scholarly journals Obstructed labour in a Nigerian tertiary health facility: a mixed-method study

2021 ◽  
Vol 10 (8) ◽  
pp. 2937
Author(s):  
Akaninyene Eseme Ubom ◽  
Omotade Adebimpe Ijarotimi ◽  
Ifeoluwa Emmanuel Ogunduyile ◽  
Ayobami Omilakin ◽  
Solomon Nyeche ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Birth Asphyxia ◽  
Case Fatality ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Mortality And Morbidity ◽  
Obstructed Labour ◽  
Sub Saharan ◽  
University Teaching Hospitals

Background: Obstructed labour remains a leading cause of maternal and perinatal mortality and morbidity in sub-Saharan Africa. This study aimed to determine the incidence, causes, complications and outcomes of obstructed labour at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun state, Nigeria.Methods: A mixed methods approach was employed for this study. A 10-year retrospective review of all cases of obstructed labour managed at the OAUTHC, between January 1, 2008, and December 31, 2017, was done. Ten in-depth interviews were conducted for some selected patients. The quantitative data was analysed using SPSS version 24, while the qualitative data was analyzed with NVivo version 12.Results: The incidence of obstructed labour was 1.99%. Most of the patients were unbooked (217, 90.4%), primigravid (138, 57.5%), and either had no formal or only primary/secondary education (120, 50%). Cephalopelvic disproportion (CPD) was the commonest cause of obstructed labour (227, 94.6%). The most common maternal complication was wound infection (48, 20%). There were three maternal deaths, giving a case fatality rate of 1.25%. The most common foetal complication was birth asphyxia (85, 34.7%). The perinatal mortality rate was 18.8 %. From the qualitative arm of the study, reasons given by parturients who suffered obstructed labour, for avoiding hospitals for delivery, included religion, finance, fear of hospitals, faith/belief in mission homes/maternity houses, and proximity.Conclusions: Obstructed labour remains an important obstetric problem in our environment, contributing significantly to the burden of maternal and perinatal mortality and morbidity. 

scholarly journals Global trends in incidence and mortality of neonatal encephalopathy due to birth asphyxia and trauma

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Lau
Keyword(s):  
Birth Asphyxia ◽  
Case Fatality ◽  
Premature Death ◽  
Sub Saharan Africa ◽  
Neonatal Encephalopathy ◽  
Global Trends ◽  
The Past ◽  
Incidence And Mortality ◽  
Sub Saharan ◽  
Over Time

Abstract Background Neonatal encephalopathy due to birth asphyxia and trauma is a leading cause of premature death and long-term disability as estimated by the Global Burden of Disease (GBD) 2017 study. To evaluate comparative improvements in prevention and survival, this analysis evaluated GBD 2017 mortality to incidence (MI) ratios as a proxy for case fatality over time, location, and socio-demographic status. Methods We derived estimates of cause-specific mortality and incidence at birth from GBD 2017, calculating MI ratios of neonatal encephalopathy in children <1 year. We analyzed temporal, geographic, and socio-demographic trends in incidence, mortality, and MI ratio. Results Neonatal encephalopathy incidence shows little change over time, with global incidence in children under one essentially the same in 2017 (1,996 cases per 100,000 (1,334-2,912)) and 1990 (1,996 cases per 100,000 (1,331-2,926)). Regions show the same trend, though a large difference exists between the highest and lowest regional incidence, with incidence in Central Sub-Saharan Africa over 20 times higher than in Australasia. Over the same period, MI ratios for neonatal encephalopathy have decreased across all regions. Model input data represented 52 countries for prevalence and 145 countries for mortality, with notable data sparsity in Africa and Eastern Europe. Conclusions Case fatality of neonatal encephalopathy, as approximated by MI ratio, has declined worldwide over the past three decades, but incidence has shown little change. This suggests treatment of neonatal encephalopathy has improved, but more research is needed on risk factors in order to increase prevention. Continued work is also needed to reduce disparities in incidence and mortality between countries with different levels of SDI. Improving data coverage in lower SDI regions will be critical to accurately monitor progress toward reducing inequity. Key messages Neonatal encephalopathy is a leading cause of premature death and disability. Incidence of neonatal encephalopathy has changed little since 1990, indicating more work is needed on prevention. Case fatality of neonatal encephalopathy can be approximated by the mortality to incidence ratio, and has declined worldwide over the past three decades, suggesting improvements in treatment.

Midwife-assisted planned home birth: an essential component of improving the safety of childbirth in Sub-Saharan Africa

2018 ◽  
Vol 47 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Aliyu Labaran Dayyabu ◽  
Yusuf Murtala ◽  
Amos Grünebaum ◽  
Laurence B. McCullough ◽  
Birgit Arabin ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Developing World ◽  
Home Birth ◽  
Sub Saharan Africa ◽  
Ethical Challenges ◽  
Home Births ◽  
Mortality And Morbidity ◽  
Sub Saharan ◽  
Hospital Births ◽  
Planned Home Birth

Abstract Hospital births, when compared to out-of-hospital births, have generally led to not only a significantly reduced maternal and perinatal mortality and morbidity but also an increase in certain interventions. A trend seems to be emerging, especially in the US where some women are requesting home births, which creates ethical challenges for obstetricians and the health care organizations and policy makers. In the developing world, a completely different reality exists. Home births constitute the majority of deliveries in the developing world. There are severe limitations in terms of facilities, health personnel and deeply entrenched cultural and socio-economic conditions militating against hospital births. As a consequence, maternal and perinatal mortality and morbidity remain the highest, especially in Sub-Saharan Africa (SSA). Midwife-assisted planned home birth therefore has a major role to play in increasing the safety of childbirth in SSA. The objective of this paper is to propose a model that can be used to improve the safety of childbirth in low resource countries and to outline why midwife assisted planned home birth with coordination of hospitals is the preferred alternative to unassisted or inadequately assisted planned home birth in SSA.

scholarly journals Clinical characterisation and management outcomes of COVID-19 infection in pregnancy in a Nigerian tertiary hospital

2021 ◽  
Vol 10 (10) ◽  
pp. 3691
Author(s):  
Omotade A. Ijarotimi ◽  
Akaninyene E. Ubom ◽  
Ibraheem O. Awowole ◽  
Ekundayo O. Ayegbusi ◽  
Oluwafemi Kuti
Keyword(s):  
Perinatal Outcomes ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Categorical Variables ◽  
Chi Square ◽  
The Mean ◽  
Sub Saharan ◽  
In Pregnancy

Background: Literature on the antenatal and perinatal management and outcomes of COVID-19 infection in pregnancy in Nigeria and sub-Saharan Africa is gradually emerging but sparse. There is an urgent need to build up the knowledge base of COVID-19 infection in Nigerian pregnant women. The objective of the current study was to determine the clinical characteristics and management outcomes of COVID-19 infection in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.Methods: A one-year retrospective review of all cases of COVID-19 infection in pregnancy managed at the OAUTHC. Relevant data were extracted from the case records of all cases managed using a purpose-designed proforma. Data collected was analysed using IBM-SPSS, version 24. Associations between categorical variables were assessed using chi square, with level of significance set at <0.05.Results: A total of 22 cases were managed. Majority (15, 68.2%) of the women were either asymptomatic or had mild symptoms. The commonest symptom was cough (8, 36.4%). The mean duration of admission was 6.6±4.2 days. The most common maternal and perinatal complication was preterm delivery/birth (3, 13.6%). There was no maternal mortality. The mean birth weight of the babies was 3226g±597g, with mean 1- and 5- minutes Apgar scores of 8.0±1.3 and 9.5±0.6 respectively.Conclusions: Although COVID-19 infection in pregnancy is an asymptomatic or mild infection in the majority of cases in Ile-Ife, Nigeria, it is associated with adverse maternal and perinatal outcomes. Further studies are recommended to determine transplacental transmission of COVID-19 infection and antibodies.

Maternal mortality in the last triennium of the Millennium Development Goal Era at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

2017 ◽  
Vol 38 (2) ◽  
pp. 189-193 ◽  
Author(s):  
Ibraheem Olayemi Awowole ◽  
Olusegun Olalekan Badejoko ◽  
Oluwafemi Kuti ◽  
Omotade Adebimpe Ijarotimi ◽  
Oluwaseun Oludotun Sowemimo ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Millennium Development Goal ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Development Goal ◽  
University Teaching Hospitals

scholarly journals A three year review of twin deliveries in a specialist hospital in North-Western Nigeria

2021 ◽  
Vol 1 (1) ◽  
pp. 034-039
Author(s):  
A. Oyaromade ◽  
B. A Muhammad ◽  
A. Omigbodun
Keyword(s):  
Perinatal Mortality ◽  
Mode Of Delivery ◽  
Secondary Level ◽  
University Teaching ◽  
Teaching Hospitals ◽  
The Mean ◽  
Anaemia In Pregnancy ◽  
Level Hospital ◽  
North Western ◽  
In Pregnancy

Background: Although the frequency of twin pregnancies varies from one ethnic group to another, there has been a general trend toward an increase recently. Maternal and perinatal mortality are higher in twin than singleton pregnancies. Most studies on twinning had been done in university teaching hospitals where conditions are different from what is seen in secondary-care health institutions where this study was done Objectives: To determine the incidence, mode of delivery and maternal and perinatal outcomes of twin deliveries at a secondary-level hospital in North-Western Nigeria. Methodology: This was a descriptive study of 96 twin deliveries over a three-year period between May 2013 and April 2016 at a secondary-level hospital with access to specialist obstetricians and paediatricians. Result: There were 4,567 deliveries, with 101 twin deliveries, an incidence of 2.2% or 1 in 45 deliveries. The mean maternal age and parity were 26.4 years and 3.2 respectively. The mean gestational age at delivery was 35.9 weeks, with a mean birth weight of 2.18kg and 2.01kg for the first and second twins respectively. Male twins constituted 53.2% of twin births. The common presentations of the twins were cephalic–cephalic (64.6%), cephalic–breech (16.7%) and breech–breech (6.3%). Mode of deliveries were vertex vaginal (77.1%) and caesarean (14.6%). Breech presentation of the leading twin was the commonest indication for caesarean section (57.1%). Anaemia in pregnancy (16.7%) was the commonest maternal complication, while prematurity was the leading cause of perinatal mortality. Conclusion: Preterm delivery, malpresentation, operative delivery and maternal anaemia in pregnancy were commonly seen in association with twin pregnancy in this cohort of patients.

scholarly journals The seasonality of cholera in sub-Saharan Africa

2021 ◽  
Author(s):  
Javier Perez-Saez ◽  
Justin Lessler ◽  
Elizabeth C. Lee ◽  
Francisco J. Luquero ◽  
Espoir B. Malembaka ◽  
...  
Keyword(s):  
Large Scale ◽  
Task Force ◽  
Case Fatality ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
National Differences ◽  
Sub Saharan ◽  
Eastern And Southern Africa ◽  
Positive Correlations ◽  
Gates Foundation

Background Cholera remains a major threat in Sub-Saharan Africa (SSA) where some of the highest case fatality risks are reported. Knowing in what months and where cholera tends to occur across the continent can aid in improving efforts to eliminate cholera as a public health concern; though largely due to lack of unified large-scale datasets, no continent-wide estimates exist. In this study we aim to estimate cholera seasonality across SSA. Methods We leverage the Global Task Force on Cholera Control (GTFCC) global cholera database with statistical models to synthesize data across spatial and temporal scale in order to infer the seasonality of excess suspected cholera occurrence in SSA. We developed a Bayesian statistical model to infer the monthly risk of excess cholera at the first and/or second administrative levels. Seasonality patterns were then grouped into spatial clusters. Finally, we studied the association between seasonality estimates and hydro-climatic variables. Findings The majority of studied countries (24/34) have seasonal patterns in excess cholera, corresponding to approximately 85% of the SSA population. Most countries (19/24) also had sub-national differences in seasonality patterns, with strong differences in seasonality strength between regions. Seasonality patterns clustered into two macro-regions (West Africa and the Sahel vs. Eastern and Southern Africa), which were composed of sub-regional clusters with varying degrees of seasonality. Exploratory association analysis found most consistent and positive correlations between cholera seasonality and precipitation, and to a lesser extent with temperature and flooding. Interpretation Widespread cholera seasonality in SSA offers opportunities for intervention planning. Further studies are needed to study the association between cholera and climate. Funding The NASA Applied Sciences Program and the Bill and Melinda Gates Foundation.

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