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1.
J Obstet Gynaecol ; 34(8): 714-7, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24922093

RESUMO

Human papilloma virus (HPV) is a necessary cause of cervical cancer and cervical cancer is largely a vaccine-preventable disease. The aim of the study was to document the knowledge of healthcare professionals of the HPV vaccine and its acceptability. It was a cross-sectional study in three of the six geo-political zones of Nigeria, carried out between June 2010 and January 2011. The 602 adult Nigerian respondents were made up of 147 (24.4%) males and 455 (75.6%) females aged 20-57 years, with a mean of 34.3 ± 7.9 years; most were under 40 years (70.1%) and married (n = 394; 65.5%). In total, 548 (91%) were aware of HPV; 83.4% knew HPV as an STI; 78.2% knew HPV can cause cervical cancer but only 265 (44.0%) were aware of the HPV vaccine. Among the healthcare professionals studied, nurses were the least aware of the existence of the HPV vaccine (χ(2) = 1.54, p = 0.001). A total of 489 (81.0%) would approve HPV vaccine for their teenage daughters. The men were more likely to accept the vaccination of their daughters than the women (χ(2) = 14.76, p = 0.002). The unmarried were more favourably disposed to vaccination of teenagers than the married (χ(2) = 27.37, p = 0.001). Safety concerns were the commonest reasons expressed by the 7% who were reluctant to accept the vaccination of their teenage daughters. In conclusion, healthcare providers are the custodians of health in a community, yet have low knowledge of a vaccine that can prevent the commonest cancer in women in sub-Saharan Africa.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Papillomavirus , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
2.
Niger J Clin Pract ; 17(2): 154-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24553023

RESUMO

OBJECTIVE: This study determined the prevalence and socio-demographic characteristics of bacterial vaginosis (BV) among pregnant women with abnormal vaginal discharge. STUDY DESIGN: Descriptive cross-sectional study. SETTING: University of Maiduguri Teaching Hospital. MATERIALS AND METHODS: Vaginal swab samples and data on epidemiological risk factors were collected from 400 consecutive pregnant women with complaints of abnormal vaginal discharge. The data was analyzed using the SPSS 16.0 statistical software. Association between variables was compared by using the Chi-square (χ2 ) and Fisher's exact tests while P < 0.05 was considered significant at 95.0% confidence level. RESULT: The prevalence of BV among pregnant women with abnormal vaginal discharge was 17.3%. Age 20-24 years, multigravidity, lack of western education and unemployment were associated with increased prevalence of BV. Yellowish, watery vaginal discharge (P = 0.001) was associated with BV. Dysuria, dyspareunia and lower abdominal tenderness were associated with BV (P = 0.001). Fifty three (77%) of patients had BV during the second trimester compared to 6 (9%) who had it in the 1 st trimester of pregnancy (P = 0.012). CONCLUSION: The high prevalence of BV in this study may necessitate adequate screening of pregnant women with abnormal vaginal discharge in order to give appropriate treatment and avoid complications associated with it.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Vaginose Bacteriana/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Nigéria/epidemiologia , Gravidez , Prevalência , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
3.
J Obstet Gynaecol ; 33(2): 152-4, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23445137

RESUMO

Puerperal sepsis is a leading cause of mortality in developing countries. The objective of this study is to determine the knowledge of symptoms and signs of puerperal sepsis. It was a cross-sectional community-based study. Of the 400 respondents interviewed, 289 (72.2%) were between the ages of 20 and 39 years, and most, 374 (93.5%), were married. Only 14 (3.5%) had tertiary education. Most respondents, 224 (56.0%) were farmers and grandmultiparae accounted for 187 (46.7%). A reassuring number of respondents, 265 (66.3%), knew that fever with abnormal vaginal discharge; 252 (63%) fever with foul smelling lochia; 346 (86.4%) fever occurring with lower abdominal pain and 182 (45.5%) knew that fever occurring with prolonged flow of lochia, are all indicators of puerperal sepsis. A total of 53% of respondents were not aware of the causes of puerperal sepsis; 10% believed it is caused by evil spirits. The knowledge of the causes of puerperal sepsis is poor. There is the need to put more emphasis on the causes of puerperal sepsis during antenatal health talks. This could help reduce morbidity and mortality associated with puerperal sepsis.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Infecção Puerperal , Sepse , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Gravidez , População Rural , Adulto Jovem
4.
J Obstet Gynaecol ; 33(2): 180-3, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23445144

RESUMO

Multiple factors influence the acceptance, choice and utilisation of contraceptive. The objective of the study is to identify individual attitude towards the empowerment of women to an independent right to accept, choose and utilise a contraceptive method of their choice without recourse to their male partners. This is a cross sectional study of men and women of different socio-cultural background working or utilising the services of the Federal Medical Centre Gombe, Nigeria. There were 554 respondents. Only 187 (34.4%) respondents thought that all women, irrespective of marital status, should have an independent right to contraceptive acceptance, choice and practice. Significantly more men (85.4%) than women (61.8%) rejected that women should have an independent right to contraceptive acceptance, choice and practice. Majority of both gender favoured male influence in the acceptance and choice of method of contraception. Our study has re-echoed the importance of male involvement in contraception decision-making.


Assuntos
Atitude Frente a Saúde , Comportamento Contraceptivo/psicologia , Anticoncepção , Poder Psicológico , Direitos da Mulher , Estudos Transversais , Tomada de Decisões , Feminino , Humanos , Masculino , Casamento , Nigéria
5.
Niger J Med ; 22(2): 138-42, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23829126

RESUMO

BACKGROUND: Pregnancy represents a risk factor in the occurrence of vaginal candidiasis. OBJECTIVES: To determine the prevalence and clinical features associated with abnormal vaginal discharge and C. albicans infection in pregnant women. METHODS: High vaginal swab samples and data on epidemiological characteristics were collected from 400 pregnant women with complaints of abnormal vaginal discharge at booking clinic of University of Maiduguri Teaching Hospital. The data was analysed using SPSS 16.0 statistical software. RESULTS: The prevalence of abnormal vaginal discharge in pregnancy was 31.5%. The frequency of abnormal vaginal discharge was 183 (45.8%) among those aged 20-24 years, 291 (72.8%) in multipara, 223 (55.8%) in those with Primary education and 293 (73.2%) in unemployed. Vulval pruritus 300 (75.0%) was significantly related to abnormal vaginal discharge (P < 0.001). The prevalence of C. albicans was 41%. The frequencies of Vulval itching, Dyspareunia and vulval excoriation among those with candidiasis were 151 (50.3%), 14 (56.0%) and 75 (75.0%) respectively (P < 0.001). CONCLUSION: The prevalence of abnormal vaginal discharge in pregnancy was high in this study and C. albicans was the commonest cause. It is recommended that a pregnant woman complaining of abnormal vaginal discharge be assessed and Laboratory diagnosis done in order to give appropriate treatment.


Assuntos
Candidíase Vulvovaginal/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Descarga Vaginal/etiologia , Adolescente , Adulto , Candidíase Vulvovaginal/complicações , Estudos Transversais , Feminino , Humanos , Nigéria/epidemiologia , Gravidez , Prevalência , Adulto Jovem
6.
Niger J Clin Pract ; 16(2): 232-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23563468

RESUMO

BACKGROUND: Home births are common in resource poor countries and postnatal practices vary from one community to the other. OBJECTIVE: To determine the proportion of home births, reasons for home delivery, and evaluate postnatal practices in Madagali, north-eastern Nigeria. MATERIALS AND METHODS: This was a cross-sectional descriptive study of 400 women of reproductive age, who had put to birth in the past 1 year. The study was carried out over a period of 8 weeks from April to June 2010. The multistage method of sampling was used to select respondents. In the first stage, four of the five health districts were chosen randomly, namely, Gulak, Madagali, Sukur, and Duhu. The questionnaires were evenly distributed among the four health districts. In the second stage, from each district, two villages were chosen by simple random sample. In the third stage, two wards were selected in each village by simple random sampling. RESULT: Of the 400 respondents interviewed, 289 (72.2%) were aged between 20 and 39 years, and most, 374 (93.5%) were married. Only 14 (3.5%) had tertiary education. Most respondents, 224 (56.0%) were farmers and grandmultiparae, 187 (46.7%). A total of 196 (49.0%) women delivered at home, whereas 204 (51.0%) delivered at the hospital. Of the 196 respondents who delivered at home, the bedroom 142 (72.4%), was the preferred place of birth. The most common reason for home birth was short duration of labor in 71 (36.3%) cases. Delivery was conducted by untrained persons in 50, (25.4%), whereas 99 (50.8%) and 31 (15.5%) deliveries were supervised by Traditional Birth Attendants (TBAs) and Midwives/Nurses, respectively. Postpartum, the majority, 235 (58.7%) respondents used sanitary pads to stanch lochia, whereas 140 (35%) used rags. CONCLUSION: A significant number of births take place in the home and supervised by unskilled persons. Against the backdrop of poor education and low socio-economic status of respondents, perineal hygiene can be adjudged satisfactory. There is the need to increase on the number of hospital birth and also trained TBA who conduct most of home deliveries.


Assuntos
Parto Domiciliar/estatística & dados numéricos , Tocologia/estatística & dados numéricos , Período Pós-Parto , Autocuidado , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários , Adulto Jovem
7.
Afr J Med Med Sci ; 41(2): 183-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23185917

RESUMO

BACKGROUND: The utilization of cervical cancer screening services is very poor in developing countries. OBJECTIVE: The study was aimed at establishing the determinants of the awareness of cervical cancer, Papanicolaou smear and its utilization among outpatient clinic attendees in north-eastern Nigeria. METHODOLOGY: Cross sectional study among outpatient clinic attendees in two tertiary institutions in north-eastern Nigeria. RESULTS: A total of 235 women of reproductive age were interviewed during the study period. Sixty two (62%) were aware of cervical cancer, while 44.3% were aware of screening with Pap smear. However, overall, only 11.5% had ever been screened for cervical cancer before our study. More than half (54%) of the respondents did not state any reason for not doing the test. Compared with women who were not screened, screened women were aged 30 years and above with a mean age of 29.7 +/- 7.6 years (p = 0.021), better educated (p = 0.046), multiparous and employed outside home (p = 0.000). Determinants of awareness of cervical cancer and Pap smear were higher level of education (O.R. 7.80, 95% CI: 7.2-9.4; O.R. 5.12, 95%; CI: 5.0-6.4) and being civil servants (O.R. 2.01, 95% CI: 2.5-3.0; O.R. 3.23, 95%; CI: 2.9-4.7) respectively, while utilization of Pap smear depended on the age (O.R. 3.25, 95%; CI: 2.7-4.0) and higher educational status (O.R. 2.87, 95%; CI: 2.9-3.2). CONCLUSION: The utilization of Pap smear among women studied is very low. But the reasons advanced for poor utilization are modifiable. Efforts at addressing these reasons might improve the take up rate of cervical cancer screening in North-eastern Nigeria.


Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Teste de Papanicolaou , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Países em Desenvolvimento , Feminino , Humanos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
8.
Niger J Clin Pract ; 15(3): 302-5, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22960965

RESUMO

OBJECTIVE: The objective of this study was to document oral health practices of pregnant women in two tertiary institutions in North-eastern Nigeria. MATERIALS AND METHODS: This was a cross-sectional study of pregnant women seen at the antenatal clinics of the University of Maiduguri Teaching Hospital and Federal Medical Centre Yola from May 1, 2009 to July 1, 2009. RESULTS: A total of 294 women were interviewed. They were aged 15-46 with a mean of 27.42 ± 5.97 years. The parity ranged from 1 to 9 with a mean of 2.23 ± 1.65. Twelve (4.1%) women gave a history of symptomatic oral lesion in index pregnancy. Forty-four (15%) had had previous encounter with a dentist, while the highest frequency of oral care was twice a day in 164 (55.8%) of respondents. The majority, 264 (89.9%), used toothbrush/toothpaste as a form of oral care while 2 (0.7%) used charcoal. Women of low parity tended to have better oral care than those of high parity (P = 0.002). Women who are employed had better oral care than housewives (x2 = 27.749, P = 0.001). There was no significant relationship between oral complaints and trimester of pregnancy (x2 = 4.271, P = 0.118). CONCLUSION: Oral healthcare among the respondents was encouraging but involvement of the dental surgeon in preventive oral care in pregnancy is rather dismal.


Assuntos
Saúde Bucal , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Nigéria , Paridade , Gravidez , Adulto Jovem
9.
Niger J Clin Pract ; 14(2): 168-70, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21860133

RESUMO

OBJECTIVES: To review the hysterosalpingographic (HSG) findings in women investigated for infertility in a tertiary center in north eastern Nigeria. MATERIALS AND METHODS: A retrospective review of HSG films of 272 women investigated for infertility between January 2000 and December 2006 were reviewed. RESULTS: One hundred and thirty (47.8%) were investigated for primary infertility, while 142 (52.2%) were investigated for secondary infertility. Most of the women investigated for infertility by HSG had abnormal findings 192(70.6%). The most common pathology revealed among the infertile women was tuboperitoneal factor in 196 (72.1%) followed by uterine synechia in 35(12.9%). Seventeen (6.3%) had bilateral tubal block and 5 (1.8%) had bicornuate uterus. CONCLUSION: HSG is helpful in the investigation of infertile women.


Assuntos
Doenças das Tubas Uterinas/diagnóstico por imagem , Ginatresia/diagnóstico por imagem , Histerossalpingografia , Infertilidade Feminina/diagnóstico por imagem , Doenças Uterinas/diagnóstico por imagem , Adolescente , Adulto , Distribuição por Idade , Doenças das Tubas Uterinas/complicações , Doenças das Tubas Uterinas/epidemiologia , Feminino , Ginatresia/complicações , Ginatresia/epidemiologia , Humanos , Incidência , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etiologia , Pessoa de Meia-Idade , Nigéria/epidemiologia , Estudos Retrospectivos , Doenças Uterinas/complicações , Doenças Uterinas/epidemiologia , Adulto Jovem
10.
J Obstet Gynaecol ; 30(7): 690-3, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20925611

RESUMO

The aim of maternal calcium homeostasis is to provide adequate calcium flux across the placenta during pregnancy and into breast milk during lactation, to ensure normal fetal and neonatal skeletal mineralisation. The objective of this study was to document the characteristics and outcome of patients who had postpartum hypocalcaemia. Cases of symptomatic postpartum hypocalcaemia managed over a 10-year period (1 January 1998 to 31 December 2007) at the University of Maiduguri Teaching Hospital, were retrospectively reviewed. A total of 34 cases were identified. The sociodemographic characteristics, corrected calcium level, duration of treatment, mode of delivery and the packed cell volume (PCV) were analysed using the EPI-INFO Version 3.4.3 statistical package. The mean age and parity were 24.29 ± 5.88 and 3.39 ± 2.32, respectively. All the patients presented with carpopedal spasm with or without associated symptoms. There was a direct relationship (R² linear = 0.292, p = 0.001) between PCV and serum calcium. Multiparous women were significantly more affected than primiparae (χ² = 15.08; p = 0.0005). Half of the patients presented within 1 week of onset of symptoms. In conclusion, the association between anaemia and postpartum hypocalcaemia needs further study to determine the cause and effect relationship.


Assuntos
Anemia/epidemiologia , Cálcio/sangue , Hipocalcemia/epidemiologia , Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Anemia/metabolismo , Feminino , Hematócrito , Humanos , Hipocalcemia/metabolismo , Nigéria/epidemiologia , Período Pós-Parto/metabolismo , Gravidez , Complicações na Gravidez/metabolismo , Estudos Retrospectivos , Adulto Jovem
11.
J Obstet Gynaecol ; 30(8): 822-5, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21126121

RESUMO

The objective of this study is to document the anaesthetic preference of pregnant women in two tertiary institutions in North-eastern Nigeria. This was a cross-sectional study of pregnant women seen at the antenatal clinics of the university of Maiduguri teaching hospital and Federal Medical Centre, Yola, from August to October 2009. A total of 254 women were interviewed. They were aged 18-43 with a mean of 28.56 ± 5.602 years. The parity ranged from 1-9 with a mean of 2.71 ± 1.956. Most (178, 70.1%) respondents preferred general anaesthesia and the commonest reason for the preference was various forms of fear 128 (71.9 %). The commonest reason for preference for regional anaesthesia was to watch the procedure live 50 (65.8%). Age (χ(2) = 52.364, p = 0.000), education (χ(2) = 8.780, p = 0.032), occupation (χ(2) = 18.555, p = 0.002) and religion (χ(2) = 4.936, p = 0.026) were significantly associated with preference for general anaesthesia. Only age (p = 0.000, OR 8.17, CI = 0.000-1.00) retained significance after multivariate analysis. Considering the fact that the global trend is towards regional anaesthesia due to lower morbidity and mortality, the high preference for general anaesthesia in our survey is worrisome. Health education during antenatal clinics should highlight the superiority of regional over general anaesthesia for caesarean delivery.


Assuntos
Anestesia por Condução/psicologia , Anestesia Geral/psicologia , Cesárea , Preferência do Paciente/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Análise Multivariada , Nigéria , Gravidez , Adulto Jovem
12.
Niger J Med ; 19(1): 42-5, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20232755

RESUMO

BACKGROUND: Cephalo pelvic disproportion is still the leading indication for caesarean section in many developing countries and the contribution of pelvic typology may play some role in this regard. Our objective is to determine the proportion of pelvic types as seen in a tropical setting. METHOD: A retrospective review of preliminary films of hysterosalpingography of 400 women who underwent the study between January 2000 and December 2007 was reviewed to determine the pelvic typology. RESULT: Of the 400 films reviewed, 361 (90.3%) were gynaecoid, 36 (9%) were androidc and 3 (0.8%) were andropoid. There was no platypelloid pelvis seen in the films reviewed and a mixed type pattern was not observed in this study. CONCLUSION: The proportion of pure gynaecoid pelvis seen in this review is about the highest reported in the literature.


Assuntos
Desproporção Cefalopélvica , Cesárea , Histerossalpingografia/métodos , Ossos Pélvicos/anatomia & histologia , Adolescente , Adulto , Feminino , Hospitais Universitários , Humanos , Nigéria , Ossos Pélvicos/diagnóstico por imagem , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Adulto Jovem
13.
Niger J Med ; 19(4): 467-70, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21526641

RESUMO

BACKGROUND: Total abdominal hysterectomy is a commonly performed gyneacological procedure. Although it is safe, it can still be associated with development of complication. The aim of this study was to determine morbidity associated with total abdominal hysterectomy in our environment. METHOD: All cases of total abdominal hysterectomy done over a five-year period (January 2003-December 2006) at the University of Maiduguri Teaching Hospital (UMTH) were reviewed. Information was obtained from the patients' case notes, gynaecology ward, and theatre records. The complications of the procedure were determined. Multiple logistic regression was used to find the factors that were independently associated with development of complications. RESULTS: During the study there were 101 cases of total abdominal hysterectomy out of 729 gynaecological operations, a rate of 13.8%. In majority of the cases 56 (68.3%) the indication of the hysterectomy was uterine fibroid (symptomatic). Overall 37 (45.1%) experience some form of complication out of which 26 (70.3%) was febrile morbidity Finding enlarged uterus intraoperatively {OR (95% CI) = 14.5 (1.84-114.6), p = 0.011}, blood transfusion {OR (95% CI) = 31.1(1.35-718.8), p = 0.032}and postoperative PCV < 30% {OR (95%CI) = 9.63 (1.14-81.3) p = 0.037} were found to be significantly associated with development of complication. conclusions: Total abdominal hysterectomy was associated with development of complications and enlarged uterus, increasing parity independent risk factors for development of the complication.


Assuntos
Histerectomia/efeitos adversos , Leiomioma/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Doenças Uterinas/epidemiologia , Adulto , Feminino , Hospitais de Ensino , Humanos , Histerectomia/métodos , Leiomioma/etiologia , Leiomioma/cirurgia , Modelos Logísticos , Pessoa de Meia-Idade , Morbidade , Nigéria/epidemiologia , Paridade , Complicações Pós-Operatórias/etiologia , Gravidez , Fatores de Risco , Resultado do Tratamento , Doenças Uterinas/etiologia , Doenças Uterinas/cirurgia
14.
J Obstet Gynaecol ; 29(4): 322-5, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19835501

RESUMO

SUMMARY: Hydatidiform mole (HM), is a known cause of early pregnancy wastage and has the risk of malignant potential. This is a retrospective study of 71 patients who were managed for hydatidiform mole at the University of Maiduguri Teaching Hospital, (UMTH) Maiduguri over a 10-year period, from January 1996 to December 2005, inclusive. The objective of the study was to determine the incidence, risk factors, clinical presentations and histological types of HM. Case records of 71 histologically confirmed HM were studied. Their sociodemographic characteristics, clinical presentations and histology reports were obtained and analysed. The institutional incidence of molar pregnancy was 3.8/1,000 deliveries. Histological findings showed partial mole in 51 (71.8%) cases and complete mole in 20 (28.2%) cases. The peak age-specific incidence rate was 17.5 years. The leading presenting clinical feature was abnormal vaginal bleeding seen in 100%. No case of invasive mole was found. Maternal complications included severe haemorrhage requiring blood transfusion (30.0%) and infections (15.5%). There was no maternal death. In conclusion, the incidence of partial hydatidiform mole was found to be higher than that of complete variety in our environment and the identified risk factors were young age, low parity and previous history of HM.


Assuntos
Hospitais de Ensino/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Mola Hidatiforme/epidemiologia , Neoplasias Uterinas/epidemiologia , Adolescente , Adulto , Fatores Etários , Amenorreia/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Nigéria/epidemiologia , Paridade , Gravidez , Estudos Retrospectivos , Fatores de Risco , Hemorragia Uterina/epidemiologia , Adulto Jovem
15.
J Obstet Gynaecol ; 29(6): 536-8, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19697205

RESUMO

Tubal factor infertility is the commonest cause of female infertility in developing countries. The option of management is either tubal surgery or in-vitro fertilisation and embryo transfer (IVF-ET). This study aims to determine the outcome of tubal macrosurgery in Gombe, North-eastern Nigeria. It was a 6-year retrospective review of tubal macrosurgeries performed between January 2001 and December 2006. Of the 92 women who underwent tubal surgery, during the 1-year follow-up, seven (7.6%) became pregnant: five (5.4%) had full-term pregnancies and two (2.2%) had a spontaneous abortion. The majority (64, 69.6%) were aged between 25 and 34 years. The mean age and parity were 29.41 +/- 4.36 and 0.57 +/- 0.80, respectively. Most (48, 52.2%) of the patients presented within 4 years and three (3.3%) presented more than 19 years later. Secondary infertility (58, 63%) was the commonest cause; mild tubal disease occurred in 21 (22.8%) patients. Salpingostomy was performed in 29 (31.5%); salpingolysis in 19 (20.7%) and multiple procedures in 33 (35.9%). The low pregnancy rate seen in this study is unlikely to improve significantly even with good case selection as long as tubal macrosurgery is the modality of treatment. Establishment of affordable in vitro fertilisation (IVF) centres is the key to solving the problem of tubal factor infertility in our environment.


Assuntos
Tubas Uterinas/cirurgia , Infertilidade Feminina/cirurgia , Salpingostomia , Adolescente , Adulto , Feminino , Humanos , Nigéria , Gravidez , Resultado da Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Adulto Jovem
16.
J Obstet Gynaecol ; 29(4): 326-8, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19835502

RESUMO

SUMMARY: Tubal factor infertility is the commonest cause of infertility seen in gynaecological clinics in Nigeria. This, to a large extent, is a preventable cause of infertility. The objective of the study was to determine the prevalence of utero-tubal factors in the causation of infertility. This is a prospective descriptive study of infertile women seen at the gynaecological clinic of the Federal Medical Centre Gombe from June 1999 to May 2002. A total of 229 infertile women were studied. The prevalence of primary and secondary infertility was 37.1% and 62.9%, respectively. Tubal factor was the cause in 67.2% and cervical factors contributed to 19.2%. The women were aged 17-44, with a mean of 28.6 +/- 5 years. There were four (1.7%) teenagers and eight (3.5%) women were aged 40 years or above. The majority, 55% (126), were in their third decade, with those aged 20-34 years constituting 86% (197) of patients. The high prevalence of tubal factor infertility in our environment is unacceptable. Primary prevention of reproductive tract infections and syndromic management of STD will go a long way in reducing the high prevalence of tubal factor infertility.


Assuntos
Doenças das Tubas Uterinas/epidemiologia , Infertilidade Feminina/epidemiologia , Doenças Uterinas/epidemiologia , Aborto Induzido/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Coito , Feminino , Humanos , Nigéria/epidemiologia , Prevalência , Estudos Prospectivos , Adulto Jovem
17.
Niger J Med ; 18(1): 94-7, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19485158

RESUMO

BACKGROUND: The need to conserve the uterus, against all odds even when child bearing is complete makes conservative management of uterine fibroids quite appealing in our environment. Our objective is to document the prevalence, demographic characteristics and the outcome of patients who had myomectomy METHODOLOGY: All cases of myomectomy performed at the Federal Medical Centre Gombe between 1st January 2002 and 31st December 2004 were retrospectively reviewed. Only cases of histologically confirmed fibromyomata were included in the study. Fourty three (43) out of the 45 retrieved cases met the criteria for inclusion in the study. The age, parity Marital status, clinical presentation, and outcome were analysed using the EPI-INFO Version 6.0 statistical package. RESULTS: There were 51 cases of myomectomy out of 581 major gynaecological surgeries giving an incidence of myomectomy of 8.8% for the period under study. The majority of the patients, 30 (69.8%) were aged between 30 and 39 years and 40 (93.0%) were of low parity. The commonest indication for myomectomy was infertility 18, (41.9%), followed by menorrhagia 12, (27.9%). The uterine size at presentation was greater than twelve weeks gestation size in 33, (76.7%) of the cases. Wound infection 6, (14%) was the commonest morbidity followed bypyrexia 3, (7%). About 10(23.3%) were single while 33 (76.7%) were married. Forty (93%) of the fibroids were located in the body of the uterus while 3 (7%) were cervical in location. Most 28 (65.1%) of the skin incisions were Pfannenstiel while 15 (34.9%) had midline subumbilical skin incision. Only 7 (16.3%) of the patients had blood transfusion. Of the 18 patients who complained of infertility, 6 (33%) had conceived. CONCLUSION: Two thirds of the patients in this study presented with uterine masses greater than twelve week size, suggesting some delay in presentation. Liberal pelvic examination for women at risk of uterine fibroids may lead to early detection with consequent reduction in morbidity.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Leiomioma/cirurgia , Neoplasias Uterinas/cirurgia , Adulto , Fatores Etários , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Humanos , Infertilidade Feminina/etiologia , Leiomioma/epidemiologia , Tempo de Internação , Pessoa de Meia-Idade , Miométrio/cirurgia , Nigéria/epidemiologia , Prevalência , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias Uterinas/epidemiologia
18.
Niger J Med ; 18(2): 179-83, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19630325

RESUMO

BACKGROUND: Caesarean delivery carries a higher morbidity and mortality than vaginal delivery. This first audit of caesarean delivery in our centre will be compared with previous studies around the world. Our objective is to document the indications and outcome of caesarean delivery. METHOD: This was a retrospective study of patients who had caesarean delivery in Federal Medical Centre Gombe, from January 2001 to December 2003. The biosocial characteristics, indication for surgery, booking status, number and type of caesarean deliveries, type of uterine incision, complications, and cadre of surgeon and duration of hospital stay were obtained for each patient. RESULTS: 264 caesarean deliveries were performed, 250 cases made the criteria for inclusion. There were 2,172 total deliveries during the study period giving a caesarean delivery rate of 12.2%. The majority, 181 (72.4%) of the patients had emergency caesarean delivery while 69 (27.6%) had elective caesarean delivery. The commonest indication for caesarean delivery was cephalopelvic disproportion (20.8%), followed by preeclampsia/eclampsia (18.8%) and ante partum haemorrhage (14.4%). Others were fetal distress (8.8%), and previous caesarean delivery (7.2%). Majority of the patients, 104 (41.6%) were booked with the Federal Medical Centre Gombe, 88 (35.2%) booked elsewhere and 58 (23.2%) were unbooked. Twenty one (8.4%) had complications of which wound infection 11 (5.2%) was the commonest morbidity encountered. There were two maternal deaths and twenty one perinatal deaths giving a maternal and perinatal mortality rates of 800/100,000 and 82/1000 respectively. CONCLUSION: The indications for caesarean delivery in our study are comparable to findings from other parts of the world. The high emergency caesarean delivery rate among those booked elsewhere is a cause for concern. Health education could reduce the number of emergency caesarean deliveries. Consequently this might reduce the high infectious morbidity associated with the procedure in this study.


Assuntos
Cesárea/estatística & dados numéricos , Adolescente , Adulto , Cesárea/mortalidade , Serviços Médicos de Emergência , Feminino , Humanos , Morbidade , Nigéria/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/cirurgia , Estudos Retrospectivos , Adulto Jovem
19.
J Obstet Gynaecol ; 28(8): 775-8, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19085542

RESUMO

Anaemia in pregnancy is an important reproductive health problem associated with increased maternal and perinatal morbidity and mortality. This study was undertaken to determine the prevalence of anaemia in pregnancy at booking in Gombe, North-eastern Nigeria. A cross-sectional study of 461 women attending the antenatal clinic was carried out. Anaemia in pregnancy was defined as a packed cell volume (PCV) of <30%. The capillary technique was used for the estimation of the PCV. The biosocial characteristics (age, parity and social class); and gestational age at booking were obtained and analysed. Of the 461 pregnant women studied, 239 were anaemic, a prevalence of anaemia at booking of 51.8%. The majority of these patients, 67.4%, were mildly anaemic, 30.5% were moderately anaemic while only 2.1% had severe anaemia. Most, 316 (68.5%) of the women booked in the second trimester while only 3.0% booked in the first trimester. There was no relationship between parity and anaemia in pregnancy in this study The majority of the women, 293 (63.5%) were in the lower social class. Because the majority of the anaemic gravidae are in the low social class, provision of haematinics at little or no cost will go a long way towards reducing the high prevalence of anaemia in pregnancy. In the long run, educational and economic empowerment of the women is the key to reducing the overall prevalence of anaemia to the barest minimum.


Assuntos
Anemia/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Estudos Transversais , Feminino , Idade Gestacional , Humanos , Nigéria , Gravidez , Prevalência , Fatores Socioeconômicos
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