scholarly journals Rhesus Negative Pregnancy: Prevalence and Foetomaternal Outcomes in a Tertiary Hospital, South-South Nigeria

Rhesus incompatibility can pose a problem in pregnancy and cause obstetric failure in a handful of women. The Rhesus factor is a red blood cell surface antigen; and there are many antigen subtypes that make up the Rhesus blood group systems, of which the most commonly involved and most immunogenically associated with Rhesus isoimmunisation is the D antigen. The objective of this study is to determine the prevalence of Rhesus negativity and the foetomaternal outcomes at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. This was a 5-year retrospective study conducted between 1st January, 2016 and 31st December, 2020 at our Obstetric Unit. Data were retrieved, entered into a pre-designed preformed and analyzed using SPSS version 25.0. Results were presented as mean and standard deviation for continuous variables and frequencies or percentages for categorical variables. Of the 4,571 pregnant women, 104 were Rhesus negative, giving a rate of 2.27%. The most common blood group among the women (53.8%) and their partners (84.6%) was the O blood group. Only 2 (1.9%) women were sensitised. Out of the 104 Rhesus negative women, 81 were unsensitised (77.9%) and received anti-D immunoglobulin. Majority of the babies had a good outcome, though 19 (18.2%) of them were admitted into the special care baby unit for various conditions. The incidence of Rhesus negative pregnancy in our study was 2.27%, and 1.9% of the women were sensitised. Prompt administration of anti-D immunoglobulin after sensitising events and post-delivery is key in the prevention of Rhesus isoimmunisation.

PEDIATRICS ◽  
1978 ◽  
Vol 61 (2) ◽  
pp. 306-308
Author(s):  
Henry F. Pabst ◽  
Paul M. Gelpke

A major advance in pediatric preventive medicine has been the administration of anti-D globulin to D-negative mothers after delivery to inhibit development of antibodies to the D antigen in the rhesus blood group. This globulin is prepared commercially from pooled plasma of individuals with a high anti-D antibody titer. The indirect Coombs' titer of anti-D of acceptable preparations is usually 1:3,200 or higher.1 Injections of twice the usual therapeutic amounts of anti-D globulin into a D-positive volunteer have caused only minimal reductions in hemoglobin level and hematocrit value and no ill effects.1 Our observations in an agammaglobulinemic 4-year-old D-positive girl who received 1,800 µg of anti-D globulin with resulting hemolysis are therefore pertinent.


2021 ◽  
Vol 3 (2) ◽  
pp. 122-127
Author(s):  
Dennis O. Allagoa ◽  
Peter C. Oriji ◽  
Ebiye S. Tekenah ◽  
Lukman Obagah ◽  
Onyekachi S. Ohaeri ◽  
...  

Background: Caesarean section is the delivery of the foetus, placenta, and foetal membranes through an incision on the abdominal and uterine walls after the age of foetal viability. It is a life-saving surgical procedure, which has helped reduce maternal and perinatal morbidity and mortality over the years. Objective: To determine the rates, indications, outcomes, and complications of Caesarean section at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. Materials and Methods: This research was carried out at the Department of Obstetrics and Gynaecology, Federal Medical Centre (FMC), Yenagoa, Bayelsa State, South-South, Nigeria between 1st January 2018 and 31st December 2020. It was a retrospective study. Data was retrieved from the labour ward records, delivery register, theatre records, and patients’ folders during the period under review, and entered into a pre-designed proforma. Data were analysed with IBM SPSS version 23.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Results: About 959 women had Caesarean section (CS) out of 2,263 deliveries, giving a Caesarean section rate of 42.4%. The commonest indication for emergency Caesarean section was cephalopelvic disproportion (36.0%), while that for elective Caesarean section was repeat Caesarean section (19.6%). Conclusion: The Caesarean section rate in our Centre is extremely high, almost three times the acceptable upper limit set by the WHO. Encouraging vaginal birth after Caesarean section as a means to reduce this high rate is recommended as it was noted that previous Caesarean section was a leading indication for surgeries.


Author(s):  
P. C. Oriji ◽  
D. O. Allagoa ◽  
D. C. Briggs ◽  
M. N. Chika ◽  
A. E. Ubom ◽  
...  

Background: Umbilical cord prolapse is an obstetric emergency when the foetus is still alive, and it is associated with high foetal morbidity and mortality. If umbilical cord prolapse occurs outside the hospital, mortality rate can be as high as 44% – 70%, and as low as 3% when it occurs in the hospital. Objective: To determine the incidence of umbilical cord prolapse and the perinatal outcomes associated with it at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria over 5 years. Materials and Methods: This retrospective survey was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Results: Forty-one women had umbilical cord prolapse out of 4,571 deliveries, giving a case incidence rate of 8.9 per 1,000 deliveries. About three-quarters (75.6%) of the women were multiparous. A fifth (21.9%) of the foetuses died in-utero, while 27 (65.9%) babies survived. Five (15.6%) babies had severe birth asphyxia, and died (early neonatal death) in the special care baby unit. Decision-to-delivery interval was ≤ 30 minutes in only 12.5% of patients. Conclusion: Umbilical cord prolapse is associated with significant perinatal morbidity and mortality. Prompt diagnosis and intervention are very key in preventing adverse perinatal outcomes.


2021 ◽  
Vol 3 (6) ◽  
pp. 11-13
Author(s):  
Simon P. O. Akogu ◽  
Owemidu Idowu Olumorin ◽  
Shedrack Egbunu Akor

Background: In the practice of obstetrics and gynecology, the ABO and Rhesus factor (Rh) blood type are important. Blood typing for blood transfusion of compatible blood is very common in emergency and routine care. There is a scanty literature on the distribution of ABO and Rhesus blood types in Anyigba, (North central) Nigeria. Objective: This study aims to determine the distribution of ABO blood and Rhesus blood group phenotypes and Hemoglobin genotypes among antenatal clinic attendees in a teaching hospital. Methods: Antenatal records of attendees (October 2017 to September 2020) at the Kogi State University Teaching Hospital were retrieved and results of antenatal hematological investigations were collected using a structured tool.Bio data, ABO blood group, Rhesus group phenotype and Hemoglobin genotype were collected, inputted and analyzed using SPSS version 20. Results: The mean age was 26 +/- 7years, blood group O is most prevalent,561 (53.6%) then A 276 (26.4%), B 189 (18.1%) and AB,21 (2%).1014 (96.4%) were Rhesus D positive, 33 (3.1%) were Rhesus D negative. For hemoglobin genotype, 786 (75.1%) were AA, 258 (24.6%) were AS, AC were 3 (0.3%). Conclusion: The distribution of the ABO, the Rhesus (D) blood groups and hemoglobin genotypes are in concurrence with the findings of previous studies; Blood group O is the most prevalent and AB the least prevalent, Rhesus (D) positive in the population is high and the hemoglobin genotype AA is the most prevalent. There is no association between blood group phenotypes studied and the hemoglobin genotypes.


Author(s):  
Omotade A. Ijarotimi ◽  
Akaninyene E. Ubom ◽  
Ibraheem O. Awowole ◽  
Ekundayo O. Ayegbusi ◽  
Oluwafemi Kuti

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.


2020 ◽  
Vol 132 (3) ◽  
pp. 692-699 ◽  
Author(s):  
Sarah K. Bick ◽  
Marjan S. Dolatshahi ◽  
Benjamin L. Grannan ◽  
Andrew J. Cole ◽  
Daniel B. Hoch ◽  
...  

OBJECTIVEForamen ovale electrodes (FOEs) are a minimally invasive method to localize mesial temporal seizures in cases in which noninvasive methods are inconclusive. The objective of this study was to identify factors predicting the ability of FOEs to yield a diagnosis in order to determine optimal candidates for this procedure.METHODSAll cases of diagnostic investigations performed with FOEs at the authors’ institution between 2005 and 2017 were reviewed. FOE investigation was defined as diagnostic if it led to a treatment decision. Demographic and clinical variables for diagnostic and nondiagnostic investigations were compared using a Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables.RESULTSNinety-three patients underwent investigations performed with FOEs during the study period and were included in the study. FOE investigation was diagnostic in 75.3% of cases. Of patients who underwent anterior temporal lobectomy following diagnostic FOE evaluation, 75.9% were Engel class I at last follow-up (average 40.1 months). When the diagnostic and nondiagnostic FOE groups were compared, patients who had diagnostic investigations were more likely to be male (57.1% male vs 26.1% in the nondiagnostic group, p = 0.015). They were also more likely to have temporal lesions on preoperative MRI (p = 0.018).CONCLUSIONSFOEs are a useful, minimally invasive diagnostic modality resulting in a treatment decision in 75% of cases. Male patients and patients with temporal lesions on MRI may be most likely to benefit from FOE investigation.


1977 ◽  
Vol 40 (4) ◽  
pp. 403-405
Author(s):  
G. CORNEY ◽  
R. A. FISHER ◽  
P. J. L. COOK ◽  
J. NOADES ◽  
E. B. ROBSON

2021 ◽  
pp. 1-10
Author(s):  
Vishal Raval ◽  
Shiming Luo ◽  
Emily C. Zabor ◽  
Arun D. Singh

<b><i>Purpose:</i></b> The aim of the study was to evaluate equivalence of growth rate and pathologic confirmation in small choroidal melanoma (SCM). <b><i>Design:</i></b> This study is a case series. <b><i>Subjects, Participants, and Controls:</i></b> A total of 61 patients with a choroidal melanocytic tumor of size 5.0–16.0 mm in the largest basal diameter and 1.0–2.5 mm in thickness were classified into the pathology-confirmed group (<i>n</i> = 19), growth-confirmed group (<i>n</i> = 30), and with combined observations (<i>n</i> = 12). <b><i>Methods:</i></b> Distribution of clinical variables (age, gender, laterality, tumor dimensions, tumor location, and presence of orange pigment, subretinal fluid, drusen, and retinal pigment epithelial [RPE] atrophy) between the groups was analyzed. Patient and disease characteristics were summarized as the median and interquartile range for continuous variables and the frequency and percentage for categorical variables. Comparisons were made using the Wilcoxon rank sum test for continuous variables and either Fisher’s exact test or the χ<sup>2</sup> test for categorical variables with a <i>p</i> value threshold of 0.05 for statistical significance. Growth rate (change in basal dimension/12 months) diagnostic of SCM was quantified. <b><i>Main Outcome Measures:</i></b> The primary aim of this study was to test the hypothesis that “growth” was diagnostic of SCM with the secondary aim of quantifying the malignant “growth rate” (growth rate of SCM). <b><i>Results:</i></b> The clinical characteristics among all 3 groups were similar except more patients with symptoms (68 vs. 20 vs. 42%, <i>p</i> = 0.004) and juxtapapillary location (<i>p</i> = 0.03) were in the pathology group than in the growth-confirmed group. Those in the combined and growth-confirmed groups had more patients with drusen (11 vs. 60 vs. 50%, <i>p</i> = 0.003) and RPE atrophy (11 vs. 23 vs. 67%, <i>p</i> = 0.003), respectively, than in the pathology group. The median time to detect growth was 9 months (range 3–26 months). The mean growth rate in basal dimension was 1.8 mm/12 months (range, 0.0–7.4 mm; [95% CI: 1.32–2.28]). <b><i>Conclusions and Relevance:</i></b> Choroidal melanocytic lesions exhibiting a defined growth rate can be clinically diagnosed as SCM without a need for biopsy.


2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 289-291
Author(s):  
L Russell ◽  
R Mangat ◽  
J Plant ◽  
S Hansen ◽  
D Armstrong ◽  
...  

Abstract Background Iron deficiency (ID) is common in patients receiving parenteral nutrition (PN), likely due to a lack of iron in the PN formula. There is no clear consensus on how often serum iron should be tested or iron supplementation should be given, at which dose or route, in patients on long-term PN. Within the Hamilton Health Sciences (HHS) home PN (HPN) program, the prevalence of ID or iron deficiency anemia (IDA) is unknown. This knowledge will contribute to better iron prescribing practices with ultimate benefit on patient’s health. Aims To assess the prevalence of ID and IDA in patients enrolled in the HHS HPN Program. The secondary aim was to assess supplementation practices for patients enrolled in the HPN program according to gastrointestinal(GI) diagnosis and duration on PN. Methods We conducted a retrospective study including consecutive adult patients enrolled in the HHS-HPN program from January 2015 to November 2020. We collected data on demographics (age, sex, and GI diagnosis), iron supplementation (dose, duration, and route), and information related to iron-deficiency (hemoglobin, serum iron, ferritin, TIBC, and folate) at pre-set intervals (enrollment, 3, 6, 12, 18, 24, 30, 36, 48, 60 months) and last measured. ID was defined as ferritin ≤45μg/L or serum iron ≤9μmol/L. IDA was defined as hemoglobin &lt;130g/L in men or &lt;120g/L in women in the context of ID. Data were expressed as median (IQR) for continuous variables and n/N(%) for categorical variables. Chi2 was performed to assess differences between groups and logistic regression to assess predictors of ID and IDA. The analysis was conducted using SPSS software(v26). Results The analysis included 125 HPN patients (50 males, median age of 55 (40–65) years). Patients received PN for a median of 195 (83–521) days. The most common diagnoses were malignancy (36.8%) and inflammatory bowel disease (23.2%); the most common indications for HPN was short bowel (29.6%) and bowel obstruction (27.2%). Iron profiles were measured in 77% of patients. At enrollment, 42.2% of patients had ID and 38.9% had IDA. Only 13% of patients with ID and 22.8% with IDA had iron supplementation (Figure 1). A total of 38 patients received iron either oral or IV (oral=44.7% vs IV=55.3%; p=0.66). There was no correlation between low levels of serum iron or ferritin with iron supplementation (p=0.23, 0.45 respectively). Age, sex, diagnosis, or reason for PN did not correlate with ID or IDA at any time point. Conclusions Iron-deficiency and IDA are common in patients enrolled in the HHS HPN program independently of age, sex, diagnosis and reason for PN. Prospective studies are needed to implement the most effective way to ensure proper monitoring and treatment of iron deficiency in this population. Funding Agencies None


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