Comparison of maternal and neonatal outcomes following caesarean section in second versus first stage of labour in a Tertiary Hospital in Nigeria.

AIMS AND OBJECTIVES: To compare maternal and neonatal outcomes between caesarean section performed in the first and second stages of labour at the maternity unit of the Lagos State University Teaching Hospital, Lagos, Nigeria. MATERIALS AND METHODS: Patients hospital records from 1st January 2008 to 31st December 2009 were examined. Data were extracted using a structured proforma. Information on demographics, intrapartum and intraoperative characteristics as well as selected maternal and neonatal outcomes were obtained. Comparative analysis was done using the student t test for continuous variables and the chi- square with Yates correction or the Fisher exact test for categorical variables. RESULTS: Of the 347 caesarean deliveries available for analysis, 245 (70.6%) were performed in the first stage while 102 (29.4%) were performed in the second stage of labour. Women who had caesarean deliveries performed in the second stage were more likely to be referred rather than institutional patients (p< 0.001), to have longer operative time, higher blood loss, more cases of intraoperative trauma, primary post partum haemorrhage, blood transfusion, re-look laparotomy, hysterectomy, post op pyrexia, wound infection and longer hospital stay (all with p value <0.05). Infants born to women who had caesarean section in the second stage of labour, had higher incidence of birth asphyxia, admission to neonatal intensive care unit, sepsis, seizure, need for ventilation and neonatal death (all with p value <0.05). CONCLUSION: Caesarean section in the second stage of labour is associated with significantly increased maternal and neonatal morbidity as well as increased neonatal mortality.

Sesame radiatum phytoestrogens stimulate spermatogenic activity and improve sperm quality in adult male Sprague Dawley rat testis / Fitoestrógenos sesame radiatum estimulan la actividad espermatogénica y mejoran la calidad del esperma en el testículo de ratas Sprague Dawley adulto de sexo masculino

Increasing concern has been expressed about the declining sperm count of humans and the potential environmental effects of both synthetic and natural estrogenic endocrine disruptors (EEDs) on human reproductive health in the last few decades. However, due to paucity of knowledge, we evaluate the chronic reproductive toxicity of sesame phytoestrogenic lignans on the male Sprague Dawley (SD) rats' testis. Thirty adult male SD rats weighing 150-200g were divided into three groups. Two treated groups received a daily dose of aqueous leaves extract of Sesamum radiatum at 14.0 mg/kg bw and 28.0mg /kg bw respectively via gastric gavage, while equal volume of normal saline was administered to the control group for six weeks. Seminal analysis and hormonal assay study were analyzed using SPSS software and P< 0.05 was considered statistically significant. The results showed significant (P< 0.05) body weight gains observed in all the animals with significant (P< 0.05) weight increase in their raw testicular weights compared to control. The relative testicular weight per 100g bw was significantly (P< 0.05) higher in control than treated. However, the weight gain was dose related with a reversal in their relative testicular weight. The cauda sperm count including the motility and morphology of the treated were significantly (P< 0.05) higher than control in a dose related manner. In addition, significant (P > 0.05) increases in testosterone and a significant decrease in FSH in the high dose (treated) compared to control. Sesame phytoestrogenic lignans improves spermatozoa quality in a dose related manner.

Una mayor preocupación se ha expresado en las últimas décadas por la disminución en la cantidad de espermatozoides de los seres humanos y los posibles efectos ambientales de disruptores endocrinos estrogénicos (DES) sintéticos y naturales sobre la salud reproductiva humana. Sin embargo, debido a la escasez de conocimientos, evaluamos la toxicidad crónica para la reproducción de fitoestrógenos lignanos del sésamo en el testículo de ratas Sprague Dawley (SD) macho. Treinta ratas macho adultas, de un peso de 150-200g se dividieron en tres grupos. Dos grupos de tratamiento recibieron una dosis diaria de extracto acuoso de las hojas Sesamum radiatum de 14,0 mg/kg de peso corporal y 28,0mg / kg de peso corporal, respectivamente, a través de una sonda gástrica, mientras que igual volumen de solución salina normal se administró al grupo control durante seis semanas. El análisis seminal y estudio de ensayo hormonal fueron analizados mediante el software SPSS y P <0,05 fue considerado estadísticamente significativo. Los resultados mostraron significativas (P <0,05) ganancias de peso corporal observados en todos los animales con un peso significativo (P <0.05), aumento de peso en su peso testicular bruto en comparación con el control. El relativo peso testicular por 100 g de peso corporal fue significativamente mayor (P <0,05) en control que en tratamiento. Sin embargo, el aumento de peso dosis se ha relacionado con un retroceso en su peso relativo testicular. La cantidad de espermatozoides, incluyendo la motilidad y morfología de los que recibieron tratamiento fue significativamente más alto que el control (P <0,05) en una dosis relacionados. Además, significativo aumento en los niveles de testosterona (P> 0,05) y una disminución significativa de FSH en la dosis alta (tratados), en comparación con el control. Fitoestrógenos lignanos del sésamo mejoran la calidad de los espermatozoides en una dosis adecuada.