Department of Obstetrics and Gynaecology

Permanent URI for this community

https://ir.unilag.edu.ng/handle/123456789/3609

Browse

Browsing Department of Obstetrics and Gynaecology by Author "Abodunrin, ON"

Now showing 1 - 3 of 3
  • Item
    Open Access
    Non-Fistulous Complications of Prolonged Obstructed Labour among Obstetric Fistula Patients in Southern Nigeria
    (2019) Abodunrin, ON; Daniyan, ABC; Okusanya, B; Ekwedigwe, KC; Uguru, SM; Yakubu, EN; Sunday-Adeoye, I
    Background: Long-term complications of prolonged obstructed labour are multisystemic, obstetric fistula about the most devastating. Efforts at controlling obstetric fistula pay little attention to the non-fistulous injuries which reduce the quality of life of the affected women even after a successful fistula repair. The objectives of this study were to determine the burden of the non-fistulous complications among fistula patients, identify these injuries and the factors associated with them. Methods: This cross-sectional study was conducted at the National Obstetric Fistula Centre, Abakaliki, South-East Nigeria from July to December 2016. The hospital has performed over 2600 free fistula repairs. This study was approved by the Research and Ethics Committee of the hospital. The study population comprised of women who developed obstetric fistula following prolonged obstructed labour. Direct questioning, examination findings, operation findings and laboratory results, using a pre-tested, semi-structured and interviewer-administered proforma were used to collect data. Informed consent was obtained from the subjects. Data were analyzed using the Statistical Package for Social Sciences [SPSS] version 21. Frequency and proportions were used to describe categorical variables while means and standard deviation were used to describe continuous variables. Association between categorical variables and direct obstructed labour injuries was tested using chi-square test and predictors of obstructed labour injuries were determined using logistic regression. A P-value < 0.05 was considered statistically significant. Results: One hundred and sixty one (161) women participated in the study. The mean age of the women was 33.4 years while the mean parity was 3.2. Non-fistulous complications of prolonged obstructed labour were found in 96.9% (156) of the women. These included cervical retraction (42.2%), obstetric nerve palsy (30.4%), vaginal scarring (29.8%), partial urethral loss (16.1%), anal sphincter injury (3.1%), cervical stenosis (5.0%) and urethral stenosis (3.7%). Others were ammoniacal dermatitis (29.2%), secondary amenorrhoea (21.7%), secondary infertility (9.3%), dyspareunia (6.8%), hypomenorrhea (1.2%) and bladder stone (3.7%). Majority (79.4%) of the women with cervical retraction had caesarean section (CS) as against 20.6% who had vaginal delivery. This was statistically significant (P < 0.001). A higher proportion of participants with amenorrhea were delivered via CS (44.3%) compared to those who had vaginal delivery (21.2%). This was also statistically significant (P = 0.012). Neurologic injury was associated with primiparity although this was not statistically significant (P = 0.171). Conclusion: Almost all fistula patients also have non-fistulous complications of prolonged obstructed labour. Efforts to manage the fistula should equally address these complications. We advocate comprehensive care for identification and management of these injuries to improve the quality of life and overall well-being of these women. To reduce complications like cervical retraction, there should be an emphasis on safer caesarean section for women with prolonged obstructed labour.
  • Item
    Open Access
    Peripartum hysterectomy in a Nigerian university hospital: An assessment of severe maternal outcomes with the maternal severity index model
    (2016) Okusanya, BO; Sajo, AE; Osanyin, GE; Okojie, OE; Abodunrin, ON
    Background: Peripartum hysterectomy is life-saving and a life-threatening criterion of the World Health Organization (WHO) maternal near-miss concept. The maternal severity index (MSI) model was developed to assess the outcome of severe maternal morbidities. This study assessed severe maternal outcomes of peripartum hysterectomy using the MSI model and related maternal severity score with mortality. Subjects and Methods: Records of women with peripartum hysterectomy over a 20-year period were retrieved and the documented WHO life-threatening conditions (severity markers) extracted. Severity markers were related with booking status, the level of specialist care and mortality. Comparison of dichotomous variables was done with Mantel–Haenszel statistics, and with one-tailed Fisher's exact test when the variable was <5, at 95% confidence interval andP< 0.05. Results: There were 30,553 deliveries and 145 women had a peripartum hysterectomy with an incidence of 4.8/1000 deliveries. Fifty women (50/116; 43%) had no associated severity markers. Fifty-eight (58/116; 50%) and 5% (6/116) women, respectively, had one and five severity markers. All women without a severity marker survived, but there was an exponential increase in mortality to 20.7% (12/58) in women with massive blood transfusion (MBT) and 66.7% (12/18) in women with both MBT and disseminated intravascular coagulopathy. Overall, peripartum hysterectomy case fatality was 13.8%. Other morbidities were anaemia (100%), febrile morbidities (55.2%), urinary tract infection (20.7%) and ureteric injuries (5.1%). Conclusion: The onset of severity markers was positively related to mortality. There should be early intervention to improve survival when an indication for peripartum hysterectomy occurs.
  • Item
    Open Access
    Serum melatonin levels in women with infertility: A case–control study in a Nigerian university hospital
    (2021) Ajepe, AA; Okusanya, BO; Abodunrin, ON; Osanyin, GE
    Background: Infertility is a public health issue in Nigeria, an environment of high daily sunlight exposure. This study objective was to assess the serum melatonin levels among infertile women and parous women in Nigeria. Methods: This was a case–control study involving 45 women of reproductive age with infertility and 45 parous women. Four milliliters of blood sample was collected from each of the participants between 1200 and 1600 h after written informed consent was obtained. Enzyme‐linked immunosorbent assay technique using melatonin‐specific monoclonal antibody was used for processing the samples. Obtained optical density was plotted and read off a standard curve. Data analysis was conducted with the Statistical Package for the Social Sciences version 23. A P < 0.05 was considered statistically significant. Results: The median serum melatonin values for women with infertility (27.86 pg/ml) and women without infertility (28.12 pg/ml) were similar (P = 0.735). Serum melatonin levels had insignificant negative correlation with age (P = 0.564), body mass index (P = 0.232), and daytime napping (P = 0.604). Melatonin levels had a nonstatistically significant positive correlation with duration of sleep (P = 0.789). Conclusion: This study found no significant difference in the serum melatonin levels in infertile and parous women. Melatonin supplementation in infertile women in our environment for the purpose of improving their fertility may not be recommended.