is a major contributor of perinatal mortality and morbidity in Nigeria. Detection and appropriate management of preeclampsia is critical to reduce the risk of eclampsia.