Comparison of Zuspan regimen and its 12-hour modification in women with severe pre-eclampsia and eclampsia in two hospitals in Abeokuta.

BACKGROUND: Hypertensive disorders in pregnancy (HDP) are leading causes of maternal mortality (with severe pre-eclampsia/eclampsia [SPE/EC] being causes of death). Magnesium sulphate (MgSO4) has proven to be the drug of choice for SPE/EC management. However, its availability and cost remain a drawback to its use in developing countries. This study aimed to compare Zuspan regimen with its 12-hour modification for SPE/EC management in two major hospitals in Abeokuta, Ogun state, South Western Nigeria. METHODS: A randomized controlled trial of non-inferior parallel design carried out at Federal Medical Centre and Sacred Heart Hospital, Abeokuta involving 148 consenting women who were randomized into two groups A and B. Both groups had 4 g loading dose of MgSO4, but the duration of maintenance was reduced to 12-hours in Group A (intervention) while Group B received the standard Zuspan regimen (control). Outcome measures were the occurrence/recurrence of convulsions (primary), maternal side effects and perinatal outcomes (secondary). RESULTS: There was no statistically significant difference in the occurrence/recurrence of seizures between the two groups for both SPE/EC. No signs of maternal toxicity were observed in both arm of the study. There were no statistically significant differences in the perinatal/neonatal death and Apgar scores at 1 and 5 min. However, there was a significant increase in the number of days on admission in the control group of those neonates delivered to mothers with eclampsia. CONCLUSION: A 12-hr modification of Zuspan regimen was found to be non-inferior to the standard Zuspan regimen in the management of SPE/EC.

PATTERNS OF SEMINAL FLUID ANALYSIS IN MALE PARTNERS OF INFERTILE COUPLES ATTENDING GYNAECOLOGY CLINIC AT FEDERAL MEDICAL CENTRE, ABEOKUTA.

BACKGROUND: Infertility affects 19% of the general population I, and this constitutes a reproductive health concern for the affected couples. The contribution of male factors as cause of infertility is increasingly being noted in the recent times and has become a source of concern to the affected couples with its attendant social and psychological effects and with the potential of threatening relationships. OBJECTIVES: To assess the seminal fluid analysis parameters in male partners of infertile couples presenting at gynaecological clinic of Federal Medical Centre, Abeokuta and to determine the patterns of seminal fluid abnormalities in the seminalysis results. METHODOLOGY: The study is a 3 year retrospective review of seminal fluid analysis results of male partners in infertility cases at the Federal Medical Centre Abeokuta. Analysis was done using the WHO laboratory manual for the examination and processing of human semen revised fifth edition. RESULTS: During this study period, a total of 214 semen samples were analysed for semen quality over a 3 year period. Sixty four (30%) of the men had normal semen parameters, while one hundred and fifty (70%) had abnormal semen parameters. The abnormal semen parameters consists of low volume (12.6%), prolonged liquefaction time (9.8%), oligospermia (28%), azoospermia (8%), asthenozoospermia (25%), teratozoospermia (9%), combined defects of oligo-asthenozoospermia (23.8%), oligo-teratozoospermia (9.8%), asthenoteratozoospermia (12.60%) and oligoasthenoteratozoospermia (11.20%). CONCLUSION: This study has confirmed that male factor infertility remains a significant contributor to infertility in our environment. Efforts should be made in enlightening men on the common aetiologies of abnormal semen and options of treatment of likely causes.