Chlamydia trachomatis seropositivity among women with tubal factor infertility and fertile controls: a comparative study.

Introduction: Chlamydia trachomatis is the most reported bacterial sexually transmitted infection and if not properly treated may lead to tubal blockage. Tubal factor infertility is the most common form of infertility in Nigeria. This study was designed to determine the usefulness of chlamydia antibody testing in diagnosis of tubal factor infertility. Methods: this was a comparative cross-sectional study conducted in Olabisi Onabanjo University Teaching Hospital Sagamu. One hundred and forty-seven women with tubal blockage on hysterosalpingography and confirmed with laparoscopy, and pregnant control were recruited using convenience sampling method. Information obtained and chlamydia assay results were entered into a computer and analyzed using SPSS version 21. Chi-square was used to determine association between categorical variables. Logistic regression analysis was used to determine the risk factors associated with chlamydia infection. Results: ninety-four (63.9%) of the women with tubal factor infertility were positive for chlamydia IgG antibodies while 37(25.2%) women in the control group had positive results for IgG antibody. This was statistically significant (P=0.001). Analysis using multivariate logistic regression shows early age of coitarche, presence of multiple sexual partners and previous sexually transmitted infection were significantly associated with chlamydia infection (P=0.001). Conclusion: there was a strong association between chlamydia seropositivity and tubal blockage. Early age at coitarche, previous sexually transmitted infection and multiple sexual partners are significant risk factors for chlamydial infection. Chlamydia trachomatis antibody testing could be used as marker for tubal blockage when evaluating infertile patient.

Abdominal Pregnancy: A Case Report of a Viable Nondysmorphic Fetus.

Abdominal pregnancy is a rare form of ectopic gestation. It accounts for about 0.4% of all cases of ectopic pregnancy, and often associated with significant morbidity and mortality. Clinical presentation varies, and diagnosis is commonly challenging. Although ultrasound is helpful in early gestation, this could be unsatisfactory at advanced gestational age. Hence, a high index of suspicion is required in the diagnosis. We present a case of secondary abdominal pregnancy in a 27-year-old gravida 2 para 0 + 1 at an estimated gestational age of 33 weeks and 5 days. She had ultrasound scan done at 9 weeks and 2 days confirming the diagnosis, but declined surgery to seek spiritual intervention. She subsequently presented with generalized abdominal pain and fainting attack. She had exploratory laparotomy with delivery of a live female baby with no congenital anomaly. The placenta was attached to the left infundibulopelvic ligament and was delivered wholly without remnants. She was discharged on the 8th postoperative day, and the baby was discharged after 14 days from the neonatal intensive care unit. Accurate diagnosis and prompt intervention with evaluation of placenta attachment is vital to prevent adverse consequences.

Prevalence of Group B Streptococcus Colonisation and Antimicrobial Susceptibility Pattern among Pregnant Women Attending a Tertiary Health Facility in Ogun State, Southwest Nigeria.

Background: Genital colonisation by group B Streptococcus (GBS) in pregnant women in their third trimester has been shown to be a known risk factor for morbidity and mortality among newborns. Aim: The aim of the study was to determine the prevalence of GBS colonisation among pregnant women in Abeokuta, its associated sociodemographic factors, and the neonatal outcome among exposed babies. Design: Longitudinal cohort study. Setting: Department of Obstetrics and Gynaecology, Federal Medical Centre, Abeokuta, Ogun State. Methodology: One hundred sixty pregnant women presenting for routine antenatal care between 35 and 41 weeks were recruited consecutively. Swabs were taken from the vagina and then the rectum using a single swab. The samples were processed at the hospital's Medical Microbiology Laboratory using standard microbiological methods. Babies whose mothers were positive had their bodies swabbed and the samples sent for GBS isolates. They were also screened for early-onset neonatal sepsis with C-reactive protein. Results: Prevalence of GBS vaginal colonisation was 4.3%. There was no significant association between GBS colonisation status and age, level of education, or occupation; however, women of parity ≤1 had significantly higher prevalence of GBS colonisation than those of parity ≥2. There was no incidence of GBS infection observed in the babies. The GBS isolates were 100% sensitive to cefuroxime and 83.3% resistant to ampicillin. Conclusion: The prevalence of GBS is low in our environment. The organisms were highly sensitive to cefuroxime, erythromycin, and ceftriaxone. Routine screening of all pregnant women may be unnecessary. However, women at risk of GBS who present in labour without a recent GBS screening should be offered intrapartum prophylactic cefuroxime.

Contexte: La colonisation génitale par le streptocoque du groupe B (SGB) chez les femmes enceintes au cours de leur troisième trimestre s'est avérée être un facteur de risque connu de morbidité et de mortalité chez les nouveau-nés. Objectif: Déterminer la prévalence de la colonisation par le SGB chez les femmes enceintes à Abeokuta, ses facteurs sociodémographiques associés et l'issue néonatale chez les bébés exposés. Conception: Étude de cohorte longitudinale. Cadre: Département d'obstétrique et de gynécologie, Centre médical fédéral, Abeokuta, État d'Ogun. Méthodologie: Cent soixante femmes enceintes se présentant pour des soins prénatals de routine entre 35 et 41 semaines ont été recrutées consécutivement. Des écouvillons ont été prélevés du vagin puis du rectum à l'aide d'un seul écouvillon. Les échantillons ont été traités au laboratoire de microbiologie médicale de l'hôpital à l'aide de méthodes microbiologiques standard. Les bébés dont les mères étaient positives ont eu leur corps écouvillonné et les échantillons envoyés pour les isolats de SGB. Ils ont également été dépistés pour une septicémie néonatale d'apparition précoce avec la protéine C-réactive. Résultats: La prévalence de la colonisation vaginale par SGB était de 4,3%. Il n'y avait pas d'association significative entre le statut de colonisation par SGB et l'âge, le niveau d'éducation ou la profession; cependant, les femmes de parité ≤1 avaient une prévalence significativement plus élevée de colonisation par le SGB que celles de parité ≥2. Aucune incidence d'infection à SGB n'a été observée chez les bébés. Les isolats de SGB étaient 100% sensibles au céfuroxime et 83,3% résistants à l'ampicilline. Conclusion: La prévalence du SGB est faible dans notre environnement. Les organismes étaient très sensibles à la céfuroxime, à l'érythromycine et à la ceftriaxone. Le dépistage systématique de toutes les femmes enceintes peut être inutile. Cependant, les femmes à risque de SGB qui se présentent pendant le travail sans dépistage récent du SGB devraient se voir proposer du céfuroxime prophylactique intrapartum.

Labour pain perception: experiences of Nigerian mothers.

INTRODUCTION: Labour pain perception is influenced by a variety of factors; hence women experience and cope with labour pain differently. This study was designed to assess labour pain perception among parturient. METHODS: A cross-sectional study involving 132 pregnant women who had vaginal delivery at two tertiary hospitals in south west Nigeria. A structured questionnaire was administered to women within 24 hours of delivery to record details of labour and delivery. Labour pain perception was assessed using the Visual Analogue Score (VAS). Data analysis were done using IBM-SPSS Statistics for Windows version 21.0 (IBM Corp., Armonk, NY, USA). RESULTS: The mean age of the parturients was 30.6±4.8 years. The mean pain perception of the parturients as assessed by VAS was 7.0 with range of 1.2-10.0. Sixty-six (50%) parturients rated labour pain to be severe (VAS > 7.1). Majority of the respondents 114(86.4%) desired some form of pain relief. The Body Mass Index (BMI) of respondents and birth weight of their babies had statistically significant association with pain perception (p = 0.010; p = 0.038 respectively). Factors associated with increased odds of having severe pain perception include unbooked status, secondary level education, BMI < 30, and gestational age ≥ 37 weeks. CONCLUSION: Women in south west Nigeria perceived labour pain as severe and many desired pain relief during labour. Occupation, BMI, gestational age and baby's birth weight were significant mediating variables in women's experience of labour pain. Modern methods of labour analgesia should be offered to parturients who express desire for it. This will lead to improvements women's childbirth experience.