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Open Journal of Obstetrics and Gynecology 2021年第3期11卷 252-262页

作者： Matthew Igwe Nwali Joseph Agboeze vitus okwuchukwu obi Arinze C. Ikeotuonye Ikechukwu Ogwudu Ugadu Emmanuel Ajuluchukwu Ugwa Department of Obstetrics and Gynecology Federal Teaching Hospital Abakaliki Nigeria Department of Obstetrics and Gynecology Federal Medical Center Birnin Kudu Nigeria

Background: Cervical ripening is prerequisite of successful induction of labor. Vaginal misoprostol and Foley’s catheter placement have been widely used for this purpose but the data are not always sufficient. We attempted to determine which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian setting. Methods: A randomized controlled trial was performed at Federal Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant women requiring cervical ripening and labor induction. Participants were randomly allocated to misoprostol versus catheter group. The following were recorded/measured/analyzed: Bishop’s score, age, parity, body mass index, gestational age, labor duration, indication, oxytocin use, mode of delivery, and Apgar score. Chi square test and t test were used where appropriate. Results: At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or had delivered, whereas 35.4% of catheter group had still unripe cervix (x2 = 29.856, P = 0.0001). Misoprostol group was less likely to require oxytocin infusion (x2 = 52.600,

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

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

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

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

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

Situation of Biofungicides Reconnaissance, a Case of Anthracnose Disease of Cowpea

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American Journal of Plant Sciences 2014年第9期5卷 1202-1211页

作者： vitus Ikechukwu obi Juan Jose Barriuso-Vargas Department of Agricultural Science and Natural environment University of Zaragoza Zaragoza Spain

Plant extracts have long been used in commercial agriculture as anti-microbial tools in food safety applications. These offer growers and agrobiologists many unique benefits which include their eco-friendliness. This work reviews the situation of Biofungicides reconnaissance in reference to fungal disease of cowpea. Twenty different pathogens were associated with various fungal diseases of cowpea and, only the species of Colletotrichum was found to have the virulence and propensity of afflicting a 100% infection on a single susceptible cowpea crop. Plant families under the affliction of Colletotrichum were analyzed. The different forms of botanicals so far availed for use as potential biofungicidal were identified. Eighteen plant families were found to represent the entire plants and plant materials agrobiologically screened within a range of thirteen years and found to habour large spectra of species containing substances of biofungicidal potentials. Current position in the use of Botanicals to combat agricultural pests and disease is 7% of the total cowpea disease management options.

关键词： Anthracnose Biofungicides Biopesticides Colletotrichum destructivum Cowpea.

Control of Postpartum Haemorrhage with Uterine Balloon Tamponade Using Foley Catheter in a Rural Mission Hospital in Ebonyi State, Southeast Nigeria

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Case Reports in Clinical Medicine 2021年第3期10卷 79-84页

作者： Johnbosco E. Mamah Azubuike K. Onyebuchi Zubaida Aliyu vitus O. obi Chukwunenye Ibo Chichetaram R. Otu Obstetrics and Gynaecology Department Federal Teaching Hospital Abakaliki Nigeria Obstetric Division Homerton University Hospital London UK

Background: Postpartum haemorrhage is the leading cause of maternal deaths worldwide, the majority of which occur in low resource settings. Uterine atony is the commonest cause of postpartum haemorrhage. Uterine balloon tamponade (UBT) is an effective method of treating refractory postpartum haemorrhage. Aim: Commercial UBT devices are often not affordable and not readily available in rural settings. The aim of this paper is to report on three cases of postpartum haemorrhage successfully managed with uterine balloon tamponade using Foley catheters. Case Reports: We report on three patients with major obstetric haemorrhage from uterine atony who were successfully managed with uterine balloon tamponade using Foley’s urethral catheter. The first two patients had primary postpartum haemorrhage while the third patient had significant bleeding during the surgical evacuation of the uterus for a molar pregnancy. In each case, uterine bleeding was refractory to pharmacologic uterotonics. They all had uterine tamponade with a Foley catheter with the dramatic resolution of their bleeding. Conclusion: In well-selected patients, uterine balloon tamponade with Foley catheter is cheap, arrests bleeding and prevents clinical deterioration among women with refractory postpartum haemorrhage, especially in low resource settings where commercial balloon tamponade may not be available or affordable.

关键词： Balloon Tamponade Foley Catheter Management Postpartum Haemorrhage Rural Mission Hospital