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Objective To determine if genetic polymorphism of VEGF is associated with the development of endometriosis in Nigerian women. Study design Case control study of 100 women (50 healthy controls and 50 with endometriosis). Serum VEGF concentration of participants were determined using enzyme-linked immunosorbent assay (ELISA) technique. Genomic DNAs were isolated from peripheral blood samples and quantified by nanodrop spectrophotometer one. Single nucleotide polymorphisms genotyping was carried out by polymerase chain reaction and restriction fragment length polymorphism (PCR–RFLP). Results Mean age of participants was 32.96 ± 6.91 years for control and 32.04 ± 7.56 years for cases. VEGF levels in case and control groups were not statistically different (82.68 pg/ml [69.11–121.11 pg/ml] vs. 82.81 pg/ml [72.90–113.82 pg/ml] respectively; p = 0.967). All four genotypes examined were in Hardy–Weinberg equilibrium. Minor allele frequency of − 460T > C, − 1154G > A, + 936C > T and + 2578C > A were 24%, 8%, 6% and 10% in the control and 19%, 9%, 5% and 14% in endometriosis patients. However, allele and genotype distributions of − 460T > C, − 1154G > A, + 936C > T and + 2578C > A VEGF polymorphisms in endometriosis patients and control were not significantly different (p > 0.05). Conclusion Our preliminary findings revealed no association between endometriosis and − 460T > C, − 1154G > A, + 936C > T and + 2578C > A of VEGF genes among Nigerian women.

Introduction:in Africa, genetic diseases and congenital anomalies remain a significant source of morbidity and mortality. Existing data suggests a gap in the use of prenatal tests among pregnant women to better inform decision making. We examined relationships of socio-demographic factors with willingness to terminate affected pregnancies, and the use of, knowledge of, and attitudes towards prenatal screening/diagnostic tests. Methods:this was a cross-sectional descriptive study of pregnant women who attended antenatal clinics at the Lagos University Teaching Hospital (N = 422) selected by convenience sampling. Responses were obtained with assisted self-administered structured questionnaires. Results:mean ± S.D. age of the respondents was 32.5 ± 5.3 years. The majority of the participants (92.2%) had at least a secondary education. Ultrasound scans in the second trimester were the most frequently used test (39.1%). Only 77 (18.2%) of the respondents indicated willingness to terminate affected pregnancies. The majority of the respondents had fair knowledge and good attitude scores. Knowledge and attitude scores were significantly correlated (r = 0.25, p < 0.001). Compared to married women, being single was associated with a 2.62-point lower knowledge score (95% CI: -4.63, -0.62, p = 0.01). Compared to women who responded “no” when asked if they were willing to terminate an affected pregnancy, women who responded “maybe” had a 0.81-point lower attitude score (95% CI: -1.45, -0.17, p = 0.01). Conclusion:our results suggest important socio-demographic differences in women´s knowledge/behaviours towards prenatal diagnostic tests. Further research is needed to explore these relationships and broader pregnancy-related ethical beliefs among pregnant women in Lagos.

The impact on healthcare services in settings with under-resourced health systems, such as Nigeria, is likely to be substantial in the coming months due to the COVID-19 pandemic, and maternity services still need to be prioritized as an essential core health service. The healthcare system should ensure the provision of safe and quality care to women during pregnancy, labor, and childbirth, and at the same time, maternity care providers including obstetricians and midwives must be protected and prioritized to continue providing care to childbearing women and their babies during the pandemic. This practical guideline was developed for the management of pregnant women with suspected or confirmed COVID-19 in Nigeria and other low-resource countries.

Introduction:genetic diseases and congenital anomalies place a significant burden on the health of new-borns and their mothers. Despite the availability of a variety of prenatal screening tests, mothers' knowledge has been documented to determine uptake. This study aims to assess the knowledge of pregnant women about birth defects and the associated correlates with regard to willingness to do prenatal screening. Methods:a cross-sectional descriptive study was conducted among 422 antenatal mothers recruited sequentially as they attended antenatal clinics at the Lagos University Teaching Hospital. An interviewer-administered questionnaire was used to determine their knowledge of birth defects and willingness to do prenatal testing. Results:majority of the participants (92.2%) had at least secondary education. The mean total knowledge score of the respondents was 63%. Age and knowledge scores were not significantly correlated (r=-0.071, p=0.14). Being employed predicted higher knowledge scores (95% CI: 0.09, 2.09, p=0.03). Respondents who had primary school education and those who replied "I don't know" to willingness to test had significantly lower knowledge scores (95% CI:-15.01, -1.19, p=0.02 and 95% CI:-4.52, -0.68, p=0.01 respectively). Majority (79.1%) of the respondents were willing to undergo testing. Respondents' level of education was significantly associated with willingness to test (p=0.03). Conclusion:the observed knowledge gaps were considerable. There is need for improvement in education, the empowerment of women and access to quality healthcare including prenatal screening.

IntroductionPregnancy in sickle cell disease is fraught with many complications including pre-eclampsia (PE) and intrauterine growth restriction (IUGR). Previously, we found an abnormality in prostacyclin–thromboxane ratio in sickle cell pregnant women, a situation that is also found in non-sickle pregnancies with PE and unexplained IUGR. Low-dose aspirin (LDA) has been shown to reduce the incidence of PE and IUGR in high-risk women by reducing the vasoconstrictor thromboxane while sparing prostacyclin, in effect ‘correcting’ the ratio. It has been found to be safe for use in pregnancy but has not been tested in sickle cell pregnancy. We hypothesise that LDA will reduce the incidence of IUGR and PE in pregnant haemoglobin SS (HbSS) and haemoglobin SC (HbSC) women.Methods and analysisThis is a multisite, double blind, randomised controlled trial, comparing a daily dose of 100 mg aspirin to placebo, from 12 to 16 weeks’ gestation until 36 weeks, in Lagos state, Nigeria. Four hundred and seventy-six eligible pregnant HbSS and HbSC women will be recruited consecutively, randomly assigned to either group and followed from recruitment until delivery. The primary outcome will be the incidence of birth weight below 10th centile for gestational age on INTERGROWTH 21 birth weight charts, or incidence of miscarriage or perinatal death. Secondary outcomes will include PE, maternal death, preterm delivery, perinatal death, number of crises, need for blood transfusion and complications such as infections and placental abruption. Analysis will be by intention to treat and the main treatment effects will be quantified by relative risk with 95% CI, at a 5% significance level.Ethical approvalEthical approval has been granted by the Health Research and Ethics committees of the recruiting hospitals and the National Health Research and Ethics Committee. Study findings will be presented at conferences and published appropriately.Trail registration numberPACTR202001787519553; Pre-results.

Background: Though hematological changes occur in pregnancy, changes in platelet indices have not been widely studied, and we do not have reference ranges for use in pregnancy. Objective: To assess effect of pregnancy on platelet indices and establish reference values for these parameters in pregnancy. Methodology: A prospective descriptive study involving 161 consenting healthy HIV seronegative women: 80 pregnant and 81 nonpregnant. Information on their sociodemographic characteristics, obstetric, and past medical histories were obtained. Full blood count was determined by Mindray BC3200-automated hematological analyzer, and their platelet count (PLT), mean platelet volume, plateletcrit, and platelet distribution width (PDW) were retrieved. Data were analyzed using Epi Info version 3.5.1. Results: Platelet count that is most commonly used in clinical practice has a mean (±SD) value of 217.32 × 109 (± 64,990) cells/L in nonpregnant women and 205.48 × 109 (±57,226) cells/L in pregnant women. Only PDW showed statistically significant increase across the three trimesters as pregnancy advances (p = 0.02). The population reference ranges for PLT was 85.74–348.90 × 109 cells/L in nonpregnant women and 90.31–320.65 × 109 cells/L in pregnant women. Conclusion: Platelet indices are affected by pregnancy, and there is a need to redefine thrombocytopenia in pregnancy in our setting in order to minimize the risk of unnecessary interventions or denial of necessary treatment.

Background: Hypertensive disorders are one of the most common medical conditions that may complicate pregnancy. Postpartum blood pressure (BP) pattern is, however, less clear in affected women and decision to discharge them is usually decided arbitrarily. Materials and Methods: A cohort study conducted at Lagos University Teaching Hospital, Lagos, Nigeria, aimed at determining the proportion of pregnant women with pregnancy-induced hypertension (PIH) and preeclampsia (PE) whose BP remains elevated 6 weeks postdelivery and factors associated with the persistent rise. Fifteen women each with PIH and PE were studied in different phases of pregnancy and followed up until 6 weeks postdelivery. Fifteen normotensive pregnant women served as controls. BP patterns were monitored and fasting lipid levels, serum creatinine, fasting glucose profile (FGP), and FGP/insulin ratio were assayed. Data were analyzed with IBM SPSS version 20. Results: Proportion of women with PIH or PE who had persistent hypertension at 6 weeks postpartum was 3/29 (10.3%), risk ratio of 1.1. No statistically significant association was found between mean arterial BP at 6 weeks postpartum and age, parity, gestational age at delivery, body mass index, and family history of hypertension. Serum creatinine level showed moderate correlation with persistent hypertension at 6 weeks postpartum (r = 0.441,P = 0.006), with sensitivity of 100% and specificity of 81.8% at cutoff value of 1.2 mg/dL in detecting pregnant women with hypertensive disorders who will likely remain hypertensive at 6 weeks postpartum. Conclusion: There is a need for long-term follow-up of women with PIH/PE beyond puerperium.

Objective: The aim of this study was to evaluate foeto-placental (F/P) parameters, namely foetal birth weight, placental weight (PW) and F/P weight ratio, in normal pregnancy and factors affecting them. Methodology: A retrospective study was conducted on labour ward data obtained over a period of 3 years (2015–2017). Only deliveries above 28-week gestational age which met other selection criteria were included in the study. Their sociodemographic parameters, PW, foetal birth weight, foetal outcome and Apgar scores were extracted from the delivery registers. The F/P weight ratio was calculated from the values obtained. All data collected were subjected to statistical analysis using SPSS version 20. Results: The mean age ± standard error of mean of parturient was 31.84 ± 0.18 years. A larger proportion, 1455 (80.7%) of the women were booked. The mean gestational age ± standard deviation at delivery was 37.81 ± 2.72 weeks. Foetal weight (FW), PW and F/P weight ratio rise progressively with advancing gestational age in normal pregnancy, the FW rising faster than the placenta which gains weight slowly. The F/P ratio rises steadily initially and then abruptly from 42-week gestational age as the foetus outgrows the placenta, after which there is a sharp decline from 43-week gestational age. FW, PW and F/P ratio are significantly affected by gestational age and booking status (P = 0.000). Parity and foetal sex were found to have significant influence on FW alone (P = 0.026 and P = 0.000, respectively). Conclusion: This study clarifies the need to avoid undue prolongation of pregnancy beyond 42 weeks to avert adverse consequences which may be related to the differential growth in the foetus and placenta.

Objective: This study aimed at ascertaining the relationship between obesity and preeclampsia and the role of fibrinogen and C‑reactive protein (CRP).Study design: This was a case‑control study involving 200 pregnant women, 100 of whom were healthy pregnant women, and 100 preeclamptic women, matched for age, parity, and gestational age. Information about their sociodemographic characteristics was obtained and body mass index (BMI) calculated using their height and weight at recruitment. Their plasma fibrinogen and CRP levels were assayed using enzyme‑linked immunosorbent assay (ELISA) technique. All data collected were subjected to statistical analysis using Epi Info.Results: The mean (±SD) age of subjects was 31.1 ± 4.51 years. The preeclamptic subjects were found to have higher BMI (30.04 ± 6.06 kg/m2) compared to the normotensive pregnant women (28.08 ± 2.97 kg/m2). However, this was not statistically significant. Using mean arterial blood pressure as an indicator of disease severity, with a cut‑off of 125 mmHg, it was found that severe preeclamptics had higher BMI (30.18 ± 6.49 kg/m2) compared to women with mild form of the disease (29.83 ± 5.48 kg/m2) but this difference was not statistically significant (P = 0.2131). There was also statistically significant association between BMI and high‑sensitivity C‑reactive protein (hsCRP) (P = 0.0000), and between BMI and plasma fibrinogen levels (P = 0.0000).Conclusion: It can thus be inferred from this study that obesity elicits inflammatory response which might predispose to the development of preeclampsia. Lifestyle modifications such as dietary control, exercise, and pre‑pregnancy weight reduction may help in reducing the incidence of preeclampsia.Key words: C‑reactive protein; obesity; pre‑eclampsia; plasma fibrinogen; severity of the disease.