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Background: There are no known effective vaccines or drugs for curing the corona 19 virus infection as at present knowlede. This leaves the world with mainly controlling the source of infection and cutting off the transmission route through preventive measures to contain the pandemic. These entail active participation of people, high level of discipline and strict and meticulous adoption of preventive measures. Since it is known that knowledge, precautionary behavior and active social participation of the public are important to control the pandemic, this study sets out to evaluate these in the antenatal population in Ebonyi State. Objective: To evaluate the Knowledge, attitude and practice of the respondents to the corona virus 19 infection and its prevention. Methods: A self-administered pre-tested questionnaire was administered to pregnant women attending antenatal clinics in the chosen Mission hospitals and the only tertiary health institution that offer antenatal care to the bulk of antenatal population in the state. The results were analyzed using SPSS version 20 and Microsoft Excel 2016. Result: The participants had very good knowledge of corona virus 19 infection and its prevention but there were some gaps and misconceptions in knowledge and some of their attitudes and perceptions that raised concerns. Their practice of corona virus 19 preventive measures was poor despite their good knowledge. Conclusion: There is need to fashion out programs and policies that will address the gaps and concerns unearthed in the study to enhance the protection of this vulnerable study population and the general public.

Background Postpartum hemorrhage is a leading cause of maternal morbidity and mortality worldwide, with uterine atony responsible in 80% of cases. In intractable cases, hysterectomy is the final treatment, but it has complications. Many doctors in developing countries with high maternal mortality rates from postpartum hemorrhage can perform cesarean deliveries but cannot perform hysterectomy. Patients with postpartum hemorrhage who need hysterectomy in these countries will die in such cases, whereas, if doctors know this simple, easily learned technique, such patients may survive. Technique Esike's technique is a uterine-compression method that uses supplies generally available at delivery hospitals. Six sutures are placed in the lower uterine segment, three anteriorly and three posteriorly. Starting with the middle sutures, the sutures are tied at the fundus with the help of an assistant to provide uterine compression. The more laterally placed sutures are then tied similarly, resulting in uterine compression and stoppage of postpartum hemorrhage. Experience Esike's technique was used in controlling life-threatening, uncontrollable postpartum hemorrhage in 18 women and was successful in 16 (89%) without requiring hysterectomy. Conclusion Esike's technique is effective in controlling life-threatening postpartum hemorrhage and can be used in low-resource settings with commonly available supplies and performed by doctors with a common level of training.

Introduction: Cancer of the cervix is the second commonest cancer among women worldwide, the commonest female genital‑tract malignancy in Nigeria, and one of the leading causes of morbidity and mortality among women in Nigeria. Health workers are the trusted source of medical information and their attitude and practice toward diseases of public health importance like cervical cancer are very critical if the country must make progress toward the prevention of such diseases. This work assesses the knowledge, attitude, and practice of Nigeria’s specialist doctors in training toward cervical cancer and its methods of screening because this is critical to its prevention in the country.Materials and Methods: This is a cross‑sectional study involving the administration of pretested structured questionnaire to fifty specialist Nigerian doctors in training in various disciplines from different parts of the country.Results: The knowledge of the participants regarding cervical cancer and its screening is very good, with an average of 98%, but their attitude toward cervical cancer screening is poor as only 7 (14%) had ever recommended a woman for cervical cancer screening. The practice of cervical cancer screening among the participants is poor as only 5 (22.7%) of the 22 female doctors in training had ever screened for cervical cancer and only one male specialist doctor in training out of the 28 of them had the partner screened for cervical cancer before this study. Only 4 (9%) of the 28 males had ever recommended cervical cancer screening to their female partner and 44 (88%) of the specialist doctors in training had never spoken to any organization about cervical cancer screening.Conclusion: Though the knowledge of Nigerian specialist doctors in training on cancer of the cervix and its screening is very good, their attitude to it and practice are very poor.Keywords: Attitude; cervical cancer screening; knowledge; Nigerian specialist doctors; practice

BACKGROUND: Cervical cancer is the most common type of cancer affecting the genital tract among women in developing countries. Screening programmes have been well talked about in Nigeria, but they are not well organized. Hence, the incidence of cervical cancer does not appear to be reducing. A possible way of solving this problem is by doing an opportunistic pap smear among women attending antenatal clinics, since a good number of women do access antenatal care. OBJECTIVES: To determine the prevalence, knowledge, awareness, practice, risk factors and pattern of Pap smear among women attending antenatal clinic in Mile 4 hospital, Abakaliki. METHOD: This is a cross-sectional study carried out at the antenatal clinic of Mile 4 Hospital, Abakaliki, Nigeria. A total of 110 consecutive pregnant women who fulfilled the inclusion criteria and have given their consent were recruited into the study at the time of their first prenatal (booking clinic) visit for antenatal care. Data was collected using a questionnaire. Conventional Papanicolaou smear was taken using the standard procedure. The cytopathologic findings were documented in the questionnaire. RESULTS: Out of the 110 pregnant women who had cervical cytology by Pap smear, 7 had pre-invasive cervical lesion, giving a prevalence rate of 6.3%; 5 (71.4%) were low-grade squamous intraepithelial lesion (LGSIL) while 2 (28.6%) were high-grade squamous intraepithelial lesion (HGSIL). Fifty women (45.5%) had negative smears. Inflammatory smears were seen in 50 women (45.5%). Insufficient smear was seen in 3 women (2.7%). Fifty-six women had knowledge about cervical cancer (50.9%), while thirty-six women (32.7%) were aware of a screening program for cervical cancer and only 2 women (1.8%) had been screened in the past. Hence, from this study, the population screening rate was approximately 2%. The risk factors were age of coitarche

Background: Stillbirths are very traumatic events to the parents, family, and obstetricians. Although a global public health crises, it has remained relatively hidden while their devastations continue unabated in different parts of the world. We have not evaluated this tragedy in our practice environment hence the need for this paper. Methods: This is a retrospective study involving all cases of stillbirths that occurred at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, over a 3-year period, 2017–2019. The case notes were gotten and relevant information was retrieved and analyzed. Results: The prevalence of stillbirths in our centre was 16.1 per 1000 deliveries or one stillbirth in 62 deliveries. Majority of our parturients who had stillbirths 89 (81.7%) were unbooked, 43 (39.5%) had only primary education, 16 (14.7%) had no education at all, and only 10 (9.2%) had tertiary education. The leading cause of stillbirths was abruptio placenta 27 (24.8%) followed by prolonged obstructed labor 22 (21.1%), intrauterine fetal death of unknown cause 18 (16.5%), and ruptured uterus 10 (9%). Seventy-three (67%) women were delivered by spontaneous vaginal delivery while 18 (16.5%) had a caesarean section. Thirty (27.5%) women had postpartum hemorrhage. None of the dead babies had an autopsy performed on them. Conclusion: The prevalence of stillbirth in our centre is unacceptably high and majority of the causes are preventable. There is an urgent need for public enlightenment to highlight this silent tragedy and mobilize efforts toward its prevention. Carrying out autopsies on stillbirths especially those with unexplained causes will help elucidate some of the causes.

Background: Despite the availability of effective antihypertensive drugs, the quality of evidence regarding the best antihypertensive agent for the treatment of hypertensive emergencies in pregnancy is still poor. Aim: The aim of this study was to compare the efficacy and side effects of oral nifedipine and intravenous hydralazine for control of blood pressure (BP) in severe hypertension in pregnancy. Materials and Methods: An open-label, parallel, randomised, controlled trial of 78 pregnant women (≥28 weeks' gestation) with severe hypertension was conducted. Severe hypertension was defined as systolic BP of 160 mmHg or above and/or diastolic BP of 110 mmHg or above. They were randomly (1:1 ratio) administered oral nifedipine 20 mg or intravenous hydralazine 10 mg every 30 min up to 5 doses or until the target BP of 140–150 mmHg systolic and 90–100 mmHg diastolic was achieved. Intravenous labetalol was given if the primary treatment failed. The primary outcome measure was the number of doses needed to achieve targeted BP. The secondary outcome measures were the time needed to achieve desired BP, maternal adverse effects and perinatal outcome. Results: The sociodemographic characteristics did not differ between the two study groups. The average number of dosages (nifedipine; 1.4 ± 0.6 vs. hydralazine; 1.7 ± 0.5, P = 0.008) needed to control the BP was lower in the nifedipine arm. Time (min) taken to control the BP was similar between the groups (hydralazine; 43.7 ± 19.7 vs. nifedipine; 51.2 ± 18.9, P = 0.113). Adverse maternal and perinatal effects did not differ in the study groups. Conclusion: Oral nifedipine and intravenous hydralazine showed comparable efficacy in the BP control in the severe hypertensive disorders of pregnancy without significant difference in adverse maternal and perinatal outcomes. However, further studies are required to explore the role of these drugs in BP control during hypertensive emergencies in pregnancy. ClinicalTrials.gov (Identification number: NCT04435210).

The Catholic Church in Nigeria offers premarital HIV screening to couples, yet instances of voluntary screening are rare in southeast Nigeria. This study examines the contribution of such tests to HIV detection, and evaluates the prevalence of HIV infection in southeast Nigeria among couples who are planning to marry. Out of 858 individuals (or 429 couples) tested for HIV, 52 individuals were found to be HIV-positive (overall prevalence 6.1%), and females were marginally more affected than males. In both sexes, prevalence was higher in younger age groups. Prevalence among adolescent females was 10.7%. Although no male adolescents were screened, prevalence for the group aged 20 to 29 years was 6.3% for females and 10.8% for males. The prevalence estimate was slightly higher for rural dwellers (6.2%) than for urban residents (5.9%), but this was not statistically significant. We propose that screening apparently healthy individuals, such as couples intending to marry, and who are otherwise not members of a group considered at high risk for HIV infection, can serve an important role in HIV detection in the general population. Keywords: Africa, church, counselling, testing and screening, seropositive partnersAfrican Journal of AIDS Research 2005, 4(2): 99–102

Introduction: Eclampsia is one of the most dreaded causes of adverse outcomes of pregnancy worldwide. It is one of the greatest causes of maternal and perinatal morbidity and mortality world over. We do not know the prevalence, management outcome, and the devastation caused by this dreaded disease in our center hence the need for this work. Materials and Methods: This is a 7-year retrospective review of all cases of eclampsia managed in Mater Misericordiae Hospital Afikpo, a rural secondary cum referral Catholic Mission Hospital in Afikpo, Ebonyi State in Southeastern Nigeria. Results: The prevalence of eclampsia in our center is 1.12% or one case of eclampsia for every 89 women that delivered in our facility. The majority of the women that had eclampsia in our center 56 (71.8%) were primigravidae. Seventeen women (21.8%) had various antenatal complications with 4 or 23.6% presenting with intrauterine fetal deaths and two (11.8%) each with intrauterine growth restriction, and domestic violence, respectively. Thirty-five or 44.9% of the women were delivered by emergency lower segment cesarean section. Fifteen or 17.9% babies were dead giving a perinatal mortality rate of 174 per 1,000After delivery, and 3 (3.8%) of the women had postpartum hemorrhage. Two women (2.6%) died giving a maternal mortality ratio of 2564 per 100,000 deliveries. Conclusion: Eclampsia is a dreaded obstetric disease with adverse fetal and maternal consequences that are not mitigating, and no effort should be spared in managing it effectively including public enlightenment.

Introduction: Family planning is very important and confers huge benefits to the woman, her family and country. It helps reduce maternal morbidity and mortality among other benefits. In spite of these obvious benefits of and the huge expenditure on it, uptake by women continues to be very low. We conducted this study to find out the reasons for this low uptake in our practice environment.Methodology: This is a cross sectional study where structured pre-tested questionnaires were administered to women in Abakaliki, the capital of Ebonyi State from February to April 2015.Results: Of the 354 questionnaires administered, 330 (93.2%) were complete and used for analysis. Majority of the respondents, 285 (86.4%) were in the 26 to 30 years age bracket. All of them were Ibos. Sixty two(18.8%) of the participants had one of their pregnancies unplanned and 19(5.7%) had at least one of their pregnancies unwanted. Though 300 (90.9%) had heard of family planning and was aware of it, only 180(54.5%) had used a family planning method before with majority, 105(58.2%) using natural family planning method. Only 22.7% of the participants was using a family planning method at the time of the study. In majority of the women, 166(50.3%) ,their fears about family planning was the troublesome side effects followed by 110(33.3%) whose husbands objected to their using family planning. Twenty seven women (8.2%) respectively did not use family planning because it is against their culture and religion.Conclusion: Though some progress have been made in family planning, a lot more will be achieved if new programmes are designed to involve the men more actively and address other identified fears among women with regards to family planning.Keywords: Abakaliki; barrier; family planning acceptance; Nigeria

Guillain–Barre syndrome (GBS) complicating pregnancy is a rare event, with documented incidence of 1–3 per 100,000 people annually. Maternal and perinatal mortality rate of >10% is associated with GBS. We present a 28-year-old gravida four para three housewife who developed progressive ascending paralysis during the second trimester of pregnancy. A detailed history and physical examination led to the clinical diagnosis of GBS; she had a preceding gastrointestinal infective episode. She did not consent to lumbar puncture for cerebrospinal fluid analysis, but all investigation results were normal. She was managed supportively as an in-patient with physiotherapy in conjunction with the physiotherapists. Her symptoms improved and she was discharged after 12 days. The rest of the pregnancy progressed uneventfully, and she had a spontaneous vertex delivery of a live female baby that weighed 2.55 kg with good Apgar scores, after 8 h of uncomplicated labour at term. She did not have any postpartum complications, and the neonate was healthy and normal.

Ruptured uterus is an obstetric catastrophe and results in significant maternal and perinatal morbidity and mortality in Nigeria.To review the incidence and management of ruptured uterus over the 8-year period (2000-2004 and 2007-2009) and analysis of records of cases of ruptured uterus during the period under review in a descriptive study.The incidence of uterine rupture is 1 in 81 deliveries with a contribution of 13.8% to maternal mortality in Ebonyi State University Teaching Hospital, Nigeria. There was high fetal wastage as 99 (97.1%) of the babies died. The highest incidence of ruptured uterus was found in the para 2-4 group. Teenagers constituted 4 (3.96%) of the cases. Majority of the rupture, 69 (65.4%) occurred anteriorly. Fifty-seven (56.4%) had only repair of the rupture done. The greatest complication was septicemia, which occurred in 32 (31.7%) of the patients.The incidence of uterine rupture is very high in our center. It is one of the highest causes of maternal and perinatal morbidity and mortality. There should be a multi-pronged effort aimed at improving the utilization of medical services by the populace and the health institutions offering efficient obstetric emergency care.

Miss OO was seen at the gynaecology clinic in April 2008 with history of a road traffic accident three years earlier. She was thrown off a motorcycle and fell astride a culvert, sustaining perineal injury. She was treated at a private hospital, but subsequently developed faecal incontinence and was usually soiled with faecal matter during coitus. Examination revealed loss of perineal body and reconstruction was done, with success. With increase in motorcycle accidents on our roads, many more gynaecologically-related traumas are bound to occur. Proper and timely referral will lead to improved management with reduced psychosocial trauma. Organized awareness creation programmes will reduce these accidents in the long-term.

Background: Teenage pregnancy is a high risk pregnancy associated with obstetric, fetal, neonatal and psycho‑social complications. These complications are worsened by poverty, ignorance and lack of special care during pregnancy. Aim: The objective of the following study is to determine the obstetric and neonatal outcome of teenage pregnancy. Materials and Methods: A retrospective case control study was carried out over a 6 years period, 2006‑2011. All teenage pregnancies (aged 13‑19 years) at Federal Medical Center Abakaliki, Ebonyi were taken as cases. Pregnancy deliveries from mothers aged 20 to 29 that met the inclusion criteria were selected as controls. A total of 137 teenage pregnancies were analyzed and compared with 948 controls. Statistical analysis was performed using 2008 Epi‑info statistical software version 3.5.1 (Atlanta, Georgia, USA). Results : The incidence of teenage deliveries over the period of the study was (137/8020) 2.25%. Single mothers were commoner (40.9% [56/137] vs. 3.1% [29/948], P < 0.01) among the teenagers. Low educational status was more common among teenage mothers (P < 0.01). Unbooked pregnancies were significantly common among teenage mothers (23.4% [32/137] vs. 12.3% [117/948], P < 0.01). Anemia in pregnancy (18.1% [41/226] vs. 11.2% [65/579], P = 0.01), human immunodeficiency virus (HIV) in pregnancy (4.9% [11/226] vs. 1.7% [10/579], P = 0.01) and malaria in pregnancy (26.1% [59/226] vs. 12.4% [72/579], P < 0.01) were significantly common in teenage pregnancies than the control. Teenage mother had significantly increased cesarean deliveries (23% [31/137] vs. 14.8% [140/948], P < 0.02), male deliveries (64.3% [90/140] vs. 52.1% [502/963], P < 0.03) and low birth weight (19.3% [27/140] vs. 12.7% [122/963], P < 0.03). Fetal loss (22.1% [31/140] vs. 3.3% [32/963] P < 0.01) and birth asphyxia (19.3% [27/140] vs. 6.8% [65/963], P < 0.01) were significantly common among teen mothers in the 1st min American Pediatric Gross Assessment Records score. Conclusion : Teenage pregnancies were associated with a significantly higher risk of anemia in pregnancy, HIV in pregnancy, malaria in pregnancy, cesarean deliveries and poor fetal outcome. Health education, women enlightenment and empowerment will be essential in reducing the problems of teenage pregnancy. Keywords : Abakaliki, outcome, teenage pregnancy, tertiary hospital