Birth preparedness and complication readiness among women of reproductive age group in Abakaliki, Southeast Nigeria.

BACKGROUND: Birth preparedness and complication readiness (BPCR) reduces delays in obstetric care, improves health-seeking behavior during an obstetric emergency, and improves knowledge on danger signs of pregnancy. AIMS: To assess the knowledge, perception, and practice of women on BPCR. SUBJECTS AND METHODS: This was a cross-sectional study conducted at Federal Teaching Hospital in Ebonyi state, Nigeria at the postnatal ward from June to December 2016. Women who delivered were recruited consecutively on discharge from the postnatal ward. Their knowledge, perception, and practice of BPCR in the last pregnancy were sought. Information obtained were analyzed using 2008 Epi-info™ software version 3.5.1 (Atlanta Georgia USA). RESULT: A total of 438 of 445 questionnaires were correctly filled and analyzed giving a response rate of 98.4%. Most of the women knew about birth preparedness 384 (87.7%) and complication readiness 348 (79.5%). A significant number of women did not access antenatal care within the first trimester 236 (53.9%), did not know that family planning is important in BPCR 216 (49.3%), and did not identify means of transport in the event of emergency 354 (80.8%). No provision of blood during antenatal care for the blood banking system was a common finding 258 (58.9%). In multivariate logistic regression analysis, choosing a health care provider was a common finding among literate mothers (OR = 2.8,95% CI = 1.02,7.72), woman within 25-29 years (OR = 1.09, 95%CI = 1.02,1.16), and multiparas (OR = 0.82, 95% CI = 0.67,0.99). CONCLUSION: There is increased knowledge and awareness of BPCR but the comprehensive components and practices of BPCR are still not optimal in our setting.

Ruptured ectopic in heterotopic pregnancy: Management and spontaneous vertex delivery of a live baby at term.

Spontaneous heterotopic pregnancy is an uncommon clinical condition in which there is a simultaneous development of intrauterine and extrauterine pregnancies. It is a life-threatening emergency when the ectopic ruptures. We present Mrs. EC, a 27-year-old G1P0 + 0 with a family history of multiple gestations who had a heterotopic pregnancy at a gestational age of 7 weeks. She presented with features of threatened miscarriage at early pregnancy with an ultrasound confirmation of intrauterine pregnancy. The diagnosis of ruptured ectopic pregnancy coexisting with intrauterine gestation was made with ultrasound findings as well as clinical features necessitating emergency exploratory laparotomy. Thereafter, pregnancy was carried to term, and she delivered a live male baby that weighed 3.0 kg. Heterotopic pregnancy should be sort for in all pregnancies during the early scan, especially in those with predisposing factors for multiple gestations and risk factors for ectopic gestation. A high index of suspicion is necessary for making a diagnosis in women with intrauterine pregnancy, with or without symptoms of ectopic gestation, and irrespective of the existence of risk factors for ectopic pregnancy.

The prevalence of osteoporosis among antenatal clinic attendees in a rural mission hospital in South-East Nigeria.

INTRODUCTION: Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital. MATERIAL AND METHODS: This was a cross-sectional study of booking Antenatal Clinic Attendees at Mile 4 Catholic Hospital, Abakaliki, between October 2014 and February 2015. The study participants were selected through systematic random sampling. The BMD of the right calcaneal bone of the participants was measured using the OsteoPro, a Quantitative ultrasound scan. RESULTS: A total of 327 eligible women participated in the study. The average age of the participants was 29 ± 4.5 years. The average parity was 2 ± 1.6 childbirths. The mean T-score was -1.19 ± 4.9. Osteoporosis and osteopenia were recorded in 119 women (36.4%) and 56 women (17.1%), respectively, whereas 152 (46.5%) were within normal range. History of regular exercise by the respondents is statistically significant on the reduction of osteopenia and osteoporosis (P ≤ 0.05). The history of ever use of calcium supplementation by the study participants in the index pregnancy did not have any significant effect on the reduction of osteoporosis. CONCLUSION: There is a high prevalence of osteoporosis among pregnant women in Southeast Nigeria. This may be due to the predominant poor adherence and low dose of calcium supplementation among pregnant women in this environment. Therefore, there is an urgent need for sensitization on this public health problem.

Fitz-Hugh-Curtis syndrome: An incidental diagnostic finding in an infertility workup.

A case of Fitz-Hugh-Curtis syndrome in a 32-year-old para 1+1 is reported. She presented with inability to conceive of 4 years duration. Her husband's semen analysis was within normal range. She had a hysterosalpingogram that showed bilateral tubal blockage and clinical assessment showed right sided abdominal tenderness, cervical excitation tenderness, and adnexa tenderness. The endocervical swab test for Chlamydia trachomatis was a positive. Laparoscopy and dye test showed adhesion bands on the under surface of the liver (the violin string appearance). She recovered well postoperatively. The couple received ofloxacin and metronidazole for 2 weeks. Literatures on Fitz-Hugh-Curtis syndrome presentation, pathogenesis, and management were reviewed.

Pattern and outcome of induced abortion in abakaliki, southeast of Nigeria.

BACKGROUND: Unsafe abortion accounts for a greater proportion of maternal deaths, yet it is often not adequately considered in discussions around reducing maternal mortality. AIM: The aim of this study is to determine the pattern of unsafe abortion and the extent to which unsafe abortion contributes to maternal morbidity and mortality in our setting as well as assess the impact of post-abortion care. SUBJECTS AND METHODS: A descriptive study of patients who were admitted for complications following induced abortions between January 1, 2001 and December 31, 2008 at the Federal Medical Center, Abakaliki South East of Nigeria with data obtained from case records. RESULTS: Out of the 1,562 gynecogical admissions, a total of 83 patients presented with the complications arising from induced abortion. The age group 20-24 years was mostly affected and adolescents constituted 32.5% (27/83). Nearly 15.7% (13/83) of these patients died while the remaining 84.3% (70/83) had various complications, which were mainly septicemia 59.0% (49/83), anemia 47.0% (39/83), peritonitis 41.0% (34/83), hemorrhages 34.9% (29/83) and uterine perforation 30.1% (25/83). During the study, there were 38 gynecological deaths and abortion related death accounted for 34.2% (13/38) of these gynecological deaths. 84.3% (70/83) of the patients had no documented evidence of counseling on family planning and 59.0% (49/83) were not aware of the different methods of contraception. CONCLUSION: Unsafe abortion remains one of the most neglected sexual and reproductive health problems in developing countries today despite its significant contribution to maternal mortality and morbidity. Solutions and remedies include prevention of unplanned and unwanted pregnancies by sex education and access to safe and sustainable family planning methods.

Pattern and determinants of antenatal booking at abakaliki southeast Nigeria.

BACKGROUND: Antenatal care is one of the pillars of SAFE Motherhood Initiative aimed at preventing adverse pregnancy outcome. Early antenatal booking is recommended for this benefit. AIM: The objective of this study was to determine the antenatal booking pattern of pregnant women and its determinants. SUBJECTS AND METHODS: A cross-sectional survey of pregnant women attending the antenatal booking clinic at Federal Medical Centre Abakaliki Ebonyi State between April 6, 2011 to August 5, 2011 was undertaken. Epi info 2008 version was used for analysis. RESULTS: The mean age of the respondents was 27.46 (5.81) years and the mean gestational age at booking was 24.33 (5.52) weeks. A total of 83.1% (286/344) of the pregnant women booked after the first trimester while the remaining 16.9% (56/344) booked early. Socio-biological variables and past obstetrics history did not contribute significantly to the gestational age at booking while sickness in index pregnancy, personal wishes, and financial constraint were statistically significant reasons given for seeking antenatal care. Majority of the pregnant women 37.2% (128/344) suggested that the second trimester was the ideal gestational age for booking while 18.3% (63/344) did not know the ideal gestational age for booking. Most pregnant women 81.1% (279/344) knew the benefits of early antenatal care even though they booked late 83.1% (286/344). CONCLUSION: Most pregnant women access antenatal care late at Abakaliki because of misconception and poverty. Health education and subsidization of cost of medical services will help in reversing the trend of late antenatal booking.