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ABSTRACT: Infertility has serious consequences especially in Africa where a high premium is place on child bearing. An interviewer-administered questionnaire was administered on 396 consenting women seeking infertility treatment at the gynaecological clinic of the University College Hospital, Ibadan in an attempt to assess the attitude of infertile women in Nigeria to child adoption and its acceptability as a management option for infertility. Most (64%) believed its culturally unacceptable and only 17% will try it as an option. Sustained advocacy, community mobilization and enactment of supportive laws were some of the suggestions made by respondents to improve its uptake.
Nigerian journal of physiological sciences: official publication of the Physiological Society of Nigeria 01/2010; 25(1):47-9.
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ABSTRACT: To determine the risk factors that predispose patients to post-caesarean wound infection at a tertiary health institution in developing country.
It was an observational study of all women that had caesarean (elective and emergency) delivery between July and September, 2004. The outcome of their post-caesarean wound was assessed. Statistical analysis (Bivariate and logistic regression) of the identified risk factors in patients who developed wound infection was performed at a 95% level of confidence.
The post-caesarean wound infection rate was 16.2%. The identified risk factors were lower educational status, multiple pelvic examination, offensive liquor at surgery and patients that are unbooked. Following logistic regression, women with up to primary school were 20 times more likely than those with secondary education and above to develop wound infection (95% CI OR = 1.8 to 250.0).
The outcome showed that the identified determinants of post-caesarean wound infection were comparable with earlier reports. Women with lower educational status are more at risk in this study. Therefore, these women need special attention to reduce the risk.
Nigerian journal of clinical practice 04/2009; 12(1):1-5. · 0.19 Impact Factor
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ABSTRACT: Disturbances of menstrual function are the commonest complaints among adolescents. Disorders of menstruation may have implications for future reproductive health.
To assess menstrual patterns among school girls in Ibadan, south-western Nigeria.
This was cross-sectional descriptive study in which 1,213 apparently healthy school girls were selected by multistage sampling technique in fifteen secondary schools from the five local governments within the metropolis. Information about details of menstrual experience was obtained with a self-administered questionnaire.
The girls were aged between 9 and 23 years. Majority of respondents 768 (633%) experienced normal cycle length, 391 (32.2%) had short cycles; and 55 (4.5%) had cycle length greater than 35 days. Prevalence of normal cycles increased with increasing age; abnormalities of cycle length tended to decrease with increasing age (p < 0.01). The majority, 1,152 (95%), had normal menstrual loss. The majority 882 (72.7%) experienced dysmenorrhoea; severe dysmenorrhoea was reported by 154 (12.7%). Cycle length was not associated with presence of dysmenorrhoea (p > 0.05); 695 (57.3%) had symptoms of pre-menstrual syndrome.
Prevalence of menstrual abnormalities among adolescent schoolgirls is high. More attention should be paid to identify and treat these menstrual morbidities.
West African journal of medicine 03/2009; 28(2):92-6.
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ABSTRACT: This was a hospital-based cross-sectional study of 224 randomly selected antenatal women receiving care at the University College Hospital, Ibadan, Nigeria. The study aimed to seek the attitude and preferences of respondents about social support during childbirth and also identify variables that may influence their decisions. Seventy-five per cent of respondents desired companionship in labour. Approximately 86% preferred their husband as companion while 7% and 5% wanted their mother and siblings as support person respectively. Reasons for their desire for social support were emotional (80.2%), spiritual (17.9%), errands (8.6%) and physical activity (6.8%). Socio-demographic variables found to be statistically significant on logistic regression analysis for the desire of a companion in labour were nulliparity (OR 3.57, 95% CI 1.49-8.52), professionals (OR 3.11, 95% CI 1.22-7.94) and women of other ethnic groups besides Yoruba (OR 2.90, 95% CI 1.02-8.26), which is the predominant ethnic group in the study area. Only those with post-secondary education were found to want their husbands as doula (OR 2.96, 95% CI 1.08-8.11). More than half of the respondents wanted information about labour prior to their experience. It is important that Nigerian women are allowed the benefit of social support during childbirth, particularly as there is a lack of one-to-one nursing care and other critical services, including epidural analgesia in labour, at many of the health care facilities in Nigeria. Men could play a pivotal role in the process of introducing support in labour so as to improve the outcome for both the mother and her newborn.
Journal of Biosocial Science 08/2008; 40(4):553-62. · 0.98 Impact Factor
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ABSTRACT: This was a comparative crossectional study that was conducted among 557 antenatal women at the University College Hospital, Ibadan, Nigeria between 1st April and 30th May 2006. The study compared the accuracy of haemoglobin estimation using an automated HemoCue B analyzer kit with a standard laboratory method (haemogloincyanide) as the gold standard. The result showed a positive correlation of HaemoCue haemoglobin results when compared with the standard methods (Pearson's correlation coefficient = 0.892; p value = 0.000). We concluded that the use of the automated HemoCue kit for haemoglobin estimation gives an objective assessment which overcomes the challenge of extra skilled manpower or power outages in rural areas thereby enhancing access to quality of care in resource poor countries.
African Journal of Reproductive Health 08/2008; 12(2):153-9.
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ABSTRACT: This study was a crossectional survey conducted among 716 senior secondary school adolescents in Ibadan from March to August 2005. The result of 695 that was analyzed revealed that the mean age of 15 +/- 2.6years. 28.3% of the respondents had previous sexual exposure with higher proportions being male (p = 0.00043). Majorities' first sexual exposure was unplanned. Family settings and educational level do not have significant influence on the previous sexual exposure. The methods of sexual activity were mainly through vagina route while some had also practiced oral and anal sex. Most of those that are sexually exposed had more than one partner. About half of the respondents learn about sex from their friends while others through their parents and media. We conclude that in-school adolescents practiced unsafe sexual activity and they are therefore predisposed to STI/HIV and other reproductive health risks.
African Journal of Reproductive Health 08/2008; 12(2):89-97.
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ABSTRACT: In Nigeria, breast-feeding has been shown to be very closely related to infant survival. Prolonged and adequate breast-feeding is critical to most infants' nutritional health and growth. This study aims to determine the influence of family support on the duration of exclusive and total breast-feeding of infants of antenatal patients. This cross-sectional study was conducted between 1 September and 30 December 2005. The tool was a structured questionnaire. The main outcome variables were the duration of breast-feeding; both total and exclusive explanatory variables were mainly related to support obtained during breast-feeding from husband and older female relations. Husbands support significantly increased the total duration of breast-feeding by a mean of 1.69 months (95% CI 0.88, 2.51), however, exclusive breast-feeding was not significantly affected by the husband's support (OR 0.94; 95% CI 0.63, 1.39). Female support had a significant influence on both the total duration of breast-feeding which is increased by a mean of 1.08 months (95% CI 0.14, 2.02), and the adequate conduct of exclusive breast-feeding (OR 1.83; 95% CI 1.17, 2.86). The cultural practice of having additional female support in the postpartum period has been shown by this study to be beneficial. Therefore, this cultural practice should be encouraged and catalogued as a beneficial cultural practice. This practice is also cheap and sustainable.
Journal of Obstetrics and Gynaecology 12/2007; 27(8):802-5. · 0.54 Impact Factor
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ABSTRACT: The repair of combined vesico-vaginal fistulas (VVFs) and recto-vaginal fistulas (RVFs) is challenging to both surgeon and patient. The multistage approach involves at least 3 surgical sessions, all associated with morbidity and sometimes with a colostomy procedure as well. The outcomes of the 1-stage approach were examined.
Twenty patients aged between 16 and 38 years were recruited for a multicenter study conducted from March 2005 to August 2006. Prolonged obstructed labor was the cause of all fistulas. The VVFs were mainly midvaginal (60%), juxtaurethral (25%), and juxtacervical (15%). The RVFs measured between 1 and 3 cm, they were low in 70% of cases, and 1 was associated with fourth-degree perineal tear. Bowel preparation was performed in all patients prior to surgery. No patient underwent temporary colostomy.
Both VVFs and VVFs were successfully closed in all patients, as evidenced by the continence dye test.
The combined repair relieves economic constraints and emotional challenges, and it accelerates restoration to health and social reintegration for women affected with both VVFs and RVFs.
International Journal of Gynecology & Obstetrics 12/2007; 99 Suppl 1:S90-3. · 2.05 Impact Factor
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ABSTRACT: Nigeria harbors an estimated 40% of all the women affected with obstetric fistulas today, and at the current rate of treatment in this country, it would take about 300 years to treat them if no new fistulas occurred. This situation obviously runs contrary to the ideals of the United Nations Millennium Development Goals and needs to be reversed. We reviewed the literature on fistula treatment in Nigeria to identify strategies and practices that, if adopted, would likely accelerate the pace of fistula repair and improve postoperative fistula care in this country. A comprehensive nationwide survey, a stronger political will and commitment of resources, a systematic postoperative care and follow-up, more fistula centers, and more fistula campaigns are necessary. Technically, the involvement of all surgeons trained in fistula repair and an experience-based postoperative management protocol will relieve the disease burden carried by women living with fistulas in Nigeria.
International Journal of Gynecology & Obstetrics 12/2007; 99 Suppl 1:S79-84. · 2.05 Impact Factor
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ABSTRACT: To assess the efficacy of local infiltrative anesthesia with lidocaine hydrochloride in patients undergoing the surgical repair of a simple vesico-vaginal fistula.
The study was carried out with 21 patients undergoing the repair of a simple midvaginal vesico-vaginal fistula. The patients' perception of pain was evaluated intraoperatively.
Most patients indicated that the anesthetic agent provided adequate analgesia, and all fistulas were repaired successfully without postoperative complications.
Repairing simple vesico-vaginal fistulas is feasible with a local infiltrative anesthetic.
International Journal of Gynecology & Obstetrics 12/2007; 99 Suppl 1:S75-8. · 2.05 Impact Factor
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ABSTRACT: To document trends in parameters of nutrition in south-western Nigerian school girls in comparison with earlier reports and provide baseline data for future comparison.
A cross-sectional study.
Fifteen secondary schools from the five local governments in Ibadan, Oyo State in south-western Nigeria.
One thousand six hundred and seventy five apparently healthy female students aged between nine and twenty three years.
One thousand six hundred and seventy three questionnaires were analysed. The mean age, mean height and mean body weight were 15.45 years +/- 2.06 (SD), 154.98cm +/- 8.4(SD) and 46.09kg +/- 8.8 (SD) respectively. The mean body fat was 11.12kg +/- 4.6 (SD); mean lean body mass (LBM) was 34.96kg +/- 4.6 (SD); mean total body water (TBW) was 25.17L +/- 3.3 (SD) and the mean body index (BMI) was 19.07kg/m2 +/- 2.7 (SD). Girls from upper socio-economic background had significantly higher values of anthropometric measurements and body composition for each age than lower socioeconomic class girls. Compared with their peers from another Nigerian city investigated two decades ago, girls in this study were significantly lighter and shorter.
The study revealed a decline in nutritional parameters among adolescents. The implications of these findings for the reproductive health of Nigerian women are discussed. Serial studies to monitor trends in adolescents are recommended.
East African medical journal 05/2005; 82(4):198-202.
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ABSTRACT: Pregnancy after the fifth delivery is viewed with anxiety, especially by obstetricians in developing countries working with inadequate facilities. High parity is still common with serious consequences to the fetus, the mother, the family and society. In the last 40 years, non-governmental, national and international efforts have been made to reduce fertility rates. We therefore intended to determine the trend in the grandmultiparity rates from 1 January 1987 to 31 December 1994 in the South Western part of Nigeria. The obstetric performance of these grandmultiparae in two different settings were to be compared. This was a retrospective, case-note analysis of all the grandmultiparae delivered at the University College Hospital (UCH) (Group A) and the Oluyoro Catholic Hospital (OCH) (Group B), both in Ibadan city. The former is a tertiary health care centre while the latter is a secondary centre. The socio-clinico-demographic characteristics of these patients were collated and analysis and comparison performed using EPI-INFO software. In Group A, 828 grandmultiparae were seen among 9215 deliveries, a rate of 8.99% (10.90% in 1987 to 3.36% in 1994). In Group B, there were 1940 cases among 22 587 deliveries, i.e. 8.59% (12.75% to 6.07%), respectively. The modal age group was 31-35 years, and women above 35 years formed one-third of cases. The parity group 5-7 was the most frequent in both groups (91.6% vs. 94.9%). Only two mothers (both in group B) had parity above 10. Booked patients formed a larger percentage in Group B than in Group A (85.8% vs. 69.7%, respectively). In Group B 85.9% had spontaneous vertex delivery as opposed to 66.3% in Group A. Caesarean section was the mode of delivery in 9.0% and 24.2% in Groups B and A, respectively. Equal percentages had breech delivery. The modal birth weight was 2.51-3.00 kg in both groups. Macrosomic babies formed 3.7% in Group A and 2.4% in Group B, while low birth weight babies formed 17.7% and 11.7% in Groups A and B, respectively. The crude perinatal death ratio was 123/1000 in Group A and 68/1000 in Group B. Antepartum haemorrhage, anaemia and premature rupture of membranes in Group A and anaemia, hypertension and antepartum haemorrhage in Group B were the most common pregnancy complications noted. In labour, abnormal lie/presentation, prolonged labour and premature labour in Group A and abnormal lie/presentation, antepartum haemorrhage and birth asphyxia in Group B formed the majority of the complications. The most common puerperal complications were primary postpartum haemorrhage, wound/genital sepsis in Group A and anaemia and primary postpartum haemorrhage in Group B, respectively. Maternal death ratio was 10.85/100 000 total deliveries in Group A and 35.42/100 000 in Group B. High parity is still common in developing countries, although the incidence is declining, with rates of 3.4% and 6.1% of total deliveries in Groups A and B, respectively. More patients are delivered per abdomen at UCH compared to OCH. The perinatal mortality rate is higher at UCH than OCH but the maternal mortality rates follow the reverse. Recommendations are made concerning the reduction in high parity rates and its associated complications.
Journal of Obstetrics and Gynaecology 08/2001; 21(4):361-7. · 0.54 Impact Factor
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Journal of Obstetrics and Gynaecology 05/2000; 20(3):277-9. · 0.54 Impact Factor
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ABSTRACT: One hundred and twenty consecutive patients with cancer of the uterine cervix were screened for human immunodeficiency virus (HIV) seropositivity before and after radiotherapy. The severity of the disease in terms of clinical staging and histological grading of HIV seropositive women was compared with that of seronegative women. The result showed a prevalence rate of 4.2% for HIV seropositivity which was similar to the rate quoted for the general populace in Nigeria. The HIV seropositive women presented with more severe disease state than the HIV seronegative women. The mean duration of remission was significantly shorter in the HIV seropositive women following radiotherapy (18.36+/3.96 vs. 24.24+/-6.3 months). It was concluded that HIV infection increases the severity and progression of cancer of the cervix in Nigerians. Radiotherapy has no effect on the patients' seropositivity and possibly no effect on the virus. A more aggressive treatment of carcinoma of the cervix and closer follow-up of HIV seropositive patients following treatment are necessary.
Journal of Obstetrics and Gynaecology 07/1999; 19(4):403-5. · 0.54 Impact Factor
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ABSTRACT: In this preliminary study, maternal and fetal blood lactate and 3-hydroxybutyrate (3-OHB) levels were assayed by specific enzymatic spectrophotometric methods in two groups of parturient Nigerian women during the three labour stages and their newborn: (i) thirty two women with babies' Apgar score > or = 6, and, (ii) eighteen women with babies' Apgar scores á 5. Cord blood was collected within 1 min. of cord clamping. In all the patients there was a lactate gradient between the foetus and mother. Neonates with Apgar score < 5 had greater cord blood 3-OHB levels. This could indicate reduced utilisation and/or increased production of this metabolite. Since in states of glucose deprivation as could be found in placenta insufficiency, 3-OHB is utilised by the foetus for the synthesis of essential cerebral lipids. It is speculated that the immediate poor clinical condition of babies with low Apgar scores may be a consequence of reduced synthesis of these cerebral lipids as they were unable to utilise circulating 3-OHB. The rapid response to routine resuscitative measures in these newborn babies could also indicate improved 3-OHB utilisation secondary to an improved tissue oxygenation status. These hypotheses from the basis for further studies.
African journal of medicine and medical sciences 06/1995; 24(2):169-72.
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ABSTRACT: To assess the safety of Norplant contraceptive implant use by women with mild-moderate homozygous sickle cell disease (HbSS).
Prospective observation of women pre- and post-insertion of Norplant, with each woman serving as her own control. Participants: 25 women 18-40 years of age who attended a hospital sickle cell clinic; post-insertion data were available for 23 women. Outcome measures: Changes in hematologic parameters including PCV, MCV, reticulocytes, ISCs, HbF and bilirubin; changes in biochemical parameters including HDL cholesterol, aspartate transaminase, alkaline phosphate, serum creatinine and serum albumin.
With a mean follow-up of 12.4 months (range 1-29 months), there were no clinically or statistically significant group or individual changes in the hematologic or biochemical parameters after Norplant insertion.
Norplant appears to be a safe and appropriate contraceptive for women with mild-moderate HbSS disease.
International Journal of Gynecology & Obstetrics 05/1993; 41(1):85-7. · 2.05 Impact Factor
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ABSTRACT: The use of cervical mucus scoring (modified Insler Score) in prediction and detection of ovulation in ovulatory cycles has been evaluated against serial ultrasonic follicular monitor and estimation of mid-luteal phase progesterone assay using the WHO match reagent system. The study showed that there was a very high positive correlation (r = +0.96) between the determination of day of ovulation by serial Insler score assessment and serial ultrasonography. Being simple to perform, cheap, rapid and reasonably accurate method of ovulation prediction and detection, cervical score assessment is recommended for use in fertility management in our environment with limited manpower, infrastructure and resources.
African journal of medicine and medical sciences 04/1993; 22(1):65-9.
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ABSTRACT: Obstruction of the vas deferens has been screened for, using the alpha-glucosidase reaction in seminal plasma as previously described by Comhaire. Eighteen patients with azoospermia were studied. The result showed positive reaction in 17 patients (95.0%) and only a weak yellow reaction in 1 patient. The results did not corroborate the working hypothesis that the azoospermia was due to obstruction of the vas deferens. The implications of this findings in the management of male infertility in Nigeria are discussed.
African journal of medicine and medical sciences 01/1993; 21(2):79-81.
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ABSTRACT: Thirty-nine spontaneous cycles in 34 women (22 patients from the infertility clinic and 12 normal volunteers) were serially studied by ultrasound to monitor follicular growth for ovulation prediction and detection. Ovulation was also confirmed by a mid-luteal phase progesterone assay using WHO match RIA kits. Ovulation occurred from the left ovary in 21 cycles (54%) and from the right ovary in 18 cycles (46%). The maximum follicular diameter prior to ovulation was 21.0 +/- 3.48mm with a range of 15-28 mm. The maximum pre-ovulatory size in the group of infertile patients 21.4mm (range 15-28 mm) was not statistically different from the size in normal volunteers 20.8mm (range 15.5-27mm) (P > 0.05). Bilateral ovulation occurred in two patients. Changes in shape and/or size of the follicle mostly associated with increased internal echoes were the indices of ovulation in 84.7% of cases. Follicular diameter of 15mm may indicate imminent ovulation in Nigerian women. Infertility management procedures such as artificial insemination, timed sexual intercourse may commence just before or once this follicular size has been attained until ovulation is detected.
African journal of medicine and medical sciences 12/1992; 21(2):57-61.
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ABSTRACT: Digitalis-like substance or plasma inhibitor factor was measured by a competitive binding method in 56 subjects comprising: (1) 12 normotensive normally menstruating non-pregnant women without a family history of hypertension; (2) 13 normotensive normally menstruating non-pregnant women with a family history of hypertension; (3) 15 normotensive pregnant subjects without a family history of hypertension; and (4) 16 subjects with clinical features of pregnancy-induced hypertension. Even though the mean value (1.14 +/- 0.12) of the inhibitor factor (expressed as KD ratios) in the non-pregnant women with family history was slightly higher than the mean value (0.95 +/- 0.12) in the non-pregnant women without a family history, the difference did not attain statistical significance. The mean value (1.25 +/- 0.24) of the inhibitor factor in the pregnant subjects without family history was, however, significantly elevated when compared with the non-pregnant subject without family history (P less than 0.05). The inhibitor factor levels in the subjects with pregnancy-induced hypertension were generally lower than those of the normotensive pregnant subjects, although the difference was not statistically significant. The relevance of these results to the understanding of the pathophysiology of pregnancy-induced hypertension is discussed.
African journal of medicine and medical sciences 10/1990; 19(3):167-71.
