Search

Introduction: Cervical cancer is a leading cause of cancer-related mortality in Sub-Saharan Africa. Although the disease is largely preventable via routine cervical cancer screening, the uptake is ridiculously poor in the sub-region. In Nigeria, current efforts are directed at counselling and screening of eligible women in health care facilities. Therefore, the routine post-natal clinic visit at six weeks postpartum provides a good opportunity to offer cervical cancer screening services. Aim: To compare the acceptability of Pap-test and prevalence of abnormal cervical cytology between post-natal clinic attendees and other non-pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria. Materials and Methods: A cross-sectional analytical study was conducted from January to November 2014 in which acceptability and Pap-test results of 172 women attending the post-natal clinic were compared with an equal number of non-pregnant women from gynaecology and family planning clinics of the hospital. Both groups were selected by systematic sampling method. Outcome measures for each group included the prevalence of abnormal Pap-test and the proportion of women that accepted the Pap-test after appropriate cervical cancer education. Statistical analyses were both descriptive and inferential at 95% confidence level. Results: Prior to the study, 44.2% (76/172) of participants in postpartum group, and 47.7% (82/172) in control group were aware of Pap-test (p=0.473); while 9.3% (16/172) and 10.5% (18/172) had used Pap-test in the two groups respectively (p=0.718). All participants in each group accepted the Pap-test after cervical cancer education. Prevalence of cervical Squamous Intraepithelial Lesion (SIL) in the postpartum group was similar to that of the control group (OR: 1.8; 95%CI: 0.75-4.10; p=0.21). The most common SIL in both groups was low-grade squamous intraepithelial lesion. There was no statistically significant difference in the distribution of SIL categories (p>0.05). Conclusion: Acceptability and outcome of Pap-test are similar in post-natal and non-pregnant women in Enugu, Nigeria. Post-natal clinic visit provides an effective opportunity for routine cervical cancer information and screening in Nigeria.

Background and Aims: Although pregnancy and labor are considered physiological processes, the potential for catastrophic complications is constant and may develop rapidly. There is growing evidence that admission of high-risk patients into the Intensive Care Unit (ICU) is associated with a reduction in maternal mortality. This study was aimed at reviewing all obstetric patients admitted into the ICU. Materials and Methods: This was a retrospective study of all obstetric patients who were admitted into the ICU between January 1, 2012, and December 31, 2013. Results: There were 89 obstetric patients admitted and managed at the ICU out of 5176 deliveries, thereby accounting for 1 admission in 58 deliveries. Majority of the patients were between 26 and 30 years, primiparous, and unbooked. The indications for ICU admission in this study were ruptured uterus (36.0%), eclampsia (22.5%), obstetric hemorrhage (19.1%), septicemia (10.1%), severe preeclampsia (6.7%), and obstructed labor (6.7%). The maternal and perinatal mortality was 13.5% and 47.2%, respectively. Maternal unbooked status was significantly associated with maternal mortality ( P &*#60; 0.05). Conclusion: Ruptured uterus was the most common indication for ICU admission in the center. Maternal mortality was significantly associated with unbooked status. This underscores the importance of booking for antenatal care, prompt presentation at the hospital during emergencies, skilled birth attendance, and provision of adequate facilities for the management of critical obstetric cases in this environment.

Urinary and anal incontinence are major public health problems impacting on the quality of life of affected women, with resultant loss of self-esteem. Despite the anticipated magnitude of this public health problem in sub-Saharan Africa, there is paucity of data on the prevalence of urinary and/or anal incontinence after childbirth in the region. This study determined the prevalence and predictors of urinary and anal incontinence after vaginal delivery among women in Enugu, southeastern Nigeria.This was a longitudinal study of 230 consecutive parturients at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Eligible women were followed up immediately, 6 weeks, and 3 months postpartum to assess the development of urinary and/or anal incontinence using validated questionnaires.Overall, 28 women had urinary incontinence, giving a cumulative prevalence rate of 12.2 %. The cumulative prevalence rate was 13.5 % for anal incontinence and 3 % for combined urinary and anal incontinence. Age, social class, parity, prolonged second stage of labor, and neonatal birth weight were significantly associated with postpartum urinary incontinence (P 0.05). On the other hand, age, parity, prolonged second stage of labor, episiotomy, and instrumental vaginal delivery were significantly associated with postpartum anal incontinence (P 0.05).Urinary and anal incontinence are common after vaginal delivery in Enugu, Nigeria. Modification of obstetric care and discouraging preventable predisposing factors for incontinence, such as prolonged second stage of labor and vaginal delivery of macrosomic babies, are measures that may reduce the prevalence of postpartum incontinence in our population.

Background. Volume of red cells in capillary blood varies from that of venous blood. The magnitude of this variation as well as its impact on the diagnosis of anaemia in pregnancy needs to be studied. This study demonstrates the disparity between capillary and venous PCV in pregnancy.Objectives. To determine whether capillary blood PCV (cPCV) differed from venous blood PCV (vPCV) of normal pregnant women in Enugu, Nigeria, and its effect on diagnosis and prevalence of anaemia.Methods. PCV was estimated using pairs of venous and capillary blood samples from 200 consecutive pregnant women at the Antenatal Clinic of University of Nigeria Teaching Hospital, Enugu, Nigeria.Results. Participants’ cPCV(median=34.0%,IQR=31.0–35.8)was significantly lower than their vPCV(median=34.0%,IQR=32.0–37.0)(Z=-6.85,P<0.001). However, women’s cPCV had strong positive correlation with their vPCV (r=0.883,P<0.001). The prevalence of anaemia among participants using capillary and venous blood was 33.5% (67/200) and 28.0% (56/200), respectively (O.R=1.3(CI 95%: 0.85, 1.98), P=0.233).Conclusions. Capillary blood PCV was lower than vPCV among pregnant women in Enugu, Nigeria. Nevertheless, the prevalence of anaemia derived from cPCV did not differ significantly from that of vPCV.