Maternal and perinatal outcome in severe preeclampsia and eclampsia at the Rivers State university teaching hospital, Nigeria

Background: Severe preeclampsia and eclampsia remain a challenge in tropical obstetric practice. It is a major contributor to feto-maternal morbidity and mortality in developing countries. This study seeks to determine the prevalence, associated risk factors and the feto-maternal outcome of severe preeclampsia and eclampsia at the rivers state university teaching hospital (RSUTH).Method: A retrospective study of all women who had severe preeclampsia and eclampsia and were delivered at the RSUTH in a two-year period, 1ST January 2018 to 31ST December 2019, was carried out. Data on patients’ age, parity, education, booking status, gestational age at delivery, diagnosis, complications, mode of delivery and fetal sex, birth weight and Apgar scores were retrieved using structured pro-forma. Data were analyzed using SPSS version 20.Results: There were 4496 deliveries of which 128 had severe preeclampsia and eclampsia, giving a prevalence of 2.85%. Of these, 94 (73.4%) had severe preeclampsia and 34 (26.6%) had eclampsia. The mean age of the women ± SD was 29.84±5.44 years, median parity was para 1, and mean gestational age ± SD was 35.38±3.84 weeks. There were 10 maternal deaths giving case fatality of 7.8%. The mean birth weight ± SD was 2.61±0.91 kg and stillborn rate was 14.4%. There was significant association with maternal age, education, booking status, method of delivery and Apgar score of the baby.Conclusion: The prevalence in this study is high with associated high maternal mortality and stillborn rates. Timely and appropriate intervention including primary management and judicious termination of pregnancy will reduce mortality of mother and fetus.

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Post Neonatal Tetanus as Seen in Rivers State University Teaching Hospital, Nigeria: Prevalence, Clinical Profile and Outcome

Asian Journal of Research in Infectious Diseases ◽

10.9734/ajrid/2021/v7i130209 ◽

2021 ◽

pp. 38-47

Author(s):

Tamunoiyowuna Grace Okari ◽

Boma Awoala West

Keyword(s):

Teaching Hospital ◽

Tetanus Toxoid ◽

Rural Areas ◽

Case Fatality ◽

Clinical Profile ◽

University Teaching ◽

Neonatal Tetanus ◽

State University ◽

The Mean ◽

Rivers State

Background: Post neonatal tetanus, a vaccine preventable disease is a cause of childhood morbidity and mortality in many developing countries including Nigeria. This study was carried out to determine the prevalence, clinical profile and outcome of children with post-neonatal tetanus. Methods: This prospective observational study carried out over 3years in the Paediatric ward of the Rivers State University Teaching Hospital, was among children older than 28days and up to 16years. Result: Of 966 children admitted during the period of study, 12 had post-neonatal tetanus giving a prevalence of 1.2%. Six (50%) were > 10years old with a M:F ratio of 5:1, 5(41.7%) resided in rural areas and all (100%) were of low socioeconomic status. Six (50%) did not receive tetanus toxoid vaccine and no child had booster doses. Portal of entry for the infection was majorly via injuries on their limbs, 7(58.3%). The mean incubation period was 10.58±7.39 days while the mean onset interval was 31.58±27.85 hours. Three (25%) children had severe tetanus using Ablett’s classification with spasm 11(91.7%) documented as the commonest symptom. Half, 6(50%) of the children had autonomic complications and an overall case fatality rate of 25%. Conclusion: The prevalence of post-neonatal tetanus in the Rivers State University Teaching Hospital was low being 1.2%, although unacceptable. The mortality rate of post-neonatal tetanus of 25% was high. Thus, there is a need to strengthen existing immunization program and immediately adopt the commencement of booster doses of tetanus toxoid vaccines for eligible children in Nigeria.

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Prevalence and Demographic Correlates of Seropositive HIV and HBsAg Cases among Women Booking for Antenatal Care at the Rivers State University Teaching Hospital, Nigeria

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2019/v40i130219 ◽

2019 ◽

pp. 1-9

Author(s):

P. A. Awoyesuku ◽

D. A. Macpepple ◽

B. O. Altraide ◽

D. H. John

Keyword(s):

Pregnant Women ◽

Teaching Hospital ◽

Educational Status ◽

University Teaching ◽

P Value ◽

Seroprevalence Rate ◽

State University ◽

Global Public Health ◽

The Mean ◽

Rivers State

Background: Infection with hepatitis B (HBV) and human immunodeficiency virus (HIV) are global public health problems. These infections during pregnancy increase the risk of maternal morbidity and mortality, and also pose a risk to the fetus due to mother to child transmission. Objective: To determine the prevalence of seropositive HIV and HBsAg cases amongst pregnant women at the Rivers State University Teaching Hospital (RSUTH). Methodology: A retrospective review of hospital and laboratory records of all pregnant women booked at RSUTH in two years, from May 2017 to April 2019, was carried out. Data on patients’ age, parity and educational level and reactivity of HIV and HBsAg test at booking were retrieved using structured proforma and analyzed using Epi Info Version 7. Test for significance using Chi-square was set at a significant level of P<0.05. Results: 3560 patients had HIV and HBsAg screening out of which 148 (4.2%) and 9 (0.3%) respectively were positive. The comorbidity rate in this study was 0.06%. The mean age was 31.5±4.7 years and the mean gestational age at booking was 22.1±6.8 weeks. There was no significant relationship between their age (χ2 = 2.690, p-value=0.442) and parity (χ2 = 3.759, p-value = 0.145) with HIV seropositivity, but these were significant for HBsAg (χ2 = 13.691, p-value = 0.003) (χ2 = 13.121, p-value=0.001). Educational status was significant for HIV (χ2 = 16.188, p-value=0.000) but not for HBsAg (χ2 = 0.229, p-value=0.892). Conclusion: The seroprevalence rate of HIV and HBsAg in this study were low. HIV seroprevalence was significantly affected by lower education, while HBsAg seroprevalence was significantly affected by younger maternal age and nulliparity. Continued screening of pregnant women for these infections remains valuable and further community-based studies to identify risk factors are recommended.

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Prevalence of Seropositive VDRL Cases amongst Pregnant Women at the Rivers State University Teaching Hospital, Nigeria: Is Routine Screening for Syphilis Using VDRL Still Relevant?

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v31i430293 ◽

2019 ◽

pp. 1-7

Author(s):

P. A. Awoyesuku ◽

D. A. MacPepple ◽

N. J. Kwosah

Keyword(s):

Pregnant Women ◽

Teaching Hospital ◽

University Teaching ◽

P Value ◽

Seroprevalence Rate ◽

State University ◽

Serological Screening ◽

Specific Test ◽

The Mean ◽

Rivers State

Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low seroprevalence in their antenatal population. Objective: To determine the prevalence of seropositive VDRL cases amongst pregnant women at the Rivers State University Teaching Hospital (RSUTH) in order to justify the need and cost-effectiveness for continued routine syphilis screening using VDRL alone. Methodology: A retrospective review of hospital and laboratory records of all pregnant women booked for antenatal care (ANC) at RSUTH in a two-year period, from May 2017 to April 2019, was carried out. Data on patients’ age, parity and educational level, and reactivity of VDRL test at booking were retrieved using structured pro-forma and analyzed using Epi Info Version 7. Test for significance using Chi-square was set at significant level of P<0.05. Results: 3560 clinic patients had VDRL screening out of which 63 were positive. The overall prevalence rate in this study was 1.8%. The mean age was 31.5±4.7 years and the mean gestational age at booking was 22.1±6.8 weeks. There was no significant relationship between their age (χ2 = 0.403, p-value=0.940), parity (χ2 = 3.707, p-value=0.0.157), and educational status (χ2 = 1.853, p-value=0.396), and seropositivity. The cost of VDRL test per patient in RSUTH is $3, to detect the 63 cases the sum of $10,680 was spent. Conclusion: The seroprevalence rate of syphilis in this study was low. Initial screening using VDRL alone is neither justified nor cost effective. Selective screening based on risk factors and specific test with TPHA is recommended.

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Prevalence, trend and outcome of twin pregnancy in Rivers State University Teaching Hospital, Southern Nigeria

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212641 ◽

2021 ◽

Vol 10 (7) ◽

pp. 2571

Author(s):

Felix Chikaike Clement Wekere ◽

Dickson H. John ◽

Gift A. F. Clement-Wekere ◽

Rose S. Iwo-Amah

Keyword(s):

Preterm Delivery ◽

Teaching Hospital ◽

Perinatal Care ◽

Multiple Pregnancy ◽

University Teaching ◽

State University ◽

Live Births ◽

Risk Pregnancy ◽

The Mean ◽

Rivers State

Background: Multiple pregnancy is a high-risk pregnancy associated with a higher maternal and perinatal complications compared to singleton pregnancy. Twinning is the commonest form of multiple pregnancy, and its prevalence varies across the globe, with lowest value in Japan and highest in Nigeria.Methods: The aim of the study was to review twin births in Rivers State University Teaching Hospital (RSUTH), to determine its prevalence, trend, and management outcome.Results: During the period under review, there were 13516, and 263 twin births, giving the prevalence of twinning in RSUTH as 19.5 per 1000 live births or 1 in 51 deliveries. The rate of twinning increased from 7.6 per 1000 deliveries in 2015 to 35.7 per 1000 deliveries in 2019. Mean age of patients was 31 SD 4.82 years, 95% CI: 30.42, 31.59, and modal age group was 30-34 years. Patients’ parity ranged from 0 to 7 with modal parity being para-1. Majority (51.7%) had secondary level education, and were Christians. Preterm delivery rate was 62.4%. The mean gestational age at delivery was 35.7 SD 2.9 weeks, 95% CI: 35.3, 36.0. The mean birth weights of the first and second twins were 2.39 SD 0.67 and 2.30 SD 0.69 respectively. Majority (92%) of the foetuses were alive at birth. Still birth and perinatal mortality rate were 4.2 and 7.8 per 1000 live births. There was no case of maternal mortality.Conclusions: The rate of twining in our setting is high, with an increasing trend. Most of the parturient had preterm delivery, and improved perinatal care services would ensure best perinatal outcome.

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Religion, Culture and Medicine Analysis of Female Genital Mutilation amongst 84 Antenatal Clinic Attendees at the Rivers State University Teaching Hospital

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i1530615 ◽

2020 ◽

pp. 89-90

Author(s):

S. Eli ◽

D. G. B. Kalio ◽

N. C. T. Briggs ◽

K. E. Okagua

Keyword(s):

Teaching Hospital ◽

Female Genital Mutilation ◽

Antenatal Clinic ◽

University Teaching ◽

State University ◽

Genital Mutilation ◽

The World ◽

The Mean ◽

Rivers State ◽

Female Genital

Introduction: Female Genital Mutilation (FGM) or Female Circumcision (FC) have been influenced by religion, culture and medicine. The practice of FGM have been associated with myriads of negative health consequences, resulting in its abolishment by the World Health Organization (WHO). This is unlike male circumcision which is well accepted by most religions of the world, culture and medically. Aim: To ascertain the influence of religion, culture and medicine as regards FGM amongst antenatal clinic (ANC) attendees at the Rivers State University Teaching Hospital (RSUTH). Methods: It was a cross sectional study of ANC attendees at The RSUTH. The Information was retrieved using a self structured questionnaire which was coded and analyzed using SPSS version 25. Results: A total number 84 ANC attendees were recruited for the study. The mean age was 30.7 years and the modal parity was 1. The mean gestational age was 15.8 weeks. Twenty (23.8%) respondents had FC, all of whom were Christians. Eighteen (21.4%) of the respondents were of the opinion that FGM was a good practice; while 66 (78.6%) respondents believed that FGM was a wrong practice. The 2 most common reasons for FGM were to prevent promiscuity 7 (8.3%) and cultural reasons 7 (8.3%). The commonest known complication by respondents following FGM was bleeding from the genital tract 24 (28.6%). Conclusion: The prevalence of FGM from the study was 23.8% amongst ANC attendees at the RSUTH. Religion, culture and medicine may play vital roles in the eradication of FGM in our sub-region as recommended by WHO.

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Prevalence of Diabetes Mellitus in Pregnancy amongst Antenatal Clinic Attendees at Booking at the Rivers State University Teaching Hospital

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i1630621 ◽

2020 ◽

pp. 7-8

Author(s):

S. Eli ◽

D. G. B. Kalio ◽

K. E. Okagua ◽

A. A. Aloku ◽

B. O. A. Atraide ◽

...

Keyword(s):

Diabetes Mellitus ◽

Family History ◽

Teaching Hospital ◽

Antenatal Clinic ◽

University Teaching ◽

State University ◽

History Of ◽

Rivers State ◽

Prevalence Of Diabetes Mellitus ◽

In Pregnancy

Background: The prevalence of diabetes mellitus (DM) have tripled from 1980 till date as a result of many factors of which obesity/excessive weight gain is a closely related factor of DM. There are many adverse challenges of DM in pregnancy with its associated fetal and maternal consequences. Aim: To determine the prevalence of DM in pregnancy amongst antenatal clinic (ANC) at booking at the Rivers State University Teaching Hospital (RSUTH). Methods: It was a cross sectional study of ANC attendees at booking at the RSUTH. Simple random sampling method was used. The Information was coded and analyzed using SPSS version 25. Results: A total of 99 pregnant women were recruited at booking in the ANC of the RSUTH. The mean age was 32.2 years and the modal parity was 1.0.The number of ANC attendees with weight equal to or greater than 90 Kg were 21 (21.2%), number with weight greater than equal to 90 Kg with glucose in urine were 10 (10.1%) Three (3.0%) of the subjects were known diabetic whereas 12 (12.1%) had family history of DM. Conclusion: The study revealed the prevalence of DM amongst ANC attendees at the RSUTH as 3.0%. There was corresponding glycosuria in 10.1% of the ANC attendees. ANC attendees had family history of DM were 12.1%. Advocacy is needed to educate the populace on the predisposing factors of DM and its adverse effect on maternal and child health.

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Incidence and Predictors of Mortality Among Newborns With Perinatal Asphyxia: A 4-Year Prospective Study of Newborns Delivered in Health Care Facilities in Enugu, South-East Nigeria

Clinical Medicine Insights Pediatrics ◽

10.1177/1179556517746646 ◽

2017 ◽

Vol 11 ◽

pp. 117955651774664 ◽

Cited By ~ 6

Author(s):

Uchenna Ekwochi ◽

Nwabueze I Asinobi ◽

Chidiebere DI Osuorah ◽

Ikenna K Ndu ◽

Christian Ifediora ◽

...

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Perinatal Asphyxia ◽

Mode Of Delivery ◽

Case Fatality ◽

Health Care Facilities ◽

University Teaching ◽

State University ◽

Low Oxygen ◽

Gestational Age At Delivery

Fatalities from perinatal asphyxia remain high in developing countries, and continually assessing its risk factors will help improve outcomes in these settings. We explored how some identified risk factors predict mortality in asphyxiated newborns, to assist clinicians in prioritizing interventions. This was a 4-year prospective study conducted at the Enugu State University Teaching Hospital, Enugu, Nigeria. All newborns who met the study criteria that were admitted to this facility in this period were enrolled and monitored. Data collected were analysed with SPSS Version 18. A total of 161 newborns with perinatal asphyxia were enrolled into the study with an in-hospital incidence rate of 12.81 per 1000 birth and a case fatality rate of 18%. Overall, the APGAR scores were severe in 10%, moderate in 22%, mild to normal in 68%, whereas the SARNAT stages were III in 24%, II in 52%, and I in 25%. In terms of mortality, 66.7%, 22.2%, and 11.1% mortalities were, respectively, observed with SARNAT scores III, II, and I ( P = .003), whereas the findings with APGAR were 31.2% (severe), 25.0% (moderate), 25.0% (mild), and 18.8% (normal) ( P = .030). Fatality outcome was more correlated with SARNAT ( R = .280; P = .000) than APGAR ( R = −.247; P = .0125). The SARNAT score significantly differentiated between the degrees of asphyxia in newborns based on gestational age at delivery ( P = .010), place of delivery ( P = .032), and mode of delivery ( P = .042). Finally, it was noted that newborns that were female ( P = .007), or born outside the hospital ( P = .010), or with oxygen saturations <60% ( P = .001), or with heart rate <120 ( P = .000), and those with respiratory rate <30 ( P = .003), all have significantly higher likelihood of deaths from asphyxia. Therefore, predictors of neonatal mortality from perinatal asphyxia in our centre include being female and being born outside the hospital, as well as low oxygen saturations, heart rates, and respiratory rates at presentation.

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Ferritin and transferrin levels of the elderly population at Lagos State university teaching hospital, Ikeja, Lagos, Nigeria

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20214492 ◽

2021 ◽

Vol 7 (12) ◽

pp. 559

Author(s):

Abdulateef O. Kareem ◽

Akinsegun A. Akinbami ◽

Ebele I. Uche ◽

Aishatu M. Suleiman ◽

Rafah A. Bamiro ◽

...

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Teaching Hospital ◽

Blood Count ◽

The Elderly ◽

University Teaching ◽

Full Blood Count ◽

State University ◽

Lagos State ◽

The Mean

Background: The elderly have limited regenerative abilities thus predisposing them to various diseases. Measuring both serum ferritin and transferrin serve as biomarkers of iron deficiency. This study, using enzyme-linked immunosorbent assay (ELISA) determined the serum levels of ferritin and transferrin in the elderly. Full blood count was also done and correlated with serum ferritin and transferrin levels of every participant.Methods: This was a cross-sectional study at the Geriatric Clinic of Lagos State University Teaching Hospital (LASUTH). Following receipt of written consents from ninety (90) elderly participants, venous samples were drawn for full blood count (FBC) and samples for serum ferritin and transferrin ELISA assay collected and stored at -40oC until the required sample size was obtained. Data were analyzed using SPSS version 23.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill). The Pearson chi-square test was used for statistical analysis. P value was considered to be statistically significant when <0.05. Results: Participants consisted of 50 (55.6%) females and 40 (44.4%) males. The mean age of all participants was 71.31±7.38 years. The Majority, 90% (36 of 40) of the males had haemoglobin values lower than 13 gm/dl, while 66% (33 of 50) of females had haemoglobin values lower than 12 gm/dl. The mean ferritin concentration of all participants was 196.19 ±121.21ng/ml. The overall mean serum transferrin was 0.187±0.157 ng/ml with a minimum of 0.03 ng/ml and a maximum of 1.18 ng/ml.Conclusions: Anaemia in the elderly is very common using the World Health Organization (WHO) haemoglobin cut-off values, however, iron deficiency anaemia prevalence is low.

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Prevalence of post-operative anaemia in surgical patients at the Rivers State University Teaching Hospital

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2021.10.1.0149 ◽

2021 ◽

Vol 10 (1) ◽

pp. 218-223

Author(s):

Kalio DGB ◽

Eli S ◽

Okagua KE ◽

Allagoa DO

Keyword(s):

Teaching Hospital ◽

Cross Sectional Study ◽

University Teaching ◽

World Health ◽

Surgical Patients ◽

State University ◽

Cross Sectional ◽

Health Organization ◽

Rivers State ◽

Work Up

Background: Post-operative anaemia is often a reflection of pre-operative pre-operative work-up and pre-operative anaemia. In addition. Post-operative anaemia is also determined by co-morbidities of patients prior to surgery. The prevalence of post-operative anaemia varies based on surgical specialties and the experience of the surgeon; prevalence rates as high as 85% have been recorded in orthopaedic surgeries. Aim: To determine the prevalence of post-operative anaemic in surgical patients at the Rivers State University Teaching Hospital (RSUTH). Method: This was a six months cross sectional study of the post-operative anaemia of patients who had operation at the Surgery and Obstetrics/Gyaecology departments of The Rivers State University Teaching Hospital. The permission for the study was granted by the head of department of obstetrics and gynaecology in conjunction with the head of .the hospital management. The yard stick for anaemia was packed cell volume less than 33% in line with the World Health Organization (WHO). A structured proforma was used to obtain information from patient’s case notes and analyzed using SPSS version 25. Result: Three hundred and eigthy subjects were recruited for the study. Males subjects were 150 (39.5%) while females were 230 (60.5%) respectively. The mean age was 31 years. One hundred and ninety nine (52.4%) were obstetrics and gynaecological surgeries while 181 (47.6 %) were non-gynaecological surgeries. The commonest indication for surgery was caesarean section representing 130 (34.2%) of the subjects. Two hundred and sixty six of the subjects (70%) had PCV less than 33%. One hundred and fifty two (40%) women had PCV less than 33% while 114 (30%) of the men had PCV less than 33%. Conclusion: The study revealed that prevalence of post-operative anaemia amongst surgical patients at RSUTH was 70 %. The post-operative anaemia amongst women was worrisome. The need to optimize patients prior to surgery cannot be over-emphasized to prevent morbidities and mortalities post-operative.

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Maternal and Perinatal outcome in eclampsia at a teaching hospital of Eastern Nepal

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i3.33692 ◽

2020 ◽

Vol 5 (3) ◽

pp. 1186-1190

Author(s):

Seema Kumari Mishra ◽

Roshan Pradhan ◽

Hanoon P Pokharel ◽

Surya B. Parajuli

Keyword(s):

Socioeconomic Status ◽

Birth Weight ◽

Low Birth Weight ◽

Teaching Hospital ◽

Rural Areas ◽

Perinatal Outcome ◽

Neonatal Outcome ◽

Mode Of Delivery ◽

Case Fatality ◽

Maternal Condition

Introduction: Eclampsia is a multisystem disorder with potential life-threatening complications that can result in significant maternal and fetal morbidity and mortality. The case fatality rate of eclampsia is 1.8% in developed countries, 17.7% in India and 13% in Nepal. The incidence of pre-eclampsia and eclampsia is high in developing countries due to hypoproteinemia, malnutrition and poor obstetric facilities. Objective: To assess the maternal and perinatal outcome in patients of eclampsia Methodology: This was a hospital based cross-sectional study where all the patients presenting with eclampsia from June 2019 to November 2020 in the department of Obstetrics & Gynecology, Birat Medical College and Teaching Hospital were enrolled for the study. Data analyzed included various maternal parameters and fetal parameters along with the mode of delivery, outcome of baby, postpartum maternal condition and maternal mortality were noted. Results: Among 6631 deliveries, 50 patients had eclampsia with the incidence of 7.54/1000 deliveries. Thirty four (68%) patients were of 20-30 years of age, 37 (74%) were primigravidas, 36 (72%) from rural areas, 34 (68%) were illiterate, 49 (98%) were low to middle socioeconomic status, 41 (82%) were unbooked and 33 (66%) patients had antepartum eclampsia. Eleven (22%) women developed eclampsia related complications. There were 02 (4%) maternal deaths and the common causes were HELLP Syndrome and pulmonary oedema. Neonatal outcome consisted of live births in 39 (78%) newborns, 03 (6%) were still births, 08 (16%) were birth asphyxia and 15 (30%) were low birth weight. Conclusion: Majority of the patients were young, illiterate, unbooked primi gravidas with poor to average socioeconomic status from rural areas. Majority of the eclamptic women nearly 39 (78%) cases delivered via caesarean section for better neonatal outcome. Two (4%) eclamptic women died as a result of eclamptic complications and three (6%) newborns had neonatal deaths because of low birth weight and prematurity. Adequate antenatal screening, early detection of hypertension, timely referral, and early initiation of treatment and termination of eclamptic patients can help to improve the maternal and perinatal outcomes.

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