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Prevalence of Dyspareunia and Its Effect on Sexual Life among Gynaecological Clinic Attendees in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria

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Advances in Sexual Medicine 2019年第4期9卷 110-119页

作者： Sunday Uchenna Asogwa johnbosco ifunanya nwafor Ayodele Adegbite Olaleye Darlington-Peter Chibuzor Ugoji Chuka Nobert Obi Chukwunenye Chukwu Ibo Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dyspareunia and its effect on sexual life among gynaecology clinic attendees in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Methods: A cross-sectional study was conducted on consenting participants between 12th May 2016 and 25th July 2016. Anonymous self-administered questionnaires were used collection information on dyspareunia and its effect on sexual life at the Gynaecology clinic. The data was analyzed using Epiinfo version 7.1.5. Results: One hundred and four (104) women participated in this study. Most of the women studied were Igbos (95.19%), and were mainly between the age ranges of 21 - 30 years (66.35%). Most of them were married (89.42%), and were also mainly of the Pentecostal denomination (40.78%). The mean age at coitarche was 20.6 ± 3.95 years. Prevalence of dyspareunia was 36% and only 16% sought medical help. The various responses to dyspareunia were avoidance of sex 11%, reduced frequency of intercourse 8%, less desire for sex 19%, while majority of women with dyspareunia tolerated it (62%). Conclusion: The prevalence of dyspareunia is high in our society afflicting young women in their reproductive years with associated enormous stress on their sexual life.

关键词： Prevalence of Dyspareunia and Its Effect on Sexual Life among Gynaecological Clinic Attendees in Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

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Profiling the Socio-Demographic Characteristics and Outcome of Preterm Delivery in Alex Ekwueme Federal University Teaching Hospital Abakaliki

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Open Journal of Obstetrics and Gynecology 2019年第8期9卷 1168-1177页

作者： Malachy Chizoba Onyema Vitus Okwuchukwu Obi johnbosco ifunanya nwafor Chinwe Wendy Oliobi Bridget Nkiruka Uche-Nwidagu Assumpta Nnenna Nweke Paschal Chijioke Okoye Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Background: Preterm delivery is a major cause of perinatal morbidity and mortality globally. In more than half of the cases, the exact cause is unknown and it is largely unpredictable. Certain maternal, social and demographic characteristics are risk factors and often help to predict and prognosticate the neonatal outcomes. Objective: This study was designed to determine the maternal socio-demographic characteristics and neonatal outcomes of patients managed for singleton preterm delivery in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Method: This was a 4-year retrospective analysis of patients managed for preterm birth from 1st January 2012 through 31st December 2015. Results: Over the study period there were a total number of 623 singleton preterm deliveries in the facility, while there were 9647 deliveries in the facility;the preterm birth rate was 6.5% or 65 per 1000 deliveries. The mean maternal age was 28.79 ± 5.33 while the mean parity was 1.89 ± 1.98. The mean gestational age and birth weight were 33.67 ± 2.62 and 2.30 ± 0.78 kg respectively. Apgar score in 1 minute was 6.89 ± 3.27, while in the 5th minute was 7.95 ± 3.42. Majority of the patients were multiparous and booked for antenatal care in the facility. Most of the preterm labour started spontaneously and were delivered vaginally. The caesarean section rate in this study was 35.5%. Fetal distress and preeclampsia/eclampsia were the commonest indications for caesarean section. The male to female ratio was 1.1:1. Nearly half of the neonates were born with normal birth weight and 427 (68.5%) were alive at discharge. However, 196 (31.5%) suffered early neonatal death due to prematurity. Maternal parity, booking status and fetal weight were significant determinants of fetal outcome with a p-value 0.05. Conclusion: Birth weight was the most important determinant of neonatal survival and the unbooked patient was an important determinant of poor outcome. Booking for antenatal care and ensuri

关键词： Preterm Delivery Maternal Sociodemographic Characteristics Neonate

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Epidemiology and Management of Ectopic Pregnancy in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Southeast, Nigeria

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Open Journal of Obstetrics and Gynecology 2019年第8期9卷 1202-1211页

作者： Bridget Nkiruka Uche-Nwidagu Vitus Okwuchukwu Obi johnbosco ifunanya nwafor Assumpta Nnenna Nweke Chinwe Wendy Oliobi Malachy Chizoba Onyema Paschal Chijioke Okoye Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Background: Ectopic pregnancy is a common cause of maternal morbidity and mortality in the 1st trimester of pregnancy;without timely diagnosis and intervention, ruptured ectopic pregnancy can become a life threatening condition. Objective: This study aims to give baseline indices on the incidence, clinical presentation, risk factors and the management of cases of ectopic pregnancy that presented in Alex Ekwueme Federal University Teaching Hospital, Abakaliki over a 5-year period. Materials and Method: This is a 5-year retrospective study of patients who were diagnosed with ectopic pregnancy between January 1st 2012 and December 31st 2016. The statistical analysis was done using SPSS version 22. Result: During the study period, there were 11,932 deliveries while 7725 Gynaecology patients were admitted. Over the same period there were 156 patients diagnosed and managed for ectopic pregnancy, accounting for 1.31% of all deliveries and 2.0% of all Gynaecological admissions. The modal age group was 26 - 30 years 68 (43.6%), 122 (78.2%) were married, while 34 (21.7%) were single. Nulliparous were 41 (26.3%) and primiparous were 33 (21.2%). The commonest presenting complaints were lower abdominal pain and amenorrhea, and the commonest identified risk factor was previous pelvic inflammatory disease. Most of the cases were ruptured prior to presentation and partial salpingectomy was the management in all tubal pregnancy while two cases were unruptured and had salpingostomy and another case was abdominal pregnancy and had exploratory laparotomy only. Out of 156 women that presented with ectopic pregnancy, 8 (5.1%) died before surgery could be done due to late presentation. Fifty-seven women presented in a state of shock and 9 (5.8%) of the cases were complicated with acute renal failure. Conclusion: Ruptured ectopic pregnancy is a major cause of maternal morbidity and early pregnancy loss. Late presentation is a common feature in our environment;hence widespread advocacy on c

关键词： Epidemiology Management Ectopic Pregnancy Abakaliki

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Pregnancy Outcome among Women with Sickle Cell Disease in a Tertiary Health Institution in Abakaliki: A Retrospective Case-Control Study

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International Journal of Clinical Medicine 2019年第8期10卷 395-403页

作者： johnbosco ifunanya nwafor Darlington-Peter Chibuzor Ugoji Chukwunenye Chukwu Ibo Blessing Idzuinya Onwe Victor Jude Uchenna Onuchukwu Chuka Nobert Obi Vitus Okwuchukwu Obi Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Background: Sickle cell disease (SCD) is associated with an increased risk of medical complications during pregnancy and they constitute a very high-risk group with associated increased maternal and perinatal morbidity and mortality especially in a low resource setting. Objective: To determine the pregnancy outcomes among women with sickle cell disease delivered at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and methods: This was a 7-year retrospective case-control study undertaken from January 2012 to December 2018 that compared pregnancy outcomes among women with and without haemoglobinopathy in pregnancy managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA). The statistical analysis was done using SPSS version 22. Results: The incidence of SCD in pregnancy was 6.9 per 1000 deliveries. The age distribution of the women ranged from 18 to 45 years of age with a mean of 26.4 ± 2.4 years. The incidence of stillbirth was higher in women with HbSS when compared with HbSC but this difference did not reach statistical significance (P = 0.05). Live birth rate was higher in women with HbAA genotype when compared with those with SCD. Caesarean section rate was higher among women with SCD when compared with control (SS versus AA, P = 0.004;SC versus AA, P Conclusion: This study showed that the maternal mortality in SS and SC patients in pregnancy was not different from those of HbAA women in our hospital, although other maternal and fetal outcomes were still poor among women with SCD when compared with women without SCD.

关键词： Pregnancy Outcome Sickle Cell Disease Abakaliki

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A Study on the Attitude and Preference of Antenatal Clinic Attendees to Companionship during Labour and Delivery in Alex Ekwueme Federal University Teaching Hospital, Abakaliki

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Advances in Reproductive Sciences 2019年第4期7卷 71-81页

作者： Sunday Uchenna Asogwa johnbosco ifunanya nwafor Chuka Nobert Obi Chukwunenye Chukwu Ibo Darlington-Peter Chibuzor Ugoji Ikenna Chidi Ebere Alfred Nnabugwu Adiele Ayodele Adegbite Olaleye Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Background: Labour is a stressful physical and psychological experience in a woman’s life, requiring optimal coping mechanism. Companionship provides such needed support in this vulnerable moment of women. The presence of a companion of the woman’s choice had been noted to have a positive influence on her satisfaction with the birth process. Objectives: To ascertain the attitude of antenatal clinic attendees to companionship in labour and delivery and their preferred companions. Methods: A descriptive cross sectional study was conducted between 10th June 2016 and 28th July 2016 on 297 antenatal clinic attendees at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The respondents completed an anonymous, self-administered questionnaire assessing the attitude of antenatal clinic attendees to companionship in labour and delivery and their preferred companions. The data was analyzed using EpiinfoTM version 7.1.5. Results: A total of 297 pregnant women participated in the study. They were mainly Igbos (93.27%), and Christians (96.97%). Their ages ranged from 18 - 50 years with most of them between 21 - 30 years (68.35%). Most of the women had tertiary education (48%), and were unemployed (36.36%). Ninety two percent of the respondents wished for companionship in labour, while 32.66% has had companion in previous delivery(ies). All of the women that had experienced companionship expressed satisfaction with it. Majority of them preferred their Partners/Husbands as companions (47%). Conclusion: Majority of our women were desirous of companionship and preferred their partners/husbands.

关键词： Attitude Preference Antenatal Attendees Companionship Labour Abakaliki

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The Relationship between the Weight of the Placenta and Birth Weight of Term Neonate Delivered in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria

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Advances in Reproductive Sciences 2019年第4期7卷 82-93页

作者： Ayodele Adegbite Olaleye johnbosco ifunanya nwafor Ikenna Chidi Ebere Chukwunenye Chukwu Ibo Darlington-Peter Chibuzor Ugoji Nobert Chuka Obi Sunday Uchenna Asogwa Alfred Nnabugwu Adiele Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Background: The placenta is in a key position to determine the final birth weight of foetuses because adequate placental function is necessary for delivery of nutrients, oxygen, and hormones to the foetus. The relationship between the placental weight and birth weight of the neonates has been reported from several publications but such reports from Abakaliki are lacking in literature. Aim: To determine the relationship between the placental weight and birth weight of the neonates delivered at term at the Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Method: It was a retrospective study conducted between 1st January 2015 and 31st December 2015. The statistical analysis was done using Epi Info software version 7.2.1 (CDC Atlanta Georgia). Result: The mean birth weight was 3344 ± 488 g while the mean placental weight was 617 ± 78 g. The mean placental weight to birth weight ratio (PBWR X 100) was 19.94% ± 4.2%. Increase in birth weight of the neonate was associated with a corresponding increase in placental weight with a strong statistical significance level (P = 0.968). One thousand nine hundred and five (90.5%) patients had PBWR that ranged between 15% and 24%, which was associated with good immediate neonatal outcome. The placental weight to birth weight ratio outside this range was associated with increased admission into NICU and perinatal mortality at an odd ratio of 0.5844 and a statistical significance level (P) of 0.0036. Conclusion: There is a positive correlation between placental weight and birth weight of the neonate. Knowing the PBWR at birth may help to know the foetus at risk of immediate poor neonatal outcome in order to expedite actions to prevent possible poor perinatal outcome.

关键词： Placenta Weight Birth Weight Neonate Abakaliki

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Tranexamic Acid versus Placebo for Prevention of Primary Postpartum Haemorrhage among High Risk Women Undergoing Caesarean Section in Abakaliki: A Randomized Controlled Trial

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Open Journal of Obstetrics and Gynecology 2019年第6期9卷 914-922页

作者： nwafor johnbosco ifunanya Ibo Chukwunenye Chukwu Obi Chuka Nobert Onwe Blessing Ugoji Darlington-Peter Chibuzor Onuchukwu Victor Uchenna Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Objective: To evaluate the efficacy of tranexamic acid for prevention of postpartum haemorrhage among women undergoing cesarean section who were at high risk of postpartum hemorrhage. Materials and Method: This was a double blind randomized controlled trial conducted at the Alex Ekwueme Federal University Teaching Hospital Abakaliki from January 2016 to December 2017. One hundred and sixty-eight parturients at high risk of postpartum haemorrhage who underwent caesarean section were randomly assigned to receive either tranexamic acid or placebo prior to skin incision. Results: The result of the study showed that the need for additional uterotonic was higher in women in the placebo arm when compared with women in the tranexamic arm of the study (7.4% versus 33.3%, respectively). The incidence of primary post-partum hemorrhage (blood loss > 1000 ml) was significantly lower in the tranexamic acid group compared to placebo group (11.9% versus 50%, respectively, P-value Conclusion: Intravenous tranexamic acid given prior to skin incision at caesarean section reduced the need for additional uterotonics and incidence of primary postpartum among high risk women.

关键词： Tranexamic Acid Maternal Mortality Postpartum Haemorrhage

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Gestational Trophoblastic Diseases: A Review of the Clinical Presentation and Management at the Alex Ekwueme Federal University Teaching Hospital Abakaliki

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Case Reports in Clinical Medicine 2019年第6期8卷 164-171页

作者： nwafor johnbosco ifunanya Obi Vitus Okwuchukwu Ibo Chukwunenye Chukwu Obi Chuka Nobert Onwe Blessing Ugoji Darlington-Peter Chibuzor Onuchukwu Victor Uchenna Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki South-East Nigeria Nigeria

Background: Gestational trophoblastic diseases (GTD) are potentially curable with retention of reproductive function once the correct diagnosis is made and treatment is commenced early with adequate follow up. Objective: The objective of this study was to determine the incidence, clinical presentation, management and treatment outcomes of gestational trophoblastic diseases in a tertiary hospital in Abakaliki, South-east Nigeria. Materials and Methods: This was a retrospective descriptive study of gestational trophoblastic diseases managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) over a 6-year period. The statistical analysis was done using SPSS version 22. Results: The incidence of GTD was 4.6 per 1000 deliveries. Women who were less than 20 years and more than 40 years of age accounted for 5.9% and 23.5% of cases of GTD respectively. Women who were para 5 and above accounted for 76.5% of those who presented with GTD. All the patients presented with vaginal bleeding. Suction evacuation (76.5%) was the commonest form of treatment offered to women with GTD. The commonest complication was anaemia (94.1%). Maternal death due to GTD was 8.8%. Most (58.8%) of the patients did not turn up for follow-up. Conclusion: Gestational trophoblastic diseases has remained an important cause of maternal morbidity and mortality in our hospital due to poor compliance with follow-up. Call and recall system should be introduced in the management of patients with GTD to improve compliance to management standard.

关键词： Gestational Maternal Mortality Chemotherapy Follow-Up

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Evaluation of Pregnancy Outcomes among Women with Pregnancies Complicated by Diabetes Mellitus in Abakaliki, South-East, Nigeria

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Journal of Diabetes Mellitus 2019年第3期9卷 69-76页

作者： nwafor johnbosco ifunanya Onwe Blessing Idzuinya Obi Vitus Okwuchukwu Ugoji Darlington-Peter Chibuzor Ibo Chukwunenye Chukwu Obi Chuka Nobert Onuchukwu Victor Jude Uchenna Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki South-East Nige-ria

Background: Pregnancies complicated by diabetes are associated with significant increase in maternal and perinatal morbidity and mortality. The management of diabetes in pregnancy is a great challenge in a low resource setting because of limited resources and facilities to care for these women. Aim: To determine the maternal and perinatal outcomes of diabetic pregnant women managed at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Southeast, Nigeria. Materials and methods: This was a 7-year retrospective case-control study that compared pregnancy outcomes among women with pregnancies complicated by diabetes and those without diabetes managed at Alex Ekwueme Federal University Teaching Hospital, Abakalikibetween January 1st, 2012 and December 31st, 2018. The statistical analysis was done using SPSS version 22. Results: The incidence of diabetes in pregnancy in this study was 6.6 per 1000 deliveries. Of 126 women in diabetic arm of the study, 81 were diagnosed during pregnancy and 45 were known diabetic prior to conception. Over two-thirds of 126 women with pregnancy complicated by diabetes achieved good blood glucose control during pregnancy. Both groups differ in their mean BMI and women with diabetes in pregnancy were more likely to be obese compared with control (diabetic;30.1 ± 2.5 versus control;23.4 ± 2.1, P < 0.0001). Pregnant women with diabetes were more likely to be delivered by cesarean section when compared with non-diabetic women (86 versus 23, OR = 9.6, 95% CI: 5.35 - 17.32, P < 0.0001). Similarly, the incidence of polyhydramnious was higher in paturients with diabetes when compared with the control groups (26 versus 13, OR = 2.2, 95%CI: 1.10 - 4.63, P = 0.02). There were no differences between both study groups with regards to other maternal outcomes. The incidence of fetal macrosomia, neonatal hypoglycemia and neonatal respiratory distress syndrome were significantly higher among women whose pregnancies were complicated by diabetes when

关键词： Pregnancies Complicated Diabetes Mellitus Maternal Perinatal Abakaliki

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A 5-Year Retrospective Study on the Use of Manual Vacuum Aspiration in the Federal Teaching Hospital Abakaliki

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 142-148页

作者： Okechukwu B. Anozie johnbosco I. nwafor Chukwuemeka I. Ukaegbe Chidi U. Esike Rita O. Anozie Lucky O. Lawani Justus N. Eze Department of Obstetrics and Gynaecology Federal Teaching Hospital Abakaliki Nigeria Department of Radiology Federal Teaching Hospital Abakaliki Nigeria

Introduction: Since the inception of our hospital in 2011, manual vacuum aspiration has been in use for the treatment first trimester miscarriages. Hence there is a need for operational review on its use. Aim: The aim of this study is to evaluate the determinants and outcome of Manual Vacuum Aspiration (MVA) use in our hospital. Method: This was a retrospective study on the use of MVA for various indications in our facility over a 5-year period. Results: There were 625 (19.7%) manual vacuum aspirations among 3179 gynaecological patients seen during the period. The age range of the women was from 15 to 48 years and the mean age was 28.5 ± 5.3 years. Incomplete abortion was the commonest indication for the use of MVA and accounted for 89.9% of cases. Other indications for the use of MVA include missed miscarriage (1.8%), and blighted ovum (1.8%). The complications were uterine perforation (0.3%), infection (3.7%) and severe anaemia (10.7%). The mean total hospital stay was 1.6 ± 0.6 days. Overall, 267 (42.7%) patients were managed as a day case. Conclusion: Manual vacuum aspiration is an effective tool in the management of early pregnancy complications. It is a safe, easily performed and possibly cost-effective procedure, with advantages for both the patient and the health care system.

关键词： Manual Vacuum Aspiration Miscarriage Uterine Evacuation Hospital

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