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.

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.

Maternal and Perinatal Outcomes in Women with Eclampsia by Mode of delivery at Riley Mother Baby Hospital: A longitudinal case-series study

2020 ◽  
Author(s):  
Philippe Amubuomombe Poli ◽  
Koech MMED Irene ◽  
Richard Mogeni ◽  
Ann Mwangi ◽  
Andrew Cheruiyot ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Case Series ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Sub Saharan Africa ◽  
Categorical Variables ◽  
Chi Square ◽  
Case Series Study ◽  
Chi Square Test ◽  
Series Study

Abstract Background Eclampsia, considered a serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0-40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1-2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. Instead, it increases the risk of perinatal adverse outcomes, including the risk of admission to the newborn unit and perinatal death.

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 First evidence of the deletion in the Pfhrp2 and Pfhrp3 genes in P. falciparum from Equatorial Guinea

2019 ◽  
Author(s):  
Pedro Berzosa ◽  
V González ◽  
L Taravillo ◽  
A Mayor ◽  
M Romay-Barja ◽  
...  
Keyword(s):  
Malaria Diagnosis ◽  
Good Alternative ◽  
Sub Saharan Africa ◽  
Equatorial Guinea ◽  
Categorical Variables ◽  
Surveillance Program ◽  
African Countries ◽  
Chi Square ◽  
Exact Test ◽  
Sub Saharan

Abstract Background: WHO recommends RDTs as a good alternative malaria-diagnosis method in remote parts of sub-Saharan Africa. The majority of commercial RDTs currently available detect the P. falciparum protein histidine-rich protein 2 (PfHRP2). There have also been recent reports of Pfhrp2 deletions being found in parasites collected from several African countries. WHO has concluded that the lacking the Pfhrp2 gene must be monitored in Africa. The purpose of the study was to analyze why the samples that were positive by PCR were negative by RDTs; and, therefore, to determine whether there have been deletions in the Pfhrp2 and/or Pfhrp3 genes. Methods: Malaria NM-PCR was carried out to all the samples collected in the field. A group of 128 samples was positive by PCR but negatives by RDT, these samples were classified as RDT false-negatives. It was carried out a PCR for exon2 of Pfhrp2 and Pfhrp3 genes to detect the presence or absence of these two genes. Frequencies with 95% confidence intervals (CIs) were used for categorical variables. Associations were assessed by the chi-square test or Fisher´s exact test. The level of significance was set at p ≤ 0.05. Statistical analyses were performed using the software package SPSSv.15.0. Sensitivity and specificity calculations were performed using Epidat 3.1 software. Results: After the PCR, 81 samples were identified (4.7%, 95%CI: 3.8-5.8) which had deletion in both genes, Pfhrp2 and Pfhrp3. Overall, however, 11 samples (0.6%, 95%CI: 0.36-1.14) had deletion only in Pfhrp2 but not in Pfhrp3, and 15 (0.9%, 95%CI: 0.6-1.5) presented with deletion only in Pfhrp3 but not in Pfhrp2. Considering the Pfhrp2 gene separately, within the total of 1,724 samples, 92 (5.3%, 95%CI: 4.37-6.5) had evidence of deletion. Conclusion: The present study provides the first evidence of deletion in the Pfhrp2 and Pfhrp3 genes in P. falciparum isolates from Equatorial Guinea. However, larger studies across different regions within the country and across different seasonal profiles are needed to determine the full extent of Pfhrp2- and Pfhrp3-deletion. it would be strongly recommendable to implement an active surveillance program in order to detect any increases in Pfhrp2- and Pfhrp3-deletion frequencies.

scholarly journals Hypertension-Related Admissions and Outcome in a Tertiary Hospital in Northeast Nigeria

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
P. M. Kolo ◽  
Y. B. Jibrin ◽  
E. O. Sanya ◽  
M. Alkali ◽  
I. B. Peter Kio ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Detailed Examination ◽  
Tertiary Hospital ◽  
Cardiovascular Complications ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Systemic Hypertension ◽  
Sub Saharan ◽  
Medical Wards ◽  
Northeast Nigeria

Cardiovascular disease has reached near epidemic proportion in sub-Saharan Africa, and systemic hypertension (SH) remains the driver of cardiovascular complications. We studied hypertension-related admissions and their outcome at the Abubaker Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi, Northeast Nigeria. Records of all patients admitted into the medical wards between 1st November 2010 and 31st October 2011 were studied, and case files of those managed for SH complications were selected for detailed examination. Of the total 3108 admissions, 735 (23.7%) were hypertension related. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were167.4±18.2and98.6±13.5,respectively, at presentation. Although, hypertension-related admissions were 23.7% of total admissions, there was an excess of mortality associated with SH complications (42.9%). Stroke was the commonest, and it accounted for 44.4% of cases. Stroke had the highest mortality (39.3%), followed by chronic kidney disease (36.6%); hypertensive emergencies (30.9%) and hypertensive heart failure had the lowest intrahospital mortality (27.5%). In conclusion, SH-related admissions are common among medical admissions in Bauchi Nigeria and are associated with high mortality. Community interventions that promote early diagnosis and reduction of cardiovascular risk profiles are urgently needed to reduce SH deaths.

scholarly journals Trends of critical care management of obstetric patients in a tertiary hospital in sub-Saharan Africa

2019 ◽  
Vol 7 (5) ◽  
pp. 1420
Author(s):  
Fidelis A. Onyekwulu ◽  
Tochukwu C. Okeke
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Obstetric Hemorrhage ◽  
Icu Admission ◽  
Sub Saharan

Background: The maternal mortality rate in sub-Saharan Africa is high compared to other regions of the world. Management of critically ill obstetric patients is very challenging. We therefore evaluate the trends, clinical characteristics and outcome of the obstetric patients admitted into the intensive care unit of a tertiary hospital in sub Saharan Africa.Methods: This was a 9- year retrospective study carried out at the multidisciplinary Intensive Care Unit (ICU) of a University Teaching Hospital which serves as a referral centre for the south east region of the country. Data were collected from the patients’ record, ICU admission and discharge register. Also collected was data concerning labor ward admission and deliveries. Data was analyzed using SPSS Version 17 (SPSS Inc., Chicago, IL, USA).Results: The total admission into the ICU during the study period was 1243 patients of which 73 (5.87%) were obstetric patients. They were between the ages of 17 and 54 years with mean of 32.05±5.96 years. The total number of deliveries within the period was 11224 (1247 per year). The commonest obstetric cases admitted into the ICU were (pre) eclampsia 28.8% followed by obstetric hemorrhage 24.7%. The overall mortality rate in this study was 39.7%. The commonest intervention carried out in the ICU was mechanical ventilation.Conclusions: The two leading indications for ICU admission and maternal mortality are (pre)eclampsia and obstetric hemorrhage.

scholarly journals Imported Mansonella perstans infection in Spain.

2020 ◽  
Author(s):  
Sabino Puente ◽  
Mar Lago ◽  
Mercedes Subirats ◽  
Ismael Sanz-Esteban ◽  
Marta Arsuaga ◽  
...  
Keyword(s):  
Clinical Picture ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Treatment Needs ◽  
Chi Square ◽  
Filarial Nematodes ◽  
Mansonella Perstans ◽  
The Mean ◽  
Sub Saharan ◽  
Student’S T

Abstract Background: Mansonella perstans infection can be considered one of the most neglected tropical infectious diseases. Very few studies have reported on the clinical picture caused by infection with this nematode. Therefore, our study was aimed to describe the clinical patterns and treatment of imported M. perstans infection by migrants from Africa.Methods: The present study evaluated a large cohort of migrants who have been diagnosed, examined and treated for imported M. perstans infection at a Spanish reference center (Hospital Carlos III Tropical Medicine Unit, Madrid, Spain) over a 19-year period. Most patients voluntarily attend the emergency unit or are referred from primary care or general hospitals in Madrid. Categorical variable results were expressed as percentages and as the mean and standard deviation (SD) for continuous variables. Chi-square test was used to compare the association between the categorical variables. The measured outcomes were expressed as the odds ratio (OR) with a 95% CI. The continuous variables were compared by Student’s t-test or the Mann–Whitney test. The corresponding regression models were used for multivariate analysis. Results: Five hundred three cases of migrants from tropical and subtropical areas with M. perstans infection were identified. Two hundred sixty-four patients were female (52.5%). The mean age (±SD) was 44.6±18.2 years (range, 16–93 years). The mean time (±SD) between the arrival in Spain and the first consultation was 8.6±18.0 months. The origin of the patients was Equatorial Guinea (97.6%). Regarding the clinical picture, 257 patients were asymptomatic (54.7%) and 228 were symptomatic (45.3%); 190 patients had pruritus (37.8%), 50 (9.9%) had arthralgia, 18 patients had Calabar-like swelling (3.6%), and 15 (3%) had abdominal pain. Four hundred forty-two (87.9%) migrants had hyper-IgE, and 340 (67.6%) had eosinophilia. One hundred ninety-five patients had coinfections with other filarial nematodes (38.8%), and 308 migrants had only M. perstans infection (61.2%). Four hundred thirty-seven cases (86.9%) had been treated with anti-filarial drugs: 292 cases were treated with one anti-filarial drug, and 145 cases were treated with combined anti-filarial therapy. Additionally, 20 (4%) cases received steroids and 38 (7.6%) cases received antihistamines. Conclusions: A long series of M. perstans infections is presented in sub-Saharan immigrants whose data indicate that it should be included in the differential diagnosis in patients with pruritus or analytical alterations such as eosinophilia or hyper-IgE presentation, and they also have a high number of coinfections with other microorganisms whose treatment needs to be protocolized.

scholarly journals Prevalence and determinants of chronic kidney disease in women with hypertensive disorders in pregnancy in Nigeria: a cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Salisu M. Ishaku ◽  
Timothy Olusegun Olanrewaju ◽  
Joyce L. Browne ◽  
Kerstin Klipstein-Grobusch ◽  
Gbenga A. Kayode ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gestational Hypertension ◽  
Monitoring Program ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Worldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5 and 10% of pregnancies. Sub-Saharan Africa (SSA) is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce. Methods Women with HDPs (n = 410) and normotensive women (n = 78) were recruited at delivery and prospectively followed-up at 9 weeks, 6 months and 1 year postpartum. Serum creatinine was measured at all time points and the estimated glomerular filtration rates (eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR< 60 mL/min/1.73m2 lasting for ≥ 3 months. Prevalence of CKD at 6 months and 1 year after delivery was estimated. Logistic regression analyses were conducted to evaluate risk factors for CKD at 6 months and 1 year postpartum. Results Within 24 h of delivery, 9 weeks, and 6 months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12, 5.7, 4.3% versus 0, 2 and 2.4%, respectively). The prevalence of CKD in HDPs at 6 months and 1 year postpartum was 6.1 and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age was independently shown to be a risk factor for decreased eGFR at 6 months postpartum (aOR = 1.18/year; 95%CI 1.04–1.34). Conclusion Prior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function.

scholarly journals Opportunities and Challenges in Realizing Universal Access to Obstetric Ultrasound in Sub-Saharan Africa

2017 ◽  
Vol 03 (02) ◽  
pp. E52-E59 ◽  
Author(s):  
Sikolia Wanyonyi ◽  
Charles Mariara ◽  
Sudhir Vinayak ◽  
William Stones
Keyword(s):  
Universal Access ◽  
Perinatal Outcomes ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Obstetric Ultrasound ◽  
Integral Component ◽  
Challenges And Opportunities ◽  
Potential Benefits ◽  
The Subject ◽  
Sub Saharan

AbstractThe potential benefits of obstetric ultrasound have yet to be fully realized in sub-Saharan Africa (SSA), despite the region bearing the greatest burden of poor perinatal outcomes. We reviewed the literature for challenges and opportunities of universal access to obstetric ultrasound and explored what is needed to make such access an integral component of maternity care in order to address the massive burden of perinatal morbidity and mortality in SSA. Original peer-reviewed literature was searched in various electronic databases using a ‘realist’ approach. While the available data were inconclusive, they identify many opportunities for potential future research on the subject within the region that can help build a strong case to justify the provision of universal access to ultrasound as an integral component of comprehensive antenatal care.

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