Fertility regulation among women of reproductive age in Ibadan, south-west Nigeria: contraception, abortion or both.

OBJECTIVES: To assess the role of contraception and abortion in fertility regulation amongst Southwestern Nigerian women. SUBJECTS AND METHODS: A survey was conducted through a self- administered questionnaire to women of reproductive age group attending gynecology clinic. Multinominal logistic regression was done to analyze the independent effects of social and demographic variables on the odds that women would adopt any fertility regulation methods instead of doing nothing. RESULTS: Only 13% of surveyed women were using modern contraception. About 42.2% of women had had induced abortion, 15% of them neither use contraception nor abortion. Fifteen per cent of women surveyed used both contraception and abortion for fertility control. Muslims women had lower odds than Christians to use any of three fertility regulation methods instead of doing nothing. Unmarried and high levels of educational attainment were associated with significant odds of adopting each of three fertility regulation methods (Odd ratios; 1.38 - 35.5). CONCLUSIONS: There is a need for better fertility regulation. High dependency on abortion especially among the young, unmarried and high level educational status should be discouraged. Government and non-governmental agencies should assist in making modern contraceptives widely available with adequate rural coverage.

Fertility regulation among women of reproductive age in Ibadan, south-west Nigeria: contraception, abortion or both.

AIMS AND OBJECTIVES: The objective of this study is to document the prevalence and clinicopathologic features/pattern of salivary gland tumours in Ile-Ife, southwestern Nigeria. PATIENTS AND METHODS: Fifty eight (58) cases of salivary gland tumours histologically diagnosed between January 1989 and December 2007 were identified from the biopsy records of the Departments of Morbid Anatomy and Forensic Medicine and Oral/Maxillofacial Pathology of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. The records of the patients were extracted and data on incidence, age, gender and site of the various tumours were analysed using descriptive statistics. RESULTS: Pleomorphic adenoma was the most common salivary gland tumour reported accounting for twenty-five (43.1%), followed by Mucoepidermoid carcinoma (eight, 13.8%). Adenoid cystic carcinoma and myoepithelioma each accounted for six cases (10.3%). Non-Hodgkin's lymphoma of the salivary gland occurred in two patients. Twenty-six (44.8%) cases occurred in males while thirty-two (55.2%) occurred in females giving a male-to-female ratio of 1:1.2. The parotid region was the most common site accounting for twenty-eight (49.1%) cases, followed by the submandibular region 16 (28.1%) and palate 10(17.5%). CONCLUSIONS: Pleomorphic adenoma is the most common salivary gland tumour. Contrary to other African studies, our series reveals mucoepidermoid carcinoma as the commonest malignant salivary gland tumour.

Awareness and practice of vasectomy among married male health workers at the University College Hospital, Ibadan, Nigeria.

OBJECTIVE: To determine the awareness and practice of vasectomy among male health workers at University College Hospital, Ibadan and the influence of socio-demographic factors. METHOD: This is a descriptive cross-sectional study in which structured self-administered questionnaires were used to interview married male health workers at the University College Hospital, Ibadan between May and July 2006. RESULTS: Two hundred and fifty responses were analysed. The mean age was 36.7 (+/- 5.4) years. Two hundred and thirty nine (95.6%) respondents were married, 10 (4.0%) were separated while one (0.4%) was divorced. One hundred and fifty-one (60.4%) respondents were medical doctors while 34 (13.6%) were laboratory scientists. Fourteen (5.6%) respondents were pharmacists while 9 (3.6%) and 23 (9.2%) of the respondents were records officers and nurses respectively. Nineteen (7.6%) respondents belonged to other professions. Two hundred and twenty five respondents (90%) knew about vasectomy while twenty five respondents (10%) were not aware of it. One hundred and forty-five (58.0%) of the respondents were unwilling to accept sterilisation as a contraceptive procedure while 48 (19.2%) were willing to accept it and the remaining respondents 57 (22.8%) were uncertain. The cadre of medical profession and being previously aware of vasectomy were statistically significant with the willingness to accept vasectomy (chi(2) = 20.943, p= 0.021 and chi(2) = 10.666, p = 0.005 respectively). However none of the respondents had ever had vasectomy done. CONCLUSION: Some health workers are not aware of vasectomy or have some misconceptions about it. Family planning and contraception should be inculcated into the curricula of schools producing health workers such as laboratory scientists, radiographers etc. This will go a long way in improving their knowledge and attitude to vasectomy.

Gestational age at antenatal booking and delivery outcome.

Antenatal care is a form of preventive medicine that pregnant women to allows maintain a state of good health throughout pregnancy, and to improve their chances of having a safe delivery of healthy infants. To achieve this aim, it is a widely held belief that pregnant women need to book early preferable before 14 weeks gestation. This is a retrospective study which reveals among others that late booking is still a common practice in the developing countries with average gestational age at booking being 23.59 (+/- 8.45) weeks, and only 14% of the women booked before the end of first trimester. Nulliparity or low parity was found to be the only factor that favoured early booking. However, gestational age at booking as a sole factor for predicting the pregnancy outcome was found to be insignificant as the outcome was same for early and late bookers. Unbooked pregnant women were found to be twice at risk of operative delivery, four times more likely to suffer delivery complications and twice likely to have low birthweight babies when compared to booked patients. In conclusion, findings of this study confirm the importance of antenatal care for better maternal and foetal outcome, however gestational age at booking as a sole factor is a poor predictor of pregnancy outcome. It is believed that this finding which is in tandem with the new WHO antenatal care protocol will generate divergent views among the health care givers and modify our current practice of Antenatal care to a more focused and effective risk assessment system.

Knowledge, attitude and concerns about voluntary surgical contraception [corrected] among healthcare workers in Ibadan, Nigeria.

A multicentre study was conducted among healthcare workers in three major hospitals in Ibadan, south-west Nigeria. Structured questionnaires were self-administered to different cadres of healthcare workers in these hospitals with the objective of evaluating their knowledge, attitude and concerns about voluntary surgical contraception. The study revealed that though they had a generally good knowledge of voluntary surgical contraception, their attitude and concerns about the procedure was not encouraging and were largely biased. Such beliefs among healthcare workers tend to negatively influence the uptake of the procedure in the general population, further depleting the low contraceptive use in Nigeria, which has only recently attained a percentage in double figures. Strategies and means to improve on this are discussed to encourage better uptake and acceptability of the procedure among the general population.

Female condom awareness, use and concerns among Nigerian female undergraduates.

A cross-sectional study of female condom awareness, usage and concerns among the female undergraduates of the University of Ibadan was conducted in September 2004. The results of 850 out of the 879 female students interviewed were used for analysis (96.6%). Over 80% had knowledge of the female condom as a form of modern contraception and the majority of them learnt about it through the mass media (39.9%) and health workers (34.4%). However, only 11.3% had ever used the female condom, with most (40%) using it to prevent both unwanted pregnancy and sexually transmitted infections including HIV (STI/HIV). The sexual partners' approval was appreciable, accounting for about 42.7% among those that had experience of the female condom usage. Major concerns mentioned such as difficulty of inserting it into the vagina and lack of sexual satisfaction, were not different from those in earlier studies. The result of this study looks promising judging from a high awareness level of the female condom, even though its usage is low. The female condom may be an alternative strategy to combat unsafe sexual practises and its sequelae in a country like Nigeria that is male dominated.

Factors influencing gestational age at antenatal booking at the University College Hospital, Ibadan, Nigeria.

In order to achieve the aim of improved outcome of pregnancy for mother and fetus, early booking (first antenatal visit), prior to 14 weeks' gestation is usually recommended. A survey of information on personal data, index pregnancy, reasons for booking at a particular gestational age, past obstetric history and medical history of 205 pregnant women attending the antenatal booking clinic at the University College Hospital, Ibadan, Nigeria was carried out using a structured questionnaire. The mean gestational age at booking was 21.82 (+/-7.0) weeks. Only 29 patients (14.1%) booked before 14 weeks. The reasons given for early booking among them were the perceived benefits of such practice (41.4%), physician's recommendation (34.5%) and occurrence of complication(s) in previous pregnancy (24.1%). Illness in the index pregnancy and nulliparity were the only factors found to significantly favour early booking. The need to educate women of the reproductive age group, who are potential mothers, on the benefits of early booking was recommended.

Discontinuation pattern among IUCD users at the family planning clinic, University College Hospital, Ibadan.

Despite the high popularity of the intrauterine contraceptive device (IUCD) among family planning clients at University College Hospital, Ibadan, some users discontinued its use for a variety of reasons. This study was to determine the discontinuation rate among IUCD users at UCH, Ibadan. It was a 5-year retrospective analytical study. The records of patients using an IUCD seen at the Family Planning Clinic between 1 January, 1998 and 31 December, 2003 were analysed. A total of 867 clients were seen during the study period; 258(29.8%) clients discontinued within 5 years with the highest rate at 1 year 10.1% and least after 5 years 2.8%. The most common reason for discontinuation was the desire for pregnancy (57.0%). Other reasons included: side-effects (28.3%), husband's views (7.0%) and the menopause (8.0%). The reason for discontinuation varied significantly with the age of the clients (92.5% of clients that discontinued were less than 35 years), educational status, husband coercion, number of living children and religion. The discontinuation rate for the IUCD is high inspite of the high initial acceptability of the method in Nigeria. In a country experiencing a very rapid population growth where the prevalence of contraceptive use hardly attains double figures, it is imperative that policy makers double their efforts at ensuring an appreciable continuation rate of contraceptive use in general and IUCD in particular, among Nigerian women.

Carcinoma of the cervix co-existing with multiple pregnancy: a case report.

A case of a 38year old grandmultipara (Gravida9, Para7+1, all alive) woman with squamous cell carcinoma of the cervix co-existing with multiple pregnancy is presented. She had therapeutic termination of pregnancy with oxytocin at a gestation age of 18 weeks. This was followed by intracavitary and then extracavitary radiotherapy. The need to consider the possibility of carcinoma of cervix in bleeding disorders of early pregnancy and the importance of a thorough evaluation of such patients is emphasized.