ABSTRACT
OBJECTIVE: The study aimed to compare the effectiveness and side effects of 600 µg of oral Misoprostol with 10 international units (IU) intramuscular oxytocin in managing the third stage of labor. METHODS: This open-label, randomized controlled trial included 260 low-risk women in the second stage of labor with anticipated vaginal delivery. They were randomly assigned, to receive either 600 µg of misoprostol orally or 10 IU of oxytocin intramuscularly. The primary outcomes were blood loss during delivery and incidence of postpartum hemorrhage, evaluated using intention-to-treat analysis. Significance was set at P≤0.05. RESULTS: Baseline characteristics were similar in both groups (P>0.05). The misoprostol group had a significantly lower blood loss than that of the oxytocin group (306.57±176.44 mL vs. 349.37±135.50 mL; relative difference, -12.251 [95% confidence intervals [CI], -22.528 to -1.575]; P=0.012). Incidence of postpartum hemorrhage was similar in both the groups (relative risk [RR], 0.952 [95% CI, 0.543 to 0.671]; P=0.865). Additional oxytocic therapy requirement was also comparable (RR, 1.143 [95% CI, 0.671 to 1.947]; P=0.623). Nausea, shivering, and mean increase in temperature were significantly more common in the misoprostol group than in the oxytocin-parturient group. CONCLUSION: In this study, 600 µg oral misoprostol was superior to intramuscular 10 IU oxytocin in reducing blood loss at birth, and equally effective in preventing postpartum hemorrhage. However, misoprostol exhibited more side effects compared to that of oxytocin.
ABSTRACT
CONTEXT: Cases of hypertensive disorders in pregnancy (HDP) are an increase in developing economies. Identifying the pattern of HDP in a particular community and documenting their management outcome may allow for proper planning by all stakeholders. AIMS: The objective was to determine the pattern and management outcome of hypertensive disorders among pregnant women. SETTINGS AND DESIGN: This was a prospective cohort study involving 183 consecutive cases of HDP at Federal Medical Centre, Bida, Niger State, Nigeria, between September 2015 and August 2016. SUBJECTS AND METHODS: Pregnant women with hypertension were recruited and managed according to the departmental protocol. They were followed up till 6 weeks after delivery; fetal and maternal outcomes were documented. STATISTICAL ANALYSIS USED: Data were analyzed using the SPSS software version 23. The level of statistical significance was set at P < 0.05. RESULTS: A total of 1956 deliveries occurred during the study with 183 cases of HDP, giving an incidence of 9.4%. Pregnancy-induced hypertension alongside preeclampsia constitutes the majority of HDP during the study and had accounted for over 64%. Women who did not receive antenatal care in our center were at significantly greater risk of eclampsia (P = 0.000), abruption placentae (P = 0.003), maternal death (P = 0.002), very low-birth-weight (LBW) babies (P = 0.002), extremely LBW babies (P = 0.03), and perinatal death (P = 0.000). CONCLUSION: The need for prenatal screening that enables the early identification and prompt management of all expectant mothers with HDP is advised.
ABSTRACT
Aim: To determine the prevalence and risk factors associated with bacterial vaginosis (BV) among non-pregnant women of reproductive age group. Methods: A cross-sectional study among non-pregnant asymptomatic women aged 19 to 45 years, attending the gynaecological clinic at University of Ilorin Teaching Hospital, Ilorin, Nigeria. Participants were counselled and an informed consent was obtained. This was followed by vaginal swabs for microscopy, culture and sensitivity. Diagnosis of BV was by Nugent's criteria. Data analysis was by Statistical Package for Social Sciences (SPSS) version 20.0. Chi-square and Yates corrected chi-square were calculated, and p value <0.05 was significant. Results: Among the 212 participants, prevalence of BV was 40.1%; it was common among women aged 25-34 years (50; 58.8%), the married (77; 90.6%) and those with tertiary education (39; 45.9%). The risk factors for BV were common among women with laboratory evidence of the infection, however statistically significant risk factors were the use of intrauterine device (OR 1.61, 95%CI 0.543-4.759; p0.020) and previous voluntary termination of pregnancy (OR 1.04, 95%CI 0.600-1.808; p0.047). Conclusion: There was high prevalence of bacterial vaginosis in the study population. Universal screening and treatment of cases may assist in lowering the associated morbidity.
