Risk factors for placenta praevia in Jos, north central Nigeria.

BACKGROUND: Ptacento pro via, a major cause of obstetric haoemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. Several epidemiological and clinical studies report disparate data on the risk factors associated with this condition. Although several studies on risk factors for placoenta praevia have been published, data obtained from the sub-Saharan Africa remains scanty. Our objective is to describe the spectrum of risk factors for placenta praevia in Jos, north central Nigeria. METHODS: This was a retrospective cohort study of 96 women delivered form January, 1999 to December, 2002 at Jos University Teaching Hospital, Jos, Nigeria. Data on total number of deliveries, maternal age, parity, and past obstetrics history and abortion were carefully extracted from medical records and analyzed using the Epi Info 3.4.1 (CDC, Atlanta, Georgia). RESULTS: The prevalence of placenta praevia was 0.89%. Previous uterine evacuation was documented in 35.4% of cases, while previous caesarean section scar occurred in 5.2% of cases. About half (44.8%) of the cases had no known risk factor. CONCLUSION: Uterine scaring following abortion management is an important risk factor for placenta praevia. However, majority of patients with placenta praevia in this work have no identifiable risk factor.

Risk Factors for Placenta Praevia in Jos; North Central Nigeria

Background: Placenta praevia; a major cause of obstetric haemorrhage; is potentially lifethreatening to the mother and frequently results in high perinatal morbidity and mortality. Several epidemiological and clinical studies report disparate data on the risk factors associated with this condition. Although several studies on risk factors for placenta praevia have been published; data obtained from the sub-Saharan Africa remains scanty. Our objective is to describe the spectrum of risk factors for placenta praevia in Jos; North Central Nigeria. Methods: This was a retrospective cohort study of 96 women delivered form January; 1999 to December; 2002 at Jos University Teaching Hospital; Jos; Nigeria. Data on total number of deliveries; maternal age; parity; and past obstetrics history and abortion were carefully extracted from medical records and analyzed using the Epi Info 3.4.1 (CDC; Atlanta; Georgia). Results: The prevalence of placenta praevia was 0.89. Previous uterine evacuation was documented in 35.4of cases; while previous caesarean section scar occurred in 5.2of cases. About half (44.8) of the cases had no known risk factor. Conclusion: Uterine scaring following abortion management is an important risk factor for placenta praevia. However; majority of patients with placenta praevia in this work have no identifiable risk factor

Heterotopic pregnancy at term masquerading as intrauterine twin gestation, a case report.

A case of combined intrauterine and abdominal pregnancies in a 29-year-old primigravida occurring in a natural cycle is presented. She booked for routine antenatal care in the obstetric unit of the hospital. An early scan at 10 weeks showed a twin gestation (diamniotic, dichorionic placentation). She was admitted between 10-21 weeks on account of severe hyperemesis gravidarum and anaemia in pregnancy. She was managed with antiemetics, intravenous fluids and two units of blood transfused before discharge for follow up in the antenatal clinic. Pregnancy was uneventful between 22 weeks to 38 weeks when she had elective Caesarean section on account of twin gestation, primigravida and borderline pelvis. At Caesarean section a combined intrauterine and abdominal pregnancies were found. She was delivered of first twin (intrauterine), a baby boy weighing 2.5 kg with Apgar scores of 8 and 9 in 1 and 5 minutes respectively; second twin (abdominal) a baby boy weighing 2.7 kg with Apgar scores of 8 and 9 at 1 and 5 minutes respectively.

Review of maternal deaths from unsafe abortion in Jos, Nigeria.

BACKGROUND: Unsafe Abortion assumes one of the lead causes of maternal deaths so long as contraceptive services remain low or unavailable and abortion laws remain restrictive. This study seeks to highlight abortion mortality, the practice of contraception amongst these women and complications arising from unsafe abortion. METHOD: This is a retrospective review of abortion related deaths in Jos University Teaching Hospital over a five year period (1st December 1989 to 30th November 2004). Patients files were retrieved from the hospital records and were reviewed in relation to socio demographic profile, clinical features and cause of death. RESULTS: Fourteen cases of abortion related deaths out of a total number of 188 induced abortion cases. The case fatality rate was 7.4% with abortion mortality of 74.4/100,000 deliveries. It constituted 12.8% of maternal deaths during the period. Seventy eight point six percent (78.6%) were below 24 years, while 85.7% of the patients were nulliparous. Ninety two point nine percent (92.9%) and 57.1% were single and dependent respectively. Fifty seven point one percent had never practiced contraception and 35.7% had previous pregnancy terminated. In 64.3%, the index pregnancy was terminated at 9 weeks and above because the pregnancies were unwanted in all (100%) cases. In 78.6% of cases the pregnancies were terminated by quacks. Forty two point nine percent (42.9%) presented after a week of termination. The causes of death were septicemia (71.4%), and hypovolaemic shock (28.6%). The average duration of hospital stay before demise was 5.6 days. CONCLUSION: Unsafe abortion is a public health problem in Jos and policy makers should promote contraception and review existing abortion laws.

A critical look on condoms.

BACKGROUND: To protect the public health, the practice of safer sex, promoted in a sex-positive way, is necessary. It includes saying no to unwanted sex, being faithful, having fewer partners, having sex that does not include intercourse, and using condoms. This is not just to prevent HIV and Sexually transmitted infections (STIs), but also to prevent unwanted pregnancy STI-related infertility and negative pregnancy outcomes, and cervical cancer- and most importantly to protect children and for partners to protect each other. Couples in stable relationships are now changing their sexual behavior due to increasing awareness on HIV and other STIs. While some are abstaining from premarital sex, others are being faithful to their partners. However, large numbers of people are yet to adopt safer sexual behavior through correct condom use. Since the beginning of the AIDS epidemics, condom distribution has greatly increased. METHODOLOGY: Literature review on the topic was done using Pubmed. Relevant journals and topics were also reviewed. Textbooks on relevant topics were also searched. RESULTS: The consistent use of male latex condoms significantly reduces the risk of HIV infection in men and women. Consistent use of male latex condoms reduces the risk of gonorrhea in men. Laboratory studies have proved that latex condom is impermeable to the infectious agents in genital secretions, including the smallest viruses. Male condoms may be less effective in protecting against STIs that are transmitted by skin-to-skin contact, if that area is not covered by the condom. CONCLUSION: Condoms are currently the only available means of preventing the sexual transmission of HIV and some other STIs. Condoms exist for both men and women.

A Critical Look on Condoms

Background: To protect the public health; the practice ofsafer sex; promoted in a sex-positive way; is necessary. It includes saying no to unwanted sex; being faithful; havingfewer partners; having sex that does not includeintercourse; and using condoms. This is not just to preventHIV and Sexually transmitted infections (STIs); but also to prevent unwanted pregnancy; STI-related infertility and negative pregnancy outcomes; and cervical cancer- andmost importantly to protect children and for partners to protect each other. Couples in stable relationships are now changing their sexual behavior due to increasing awareness on HIV and other STIs. While some are abstaining from premarital sex; others are being faithful to their partners. However; large numbers of people are yet to adopt safer sexual behavior through correct condom use. Since the beginning of the AIDS epidemics; condom distribution has greatly increased. Methodology: Literature review on the topic was done usiong Pubmed. Relevant journals and topics were also reviewed. Textbooks on relevant topics were also searched. Results The consistent use of male latex condoms significantly reduces the risk of HIV infection in men and women.Consistent use of male latex condoms reduces the risk of gonorrhea in men. Laboratory studies have proved that latex condom is impermeable to the infectious agents in genitalsecretions; including the smallest viruses. Male condoms may be less effective in protecting against STIs that are transmitted by skin-to-skin contact; if that area is not covered by the condom Conclusion: Condoms are currently the only available means of preventing the sexual transmission of HIV and some other STIs. Condoms exist for both men and women