Obstetrics and Gynaecology- Scholarly Publications
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- ItemOpen AccessExpanding access to maternal health services for pregnant adolescent girls(2021-12) Okaga, S.K.; Momah-Haruna, A.P.; Iwayemi, V.V; Balogun, T.K.; Odeseye, A.; Ayanbadejo, J.O.; Adelakin, O.; Omosehin, O.A significant proportion of pregnant adolescent girls do not seek appropriate care during pregnancy because antenatal care services are ill-adapted to their age-group. To bridge this gap, the Lagos State Government established a “Young Moms Clinic” where antenatal care services uniquely tailored to the needs of pregnant adolescents was piloted for six months. During this period, 106 pregnant adolescent girls enrolled in the clinic and 98% of them completed the minimum four ANC visits required of them. In addition, they acquired knowledge on newborn care, sexual reproductive health and were either re-integrated back to school or empowered with income-generating skills following delivery. In this regard, the Young Mom’s Clinic is a promising approach to meet the needs of pregnant adolescent girls as it expanded their access to the type of specialized care not readily accessible to them within public health facilities. (Afr J Reprod Health 2021; 25[6]: 15-19).
- ItemOpen AccessFetal Congenital Anomaly in Tertiary Hospital in Lagos, South-West Nigeria: A Review of Presentation and its Outcome(2019) Osanyin, G.E.; Odeseye, A.; Okojie, O.O.; Akinajo, O.R.; Okusanya, B.O.Background: Congenital Anomalies are a major contributor to perinatal deaths worldwide. The World Health Organization (WHO) estimates that 303,000 newborns die within the first 4 weeks of life worldwide as a result of it. The exact cause is often difficult to determine and as such efforts are geared towards prevention AIM AND OBJECTIVE: This study was done to determine the common presentations as well as epidemiological features of pregnant women with anomalous fetus and at the Lagos University Teaching Hospital. This may help to develop strategies for patient counseling and management. Method: This study is a retrospective, cross sectional hospital based study conducted at the department of Obstetrics and Gyneacology of the Lagos University Teaching Hospita,l Idi-Araba during the period Jan 2012-Dec 2016. Relevant information regarding maternal age, parity, gestational age and pregnancy outcomes was documented from the delivery records of the mothers. Results: One hundred (100) babies out of the total of 5,747 babies within the period under study were born with congenital anomalies giving a prevalence rate of 1.7% at the Lagos University Teaching Hospital. The commonest congenital anomaly seen was hydrocephalus, others were omphalocele, anorectal anomalies and multiple congenital anomalies (in particular neural tube defects coexisting with various forms of limb defects). Conclusions: Public awareness of the importance of preconceptional care, elimination of environmental risk factors as well as provision of prenatal diagnostic facilities and improvement of antenatal care are of great benefit in early detection and management of congenital anomalies.
- ItemOpen AccessUterine rupture at Lagos University Teaching Hospital(WOLTERS KLUWER - MEDKNOW, 2017-01) Adegbola, O.; Odeseye, ABackground: Uterine rupture remains a major life‐threatening obstetric disaster encountered in many developing countries and is associated with a high maternal and perinatal mortality and morbidity. Objectives: The objective of this study was to determine the incidence, associated risk factors, trend, clinical presentation, management as well as maternal and fetal outcome of uterine rupture at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Materials and Methods: This was a retrospective study of patients with uterine rupture at the LUTH, Idi‐Araba, Lagos, Nigeria, from June 1, 2005 to May 31, 2013. The case records of patients in this period were retrieved from the medical health records department. The relevant data of sociodemographic characteristics, clinical presentation, management as well as maternal and perinatal outcome were collated using a structured questionnaire. Results: Of the 13,138 deliveries during the study period, there were eighty cases of uterine rupture giving a hospital incidence of 6.1/1000 deliveries. Patients with parities of 1 (28.36%) and 2 (38.81%) were identified to be at higher risk of uterine rupture. Previous caesarean section (46.28%), obstructed labor (26.87%), and injudicious use of oxytocin (16.42%) were the common associated factors. Rupture along previous anterior scar was the most common site affected in 32.84%; repair with bilateral tubal ligation was the surgical procedure in most of the cases (47.76%). The case fatality rate for ruptured uterus was 11.94% for the mothers and the perinatal mortality rate of 791/1000 babies. Conclusion: Uterine rupture is a major cause of maternal and perinatal death in Lagos, Nigeria.
- ItemOpen AccessExpanding access to maternal health services for pregnant adolescent girls(African Journal of Reproductive Health December, 2021-12) Okaga, S.K.; Momah-Haruna, A.P.; Iwayemi, V.V; Balogun, T.K.; Odeseye, A.; Ayanbadejo, J.O.; Adelakin, O.; Omosehin, O.A significant proportion of pregnant adolescent girls do not seek appropriate care during pregnancy because antenatal care services are ill-adapted to their age-group. To bridge this gap, the Lagos State Government established a “Young Moms Clinic” where antenatal care services uniquely tailored to the needs of pregnant adolescents was piloted for six months. During this period, 106 pregnant adolescent girls enrolled in the clinic and 98% of them completed the minimum four ANC visits required of them. In addition, they acquired knowledge on newborn care, sexual reproductive health and were either re-integrated back to school or empowered with income-generating skills following delivery. In this regard, the Young Mom’s Clinic is a promising approach to meet the needs of pregnant adolescent girls as it expanded their access to the type of specialized care not readily accessible to them within public health facilities. (Afr J Reprod Health 2021; 25[6]: 15-19).
- ItemOpen AccessRegional versus general anaesthesia for caesarean section(Cochrane Database Syst Rev, 2012) Afolabi, B.B.; Lesi, F.E.Background Regional anaesthesia (RA) and general anaesthesia (GA) are commonly used for caesarean section (CS) and both have advantages and disadvantages. It is important to clarify what type of anaesthesia is more efficacious. Objectives To compare the effects of RA with those of GA on the outcomes of CS. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 November 2011). We updated the search on 20 August 2012 and added the results to the awaiting classification section of the review. Selection criteria Randomised and quasi-randomised controlled trials evaluating the use of RA and GA in women who had CS for any indication. Cluster-randomised trials and trials using a cross-over design are not included. Data collection and analysis Two review authors independently assessed trials for inclusion, assessed risk of bias and extracted data. Data were checked for accuracy. Main results Twenty-two out of 29 included studies (1793 women) contributed data to this review. The included studies did not report some our primary outcomes: maternal death, incidence of maternal postoperative wound infection, maternal postoperative other infection such as endometritis and urinary tract infection, neonatal death. Compared to women who had GA, women who had either epidural anaesthesia or spinal anaesthesia were found to have a significantly lower difference between pre and postoperative haematocrit. For epidural, the mean difference (MD) was 1.70% and 95% confidence interval (CI) 0.47 to 2.93 (one trial, 231 women) and for spinal anaesthesia, the MD was 3.10% and 95% CI 1.73 to 4.47 (one trial, 209 women). Compared with GA, women having either an epidural anaesthesia or spinal anaesthesia had a lower estimated maternal blood loss (epidural versus GA: standardised mean difference (SMD) -0.32 mL; 95% CI -0.56 to -0.07; two trials, 256 women; spinal versus GA anaesthesia: SMD -0.59 mL; 95% CI -0.83 to 0.35; two trials, 279 women). There was evidence of a significant difference in terms of satisfaction with anaesthetic technique - compared with the epidural or spinal group, more women in the GA group stated they would use the same technique again if they needed CS for a subsequent pregnancy (epidural versus GA: risk ratio (RR) 0.80; 95% CI 0.65 to 0.98; one trial, 223 women; spinal versus GA anaesthesia: RR 0.80; 95% CI 0.65 to 0.99; one trial, 221 women). No significant difference was seen in terms of neonatal Apgar scores of six or less and of four or less at five minutes and the need for neonatal resuscitation with oxygen. Authors’ conclusions There is no evidence from this review to show that RA is superior to GA in terms of major maternal or neonatal outcomes. Further research to evaluate neonatal morbidity and maternal outcomes, such as satisfaction with technique, will be useful.