Pattern of cervical dilatation among parturients in Ilorin, Nigeria.

OBJECTIVE: To evaluate the pattern of cervical dilatation in live singleton pregnancies with spontaneous onset of labor and to compare any differences among nulliparas (P ara 0) and multiparas (Para >or=1). MATERIAL AND METHODS: Descriptive statistics are presented for 238 consecutive labor patients with spontaneous onset, >or=37 weeks gestation, live singleton pregnancy and who had spontaneous vertex delivery at the University of Ilorin Teaching Hospital, Nigeria, from May 2004 to June 2004. Pre-labor rupture of membrane and referred cases were excluded. RESULTS: The mean cervical dilatation on presentation and duration of labor before presentation in labor ward among nulliparas were 5.40 cm and 6.66 hours; and among multiparas, 6.45 cm and 5.15 hours, respectively, the overall mean being 6.12 cm and 5.63 hours, respectively. The average time spent to achieve full cervical dilatation from time of arrival in labor ward was longer in nulliparas (4.80 hours) than in multiparas (3.60 hours) (t test not significant; P> 0.05). Overall mean total length of first stage of labor was 9.36 hours, while the total length of first stage of labor was 11.03 hours and 8.53 hours for nulliparas and multiparas, respectively (difference is significant; t test P< 0.05). Significant negative correlation existed between parity and total length of first stage of labor. Mean cervical dilatation rate in labor ward (active phase) was higher in multiparas (1.83 cm/h) than in nulliparas (1.76 cm/h), but the difference was not significant (t test P> 0.05). No significant correlation existed between rate of cervical dilatation and maternal age, gestational age and fetal size. CONCLUSION: It is evident from this study that higher the parity the shorter the length of first stage of labor; however, significant difference existed only in the first half of first stage of labor between nulliparas and multiparas. Mean rate of cervical dilatation was greater than the WHO-specified and Philpott's lower limit of 1 cm/h in active phase of labor.

Acceptability of measures aimed at preventing mother-to-child transmission of HIV among pregnant women.

OBJECTIVE: To assess the acceptability of measures aimed at preventing mother-to-child transmission of HIV among counseled and yet-to-be-counseled antenatal women in a federal medical center in Nigeria. METHODS: A valid and reliable questionnaire was interviewer administered to newly booking antenatal women who were yet to be counseled about HIV/AIDS and women on an antenatal follow-up visit who had already been counseled about HIV/AIDS. RESULTS: A total of 108 newly booked women and 116 women on follow-up visit responded to the questionnaire. The proportion of the counseled women who accepted HIV screening (98%) was significantly higher than the proportion of the yet-to-be-counseled women who would want to be screened (88%). Also, the proportions of the counseled women who accepted HIV screening so as to benefit from interventions like prevention of mother-to-child transmission, antiretroviral therapy and prevention of transmission to partner were significantly higher than the proportions among the yet-to-be-counseled women. The majority of the women in the study would accept antiretroviral drugs and avoidance of breastfeeding to prevent mother-to-child transmission, while only 29 (14%) respondents would accept cesarean section to prevent mother-to-child transmission. There was no statistically significant difference in the proportion of the counseled women (15%) who would accept cesarean section to prevent mother to child transmission when compared to the proportion among the yet-to-be-counseled women (11%). CONCLUSION: Antenatal HIV screening is acceptable to most pregnant women attending our hospital, and while many would accept antiretroviral drugs and avoidance of breastfeeding to prevent mother-to-child transmission of HIV, there is low acceptability of elective cesarean section.

Awareness and knowledge of mother-to-child transmission of HIV among pregnant women.

OBJECTIVE: To evaluate the awareness and knowledge of mother-to-child transmission of HIV and its prevention among pregnant women attending the antenatal clinic of a federal medical center in Nigeria. METHODOLOGY: Valid and reliable questionnaires were interviewer administered to pregnant women at antenatal booking during the study period, prior to being counseled on HIV/AIDS. RESULTS: All respondents were aware of HIV/AIDS. The main sources of information included posters/billboards (37%), radio (36%), television (28%) and health workers (34%). The majority (90%) of the respondents were aware that HIV/AIDS can coexist with pregnancy, but only 68% were aware of mother-to-child transmission. Transplacental route, vaginal delivery and breastfeeding were identified as routes of transmission from mother to child by 65%, 38% and 52% of respondents, respectively. Caesarean section was believed to be a route of transmission by 43% of respondents, but only 3% identified caesarean section as a method of prevention of mother-to-child transmission. CONCLUSION: Though the level of awareness of HIV/AIDS among women attending our antenatal clinic is high, the level of knowledge about mother-to-child transmission is inadequate. There is a need for adequate counseling and education about HIV/AIDS and mother-to-child transmission in antenatal clinics and also through public campaign media.