scholarly journals A Five-Year Review of Caesarean Section at the Rivers State University Teaching Hospital, South-South, Nigeria

2021 ◽  
pp. 159-167
Author(s):  
Felix Chikaike Clement Wekere ◽  
Rose Sitonma Iwo-Amah ◽  
Joseph Ngozi Kwosah ◽  
Adetomi Bademosi ◽  
Simeon Chijioke Amadi
Keyword(s):  
Caesarean Section ◽  
Teaching Hospital ◽  
University Teaching ◽  
Multiple Gestation ◽  
State University ◽  
Cross Sectional ◽  
Review Period ◽  
Low Middle Income Countries ◽  
Increasing Trend ◽  
Rivers State

Background: Caesarean section (CS) is a major obstetric surgery done for pregnant women and is lifesaving.  Aim: The study was aimed at reviewing CS at the Rivers State University Teaching Hospital (RSUTH), to determine the prevalence, trend and indications, for improved management outcomes. Methods: In this cross-sectional study, we reviewed five thousand, five hundred and ninety-eight (5598) cases of caesarean sections (3699 emergency, 1899 planned) managed at the RSUTH from 1st January, 2015 to 31st December, 2019.  Data collected were analysed using IBM, Statistical Product and Service Solutions (SPSS), version 25.0 Armonk, New York. Results: There were 13,516 deliveries and 5,598 cases of CS over the review period, giving the prevalence of CS as 41.4% or 414 per 1000 deliveries.  Emergency and planned CS cases accounted for 66.1% and 33.9% respectively. An increasing trend of CS was observed over the review period. The mean age ± SD of the participants was 32.30±1.04 years (95% CI:30.26,34.34). Modal age group was 35-39 years, accounting for 33.2% followed by those aged 30-34 years (26.2%). Majority of the patients were multipara [3396 (60.7%)], married [4890 (87.4%)], Christians [5540 (99%)] and had tertiary level education [2800 (50%)]. The commonest indication for CS in RSUTH was previous caesarean section [1925(34%)], followed by cephalopelvic disproportion [757(13.4%)], foetal distress [418(7.4%)], preeclampsia [390(6.9%)] and multiple gestation [252 (4.5%)]. Conclusion: The rate of caesarean section is high in RSUTH with an increasing trend.  Although CS is lifesaving, efforts should be made to reduce the rate to the level recommended by WHO, especially in Low-middle-income countries (LMICs), where there is high aversion to CS.

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

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.

scholarly journals Decision-Delivery Interval for Emergency Caesarean Section at the Rivers State University Teaching Hospital

2020 ◽  
pp. 1-2
Author(s):  
S. Eli ◽  
D. G. B. Kalio ◽  
A. Dan- Jumbo ◽  
J. Ikimalo
Keyword(s):  
Caesarean Section ◽  
Teaching Hospital ◽  
Developed Countries ◽  
Fetal Outcome ◽  
Emergency Caesarean Section ◽  
University Teaching ◽  
State University ◽  
Cephalopelvic Disproportion ◽  
Emergency Caesarean ◽  
Rivers State

Decision-Delivery interval when carrying out emergency caesarean section (EmCS) cannot be over-emphasized especially with regards to maternal and fetal outcome. There are variety of factors that may contribute to these intervals such as logistics, personal delay, delay in obtaining of informed consent, lack of blood, and availability of theatre space. Aim: To determine the decision-delivery interval and causes of delay in EmCS at the Rivers State University Teaching Hospital (RSUTH). Methods: It was prospective study conducted at the RSUTH between July 1, 2018 to January 31, 2019. Information was obtained using a self structured questionnaire and analyzed using version SPSS 25. Results: There were 481 patients admitted into labour ward for the period under review of which 71(14.8 %) had EmCS. The mean age was 31 years. The commonest indication for EmCS was Cephalopelvic disproportion (CPD) represented by 23 (32.4%) of the subjects. The average time for decision - delivery interval was 1 to 2 hours represented by 29 (40.8%). The shortest decision - delivery interval was less than 30 minutes 1(1.3%).The decision – delivery interval time greater than 5 hours were 9 (12.7%). The 3 commonest reasons for delay with respect to average decision – delivery intervals were personal delay 21 (20.8%), logistics 19 (18.8%) and lack of blood 13 (12.9%). Conclusion: The study revealed that the average decision - delivery interval was 1 – 2 hours represented by 40.5% of the subjects. This was relatively long when compared to developed countries of the world. The commonest reason for delay in carrying out EmCS was personal delay (20.8%). The commonest indication for EmCS was CPD (32.4%). Addressing the reasons for the decision – delivery interval will help improve our practice and reduce adverse effects to mother and baby.

scholarly journals Prevalence of HIV in surgical patients at the Rivers State University Teaching Hospital

2021 ◽  
Vol 11 (3) ◽  
pp. 115-119
Author(s):  
Eli S ◽  
Aaron FE ◽  
Okagua KE ◽  
Omodu OJ ◽  
Iyama AC
Keyword(s):  
Teaching Hospital ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Surgical Patients ◽  
State University ◽  
Cross Sectional ◽  
Highly Active ◽  
Sub Saharan ◽  
Rivers State

Background: With the high prevalence of HIV in Sub-Saharan Africa, screening for this viral infection is a routine in many health institutions prior to surgery, the world has recorded success story in the research of HIV especially with the advent of Highly Active Anti-Retroviral Therapy (HAART) this disease burden has been reduced globally. The prevalence of HI in Nigeria is 1.4%. Aim: To determine the prevalence of HIV in surgical patients at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Rivers State, Nigeria. Method: This was a cross sectional study of ANC attendees at the RSUTH, from January 1st to June 31st, 2019. They were surgical patients who were systematically selected, information was obtained from patients case notes with a structured proforma. The information obtained was coded and analyzed using SPSS version 25. Result: A total of 370 patients were attended to pre-operatively. There were 146 (39.5%) males and 224 (60.5%) females. The mean age was 31 years. One hundred and ninety four (52.4%) were obstetrics and gynaecological surgeries while 176 (47.6 %) were non-gynaecological surgeries. The commonest indication for surgery was caesarean representing 126 (34.1%) of the subjects.The prevalence of HIV in surgical patients was 8 (2.1%). Three (1.6%) of the obstetrics and gynaecological patients had HIV compared to 1(0.5%) non-obstetrics and gynaecological patient. Conclusion: The study revealed that prevalence of HIV in surgical patients at the RSUTH was high (2.1%). HIV infection was thrice as common in obstetrics and gynaecological patients compared with other surgical disciplines. There is need to step up surveillance amongst ANC attendees who are reflection of the populace in this region.

scholarly journals Prevalence, Associated Factors and Outcome of Newborns with Anaemia as Seen in Rivers State University Teaching Hospital, Nigeria

2021 ◽  
pp. 23-34
Author(s):  
Boma Awoala West ◽  
Adaku Arthur ◽  
Josephine Enekole Aitafo ◽  
Hannah Omunakwe
Keyword(s):  
Caesarean Section ◽  
Gestational Diabetes ◽  
Teaching Hospital ◽  
Severe Anaemia ◽  
University Teaching ◽  
P Value ◽  
State University ◽  
Duration Of Stay ◽  
Significant Difference ◽  
Rivers State

Aim: There is paucity of literature on the prevalence of neonatal anaemia globally thus aim of the study was to evaluate the prevalence, determine the associations and the clinical outcome of neonates with anaemia. Study Design: This was a descriptive prospective cross-sectional study. Place and Duration of Study: Study was carried out among neonates admitted in the Special Care Baby Unit of Rivers State University Teaching Hospital over one year. Methodology: A convenient sampling size of 402 neonates who met the inclusion criteria were consecutively recruited. Data was analysed using SPSS version 23. Results: Of 402 neonates assessed, 106(26.4%) had anaemia with PCV less than 42%.   Anaemia was observed more in males 56(52.8%), neonates delivered via Caesarean section 74(69.8%) and at gestational age less than 37 weeks 53(50%). Mild anaemia was observed mostly, 66(62.3%). Common pregnancy complications of mothers with anaemic babies were prolonged rupture of membranes 17(35.4%) and hypertension in pregnancy 14(29.2%) while the commonest morbidities in these neonates were probable sepsis 65(63.8%), neonatal jaundice 53(52%) and prematurity 53(52%). There was significant difference in anaemic and non-anaemic neonates with regards to mothers with gestational diabetes (P value < 0.0001). The factors associated with severe anaemia were probable sepsis and the duration of stay. Blood transfusion was carried out in 27(25.5%) neonates. An overall mortality of 7.5% was documented, severe anaemia being highest (21.4%). Conclusion: The prevalence of anaemia was high being 26.4% and was observed more in males, preterms and babies delivered via Caesarean section. There was significant difference in anaemic and non-anaemic neonates with regards to mothers with gestational diabetes. Probable sepsis and duration of stay were significantly associated with severe anaemia. The mortality rate in neonates with anaemia was 7.5% thus there is need to assess newborns for anaemia with prompt intervention to prevent morbidity, mortality and long term sequelae.

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

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.

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

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.

scholarly journals 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?

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.

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

2020 ◽  
Vol 9 (11) ◽  
pp. 4389
Author(s):  
Peter A. Awoyesuku ◽  
Dickson H. John ◽  
Dickson H. John ◽  
Lewis B. Lebara ◽  
Lewis B. Lebara
Keyword(s):  
Birth Weight ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Case Fatality ◽  
Severe Preeclampsia ◽  
University Teaching ◽  
State University ◽  
The Mean ◽  
Rivers State

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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