Perception of safety and consumption of alcoholic beverages during pregnancy.

This cross-sectional study of antenatal clinic attendees aimed to determine the proportions of pregnant women that consider different alcoholic beverages safe for their babies; and the proportions that took them in the index pregnancy. Five hundred and six women completed the questionnaires. Mean age was 30.07 ± 5.13 years. Mean parity was 1.44 ± 1.32. 478 (94.5%) were married. Three hundred and eighty-three (75.69%) had tertiary education. These proportions did not consider these alcoholic beverages harmful in pregnancy: palm wine 35.77%, stout 17.03%, beer 14.03%, alcoholic wine 13.83%, ogogoro (distilled fermented palm wine) 13.04% and gin/spirits 9.88%. The proportion that consumed different alcoholic beverages during pregnancy were: palm wine 17.20%, beer 5.33%, alcoholic wine 4.35%, stout 4.15%, ogogoro 1.58% and gin/spirits 0.59%. Pregnant women who considered various alcoholic beverages safe in pregnancy were significantly more likely to consume them during pregnancy. Healthcare providers should assess women's perception of the safety of different alcoholic beverages and offer counselling to discourage their consumption during pregnancy.Impact StatementWhat is already known on this subject? Babies exposed to alcohol in pregnancy are at increased risk of developing foetal alcohol spectrum disorders. No safe level of alcohol has been established for pregnancy. The level of alcohol consumption by pregnant women is still high in our practice environment.What do the results of this study add? The perception that a specific alcoholic beverage is safe and not harmful to the foetus, significantly increases the likelihood of the consumption of that alcoholic beverage by a pregnant woman.What are the implications of these findings for clinical practice and/or further research? Healthcare workers will need to enquire about specific alcoholic beverages especially those common within their practice environment. An enquiry should be made on the perception of safety and their consumption during pregnancy. Women who perceive certain alcoholic beverages are more likely to consume them during pregnancy and hence should receive specific counselling on the alcoholic content of these beverages and the risk to their babies to discourage the consumption of that alcoholic beverage during pregnancy.

Morbidities, concordance, and predictors of preterm premature rupture of membranes among pregnant women at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.

BACKGROUND: Preterm premature rupture of membranes (PPROM) is a challenging complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of morbidities associated with PPROM is fraught with controversy. However, women should be informed of these complications. OBJECTIVE: This article aimed to review the morbidities, concordance, and predictors of PPROM over a 10-year period. METHODS: This was a retrospective review of morbidities, concordance, and predictors of PPROM among pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria between January 1, 1999, and December 31, 2008. The morbidities, concordance, and predictors of PPROM were expressed by regression analysis output for PPROM. RESULTS: Primigravidae had the highest occurrence of PPROM. Increasing parity does not significantly influence the incidence of PPROM. The concordance and predictors of PPROM are maternal age (P < 0.000), gestational age at PROM (P < 0.000), latency period (P < 0.000), and birth weight (P < 0.001). CONCLUSION: PPROM is a major complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of these morbidities associated with PPROM poses a great challenge. However, women should be informed of these complications.

Use of fetal biometry in the assessment of gestational age in South East Nigeria: Femur length and biparietal diameter.

BACKGROUND: Fetal growth is influenced by many factors such as race, socioeconomic status, genetics, geographical location, maternal diseases, and number of babies. Consequent upon these, fetal growth charts may vary from one location to another even within the same geographical entity. OBJECTIVE: This study was designed to establish the fetal growth chart in antenatal women who had ultrasound scanning at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria. PATIENTS AND METHODS: This is a descriptive analysis of fetal biometric measurement of antenatal women. Four hundred and seventy pregnant women were studied. RESULTS: The nomogram for the femur length (FL) and biparietal diameter (BPD) for the different weeks of gestation (from 13th to the 40th week) were established. Correlation coefficients between gestational age and the various fetal parameters were also reported. Growth charts using both FL and BPD were plotted. A regression model for prediction of fetal age using the fetal biometry was also deduced for the studied population. CONCLUSION: The fetal parameters used in this study were consistently smaller than reported values from European studies up to the 34th week of gestation after which a catch-up growth till the 40 weeks was observed. Fetal parameters observed in this study were larger than most of the reported Asian values.

Falls among pregnant women in Enugu, Southeast Nigeria.

BACKGROUND: Falls during pregnancy are major public health issues and a common cause of maternal injury during pregnancy. There is paucity of data on prevalence and risk factors of falls during pregnancy in African population including Nigeria. OBJECTIVE: To determine the prevalence and risk factors associated with falls during pregnancy in Enugu, Nigeria. MATERIALS AND METHODS: This was a cross-sectional study of 332 consecutive pregnant women presenting in labor for delivery at the University of Nigeria Teaching Hospital Enugu, Nigeria between 1(st) May and 31(st) December, 2012. RESULTS: The mean age of the women was 32.2 ± 2.7 (range: 20-42) years. One hundred and eight women (32.5%) reported falling at least once during the index pregnancy. Women aged ≤ 30 years had twofold risk of falling during pregnancy than women aged > 30 years [41.1% (69/168) vs. 23.8% (39/164); odds ratio (OR): 2.23; 95% confidence interval (CI): 1.39-3.58; P < 0.001)]. Similarly, women ≥ 160 cm in height had significantly higher risk of falling during pregnancy than women < 160 cm in height [43.5% (70/161) vs. 22.2% (38/171); OR: 0.37; 95% CI: 0.23-0.60; P < 0.0001)]. Furthermore, primigravidae had almost threefold risk of falling during pregnancy than multigravidae [45.3% (63/139) vs. 23.3% (45/193); OR: 2.73; 95% CI: 1.70-4.37; P < 0.0001)]. CONCLUSION: Falls during pregnancy is common in Enugu, Nigeria. It is, therefore, recommended that women should be counseled during pregnancy on this public health problem and the above-identified risk factors emphasized in order to reduce the prevalence and morbidity.

Virilized external genitalia in young girls: clinical characteristics and management challenges in a low-resource setting.

OBJECTIVE: Virilization of the external genitalia in young girls (VEG) manifests mostly as ambiguity of the genitalia and elicits concerns and uncertainties especially in settings with poor awareness. This study evaluates the profile and challenges of VEG in southeast Nigeria. METHODS: We analyzed 23 children with VEG managed in 2 referral centers in southeast Nigeria from June 2005 to January 2013. RESULTS: They presented at median age of 13.3 months (interquartile range [IQR] 3 months-3 years). The cases included 3 (13%) of Prader type 1, 6 (26%) of type 2, 11 (48%) of type 3, and 3 (13%) of type 4. Five of the Prader type 3 and all 3 cases of Prader type 4 were reared as male prior to presentation. Following evaluation, all the cases were assigned female gender at a mean age of 2.7 years (range 2 months-10.5 years). Appropriate feminizing genitoplasty was undertaken in all the cases and after a follow-up period of 3 months to 5 years (mean 2 years), 2 patients developed vaginal stenosis, and 3 cases had surgical wound infection. Poor awareness, delayed presentation, inadequate facilities, and lack of trained manpower were the challenges in the management of the cases. CONCLUSION: VEG in our setting is associated with delayed management. Focused health education and public awareness programs, and improved healthcare funding may improve outcome and minimize the need for gender reassignment.

Genital lesions complicating female genital cutting in infancy: a hospital-based study in south-east Nigeria.

BACKGROUND: Despite the global outcry against female genital cutting (FGC), the practice continues in many African communities. The morbidity of this practice on the girl child deserves more attention. OBJECTIVE: To determine the genital lesions complicating childhood FGC and the underlying factors that sustain this practice among the Igbos in south-east Nigeria. METHODS: Prospective evaluation of girls with genital complications of FGC between January 2003 and June 2005 at the Federal Medical Centre, Owerri, south-east Nigeria. The girls' mothers were interviewed at presentation and subsequent visits to determine their perception and attitudes towards FGC. RESULTS: The average age at presentation was 3.5 years (range 1-5) and the genital cutting procedures were performed 8-90 days after birth. The procedure was undertaken by traditional practitioners in 14 (66.7%) girls and by nurses in 7 (33.3%) girls. Twelve girls (57.1%) had type I genital cutting and nine (42.9%) type II. Inclusion clitoral dermoid cyst and labial fusion were the complications in 13 (61.9%) and eight (38.1%), respectively. Treatment involved complete excision of the cysts and operative division of the labial fusion. Post-operative complications were wound infection (5) and labial adhesion (2). With duration of admission ranging from 3 to 5 days, the average cost of managing each child was $120. Of the girls' mothers, 15 (71.4%) had been educated to secondary level and 17 (80.1%) were aware of the campaign against FGC. Regrettably, all the mothers had genital cutting themselves during childhood and 13 (61.9%) stated that they would like to perpetuate the practice for socio-cultural reasons. Despite this, they all volunteered that FGC is enforced by the child's paternal relations. CONCLUSION: Childhood FGC contributes to appreciable morbidity among girls, a large proportion of whom are not managed in a hospital setting. The cost of managing these complications can be enormous, especially in low-resource settings. Girl child education to tertiary level and the involvement of traditional rulers and local decision-makers in the campaign against FGC might help to eradicate the practice.