Evaluation of Prevention of Mother to Child Transmission Programme at a Tertiary Healthcare Facility in Southwestern Nigeria.

Most children acquire human immunodeficiency virus (HIV) infection through mother-to-child transmission (MTCT). The risk of MTCT of HIV is generally 15%-40% without prophylaxis. MTCT has been responsible for approximately 370,000 infant HIV infections worldwide, with Nigeria accounting for 30% of cases. The study evaluated the effectiveness of a prevention program for MTCT of HIV infection by determining the rate of MTCT of HIV in infants who underwent the program by reviewing health records of mother-infant pairs at the Olabisi Onabanjo University Teaching Hospital. This cross-sectional study conducted over 12 years used medical records of 545 mother-infant pairs. The rate of MTCT of HIV infection was 2.9% in this study compared to 7.1% reported by the center earlier. The rate of MTCT of HIV infection was the lowest among mother-infant pairs who received prophylaxis. Ages at recruitment are a strong determinant of the risk of infection. Late usage of the MTCT prevention service is a risk for HIV infection in exposed infants.

Thanatophoric dysplasia: a case report.

A case of thanatophoric dysplasia with sudden death at term is hereby presented. Thanatophoric dysplasia is an uncommon, lethal skeletal dysplasia which is associated with mutation in the extracellular region of fibroblast growth factor receptor 3 (FGFR3). It is an autosommal dominant condition that has sporadic occurrence and early ultrasound scan has not been of great benefit in its detection. Diagnosis is mostly made in the third trimester. The fetal death is usually due to severe respiratory insufficiency from a reduced thoracic capacity and hypoplastic lungs and/or respiratory failure due to brainstem compression. In view of the autosomal dominance of TD, it will be advisable for a woman with previous history to have prenatal screening to relieve parental anxiety and prevent late detection.

A seven-year review of emergency obstetric hysterectomy in a Nigerian tertiary institution

Background:Extirpativeuterinesurgeries for near-miss events are usually thelast resort when other conservative measures fail.Emergency obstetric hysterectomy(EOH)may still have a significant role where there are limited options.Objectives:To determine the prevalenceof EOH, theassociatedfactorsandthe foeto-maternal outcomeat the Olabisi Onabanjo University Teaching Hospital, Nigeria.Methods:This was a retrospective observational study covering sevenyears (January 2010 to December 2016). The case records of patients who hadEOH during this period were retrieved for data extraction. Results:There were 5,608 deliveries and 31 cases requiringEOH giving aprevalence rateof31/5,608(0.55%). The mean age of the patients was 30.3±4.2years, whilethe mean gestational age at delivery was 36.3±5.1 weeks. Most of thepatients16/25(64.0%) were of higher parity (>3), and12/25(48%)of the patients were within the age bracket of 25-34 years. Subtotal hysterectomywas the most common procedure(18; 72.0%), andruptured uterus wasthe main indication for EOH (40.0%). The twomost common interventions that were critical to survival includedmassive blood transfusion (24.0%)andIntensive Care Unit admission (20%).Two (8%)maternal deathsand 58.3% perinatal mortality wererecorded.Conclusion:EOH is still relatively frequently performedat this centredue tothehigh incidence of a ruptured uterus. Effortsshould be made to increase the proportion of deliveries attended by skilled personnel and improvethe capacity of lower levelhospitals for comprehensive emergency obstetric care