scholarly journals Outcome of instrumental vaginal delivery in university of Abuja teaching hospital: a five-year review

Author(s):  
Caroline T. Henderson Jumbo ◽  
Malachy E. Ayogu ◽  
Habiba I. Abdullahi

Background: Most women will achieve spontaneous vaginal delivery; however, a few will need assistance in form of Instrumental vaginal delivery (IVD). These are employed to shorten the second stage on labour and to minimize the incidence of cesarean section. The aim of the study was to determine the prevalence and outcomes of instrumental vaginal delivery at the University of Abuja teaching hospital.Methods: This was a retrospective study of women who had instrumental vaginal delivery over a 5-year period at the University of Abuja teaching hospital. Data on socio-demographic variables, type of instrumental delivery performed, Apgar scores of neonates delivered, indications and complication were obtained from the labour ward registers and case notes of patients and entered into a proforma and analysed using SPSS software for Windows version 23.Results: Instrumental vaginal delivery (IVD) rate performed for both Vacuum or Forceps) was 0.99%, Forceps delivery was 0.30% and vacuum accounted for 0.69% of all deliveries. The mean maternal age was 27.53±5.5 years and 51 (54.8%) of the parturient were primigravidae, 55 (59.1%) were booked patients.  Delayed second stage of labour (38.7%) was the most common indications for IVD. Maternal complications noted were genital tract laceration 17 (18.3%) and primary post-partum haemorrhage 10 (10.8%). The mean APGAR scores was 6 and 8 in the first and fifth minutes respectively, live births were 85 (91.4%), stillbirths were 7 (7.5%) and one early neonatal death was recorded (1.1%) due to asphyxia as a result of difficult forceps delivery.Conclusions: The IVD rate at UATH is low with good maternal and fetal outcome and preference for vacuum delivery.

2018 ◽  
Vol 13 (3) ◽  
pp. 10-12
Author(s):  
Basant Lamichhane

Aim: To estimate the severity of neonatal and maternal morbidity associated with instrumental vaginal delivery (IVD). Methods: Record based cross-sectional retrospective study of 80 instrumental vaginal deliveries during two years from 2013 to 2015 were performed. Variables studied were neonatal and maternal complications. Results: Out of 80 IVD, 19(23.8%) were forceps deliveries and 61(76.2%) were vacuum deliveries. The mean one minute Apgar score was 6 and 7 for forceps and vacuum delivery respectively. The five minute Apgar score for the both IVD was 8. Regarding maternal complications 7(8.75%) cases had extended episiotomy with deep vaginal tears. In forceps delivery 5 had deep vaginal tear and one each for primary post-partum hemorrhage and urinary retention but among the vacuum deliveries two had deep vaginal tear only. Regarding neonatal complications, one had subgaleal bleed in forceps delivery and one had cephalhematoma with Erbs palsy in vacuum delivery. Conclusions: The neonatal and maternal complications between both types of IVD were comparable. Forceps and repeated vacuum application resulted in low one minute Apgar score; and extended episiotomy and deep vaginal tear were associated with use of forceps.


2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.


Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.


2020 ◽  
pp. 1-3
Author(s):  
Puja verma ◽  
Vinita Kumari ◽  
Dipti Roy

When pregnancy goes beyond 40 weeks it is called post dated pregnancy. The incidence of post term pregnancy varies from 3-12%1,2. Post term or post dated pregnancies are associated with various maternal and fetal complications. A total of 80 women attending labour room emergency with post dated pregnancy (<40 weeks) were recruited for the study. This study was done to observe the maternal and fetal outcome in post dated pregnancies. The mean age was 23.14±2.2 years. Maximum women were in the age group of 20-30 years (67.5%). More than 50% had meconium stained liquor whereas 42.5% had clear liquor. A birth weight more than 3 kg was observed in 21 babies which was 26.25 % and maximum of 53 babies (66.25%) had birth weight between 2.5 kg and 3 kg. Only 6 babies had birth weight less than 2.5 kg. Ten babies were admitted to NICU. Thus, post dated pregnancies require strict vigilance during antepartum, intrapartum and post partum period due to increased incidence of complications.


Author(s):  
Gayatri Devi Sivasambu ◽  
Sujani B. Kempaiah ◽  
Urvashi Thukral

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.


Author(s):  
Barinaaziga S. Mbeera ◽  
Susanna O. Akwuebu ◽  
A. C. U. Ezimah ◽  
Nancy C. Ibeh ◽  
Evelyn M. Eze

Aim: The aim of this study was to assess some haemostatic parameters in sickle cell anaemia subjects in Rivers and Bayelsa States. Study Design: This study is a cross-sectional observational study. Place and Duration of Study: This study was carried out at the University of Port Harcourt Teaching Hospital, Rivers State, and the Federal Medical Centre, Yenagoa, Bayelsa State, between the months of February and August, 2020.  Methodology: A total of four hundred and fifty (450) subjects with age range of 1-50 years were randomly selected. There were about 200 registered patients (adults and children alike) at the sickle cell clinics of the University of Port Harcourt Teaching Hospital, and the Federal Medical Centre, Yenagoa, with an average of 4 new patients per month. The sample size was obtained using a prevalence of sickle cell anaemia of 2% and the sample size was calculated using Cochran sample size formula. Five milliliters (5ml) of venous blood sample was withdrawn from the peripheral vein in the upper limb of subjects using a standard venipuncture technique. The sample was rocked gently to mix and kept at room temperature and the haemostatic parameters (vWF, FVIII, D-dimer, L-arginine, fibrinogen, ADAMTS13) were assayed quantitatively with Bioassay Technozym kit using Microplate Reader (Labtech microplate auto ELISA plate reader, an IS0 13485:2003 CE and WHO compliance Co., Ltd. Shanghai International Holding Corp. GmbH; Europe) calibrated to a wavelength of 450 nm with strict adherence to the manufacturer's instructions, while PT and APTT were analysed with Fortress reagent and Uniscope SM801A Laboratory using water bath.Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA) and p values less than .05were considered statistically significant. Results: The results showed the mean comparison of haemostatic parameters in sickle cell anaemia and control subjects. The comparison of haemostatic parameters showed significant(p<.05) increasesand decreases inVaso-Occlusive Crisis (VOC) and steady state respectively compared with the control group. There was statistically significantreduction in the mean comparison of L-Arginine (p<.01) in VOC) condition than steady state in relation to the control group in our study population, while D-Dimer, ADAMTS13 were also significantly reduced statistically (p<.01) in VOC condition than steady state compared with the control group. However, the mean FVIII inhibitor, Fibrinogen, PT (INR) and APTT were significantly higher (p<.01) in VOC than steady state when compared to controls with normal haemoglobin (HbAA).Correlations of haemostaticparameters by sickle cell anaemia subjects’ condition showed more significant positive correlations in VOC than steady state. Conclusion: This study showed a heightened hypercoagulability in Sickle Cell Snaemia(SCA)subjects, and further pave way for better understanding particularly the diagnostic variables underlying SCA, specific to each subject condition (steady state and VOC). Subjects with SCA, particularly during VOC, undergo significant haemostatic alterations that increase their risk of developing coagulation activation-related complications. Thus, though selected markers of coagulation were significantly different between the subject conditions, they were often significantly higher in the SCA.


Author(s):  
Niranjan N. Chavan ◽  
Vibhusha Rohidas ◽  
Hanumant Waikule

Background: Abruptio placenta or accidental haemorrhage is one of the obstetrical emergencies and is truly accidental with few warning signs. Present study is planned to study the maternal and fetal outcome in patients of abruption placenta in a tertiary care referral hospital in a rural set up which is helpful to plan management strategies and to decrease mortality and morbidity.Methods: A prospective observational study was conducted at Department of Obstetrics and Gynaecology at tertiary care centre during September 2015 to August 2019. A total of 270 cases of abruptio placenta coming to the labor ward and delivered were included in the study. The information collected regarding maternal and fetal parameters were recorded in a master chart in Microsoft Excel 2010 and analyzed using the statistical package for the social sciences software (SPSS) version 20.0.Results: In the present study there were a total of 29887 deliveries with 270 cases of abruptio placenta, incidence being 0.9%. Bleeding per vagina is the most common presentation (85.6%) followed by pain abdomen (70.7%). Common risk factors for accidental hemorrhage were: Pre-eclampsia (39.6%) and anaemia (32.2%). Rate of cesarean section was 40.7% (n-110) while rate of forceps delivery was 4.8% (n-13). Associated maternal complications include: post-partum hemorrhage (18.9%), DIC (10%), acute renal failure (4.1%) and puerperal sepsis (1.9%) while maternal mortality rate was 1.9%. Low birth weight (<2.5kg) was observed in 74.8% cases while still birth and neonatal mortality rate was 35.2% and 12.6% respectively.Conclusions: Abruptio placenta or accidental hemorrhage is major risk factor for maternal and perinatal morbidity and mortality, thus efforts should be taken to reduce risk factor for abruptio placenta. Strengthening of antenatal care, anticipation and evaluation of associated high-risk factor and prompt management of complication can improve maternal and perinatal outcome in these cases. Abruptio placenta should be managed in centers where there is advanced maternal and neonatal health care facilities are available.


2018 ◽  
Vol 3 (2) ◽  
pp. 16
Author(s):  
Imasogie D E ◽  
Azeke T A

Introduction: Melanocytic naevi are benign melanocytic tumours. Some of them may progress to malignant melanoma that has an enormous and ever increasing clinical and economical importance with a high mortality rate. Despite this association, we noticed a dearth of data of benign melanocytic tumoursin Nigeria. This aim of this study is to determine the prevalence, age and sex distribution of benign melanocytic tumours in the University of Benin Teaching Hospital,(UBTH). Methodology: This was a retrospective study which was carried out over a ten-year period in UBTH between January 2004 and December 2013. All cases of benign melanocytic tumoursdiagnosed histologically during the period under review were collated. Histology slides were retrieved, reviewed and the diagnosis recorded against the corresponding patient’s name on a data spread sheet. The data obtained from this study was analysed using the Statistical Package for Social Sciences, version 16 (SPSS 16, SPSSInc. Chicago, Illinois, United States of America. Result: There were 17 cases of melanocytic naevi seen over the study period giving a prevalence of 4.5% of skin tumours. The mean age for the development of melanocytic naeviin this study was 32.71 years (SD = 22.64) and a peak in the 2nd decade. A female preponderance with a bimodal peak age, in the 2nd and 3rd decades was observed. Conclusion: There is a low prevalence rate of melanocytic naevi in our own environment, unlike in the Caucasians of Australian nationality. The differential exposure to high level of UV radiationis key to this observation.


Author(s):  
G. A. Ebughe ◽  
T. I. Ugbem ◽  
D. E. Ushie ◽  
S. Effewongbe

Aims: To determine the prevalence of cancer in the rest of Cross River State not covered by the population-based cancer registry which is limited to the capital city of Calabar. Study Design: Descriptive retrospective study involving a trend analysis of cancers from the rest of Cross River State not covered by the Calabar cancer registry. Cancers incident in the Pathology and Haematology departments of the University of Calabar Teaching hospital are included in the study. Place and Duration of Study: Pathology and Haematology departments of the University of Calabar Teaching hospital. Data was assessed between April to May 2019. Methodology: An institution-based trend analysis of cancers originating from the rest of Cross River State, out of population-based cancer registry’s coverage was carried out. Such cases incident in the Pathology and Hematology Departments of the University of Calabar Teaching Hospital were included. Cancer data from 1st January 2004 to 31st December 2013 was accessed from the archives of both departments. Data extraction was carried out though filling of a check list and these were fed into IBM statistical package for social sciences SPSS version 21 for analysis. Results: Nine hundred and fourty one (941), cancer cases were diagnosed during this period. The mean age of diagnosis was 49.18 ± 18.9.Four hundred and seventy seven (477 or 50.69%) females and 464 or 49.31% males had cancer, representing a female to male ratio 0.97: 1. Overall, the commonest age group was 40 to 64 years (46.3%), followed by 18 to 39 years (25.5%), and 65 years or greater (23.0%).Breast cancer followed by prostate cancer were the commonest cancers in adults, while cancers in the lymphohaematopoietic tissue, soft tissue and eye were the commonest in children. Conclusion: Cancer occurs at an earlier age in the rest of Cross River State, with breast and prostatic cancer dominating. Efforts should be doubled to institute effective screening programmes.


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