Domestic violence against women with infertility attending gynaecological clinics in Northern Nigeria: A multi-centre study.

Background: Due to the high premium placed on childbearing, infertility puts a lot of stress on the family which may result in aggressive and irrational behaviour if not properly managed. Domestic violence (DV) against infertile women is a public health issue but under-reported especially in northern Nigeria. Objectives: This study sought to identify the prevalence, pattern, and response to DV. Materials and Methods: This was a descriptive cross-sectional study carried out at three tertiary health facilities; one in each of the geopolitical zones in northern Nigeria. Using a pretested interviewer-administered questionnaire; the prevalence, pattern, and response to DV were determined among 422 respondents who were attending the gynaecological clinics of the three health facilities. The data obtained was entered into SPSS version 22.0 and analysed. Results: The prevalence of DV among women with infertility in the previous year was 39.8% (167/422). Among the survivors, 92.8% (155/167), 35.3% (59/167), and 10.7% (18/167) had experienced psychological aggression, physical assault, and sexual violence, respectively. A significant number of respondents who reported DV were Christians (P = 0.01). Of them, 77 (46.1%) never discussed the issue with anyone, 72 (43.1%) informed their family, and 30 (18.0%) sought help from the husband's family. Conclusion: The prevalence of DV among women with infertility is high, psychological aggression is the most typical form of DV experienced while about half have never reported the incidence to anyone. Screening infertile women for DV during their visit to the gynecological clinics would be beneficial; those found to have experienced DV should be counselled and supported appropriately.

An assessment of serum prolactin levels among infertile women with galactorrhea attending a gynecological clinic North-West Nigeria.

BACKGROUND: Galactorrhea is a common manifestation of hyperprolactinemia but may not always be present in women with hyperprolactinemia. This study was, therefore, undertaken to assess the serum prolactin levels of infertile women presenting with galactorrhea and to determine the prevalence of hyperprolactinemia among them. MATERIALS AND METHODS: This was a retrospective study of serum prolactin levels of 63 female partners of infertile couples attending the gynecological clinic of Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria, who were found to have galactorrhea from January 1, 2012, to December 31, 2013. Ethical clearance was obtained. Solid phase enzyme-linked immunosorbent assay was used to measure serum prolactin. Sociodemographic characteristics were determined. The data obtained were analyzed using SPSS version 17.0 statistical software. Absolute numbers and simple percentages were used to describe categorical variables. Similarly, quantitative variables were described using measures of central tendency (mean, median) and measures of dispersion (range, standard deviation) as appropriate. RESULTS: The average age of the women was 27.9 ± 5.6 years. In half of the cases (50%), galactorrhea was associated with menstrual disturbances, mainly amenorrhea (23.3%). Although most (63.3%) of the clients had normal serum prolactin level despite being galactorrheic, averagely there was a marked elevation in serum prolactin of as high as 40.3 ± 52.3 ng/mL. CONCLUSION: We conclude, therefore, that the prevalence of hyperprolactinemia in this study was low when compared with other studies and that galactorrhea does not always indicate raised serum prolactin levels.

Prevalence, reasons and predictors for home births among pregnant women attending antenatal care in Birnin Kudu, North-west Nigeria.

OBJECTIVE: To determine the prevalence, reasons and predictors for home birth in a rural community. METHOD: Descriptive cross sectional study which utilised a pretested interviewer administered semi-structured questionnaire to assess the place of delivery in their last childbirth among 410 pregnant women attending antenatal care in Birnin Kudu, Nigeria. Logistic regression analysis was used to assess the relative effect of determinants. PREVALENCE: Of the 410 women, 248 (60.5%) delivered at home in their last childbirth. Self reported reasons: Home birth was opted for because of: lack of transportation 113 (45.6%), onset of labour was at night 104 (41.9 %), preferred birthing position 72 (29.0%), tradition 60 (24.2%), fear of surgery 42 (16.9%) and poor attitude of health workers 32 (12.9%). PREDICTORS: The odds of giving birth at home was 3.88 times higher in women with informal education (adjusted OR 3.88; 95% CI: 2.51, 6.00) and the odds of giving birth at home was 0.27 for women with less than 5 deliveries compared with women with 5 or more deliveries (adjusted OR 0.27; 95% CI: 0.15, 0.49) after controlling for confounders. CONCLUSION: The prevalence of home birth is high in Birnin Kudu and according to our respondents the main reasons for this practice are onset of labour late at night with lack of transportation and a limited choice of birthing positions. Provision of training and retraining of skilled birth attendants to assist women birthing in squatting positions would encourage women to deliver in the hospitals.

A prospective surveillance of ruptured uterus in a rural tertiary health facility in northwest Nigeria.

OBJECTIVE: To determine the frequency, cause and management outcome of ruptured uterus at a rural tertiary hospital. METHODS: Cross sectional study which utilized a prospective surveillance of all cases of ruptured uterus that presented to the hospital from 1 April 2010 to 31 March 2013. RESULTS: Frequency: Over the study period there were 3001 deliveries and 44 cases of ruptured uterus; however, three died before surgery and 41 cases had exploratory laparatomy giving a prevalence of 14.7/1000 deliveries or 1 in 68 deliveries. Their ages ranged from 18 to 45 with a mean of 28.3 ± 6.6 years and parity varied between 1 and 13 with majority (62.7%) being grand multiparous. Twenty-five (61.0%) lived over 50 km away from the hospital. Causes: Prolonged/obstructed labour accounted for 33 (80.5%) cases, 23 (56.1%) had previous caesarean sections, while injudicious use of oxytocin was observed in 17 (41.5%). Management outcome: All the women who had surgery survived but 16 (39.0%) had anaemia, 10 (24.4%) had wound infection, three (7.3%) developed burst abdomen and 11 (26.8%) had prolonged hospital stay. There were 40 (97.5%) stillbirths of which 25 (61.0%) were fresh. CONCLUSION: The prevalence of ruptured uterus is high especially among women with prolonged/obstructed labour and previous caesarean section with associated high perinatal mortality.