Accuracy of ultrasound estimation of fetal weight at term: A comparison of shepard and hadlock methods.

Background: Ultrasound measurement provides a noninvasive means of obtaining information about fetal weight and may help in necessary preparations at and after delivery. Although some ultrasound methods include only one or two fetal indices, others, to improve accuracy, incorporate either three or all the four fetal indices. The aim of this report is to assess the accuracy of two different methods for fetal weight estimation. Materials and Methods: This was a prospective study of 170 consecutive pregnant women at term. Ultrasound was used to estimate fetal weight by the Shepard and Hadlock methods, and the actual birth weight (ABW) was determined at birth. The ultrasound-estimated fetal weights (EFWs) and ABW were analyzed. Results: The women were aged 21-42 years (mean 31.3 ± 7 years). The EFW using the Shepard method was 1.9 kg-5.0 kg (mean 3.6 ± 0.5 kg) and 1.8 kg-4.4 kg (mean 3.3 ± 0.4 kg) for Hadlock method, and ABW was 2.0 kg-4.5 kg (mean 3.4 ± 0.5 kg). The mean EFW using the Shepard method was significantly higher than that of ABW (P < 0.001). The Shepard method significantly overestimated macrosomia compared to that by the ABW. There was no significant difference in microsomia rate between the two methods and ABW. Conclusion: The Hadlock method was more accurate at estimating fetal weight compared to the Shepard method and is recommended for the ultrasound estimation of fetal weight in our setting and similar settings.

Résumé Contexte: La mesure par ultrasons fournit un moyen non invasif d'obtenir des informations sur le poids du fœtus et peut aider à préparations nécessaires à et après l'accouchement. Bien que certaines méthodes d'échographie n'incluent qu'un ou deux indices fœtaux, d'autres, pour améliorer précision, incorporent trois ou tous les quatre indices fœtaux. Le but de ce rapport est d'évaluer l'exactitude de deux méthodes différentes pour estimation du poids fœtal. Matériels et méthodes: Il s'agissait d'une étude prospective de 170 femmes enceintes consécutives à terme. Ultrason a été utilisé pour estimer le poids fœtal par les méthodes Shepard et Hadlock, et le poids réel à la naissance (ABW) a été déterminé à la naissance. le les poids fœtaux estimés par échographie (EFW) et ABW ont été analysés. Résultats: Les femmes étaient âgées de 21 à 42 ans (moyenne 31,3 ± 7 ans). le EFW utilisant la méthode Shepard était de 1,9 kg à 5,0 kg (moyenne 3,6 ± 0,5 kg) et de 1,8 kg à 4,4 kg (moyenne 3,3 ± 0,4 kg) pour la méthode Hadlock, et ABW était de 2,0 kg à 4,5 kg (moyenne 3,4 ± 0,5 kg). L'EFW moyen en utilisant la méthode Shepard était significativement plus élevé que celui d'ABW (P < 0,001). le La méthode Shepard surestimait significativement la macrosomie par rapport à celle de l'ABW. Il n'y avait pas de différence significative dans la microsomie taux entre les deux méthodes et ABW. Conclusion: La méthode Hadlock était plus précise pour estimer le poids fœtal par rapport à la La méthode de Shepard est recommandée pour l'estimation échographique du poids fœtal dans notre contexte et dans des contextes similaires. Mots-clés: Précision, poids de naissance, poids fœtal, Hadlock, Shepard, échographie.

Short versus Long-Term Antibiotic Prophylaxis in Cesarean Section: A Randomized Clinical Trial.

OBJECTIVE: The objective of the present study was to compare the efficacy of intravenous (IV) 48 h course of cefuroxime/metronidazole with long-term course using 48 h cefuroxime/metronidazole plus 5 days oral regimen of cefuroxime and metronidazole for the prevention of post cesarean section wound infection. METHODS: Two hundred and forty-eight women were randomized into two equal groups. Women in each arm of the study received IV cefuroxime 750 mg twelve hourly and IV metronidazole 400 mg eight hourly for 48 h. Those in the long-term arm received additional tablets of cefuroxime 500 mg twelve hourly and Tabs 400 mg of metronidazole eight hourly for 5 days. After the surgery, surgical site infections were evaluated. Length of hospital stay and the cost of antibiotics were also assessed. RESULTS: The wound infection rate was not statistically significantly different between the 2 groups (1.3% vs. 3.3%, P = 0.136). The incidence of endometritis was 2.1%, with no statistically significant difference seen between the two groups (0.4% vs. 1.6%, P = 0.213). Escherichia coli was the most common isolate seen in 36.4% of infected wounds. The short arm group stayed for significantly shorter days in the hospital (2.9 ± 1.0 vs. 3.8 ± 1.1 days,P < 0.001), and the cost of antibiotics was also significantly less in the short arm group (P < 0.001). Organisms associated with nosocomial infections were seen only in the long arm that stayed in the hospital for longer days. CONCLUSIONS: Short-term prophylactic antibiotics are as effective as long-term prophylaxis and have other benefits such as shorter duration of hospital stay, reduced cost of antibiotics, and reduction of nosocomial infections.

Knowledge and perception of human papilloma virus vaccine among the antenatal women in a Nigerian tertiary hospital.

BACKGROUND: Cervical cancer is a major health problem globally, especially in sub-Saharan Africa, Nigeria inclusive. One of the preventive measures is the vaccination of teenagers against oncogenic human papilloma virus. The aim of this study was to find out the level of knowledge mothers possess about these vaccines and their willingness to administer vaccination to their teenage girls. MATERIALS AND METHODS: This was a cross-sectional descriptive study of 255 consecutive women attending antenatal clinic at the University of Abuja Teaching Hospital, Abuja. They were given either a self-administered questionnaire or interviewer-administered questionnaire containing both closed and open-ended questions. Information recorded includes socio-demographic variables, knowledge of cervical cancer, knowledge of HPV/HPV vaccines and acceptance of these vaccines for their adolescent girls. The data was analysed using descriptive statistics. RESULTS: The mean age of the respondents was 26.9 years. Over 90% had at least secondary education. A total of 102 (40%) had the knowledge of cancer of the cervix while 153 (60%) had never heard about it. Overall, 236 (92.5%) of them had no idea about the predisposing factors. The study showed that only 23 (9.0%) out of the total respondents had heard about human papilloma virus (HPV) infection. In the same vein, 20 (7.8%) had knowledge about HPV vaccine. Among the respondents, who had the knowledge of HPV and vaccination, 18.2% and 23.4% of them had secondary and tertiary levels of education respectively. Overall, 160 (62.8%) accepted that the vaccines could be administered to their teenage girls. CONCLUSIONS: Awareness of cervical cancer, HPV infections, and HPV vaccines is low among antenatal clinic attendees in Gwagwalada, Abuja. However, majority of them would want their girls vaccinated against HPV infections. There is a need for all stakeholders to step up awareness creation for improved HPV vaccination project in Nigeria.

Prevalence of malaria parasitemia amongst asymptomatic pregnant women attending a Nigerian teaching hospital.

BACKGROUND: Malaria parasitemia among pregnant women is associated with complications to mother and the unborn fetus. There is paucity of data on asymptomatic malaria parasitemia, particularly in the northwest region of Nigeria. The objectives of this study were to determine the prevalence of malaria parasitemia in asymptomatic pregnant women and to estimate the packed cell volume (PCV) of this group of pregnant women. MATERIALS AND METHODS: This was a cross-sectional, descriptive study of only well pregnant women recruited consecutively at the time of booking for antenatal care. Thick film microscopy and qualitative immunoassay test for malaria parasite (MP) were performed for all the women. PCV estimation was also done using the micro-centrifuge method and comparison was made for women with parasitemia with those without MP. Some socio-demographic variables were also analyzed. Chi-square test was used to test for significance and a P-value less than 0.05 was considered statistically significant. RESULTS: Two hundred and twenty-five healthy pregnant women were studied. Seven women (3.1%) had MP by direct microscopy while 11 (4.8%) were MP positive with the qualitative immunoassay test. One hundred and eighty-five (82%) of the women were literate while 128 (57%) used insecticide treated mosquito nets in their homes. The mean PCV of the women with positive MP was 30.57 ± 2.26 as against 32.89 ± 2.45 for those without parasitemia (P < 0.05). CONCLUSION: The prevalence of asymptomatic malaria parasitemia in the study group was low but there was associated anemia in those with parasitemia. The use of intermittent preventive treatment is recommended for all pregnant women including those who are asymptomatic to forestall complications like maternal anemia.