Liberalization of abortion and reduction of abortion related morbidity and mortality in Nigeria.

This study aimed at determining the knowledge and perception of physicians in Nigeria on abortion related deaths, and also to find out if they will support the liberalization of abortion as a means of reducing deaths from unsafe abortion. Physicians' willingness to offer abortion services was also explored. A self-administered questionnaire was distributed to a convenience sample of physicians in Delta state of Nigeria. Physicians were equally divided on whether legal liberalization of abortion would significantly reduce maternal mortality in Nigeria. Only 13.4% of the doctors were willing to offer abortion services if legally liberalized. The majority of the doctors considered promoting abstinence from pre-marital sex and contraceptive use as best effective strategies for reducing abortion-related deaths. However, liberalization of abortion law in Nigeria was not considered a very effective strategy.

Solitary anterior abdominal wall leiomyoma in a 31-year-old multipara woman: a case report.

BACKGROUND: Anterior abdominal wall fibroid are uncommon and could be a cause of pain and discomfort. Very few cases have been reported in the literature but none in our region. CASE PRESENTATION: We present an uncommon case of a 31 year old para 2+2 trader from the Itsekiri tribe of the Niger Delta region of Nigeria who presented with a one year history of a periumbilcal mass, had surgical removal of the mass and histology revealed leiomyoma. CONCLUSION: Abdominal wall fibroid is a good differential diagnosis to be considered in any woman of reproductive age with an anterior abdominal mass and previous uterine surgery, including laparoscopic surgeries.

Obstetric complications, intervention rates and maternofetal outcome in teenage nullipara in Benin City, Nigeria.

An audit to determine the incidence of births to teenage nullipara, pregnancy complications, obstetric intervention rates, maternal and fetal outcomes in 114 teenage nullipara compared with 700 randomly selected older nullipara (age 20-29 years), was undertaken in a tertiary Institution. Births to teenage nullipara contributed 1.7% of all deliveries. Teenagers were significantly more likely to be unbooked for antenatal care (P < 0.0001), book late (P < 0.0001) and be single mothers (P < 0.0001). Teenagers were also significantly more likely to have primary education (P < 0.0001), secondary education (P < 0.001) or be apprentices (P < 0.0001). Teenagers had a significantly higher incidence of caesarean sections (P = 0.0002). There were no significant differences in the incidence of pregnancy complications, induction or augmentation of labour, preterm delivery, instrumental deliveries and fetal outcome. The maternal mortality ratio for teenagers was 1835 per 100,000 live births. There were no deaths among the older nullipara. It is concluded that the differences in obstetric intervention rates and maternal outcome are due to poor utilization of antenatal care and other social disparity.

Antenatal care: a comparison of demographic and obstetric characteristics of early and late attenders in the Niger Delta, Nigeria.

BACKGROUND: The utilization of modern antenatal care is poor in most parts of Nigeria and studies indicate that the majority of those who present for antenatal care do so late. MATERIAL/METHODS: This was a retrospective study involving 303 consecutively booked pregnant women over a 6-month period (March 1 to August 31, 2004) in a suburban tertiary hospital practice. The objectives were to determine the incidence of late booking for antenatal care and to compare the demographic and obstetric characteristics of women who booked late with those who booked early for antenatal care. The Fisher's exact test, odds ratio, and the 95% confidence interval were used for statistical analysis. RESULTS: Most (79.9%) of the women booked late for antenatal care. It was found that age, parity, level of education, social class, previous fetal loss, and previous obstetric complications did not differ significantly between women who booked early and those who booked late. CONCLUSIONS: The majority of the study population booked late for antenatal care. Socio-demographic and obstetric factors do not appear to be responsible for late utilization of antenatal care in the Niger Delta, Nigeria. Further studies are needed to explore the contribution of cultural factors to late presentation for antenatal care. Community-based health education programs on the importance of early presentation for antenatal care need to be put in place to address the anomaly of late utilization of antenatal care in Nigerian women.

Ruptured uterus in a Nigerian community: a study of sociodemographic and obstetric risk factors.

BACKGROUND: Ruptured uterus is a common obstetric emergency in Nigeria, associated with high maternal and perinatal morbidity and mortality. There is a need for definitive identification of the risk factors to guide effective interventions to curb its scourge. OBJECTIVE: To identify the sociodemographic and obstetric risk factors for ruptured uterus in Benin City, Nigeria, and based on this, make appropriate recommendations toward curbing the incidence and morbidity and mortality associated with it. MATERIALS AND METHODS: Sociodemographic and obstetric variables in 51 women with ruptured uterus and 300 randomly selected hospital controls from the general obstetric population were compared. Fisher's exact test was used to determine statistical significance between proportions. RESULTS: The incidence of ruptured uterus was 1 in 426 deliveries. The risk factors found were low socioeconomic class (OR = 6.8, CI = 3.6-12.9), being unbooked for antenatal care (OR = 10.4, CI = 5.4-20.0), grand multiparity (OR = 8.7, CI = 4.0-19.1), and prolonged obstructed labor (OR = 35.3, CI = 15.3-81.6). CONCLUSION: Measures that promote education and economic empowerment of women and the utilization of modern antenatal care will reduce the prevalence of rupture of the uterus in the community.