Maternal antioxidant micronutrient deficiencies among pre-eclamptic women in Enugu, Nigeria: a cross-sectional analytical study.

OBJECTIVES: To determine the prevalence of antioxidant micronutrient deficiencies in pregnant women with pre-eclampsia and healthy pregnant women, and to assess the relationships between trace element deficiency in pregnancy and the severity of pre-eclampsia in Enugu, Nigeria. METHODS: We performed a secondary analysis of a cross-sectional analytical study of serum concentrations of copper, selenium, zinc, magnesium, and manganese in 81 pregnant women with pre-eclampsia and healthy pregnant women (controls) who were matched for age, gestational age, body mass index, and parity. This study was performed at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. Participants' sera were analyzed with an atomic absorption spectrophotometer. RESULTS: Trace element deficiencies were common and similar between women with pre-eclampsia and controls. However, women with pre-eclampsia were more likely to be deficient in manganese than controls (odds ratio = 2.28, 95% confidence interval: 1.90-2.75). Among the micronutrients studied, only manganese concentrations were significantly lower in women without severe symptoms of pre-eclampsia than in those with severe symptoms of pre-eclampsia. CONCLUSIONS: Micronutrient deficiency is common in pregnant women with pre-eclampsia and in healthy pregnant women in Enugu, Nigeria. Only manganese deficiency is higher in women with pre-eclampsia than in healthy pregnant women.

Urinary and anal incontinence in pregnancy in a Nigerian population: A prospective longitudinal study.

Objectives: There are several studies from sub-Saharan Africa on postpartum urinary incontinence and anal incontinence, but very rare in pregnancy. Such data will guide obstetric caregivers in providing appropriate counseling to the women as well as in minimizing the risk factors. This study aimed to determine the comparative effects of different trimesters of pregnancy on urinary incontinence and anal incontinence, and their possible risk factors. Methods: The study was longitudinal in design, and the study population consisted of 223 pregnant women receiving care at the two largest tertiary health institutions in Enugu, South-East Nigeria. The recruitment was in the first trimester and the women were followed up to term. Interviews were conducted at specific times in the three trimesters and data regarding urinary incontinence and anal incontinence symptoms were obtained using validated questionnaires. Results: The incidence of urinary incontinence increased across the trimesters: 22%, 30.5%, and 48% in the first trimester, second, and third trimesters, respectively, with a cumulative incidence rate of 50.2%. The incidence of anal incontinence also increased across the trimesters but not as high as urinary incontinence: 1.7%, 3.6%, and 5.8%, respectively, with a cumulative incidence rate of 6.7%. The risk factors for urinary incontinence were maternal age >35 years, multiparity, previous prolonged second-stage labor, and previous history of neonatal macrosomia, while that of anal incontinence were previous instrumental vaginal delivery and previous prolonged second stage of labor. Conclusion: Our study demonstrated an increase in the incidence of urinary incontinence and anal incontinence as pregnancy advances. Obstetricians are therefore encouraged to discuss these pelvic floor issues during antenatal care services and make more efforts toward reducing the modifying obstetric risk factors.

A randomised control trial on oral dydrogesterone versus micronized vaginal progesterone pessary for luteal phase support in in vitro fertilization cycles.

This study aimed to evaluate the pregnancy rates, adverse reactions, and medication costs of two luteal phase support regimens: oral dydrogesterone and micronized vaginal progesterone (MVP) pessary in in vitro fertilization cycles. A randomized open-label trial with participants randomly assigned to either 400 mg MVP twice daily or 10 mg dydrogesterone three times daily. The primary endpoints were pregnancy rates, and the secondary endpoints included tolerance, miscarriage rates, and medication cost. Per-protocol principle analysis was performed. The baseline characteristics of the 162 participants were similar. Dydrogesterone had statistically similar (p>0.05) positive pregnancy test rates fifteen days post embryo transfer (35.8% vs. 32.7%), clinical pregnancy rates at the gestational age of 6 weeks (32.1% vs. 28.8%), ongoing pregnancy rates (26.4% vs. 23.1%) and miscarriage rates at 14 weeks of gestation (9.2% vs. 9.4%) and safety profile to MVP. Dydrogesterone was better tolerated as vaginal itching was significantly more prevalent in the MVP arm (p=0.008). Dydrogesterone is significantly less expensive than MVP pessary. Oral dydrogesterone and MVP pessary had similar pregnancy rates and adverse effects. Dydrogesterone appears more user-friendly and less expensive in cases of luteal-phase support in in vitro fertilization cycles.

Postnatal care services use by mothers: A comparative study of defaulters versus attendees of postnatal clinics in Enugu.

INTRODUCTION: Despite much emphasis on the reproductive health of women, maternal mortality is still high, especially in postnatal period. OBJECTIVE: To assess the prevalence of postnatal care use and reasons for defaults among mothers attending the child immunization clinics in Enugu, Nigeria. METHODS: This was a cross-sectional comparative study of 400 consecutive nursing mothers who presented at the Institute of Child Health of UNTH and ESUTH, Enugu for Second dose of the Oral Polio Vaccine (OPV2) for their babies at 10 weeks postpartum. Data was collected using Interviewer-administered questionnaire and subsequently analyzed with version 22.0 IBM SPSS software, Chicago, Illinois. A p-value of less than 0.05 was considered as statistically significant. RESULT: The prevalence of the 6th week postnatal clinic attendance among the mothers was 59%. The majority of the women (60.6%) who had antenatal care by skilled birth attendants attended postnatal clinic. Unawareness and being healthy were the main reasons for not attending postnatal clinic. Following multivariate analysis, place of antenatal (OR = 2.870, 95% C.I = 1.590-5.180, p < 0.001) and mode of delivery (OR = 0.452, 95% C.I = 0.280-0.728, p = 0.001) were the only significant predictors of postnatal clinic attendance (p < 0.05). CONCLUSION: Postnatal clinic attendance by women in Enugu is still suboptimal. The main reason for non-attendance of the 6th week postnatal clinic was lack of awareness. There is need for healthcare professionals to create awareness about the importance of postnatal care and encourage mothers to attend.

Comparison of Pregnancy Outcomes of History-Indicated and Ultrasound-Indicated Cervical Cerclage: A Retrospective Cohort Study.

Background: Cervical cerclage is the procedure of choice for preventing preterm delivery due to cervical insufficiency. The indication for its application may be based on the woman's reproductive history, findings at ultrasound, or clinical findings on vaginal examination. Pregnancy outcomes from these indications are variable according to the available literature. Objective: To compare the effectiveness and reproductive outcomes (miscarriage, preterm birth rates, and birth weights) of McDonald's cervical cerclage after history-indicated and ultrasound-indicated cervical cerclage in pregnant women. Methods: The retrospective cohort study was conducted at Life International Hospital Awka, Nigeria and Life Specialist Hospital Nnewi, Nigeria. Pregnant women, who had a McDonald's cervical cerclage performed due to either history or ultrasound indication between January 1, 2011, and December 31, 2020, were included in the study. Women with multiple pregnancies and those with physical examination-indicated or emergency cerclages were excluded. The main outcome measures included the prevalence of cervical cerclage, miscarriage, and preterm delivery rates. Outcomes were compared between groups with the chi-square test, Fisher's exact test, or Student's t test. p value of < 0.5 was set as significant value. Results: Overall, during the study period, 5392 deliveries occurred in the study sites, of which 103 women had a history-indicated or ultrasound-indicated cervical cerclage. This resulted in a 1.91% prevalence rate for history-indicated and ultrasound-indicated cervical cerclage. Of these, 68 (66%) had history indicated, while 35 (34%) had ultrasound-indicated cerclage. There was no difference in the sociodemographic characteristics of both groups. Both groups had similar miscarriage rates: 1.18 in 1000 and 1.04 in 1000 deliveries, respectively (RR 1.160, 95% CI: 0.3824 to 3.5186, p = 0.793). There was more preterm delivery in history-indicated cerclage than ultrasound-indicated cervical cerclage (26.50% vs. 17.10%; p = 0.292), though the difference was not statistically significant. The ultrasound group had a higher average birthweight than the history group (2.67 ± 0.99 vs. 2.53 ± 0.74). However, this difference was not statistically significant. Conclusion: The effectiveness and reproductive outcomes (miscarriage, preterm birth rates, and birth weights) of pregnant women with cervical cerclage due to history-indicated and ultrasound-indicated cervical cerclage appear similar. When needed, cervical cerclage should be freely applied for cervical insufficiency, irrespective of the type of indication.

Sublingual misoprostol versus manual vacuum aspiration for treatment of incomplete abortion in Nigeria: a randomized control study.

Introduction: single-dose of sublingual misoprostol 400mcg with the participant followed-up at the gynecology clinic one week after with an ultrasound scan for the completeness of the uterine evacuation. Objective: to compare the effectiveness of single-dose sublingual misoprostol to manual vacuum aspiration in the treatment of incomplete spontaneous abortion in Enugu, Nigeria. Methods: the primary outcome measure was the incidence of complete uterine evacuation (complete abortion) after one week of treatment while the secondary outcome measures included incidence, types, and tolerability of treatment side effects as well as participants' satisfaction with the treatment received. Results: two hundred and three participants who met the study criteria and completed the study were randomised into the intervention group (n=102) received single-dose sublingual misoprostol 400mcg and the control group (n= 101) received manual vacuum aspiration. Incidence of complete abortion was 86.3% for the misoprostol group and 100.0% for the control group, RR = 0.86, (CI 95%: 0.80 - 0.93), p <0.001. The most common side effect was abdominal pain with an incidence of 27.5% versus 48.55 for the misoprostol and control groups respectively (p = 0.002). Most participants in each group (81.1% versus 77.6% for the misoprostol and control groups respectively) considered the side effects as tolerable. The mean visual analogue scale score for maternal satisfaction was higher in the misoprostol group (86.7 ± 14.11) than the control group (81.36 ± 11.10), p < 0.001. Conclusion: the treatment of incomplete spontaneous abortion with single-dose sublingual misoprostol 400mcg produced a high rate of complete abortion among women in Enugu, Nigeria. Despite having a lower complete abortion rate, maternal satisfaction was higher when compared with women that had manual vacuum aspiration of the uterus. Trial registration: trial registration number - PACTR202009857889210, date of registration - September 23rd, 2020. Retrospectively registered.

Magnitude and predictors of female domestic abuse in pregnancy in a patriarchal African society: a cross-sectional study of pregnant women in Enugu, South East Nigeria.

INTRODUCTION: domestic abuse against women is very common globally and has far-reaching consequences on the society. Therefore, it is essential to deeply study the seriousness of this public health issue among our pregnant women. The objectives were to determine the prevalence, pattern, and predictors of domestic abuse among pregnant women in Enugu, Nigeria. METHODS: a cross-sectional study of 400 consenting pregnant women at the antenatal clinics of the University of Nigeria Teaching Hospital Ituku-Ozalla, Nigeria. Each woman completed a modified abuse assessment screen structured questionnaire. Data analysis was descriptive and inferential with Chi-square and multivariate binary logistic regression using SPSS version 21. A p-value of <0.05 was considered statistically significant. RESULTS: a total of 172 out of 400 respondents (43.0%) had ever experienced domestic abuse in their pregnancies. One hundred and ten (37.2%; 110/296) of the multigravid women were abused in previous pregnancies while 137 (34.3%; 137/400) of all respondents were being abused in the current pregnancy. For all pregnancies, the most common type of abuse experienced by the respondents was verbal abuse (85.5%; 147/172), while the commonest perpetrators of abuse were the respondents´ spouses for both the index pregnancy (82.5%; 113/137) and previous pregnancies (84.5%; 93/110). The most common women perceived cause of abuse was financial constraints (68.6%; 118/172). Age less than 25 years (AOR=1.9, 95% CI=1.01-3.76, p=0.048), not having tertiary education (AOR=2.0, 95% CI=1.17 - 3.25, p=0.01), having at least a male child (AOR=3.3, 95% CI=1.71 - 6.40, p=<0.001), and maternal unemployed status (AOR=2.0, 95% CI=1.27 - 3.19, p=0.003) were the identified predictors among women abused in pregnancy. CONCLUSION: the prevalence of domestic abuse was high among pregnant women in the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria. The predominant women perceived cause of domestic abuse was financial constraints while age less than 25 years, not having tertiary education, having at least a male child, and maternal unemployed status were the predictors in abused women. Domestic abuse poses a great threat to women´s reproductive health, and so, its screening should be incorporated into antenatal care in our environment.

Population seroprevalence of SARS-CoV-2 antibodies in Anambra State, South-East, Nigeria.

OBJECTIVE: The objective of this study was to determine the proportion of the Anambra State population that had been infected by the SARS-CoV-2 virus and developed antibodies before the second wave. METHODS: The WHO-recommended health facility-based cross-sectional approach was adapted for this survey. Between 8th and 15th December 2020, 3142 participants across the 21 local government areas (LGAs) of the State, aged one year and over, attending randomly selected health facilities, were recruited. Demographic and symptom-related information were collected from the participants as well as whole peripheral blood, which was tested for SARS-CoV-2 IgG and IgM with rapid test kits. RESULTS: 425 participants tested positive for IgG only, 74 for IgM only, while 54 were positive for both IgG and IgM. Overall, 553 positives were recorded, giving a crude seroprevalence of 17.6% (95% CI = 16.26 - 18.98). It ranged widely from 31.9% (95% CI = 24.43 - 40.22) in Onitsha North LGA to 5.4% (95% CI = 2.19 - 10.78) in Awka north. Bayesian Adjustments yielded a state seroprevalence of 16.1%. CONCLUSION: One in six state residents had been infected by SARS-CoV-2 and developed antibodies before the second wave. All LGAs, age groups, sexes, and settlement types were affected by COVID-19. A large proportion of the population remained susceptible to SARS-CoV-2.

Effects of mode of delivery on sexual functions of parturients in Nigeria: a prospective cohort study.

INTRODUCTION AND HYPOTHESIS: Female sexual function disorders (FSFDs) have received less attention than male sexual function disorders, despite being more prevalent. Furthermore, most available literature is on the effect of vaginal delivery (VD) on sexual function, and studies on the effect of caesarean section (CS) are generally lacking. This study determined the comparative effect of CS and VD on FSFDs. METHODS: A prospective cohort of postnatal mothers at two hospitals in Nigeria was studied. In the intervention group women delivered via CS whereas women in the control group had a VD. Both groups were followed up to 3 months to determine the time to first coitus and other FSFs using a validated questionnaire. RESULTS: At 6 weeks postpartum, mean time (days) to first coitus was shorter in the CS than in the VD group (29.2 ± 4.3 vs 32.1 ± 4.9; t = 2.38; p = 0.02). However, no difference was observed at 3 months (37.3 ± 8.7 vs 40.9 ± 9.9; t = 1.83; p = 0.07). Also, there were no differences in mean Female Sexual Function Index (FSFI) total scores at 6 weeks and 3 months (p > 0.05). Mean FSFI domain scores at 6 weeks for orgasm, satisfaction, and pain were significantly higher in the CS group (p < 0.05). However, there were no differences in any of the domain scores at 3 months (p > 0.05). CONCLUSION: Mode of delivery does not affect time to resumption of coitus after childbirth, and FSF disorders by 3 months postpartum. Caesarean section should therefore not be recommended to women merely for early resumption of coital activity or preservation/maintenance of sexual function after childbirth.

Serum antioxidant micronutrient levels in pre-eclamptic pregnant women in Enugu, south-East Nigeria: a comparative cross-sectional analytical study.

BACKGROUND: Pre-eclampsia is a common obstetric complication of pregnancy in Nigeria, and oxidative stress has been implicated in its aetiopathogenesis. Despite this fact, there is a paucity of information regarding the serum antioxidant micronutrient status of pre-eclamptic Nigerian women. The objective of the was to determine the mean serum levels of some antioxidant trace elements (copper, zinc, selenium, magnesium, manganese) in pre-eclamptic pregnant women and compare with that of healthy pregnant women in Enugu, South-Eastern, Nigeria. METHODS: A cross-sectional analytical study was carried out at the Obstetrics and Gynaecology department of the University of Nigeria, Teaching Hospital Ituku-Ozalla, Enugu. Using atomic absorption spectrophotometry, the sera of 81 pregnant pre-eclamptic and 81 matched healthy pregnant controls were analyzed for the antioxidant micronutrients. Both descriptive and inferential analysis was performed using the statistical package for social sciences (SPSS) version 21.0 and a P value of < 0.05 was considered to be statistically significant. RESULTS: The mean serum levels of copper, selenium, and magnesium were found to be significantly lower in the pre-eclamptic pregnant group when compared to the healthy pregnant controls (p < 0.05). The mean serum levels of zinc and manganese did not differ between the two groups (p > 0.05). All the mean serum levels of micro-nutrients studied did not vary by category of pre-eclampsia (with or without severity findings) except manganese which was significantly lower in pre-eclamptic women without severity findings when compared to those with severity findings (p = 0.043). CONCLUSIONS: The serum levels of copper, selenium, and magnesium were significantly lower among pre-eclamptics when compared to their normal healthy controls. Low levels of selenium, copper, and magnesium may have contributed to the incidence of pre-eclampsia in our environment.

Prevalence and Predictors of Alcohol Consumption during Pregnancy in South-Eastern Nigeria.

INTRODUCTION: Alcohol consumption during pregnancy is a major public health problem because of the enormous deleterious effects on a developing fetus. Sub-Saharan Africa (SSA) is among the highest per capita rates of alcohol consumption in the world, thus suggesting a high burden of Fetal Alcohol Syndrome Disorder (FASD) in the sub-region. Despite this, there is limited data on alcohol exposed pregnancies for most SSA countries including Nigeria. AIM: To determine the prevalence and predictors of alcohol consumption during pregnancy in Enugu, South-Eastern Nigeria. MATERIALS AND METHODS: It was a cross-sectional study of 380 consecutive consenting parturients accessing antenatal care at the University of Nigeria Teaching Hospital, Enugu, Nigeria. The information sought for, included the women's socio-demographic characteristics, alcohol use in pregnancy, awareness of the harmful effects of alcohol on the babies including FASD, sources of initial information on awareness, type and quantity of alcohol ingested, reasons for taking alcohol and willingness to stop alcohol ingestion in pregnancy after counseling on the risk of alcohol use in pregnancy. Statistical analysis was both descriptive and inferential at 95% confidence level. A p-value of less than 0.05 was considered statistically significant. RESULTS: The prevalence of alcohol consumption in pregnancy was 22.6%. The most common brand of alcoholic beverage consumed was stout beer (62.8%, 54/86). A total of 135 (35.5%) respondents were aware that alcohol is harmful to the fetus. Maternal age 30 years or less, nulliparity, less than tertiary education, pre-pregnancy alcohol consumption and lack of awareness of the harmful effect of alcohol on the fetus, were associated with alcohol consumption during pregnancy (p< 0.05). CONCLUSION: The prevalence of alcohol consumption during pregnancy among women in Enugu, South-Eastern Nigeria is high and lack of awareness of harmful effect of alcohol on fetus was a major predictor. There is need for a concerted public health campaign to improve the awareness of harmful effects of alcohol on the fetus.

Effect of Low CD4 Cell Count on Cervical Squamous Intraepithelial Lesions among HIV-Positive Women in Enugu, Southeastern Nigeria.

INTRODUCTION: HIV-positive women are more likely to develop cervical neoplasm. HIV-positive women with low CD4 T-lymphocyte cell count may be more predisposed to cervical squamous intraepithelial lesions (SILs). This study aimed to determine the association between low cellular immunity of HIV positive women, and the prevalence and grade of cervical squamous intraepithelial lesions. MATERIALS AND METHODS: Pap smear was carried out on two cohorts of Highly Active Anti Retroviral Therapy (HAART) experienced HIV-positive women (178 per group) at the AIDS Prevention Initiative in Nigeria-Centre for Disease Control Adult Anti-Retroviral clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria from June to November, 2012. The study group had CD4 cell count of < 200 cells/µl while the control group had CD4 cell count of ≥200 cells/µl. RESULTS: The mean CD4 cell counts of participants in the study (low CD4) group was 127.9 ± 47.49 cells/ml while that of the control (high CD4) group was 489.2 ± 186.36 cells/ml (p < 0.001). The prevalence of SIL was 10.2% (18/176) for the low CD4 group, and 5.7% (10/176) for the high CD4 group [OR = 1.9 (95% CI: 0.85, 4.22)]. The commonest category of SILs identified was Low-grade Squamous Intraepithelial Lesion (LSIL), thus 11 (6.3%) in the study versus 7 (4.0%) in the control group (p = 0.703). CONCLUSION: Prevalence of cervical SILs among HIV positive women on HAART in Enugu, Nigeria is low and has no significant relationship with their CD4 cell count.

Prevalence and predictors of urinary/anal incontinence after vaginal delivery: prospective study of Nigerian women.

INTRODUCTION AND HYPOTHESIS: Urinary and anal incontinence are major public health problems impacting on the quality of life of affected women, with resultant loss of self-esteem. Despite the anticipated magnitude of this public health problem in sub-Saharan Africa, there is paucity of data on the prevalence of urinary and/or anal incontinence after childbirth in the region. This study determined the prevalence and predictors of urinary and anal incontinence after vaginal delivery among women in Enugu, southeastern Nigeria. METHODS: This was a longitudinal study of 230 consecutive parturients at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Eligible women were followed up immediately, 6 weeks, and 3 months postpartum to assess the development of urinary and/or anal incontinence using validated questionnaires. RESULTS: Overall, 28 women had urinary incontinence, giving a cumulative prevalence rate of 12.2 %. The cumulative prevalence rate was 13.5 % for anal incontinence and 3 % for combined urinary and anal incontinence. Age, social class, parity, prolonged second stage of labor, and neonatal birth weight were significantly associated with postpartum urinary incontinence (P < 0.05). On the other hand, age, parity, prolonged second stage of labor, episiotomy, and instrumental vaginal delivery were significantly associated with postpartum anal incontinence (P < 0.05). CONCLUSION: Urinary and anal incontinence are common after vaginal delivery in Enugu, Nigeria. Modification of obstetric care and discouraging preventable predisposing factors for incontinence, such as prolonged second stage of labor and vaginal delivery of macrosomic babies, are measures that may reduce the prevalence of postpartum incontinence in our population.

A comparison of capillary and venous blood haematocrits of pregnant women in Nigeria: the impact on diagnosis and prevalence of anaemia in pregnancy.

BACKGROUND: Volume of red cells in capillary blood varies from that of venous blood. The magnitude of this variation as well as its impact on the diagnosis of anaemia in pregnancy needs to be studied. This study demonstrates the disparity between capillary and venous PCV in pregnancy. OBJECTIVES: To determine whether capillary blood PCV (cPCV) differed from venous blood PCV (vPCV) of normal pregnant women in Enugu, Nigeria, and its effect on diagnosis and prevalence of anaemia. METHODS: PCV was estimated using pairs of venous and capillary blood samples from 200 consecutive pregnant women at the Antenatal Clinic of University of Nigeria Teaching Hospital, Enugu, Nigeria. RESULTS: Participants' cPCV (median = 34.0%, IQR = 31.0-35.8) was significantly lower than their vPCV (median = 34.0%, IQR = 32.0-37.0) (Z = -6.85, P < 0.001). However, women's cPCV had strong positive correlation with their vPCV (r = 0.883, P < 0.001). The prevalence of anaemia among participants using capillary and venous blood was 33.5% (67/200) and 28.0% (56/200), respectively (O.R = 1.3 (CI 95%: 0.85, 1.98), P = 0.233). CONCLUSIONS: Capillary blood PCV was lower than vPCV among pregnant women in Enugu, Nigeria. Nevertheless, the prevalence of anaemia derived from cPCV did not differ significantly from that of vPCV.

Membrane stripping to prevent post-term pregnancy in Enugu, Nigeria: a randomized controlled trial.

OBJECTIVES: This study aimed at evaluating the effectiveness and safety of membrane stripping at 40-41 weeks of gestation as a means of preventing post-term pregnancy and the need for formal induction of labor in Enugu, Nigeria. METHODOLOGY: A randomized controlled trial of 134 post-date pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria, from February to November 2012. The intervention group received membrane stripping while the control group did not receive membrane stripping. RESULTS: The incidence of post-term pregnancy in the membrane stripping group was 16.1% (10/62) versus 39.3% (24/61) in the control group (RR 0.41; 95% CI 0.22-0.78; P = 0.004; NNT = 4). Membrane stripping reduced the duration of pregnancy by 3 days (P < 0.001). The procedure also significantly reduced the need for 'formal' labor induction [7/62 (11.3%) vs. 23/61 (37.7%); RR 0.30; 95 CI 0.14-0.65; P = 0.002]. However, maternal and neonatal complications were similar between the two groups. CONCLUSION: Membrane stripping reduces the incidence of post-term pregnancy and need for formal induction of labor in post-date pregnant women, without increased maternal or neonatal complications.

Asymptomatic malaria parasitemia does not induce additional oxidative stress in pregnant women of South East Nigeria.

OBJECTIVE: To determine the relationship between asymptomatic malaria parasitemia and some oxidative stress parameters in pregnant Nigerian women. METHODS: This is a cross-sectional study involving 130 normal pregnant women at various trimesters, who were attending antenatal clinic at the University of Nigeria Teaching Hospital (UNTH) and Kenechukwu Specialist Hospital in Enugu. A comparable group (control), made of 30 non pregnant women was also recruited. After a 24 hour dietary recall, serum levels of vitamin A, C and malondialdehyde (MDA) were determined by colorimetric method, while vitamin E was determined by absorptiometric method. RESULTS: There were no statistically significant differences in age, parity, estimated calorie, vitamins A, C and E intake between the pregnant and non pregnant groups (P> 0.05). The serum level of the vitamins (umol/L) and MDA (umol/L) in control, 1st, 2nd and 3rd trimesters respectively were: (1)Vitamin A: 1.6±0.36 vs 0.6±0.26 vs 0.62± 0.33 vs 0.46± 0.21 (P < 0.0001); (2) Vitamin C: 75.65±14.15 vs 62.97±24.4 vs 37.85±15.19 vs 28.94±8.52 (P<0.0001); (3) Vitamin E: 3.01± 1.32 vs 3.45±2.01 vs 9.36±2.75 vs 9.82±2.97 (P<0.0001); (4) MDA: 1.42± 0.02 vs 1.61±0.02 vs 1.79±0.02 vs 2.03±0.05 (P<0.0001). However, there were no significant changes in the serum level of the vitamins and MDA between the positive and the negative parasitemia subjects (P>0.05). CONCLUSIONS: Asymptomatic malaria parasitemia does not induce additional oxidative stress on pregnant women in Nigeria. The enormity of acute and complicated attack should be further investigated.