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Okoye HC, Othman M, Nwagha TU, Onwusulu DN, Onoh RC, Chigbu CO. Evaluating the hemostatic effects of tranexamic acid in women with pre-eclampsia. Int J Gynaecol Obstet 2023; 162:931-936. [PMID: 37067045 DOI: 10.1002/ijgo.14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/11/2023] [Accepted: 03/20/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE To evaluate the hemostatic effects of tranexamic acid (TXA) ex vivo in women with pre-eclampsia. METHODS This was an ex vivo study involving 45 normal pregnant women and 45 women with pre-eclampsia (nine with mild and 36 with severe features) matched for age, gestational age, and body mass index. Blood samples were collected and divided into two parts. The first served as the pre-TXA sample, while the second was spiked with TXA and served as the post-TXA sample. Plasma levels of D-dimer and plasmin-antiplasmin complex (PAP) were determined using enzyme-linked immunosorbent assay. RESULTS The mean D-dimer and PAP values in the pre-TXA samples differed significantly between groups. Following spiking with TXA, the mean D-dimer and PAP levels did not differ significantly in the pre-TXA and post-TXA samples (P = 0.560 and P = 0.500, respectively) in the pre-eclampsia cohort. In normal pregnancy, the mean D-dimer and PAP levels in the post-TXA samples did not differ significantly (P = 0.070 and P = 0.050, respectively) from the pre-TXA samples following TXA spiking. CONCLUSION TXA did not significantly affect D-dimer and PAP levels in pre-eclampsia, suggesting that TXA may not increase the thrombotic risks in patients with pre-eclampsia.
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Affiliation(s)
- Helen C Okoye
- Department of Hematology and Immunology College of Medicine, University of Nigeria Ituku-Ozalla campus, Enugu, Nigeria
| | - Maha Othman
- Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada
- School of Baccalaureate Nursing, St Lawrence College, Kingston, Ontario, Canada
- Department of Clinical Pathology, School of Medicine, Mansoura University, Mansoura, Egypt
| | - Theresa U Nwagha
- Department of Hematology and Immunology College of Medicine, University of Nigeria Ituku-Ozalla campus, Enugu, Nigeria
| | - Daniel N Onwusulu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - Robinson C Onoh
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi, Nigeria
| | - Chibuike O Chigbu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Nigeria
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Chika-Igwenyi NM, Harrison RE, Psarra C, Gil-Cuesta J, Gulamhusein M, Onwe EO, Onoh RC, Unigwe US, Ajayi NA, Nnadozie UU, Ojide CK, Nwidi DU, Ezeanosike O, Sampson E, Adeke AS, Ugwu CN, Anebonam U, Tshiang JK, Maikere J, Reid A. Early onset of neurological features differentiates two outbreaks of Lassa fever in Ebonyi state, Nigeria during 2017-2018. PLoS Negl Trop Dis 2021; 15:e0009169. [PMID: 33684118 PMCID: PMC7984835 DOI: 10.1371/journal.pntd.0009169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/22/2021] [Accepted: 01/22/2021] [Indexed: 01/15/2023] Open
Abstract
Lassa fever (LF) is an acute viral haemorrhagic illness with various non-specific clinical manifestations. Neurological symptoms are rare at the early stage of the disease, but may be seen in late stages, in severely ill patients.The aim of this study was to describe the epidemiological evolution, socio-demographic profiles, clinical characteristics, and outcomes of patients seen during two Lassa fever outbreaks in Ebonyi State, between December 2017 and December 2018. Routinely collected clinical data from all patients admitted to the Virology Centre of the hospital during the period were analysed retrospectively. Out of a total of 83 cases, 70(84.3%) were RT-PCR confirmed while 13 (15.7%) were probable cases. Sixty-nine (83.1%) patients were seen in outbreak 1 of whom 53.6% were urban residents, while 19%, 15%, and 10% were farmers, students and health workers respectively. There were 14 (16.8%) patients, seen in second outbreak with 92.9% rural residents. There were differences in clinical symptoms, signs and laboratory findings between the two outbreaks. The case fatality rates were 29.9% in outbreak 1 and 85.7% for outbreak 2. Neurological features and abnormal laboratory test results were associated with higher mortality rate, seen in outbreak 2. This study revealed significant differences between the two outbreaks. Of particular concern was the higher case fatality during the outbreak 2 which may be from a more virulent strain of the Lassa virus. This has important public health implications and further molecular studies are needed to better define its characteristics.
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Affiliation(s)
- Nneka M. Chika-Igwenyi
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | | | - Christina Psarra
- Médecins sans Frontières Operational Research Unit (LuxOR), Operational Centre Brussels, Belgium
| | - Julita Gil-Cuesta
- Médecins sans Frontières Operational Research Unit (LuxOR), Operational Centre Brussels, Belgium
| | - Maria Gulamhusein
- Médecins sans Frontières Operational Research Unit (LuxOR), Operational Centre Brussels, Belgium
| | - Emeka O. Onwe
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - Robinson C. Onoh
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - Uche S. Unigwe
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
- University of Nigeria Teaching Hospital, Ituku Ozalla Enugu, Nigeria
| | - Nnennaya A. Ajayi
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - Ugochukwu U. Nnadozie
- Division of Plastic Surgery, Department of Surgery, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - Chiedozie K. Ojide
- Department of Medical Microbiology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
- Virology Laboratory, Virology Centre,AlexEkwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - Damian U. Nwidi
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - Obumneme Ezeanosike
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - Emeka Sampson
- Ebonyi State Ministry of Health, Abakaliki, Ebonyi, Nigeria
| | - Azuka S. Adeke
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakiliki, Abakaliki, Ebonyi, Nigeria
| | - Collins N. Ugwu
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | | | | | | | - Anthony Reid
- Médecins sans Frontières Operational Research Unit (LuxOR), Operational Centre Brussels, Belgium
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Onoh RC, Egede JO, Lawani LO, Ekwedigwe KC, Aja LO, Anozie BO. Birth preparedness and complication readiness among women of reproductive age group in Abakaliki, Southeast Nigeria. Niger J Clin Pract 2020; 23:362-370. [PMID: 32134036 DOI: 10.4103/njcp.njcp_670_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Birth preparedness and complication readiness (BPCR) reduces delays in obstetric care, improves health-seeking behavior during an obstetric emergency, and improves knowledge on danger signs of pregnancy. Aims To assess the knowledge, perception, and practice of women on BPCR. Subjects and Methods This was a cross-sectional study conducted at Federal Teaching Hospital in Ebonyi state, Nigeria at the postnatal ward from June to December 2016. Women who delivered were recruited consecutively on discharge from the postnatal ward. Their knowledge, perception, and practice of BPCR in the last pregnancy were sought. Information obtained were analyzed using 2008 Epi-info™ software version 3.5.1 (Atlanta Georgia USA). Result A total of 438 of 445 questionnaires were correctly filled and analyzed giving a response rate of 98.4%. Most of the women knew about birth preparedness 384 (87.7%) and complication readiness 348 (79.5%). A significant number of women did not access antenatal care within the first trimester 236 (53.9%), did not know that family planning is important in BPCR 216 (49.3%), and did not identify means of transport in the event of emergency 354 (80.8%). No provision of blood during antenatal care for the blood banking system was a common finding 258 (58.9%). In multivariate logistic regression analysis, choosing a health care provider was a common finding among literate mothers (OR = 2.8,95% CI = 1.02,7.72), woman within 25-29 years (OR = 1.09, 95%CI = 1.02,1.16), and multiparas (OR = 0.82, 95% CI = 0.67,0.99). Conclusion There is increased knowledge and awareness of BPCR but the comprehensive components and practices of BPCR are still not optimal in our setting.
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Affiliation(s)
- R C Onoh
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - J O Egede
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - L O Lawani
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - K C Ekwedigwe
- National Obstetrics Fistula Centre, Abakaliki, Ebonyi State, Nigeria
| | - L O Aja
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - B O Anozie
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
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Ajah LO, Onu FA, Ogbuinya OC, Ajah MI, Ozumba BC, Agbata AT, Onoh RC, Ekwedigwe KC. Choice of birth place among antenatal clinic attendees in rural mission hospitals in Ebonyi State, South-East Nigeria. PLoS One 2019; 14:e0211306. [PMID: 31689292 PMCID: PMC6830769 DOI: 10.1371/journal.pone.0211306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 09/20/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Low utilization of health facilities for delivery by pregnant women poses a public health challenge in Nigeria. AIM To determine the factors that influence the choice of birth place among antenatal clinic attendees. METHODOLOGY This was a cross-sectional study of the eligible antenatal clinic attendees recruited at Mater Misericordiae Hospital, Afikpo and Saint Vincent Hospital, Ndubia in Ebonyi State from February 1, 2016 to June 30, 2016. Analysis was done using EPI Info 7.21 software (CDC Atlanta Georgia). RESULTS A total of 397(99.3%) completely filled questionnaires were collated and analysed. Approximately 71% of the health facilities closest to the respondents had maternity services. It took at least 1 hour for 80.9% of the respondents to access health facilities with maternity services. Most (60.2%) of the respondents had at least one antenatal clinic attendance and majority of them did so at public hospitals. Approximately 43.8% of the respondents were delivered by the skilled birth attendants. The respondents' age and the couple's educational level, history of antenatal clinic attendance, distance of the health facility and availability of transport fare had a significant effect on delivery by skilled birth attendants. The common determinants of birth place were nearness of the health facilities, familiarity of healthcare providers, improved services, sudden labour onset and cost. Also 61.7% of the respondents chose to deliver in public health facilities due to favourable reasons but this could be hampered by the rudeness of some healthcare providers at such facilities. A significant proportion of private health facilities had unskilled manpower and shortage of drugs. CONCLUSION A greater proportion of women will prefer to deliver in health facilities. However there are barriers to utilization of these facilities hence the need to address such barriers.
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Affiliation(s)
- Leonard O. Ajah
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria
- * E-mail:
| | - Fidelis A. Onu
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Oliver C. Ogbuinya
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Monique I. Ajah
- Institute of Maternal and Childhealth, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Benjamin C. Ozumba
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Anthony T. Agbata
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Robinson C. Onoh
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Kenneth C. Ekwedigwe
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria
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Mamah JE, Onoh RC, Umeokonkwo CD, Onwe EO, Ezeonu PO, Okafor L. Severe preeclampsia and eclampsia: A 6-year review at the Federal Teaching Hospital, Abakaliki, Southeast Nigeria. Trop J Obstet Gynaecol 2019. [DOI: 10.4103/tjog.tjog_45_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Onoh RC, Ejikeme BN, Onwe AB, Asiegbu OU. Ruptured ectopic in heterotopic pregnancy: Management and spontaneous vertex delivery of a live baby at term. Niger J Clin Pract 2018; 21:672-677. [PMID: 29735871 DOI: 10.4103/njcp.njcp_67_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Spontaneous heterotopic pregnancy is an uncommon clinical condition in which there is a simultaneous development of intrauterine and extrauterine pregnancies. It is a life-threatening emergency when the ectopic ruptures. We present Mrs. EC, a 27-year-old G1P0 + 0 with a family history of multiple gestations who had a heterotopic pregnancy at a gestational age of 7 weeks. She presented with features of threatened miscarriage at early pregnancy with an ultrasound confirmation of intrauterine pregnancy. The diagnosis of ruptured ectopic pregnancy coexisting with intrauterine gestation was made with ultrasound findings as well as clinical features necessitating emergency exploratory laparotomy. Thereafter, pregnancy was carried to term, and she delivered a live male baby that weighed 3.0 kg. Heterotopic pregnancy should be sort for in all pregnancies during the early scan, especially in those with predisposing factors for multiple gestations and risk factors for ectopic gestation. A high index of suspicion is necessary for making a diagnosis in women with intrauterine pregnancy, with or without symptoms of ectopic gestation, and irrespective of the existence of risk factors for ectopic pregnancy.
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Affiliation(s)
- R C Onoh
- Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi, Ebonyi State, Nigeria
| | - B N Ejikeme
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Ebonyi State, Nigeria
| | - A B Onwe
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Ebonyi State, Nigeria
| | - O U Asiegbu
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Ebonyi State, Nigeria
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Ekem NN, Lawani LO, Onoh RC, Iyoke CA, Ajah LO, Onwe EO, Onyebuchi AK, Okafor LC. Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria. J OBSTET GYNAECOL 2018. [PMID: 29526148 DOI: 10.1080/01443615.2017.1405922] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Preconception care (PCC) is a preventive strategy for maternal and perinatal morbidity and mortality. This study aimed to assess the level of awareness and utilisation of PCC services. A descriptive cross-sectional survey was conducted at a teaching hospital. Interviewer-administered questionnaires were used to extract information. A total of 450 participants responded; 44.2% (190/450) were aware, 31.7% (143/450) had good knowledge, while only 10.3% (46/450) received PCC. Health care providers were the main source of information (77.9%). There was statistically significant correlation between awareness and participants' level of education (p < .001) and residence (p < .001), as well as between utilisation and education (p < .001), and information from doctors (p < .001). There was a low level of awareness and poor utilisation of PCC, underpinning the need to scale up health education, establishment of functional PCC clinics and formulation of evidence-based guidelines to improve uptake and pregnancy outcome. Impact statement What is already known on the subject of the paper? PCC has been known in high-income countries as a prevention-based strategy, which aims at improving obstetric outcomes. However, the level of utilisation in low-income countries like Nigeria is either unknown or far too low. What do this study add? This work has provided local data on PCC; clearly indicating that the awareness and utilisation of PCC services in Abakaliki, Nigeria is very low when compared with other regions of the world, and this was influenced by the socio-demographic factors - particularly education and place of residence (for awareness), and level of education and information from health care providers (for utilisation), thus suggesting that enlightenment and improvement in social infrastructures could improve awareness, access and utilisation of PCC. What are the implications for clinical practice and/or further research? The implications of these findings in low resource settings like ours will include introducing interventions to scaling up health education, universal establishment of functional PCC units and formulation of evidence-based guidelines aimed at improving the uptake of PCC and pregnancy outcome. Further research will also be needed in future to assess the impact of such interventions and how to sustain potential benefits.
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Affiliation(s)
- Napoleon N Ekem
- a Department of Obstetrics & Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria
| | - Lucky O Lawani
- a Department of Obstetrics & Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria
| | - Robinson C Onoh
- a Department of Obstetrics & Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria
| | - Chukwuemeka A Iyoke
- b Department of Obstetrics & Gynaecology , University of Nigeria Teaching Hospital , Enugu , Enugu State , Nigeria
| | - Leonard O Ajah
- a Department of Obstetrics & Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria
| | - Emeka O Onwe
- c Department of Paediatrics , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria
| | - Azubuike K Onyebuchi
- a Department of Obstetrics & Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria
| | - Love C Okafor
- a Department of Obstetrics & Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria
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Onoh RC, Mgbafuru CC, Onubuogu SE, Ugwuoke I. Fitz-Hugh-Curtis syndrome: An incidental diagnostic finding in an infertility workup. Niger J Clin Pract 2018; 19:834-836. [PMID: 27811461 DOI: 10.4103/1119-3077.181357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A case of Fitz-Hugh-Curtis syndrome in a 32-year-old para 1+1 is reported. She presented with inability to conceive of 4 years duration. Her husband's semen analysis was within normal range. She had a hysterosalpingogram that showed bilateral tubal blockage and clinical assessment showed right sided abdominal tenderness, cervical excitation tenderness, and adnexa tenderness. The endocervical swab test for Chlamydia trachomatis was a positive. Laparoscopy and dye test showed adhesion bands on the under surface of the liver (the violin string appearance). She recovered well postoperatively. The couple received ofloxacin and metronidazole for 2 weeks. Literatures on Fitz-Hugh-Curtis syndrome presentation, pathogenesis, and management were reviewed.
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Affiliation(s)
- R C Onoh
- Department of Obstetrics and Gynaecology, Reproductive Endocrinology and Infertility Unit, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - C C Mgbafuru
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - S E Onubuogu
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - I Ugwuoke
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
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Ezeonu PO, Agwu UM, Ajah LO, O Dimejesi IB, Ogbonnaya LU, J Umeora OU, Onoh RC. The prevalence of osteoporosis among antenatal clinic attendees in a rural mission hospital in South-East Nigeria. Niger J Clin Pract 2018; 20:1522-1526. [PMID: 29378980 DOI: 10.4103/njcp.njcp_267_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital. MATERIAL AND METHODS This was a cross-sectional study of booking Antenatal Clinic Attendees at Mile 4 Catholic Hospital, Abakaliki, between October 2014 and February 2015. The study participants were selected through systematic random sampling. The BMD of the right calcaneal bone of the participants was measured using the OsteoPro, a Quantitative ultrasound scan. RESULTS A total of 327 eligible women participated in the study. The average age of the participants was 29 ± 4.5 years. The average parity was 2 ± 1.6 childbirths. The mean T-score was -1.19 ± 4.9. Osteoporosis and osteopenia were recorded in 119 women (36.4%) and 56 women (17.1%), respectively, whereas 152 (46.5%) were within normal range. History of regular exercise by the respondents is statistically significant on the reduction of osteopenia and osteoporosis (P ≤ 0.05). The history of ever use of calcium supplementation by the study participants in the index pregnancy did not have any significant effect on the reduction of osteoporosis. CONCLUSION There is a high prevalence of osteoporosis among pregnant women in Southeast Nigeria. This may be due to the predominant poor adherence and low dose of calcium supplementation among pregnant women in this environment. Therefore, there is an urgent need for sensitization on this public health problem.
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Affiliation(s)
- P O Ezeonu
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital/ Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - U M Agwu
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital/ Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - L O Ajah
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital/ Ebonyi State University, Abakaliki, Ebonyi State; Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Enugu State, Nigeria
| | - I B O Dimejesi
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital/ Ebonyi State University; Department of Obstetrics and Gynaecology, Mile 4 Catholic Hospital, Abakaliki, Ebonyi State, Nigeria
| | - L U Ogbonnaya
- Department of Community Medicine, Federal Teaching Hospital/ Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - O U J Umeora
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital/ Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - R C Onoh
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital/ Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
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Ezeonu PO, Anozie OB, Onu FA, Esike CU, Mamah JE, Lawani LO, Onoh RC, Ndukwe EO, Ewah RL, Anozie RO. Perceptions and practice of epidural analgesia among women attending antenatal clinic in FETHA. Int J Womens Health 2017; 9:905-911. [PMID: 29276414 PMCID: PMC5731435 DOI: 10.2147/ijwh.s144953] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The pain of childbirth is arguably the most severe pain that most women will endure in their lifetime. Epidural analgesia is widely used as an effective method of pain relief in labor. It provides almost complete relief of pain if administered timely, and does not affect the progress of the first stage labor. Objectives The objective of this study was to determine the awareness and utilization of epidural analgesia in labor in pregnant women attending the antenatal clinic at Federal Teaching Hospital, Abakaliki (FETHA). Methodology This is a cross-sectional study involving 350 women attending the antenatal clinic between April 2016 and July 2016. A total of 335 questionnaires were correctly completed, and used for analysis. Results The average age and parity of the respondents were 27.6±8.2 years and 2.4±1.8, respectively. About 58.2% of respondents were civil servants, 98.5% were married, and 74.6% had a tertiary level of education. About 43.3% of the respondents are aware of the use of epidural analgesia in labor, but only 7.5% had used it; 95% of these were satisfied and desired to use it again. The reasons responsible for the poor uptake were desire to experience natural labor, cost, and fear of side effects. However, 70% of those who had not used it expressed the desire to use it. Conclusion Epidural analgesia is one of the most effective methods of pain relief in labor. However, the present study indicates that knowledge and practice of epidural analgesia among parturients are low. Efforts should be made to raise awareness, dispel misconceptions, and subsidize the cost of providing this invaluable care in modern day obstetrics.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Rita Onyinyechi Anozie
- Department of Radiology, Federal Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria
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Onoh RC, Lawani OL, Ezeonu PO, Nkwo PO, Onoh TJP, Ajah LO. Predictors of anemia in pregnancy among pregnant women accessing antenatal care in a poor resource setting in South Eastern Nigeria. Sahel Med J 2015. [DOI: 10.4103/1118-8561.176588] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ezeonu PO, Lawani LO, Iyoke CA, Eze JN, Onoh RC, Anozie OB. The preference and practice of Nigerian obstetricians regarding focused versus standard models of prenatal care. Int J Gynaecol Obstet 2014; 128:232-5. [PMID: 25482437 DOI: 10.1016/j.ijgo.2014.09.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 09/10/2014] [Accepted: 11/11/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine preferences, practices, and acceptance of focused versus standard prenatal-care models among Nigerian obstetricians. METHODS A cross-sectional survey was performed among clinicians who attended a conference held in Lagos, Nigeria, between November 27 and 29, 2013. The questionnaire assessed sociodemographic characteristics and opinions on prenatal care. RESULTS A total of 201 delegates returned complete questionnaires. All respondents were aware of both models of prenatal care. Although 70 (34.8%) respondents stated a preference for focused care, only 6 (3.0%) used this model in clinical practice. The main reason for their preference was the evidence base (23.4%). Overall, 185 (92.0%) respondents stated institutional protocol determined preference for and practice of standard care, 108 (53.7%) believed patients preferred standard care, and 89 (44.3%) felt standard care had health benefits. Preference for one model over the other was significantly associated with type and level of the healthcare practice (P=0.002 and P<0.001, respectively). Modification of the focused model to meet local, national, and cultural needs was recommended by 171 (85.1%) respondents. CONCLUSION Most obstetricians are skeptical about focused prenatal care and have not embraced this model owing to personal, institutional, and sociocultural factors.
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Affiliation(s)
- Paul O Ezeonu
- Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Lucky O Lawani
- Department of Community Medicine, School of Post Graduate Studies, University of Nigeria, Enugu, Nigeria.
| | - Chukwuemeka A Iyoke
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Justus N Eze
- Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Robinson C Onoh
- Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Okechukwu B Anozie
- Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria
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Iyoke CA, Lawani OL, Onoh RC. Views of Nigerian gynecologists on the need to establish and implement early pregnancy assessment units (EPAUs) in Nigerian hospitals. Int J Gynaecol Obstet 2014; 126:283-4. [PMID: 24907103 DOI: 10.1016/j.ijgo.2014.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 03/29/2014] [Accepted: 05/08/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Chukwuemeka A Iyoke
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
| | - Osaheni L Lawani
- Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Robinson C Onoh
- Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria
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Lawani LO, Onyebuchi AK, Iyoke CA, Onoh RC, Nkwo PO. The challenges of adherence to infant feeding choices in prevention of mother-to-child transmission of HIV infections in South East Nigeria. Patient Prefer Adherence 2014; 8:377-81. [PMID: 24707171 PMCID: PMC3972024 DOI: 10.2147/ppa.s61796] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Global and national efforts in the 21st century are directed toward the elimination of new pediatric HIV infections through evidence-based infant feeding interventions for the prevention of mother-to-child-transmission, with patient preference, motivation, and adherence identified as key factors for success. OBJECTIVES This study assessed the challenges faced by HIV-infected parturients in adhering to the national infant feeding recommendations and their infant feeding preference for prevention of mother-to-child transmission in South East Nigeria. METHODS This is a cross-sectional, descriptive, questionnaire-based study of 556 parturients infected with HIV/AIDS. RESULTS The mean age of the participants was 28.0±5.3 years. The infant feeding choices were made jointly by both partners (61.1%) in the antepartum period. The HIV status disclosure rate was 89.2%. A large proportion (91.7%) practiced exclusive breastfeeding with highly active antiretroviral therapy, and 7.6% practiced mixed feeding because of nonadherence to their choice and national/international recommendations on infant feeding in the context of HIV/AIDS. This was mainly a result of pressure from family members (42.8%) and cultural practices (28.5%). Multivariate logistic regression analysis indicates that adherence was strongly associated with age, marital status, and employment status, but not with residence, educational status, or parity. CONCLUSION Exclusive breastfeeding is predominately the infant feeding choice among HIV-infected parturients in South East Nigeria, but there is still a gap between infant feeding preference and adherence to standard practice as a result of sociocultural challenges associated with risk for mixed feeding and the risk for mother-to-child-transmission of HIV by nursing mothers.
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Affiliation(s)
- Lucky O Lawani
- School of Postgraduate Studies, Department of Community Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria
- Correspondence: Lucky O, Lawani School of Postgraduate Studies, Department of Community Medicine, University of Nigeria, Enugu Campus, Enugu State, 400001, Nigeria, Tel +234 803 669 1209, Email
| | - Azubuike K Onyebuchi
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Chukwuemeka A Iyoke
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria
| | - Robinson C Onoh
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Peter O Nkwo
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria
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Onoh RC, Umeora OUJ, Egwuatu VE, Ezeonu PO, Onoh TJP. Antibiotic sensitivity pattern of uropathogens from pregnant women with urinary tract infection in Abakaliki, Nigeria. Infect Drug Resist 2013; 6:225-33. [PMID: 24324344 PMCID: PMC3854917 DOI: 10.2147/idr.s46002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Urinary tract infection (UTI) is a common bacterial infection during pregnancy and a significant cause of perinatal and maternal morbidity and mortality. The causative bacteria have remained virtually the same although with variations in individual prevalence. There has been an increasing resistance by these bacteria to the commonly available antibiotics. OBJECTIVES To determine the prevalence of UTI, the common causative bacteria, and their antibiotic sensitivity pattern among pregnant women with UTI. METHODOLOGY This is a descriptive study that was carried out at the Obstetrics Department of two tertiary institutions in Abakaliki, Ebonyi State, Nigeria (Federal Medical Center and Ebonyi State University Teaching Hospital) over a period of 12 months. Midstream urine specimens from selected pregnant women with clinical features of UTI were collected for microscopy, culture, and sensitivity. The results were analyzed with the 2008 Epi Info™ software. RESULTS A total of 542 pregnant women presented with symptoms of UTI and were recruited for the study over the study period. Of the 542 pregnant women, 252 (46.5%) had significant bacteriuria with positive urine culture and varying antibiotic sensitivity pattern. The prevalence of symptomatic UTI was 3%. Escherichia coli was the most common bacteria isolated with a percentage of 50.8%. Other isolated micro organisms included Stapylococcus aereus (52 cultures, 20.6%), Proteus mirabilis (24 cultures, 9.5%), S. saprophyticus (18 cultures, 7.1%), Streptococcus spp. (14 cultures, 5.6%), Citrobacter spp. (5 cultures, 2.0%), Klebsiella spp. (4 cultures, 1.6%), Enterobacter spp. (4 cultures, 1.6%), and Pseudomonas spp. (3 cultures, 1.2%). Levofloxacin had the highest overall antibiotic sensitivity of 92.5%. Others with overall antibiotic sensitivity pattern greater than 50% included cefpodoxime (87.3%), ofloxacin (77.4%), ciprofloxacin (66.7%), ceftriaxone (66.7%), and gentamicin (50.8%). CONCLUSION E. coli was the most common etiological agent of UTI in pregnancy with Enterococcus (Staphylococcus) gaining prominence. Cephalosporin and quinolones were shown to be very effective against the organisms causing UTI in these pregnant women.
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Affiliation(s)
- RC Onoh
- Department of Obstetrics and Gynecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - OUJ Umeora
- Department of Obstetrics and Gynecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - VE Egwuatu
- Department of Obstetrics and Gynecology, Enugu State University Teaching Hospital, Enugu State, Nigeria
| | - PO Ezeonu
- Department of Obstetrics and Gynecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - TJP Onoh
- Department of Pathology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
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Onoh RC. Author's Response. Ann Med Health Sci Res 2013; 3:132-4. [PMID: 23634352 PMCID: PMC3634216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- RC Onoh
- Department of Obstetrics and Gynaecology Federal Medical Centre, Abakaliki, Ebonyi State, Nigeria E-mail:
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Ezegwui HU, Onoh RC, Ikeako LC, Onyebuchi A, Umeora OUJ, Ezeonu P, Ibekwe P. Investigating maternal mortality in a public teaching hospital, abakaliki, ebonyi state, Nigeria. Ann Med Health Sci Res 2013; 3:75-80. [PMID: 23634334 PMCID: PMC3634229 DOI: 10.4103/2141-9248.109511] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Maternal mortality in sub-Saharan Africa has remained high and this is a reflection of the poor quality of maternal services. AIM To determine the causes, trends, and level of maternal mortality rate in Abakaliki, Ebonyi. MATERIALS AND METHODS This was a review of the records of all maternal deaths related to pregnancy over a ten-year period, that is, January 1999 to December 2008. Relevant information on number of deaths, booking status, age, parity, educational level of women, mode of delivery, and causes of death were extracted and analyzed. RESULTS During the study period, there were 12,587 deliveries and 171 maternal deaths. The maternal mortality ratio (MMR) was 1,359 per 100,000 live births. The trend over the period was lowest in 2008 and highest in 1999 with an MMR of 757 per 100,000 live births and 4,000 per 100,000 live births, respectively. There was a progressive decline in the MMR over the period of study except in the years 2003 and 2006, when the ratio spiked a little, giving an MMR of 1,510 per 100,000 live births and 1,290 per 100,000 live births, respectively. The progressive decline in maternal mortality corresponded with the time that free maternal services were introduced. Hemorrhage was the most important cause of maternal death, accounting for 23.0% (38/165), whereas diabetic ketoacidosis, congestive cardiac failure, and asthma in pregnancy were the least important causes of maternal deaths, each accounting for 0.6% (1/165). Majority of the maternal deaths occurred in unbooked patients (82.4% (136/165)), whereas 17.6% (29/165) of the deaths occurred in booked cases. Forty-seven (28.5% (47/165)) patients died following a cesarean section, 8.5% (14/165) died as a result of abortion complications, and 10.9% (18/165) died undelivered. Seventy-seven (46.7% (77/165)) of the maternal death patients had no formal education. Low socioeconomic status, poor educational level, and grand multiparity were some of the risk factors for maternal mortality. CONCLUSION There was a decline in MMR during the period of study. The free maternal health services and adequate staff recruitment, which may have contributed to the observed decline in maternal mortality, should be sustained in developing countries.
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Affiliation(s)
- HU Ezegwui
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - RC Onoh
- Department of Obstetrics and Gynaecology, Federal Medical Centre, Abakaliki, Nigeria
| | - LC Ikeako
- Department of Obstetrics and Gynaecology, Anambra State University Teaching Hospital, Amaku, Awka, Nigeria
| | - A Onyebuchi
- Department of Obstetrics and Gynaecology, Federal Medical Centre, Abakaliki, Nigeria
| | - OUJ Umeora
- Ebonyi State University Teaching Hospital, Abakaliki, Nigeria
| | - P Ezeonu
- Department of Obstetrics and Gynaecology, Federal Medical Centre, Abakaliki, Nigeria
| | - P Ibekwe
- Ebonyi State University Teaching Hospital, Abakaliki, Nigeria
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Umeora OUJ, Onoh RC, Eze JN, Igberase GO. Abdominal versus vaginal hysterectomy: Appraisal of indications and complications in a Nigerian Federal Medical Centre. Nepal j obstet gynaecol 1970. [DOI: 10.3126/njog.v4i1.3328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: To compare hysterectomies performed via the abdominal and vaginal routes in terms of indicationsand associated complications.Methods: Review of retrospective data on all cases of hysterectomies performed at the Federal MedicalCentre Abakaliki over a six-year period (January 2000 to December 2005).Results: There were a total of 62 hysterectomies. Of these, 33 (52.2%) were abdominal hysterectomies while29 (46. 8%) were vaginal hysterectomies. Hysterectomy was carried out predominantly for grand multiparouswomen [21 (72.4%) and 21 (63.7%) were abdominal and vaginal hysterectomies respectively]. The meanages of the patients were 48.8 years and 55.5 years for the abdominal and vaginal operations respectively.The only indication for vaginal hysterectomy in this study was uterovaginal prolapse while uterine fibroid wasthe commonest indication for abdominal hysterectomy. Complications and duration of hospital stay weremore following abdominal hysterectomy.Conclusion: There is need for training and retraining of specialist gynaecologists and trainee residents onprocedures of hysterectomies, especially vaginal hysterectomy to expand the indications for the vaginalsurgery which is attended with less postoperative morbidity.Key words: indications; complications; route; pyrexia; wound; AbakalikiDOI: 10.3126/njog.v4i1.3328Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 25-29
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