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Papers by Adebayo Akadri

Research paper thumbnail of Eclampsia: A five-year retrospective review in Sagamu, South-West Nigeria

Nigerian Journal of Medicine, 2020

Context: Eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality... more Context: Eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in developing countries. This is the result of poor health-seeking behavior of pregnant women and inadequate comprehensive emergency obstetric services. This study reviewed the presentation and management of eclampsia in Sagamu over a 5-year period. Aims: This study aims to determine the prevalence, pattern of clinical presentation and fetomaternal outcomes of eclampsia. Settings and Design: This was a retrospective study conducted in Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun state. Subjects and Methods: Relevant information was retrieved from case notes of all patients who presented with eclampsia from January 2014 to December 2018. Data were analyzed using SPSS version 21. Results: Out of the 4656 deliveries, there were 45 cases of eclampsia giving a prevalence of 0.97%. The modal age was 20–24 years. Majority were unbooked 41 (91.1%) and 29 (64.4%) of the women were ...

Research paper thumbnail of Effect of hyoscine‐N‐butylbromide on labor duration among nullipara in a southwestern Nigerian teaching hospital: A randomized controlled trial

International Journal of Gynecology & Obstetrics, 2020

To assess the effectiveness of hyoscine‐N‐butylbromide on the duration of the first stage of labo... more To assess the effectiveness of hyoscine‐N‐butylbromide on the duration of the first stage of labor among nulliparous women.

Research paper thumbnail of Vaginal Candida infection in pregnancy and its implications for fetal well-being

Vaginal Candida infection is one of the most common genital tract infections reported in pregnant... more Vaginal Candida infection is one of the most common genital tract infections reported in pregnant women. This study was designed to determine the prevalence of vaginal Candida infection and pattern of Candida species isolates in the genital tract of pregnant women during antenatal period and in early labour; and the associated fetal outcome. The study was conducted at the antenatal clinic and labor ward of Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun State, Nigeria. High vaginal swabs were collected from 408 pregnant women at the antenatal clinic and repeated in early labour. The samples were processed to isolate Candida species. Data were analysed using Statistical Package for Social Science (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA). Prevalence of Candida infection was significantly higher in early labour (46%) than during antenatal period (38%) (P=0.02). Candida albicans was the predominant isolate, followed by Candida glabrata and Candida tropicalis. ...

Research paper thumbnail of The ability and safety of community-based health workers to safely initiate lifesaving therapies for pre-eclampsia in Ogun State, Nigeria: An analysis of 260 community treatments with MgSO4 and/or methyldopa

Research paper thumbnail of Lifestyle modification adherence among patients attending diabetes clinics in selected hospitals in Remo zone Ogun State, Nigeria

Babcock University Medical Journal (BUMJ)

Objective: Lifestyle modification is an essential component of self-management of diabetes mellit... more Objective: Lifestyle modification is an essential component of self-management of diabetes mellitus. This study assessed adherence to diet and exercise recommendations and elucidated the factors that influence adherence in patients living with diabetes. Method: A cross-sectional study involving 300 patients attending diabetes clinics in some selected hospitals in Ogun State, Nigeria. Structured questionnaires were used to obtain information on the socio-demographic characteristics, and PRECEDE factors of lifestyle-modification adherence in the study participants. Pearson’s correlation and Chi-square test were used to assess the association between the variables, while binary logistic regression was used to determine the predictors of adherence to dietary recommendations. Results: The mean age of the study respondents was 62.7 years. The proportion of respondents who adhered to dietary and exercise recommendations were 87.8% and 45.6% respectively. There were no statistically signifi...

Research paper thumbnail of Hypertensive disorders of pregnancy: A five-year review in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

Babcock University Medical Journal (BUMJ)

Objective: To determine the prevalence and outcome of hypertensive disorder of pregnancy in Babco... more Objective: To determine the prevalence and outcome of hypertensive disorder of pregnancy in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State Nigeria Method: This was a retrospective descriptive study of all documented cases of hypertensive disorder of pregnancy between the 1st of June 2012 and 31st May, 2017. Information such as age, parity, booking status, level of education, blood pressure at presentation, urinalysis at presentation, gestational age at presentation, and delivery, mode of delivery, baby’s birth weight was extracted from patients’ case files. Result: There were 1,118 deliveries during the study period out of which 55 (4.9%) patients had hypertensive disorders in pregnancy. The mean age was 31.5years ±48.1 and mean parity, 1.2± 1.1. The mean systolic and diastolic blood pressures were 180.4 ± 1.88mmHg and 105.1± 1.5mmHg, respectively. Thirty-four (75.5%) of the women had preeclampsia/ eclampsia, while 7 (15.5%) had gestational hypertension. Most women ...

Research paper thumbnail of Breastfeeding Practices among Mothers in Southwest Nigeria

Ethiopian Journal of Health Sciences

BACKGROUND፡ This study was conducted to determine the breastfeeding practices among parous antena... more BACKGROUND፡ This study was conducted to determine the breastfeeding practices among parous antenatal attendees in two teaching hospitals in Southwest Nigeria.METHODS: A cross-sectional study was carried out on 340 parous antenatal clinic attendees in two teaching hospitals in Ogun State, Nigeria. A structured questionnaire was used to obtain data on breastfeeding practices. Data were analyzed using Statistical Package for Social Sciences (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA).RESULTS: Out of a total of 340 women, 319 (93.8%) breastfed their last babies. The median duration of breastfeeding was 15 months. One hundred and thirty two women (38.8%) initiated breastfeeding within 30 minutes of delivery, and 200 women (58.8%) exclusively breastfed their babies for six months. The majority of the women, 299(87.9%k) did not report any problem associated with breastfeeding. Logistic regression analysis showed that women who had no breastfeeding problems were more likely to ...

Research paper thumbnail of Bacterial vaginosis in pregnancy and early labour using Nugent scoring and the implication on foetal outcome

Ghana Medical Journal

Background: To compare the pattern of vaginal microflora during pregnancy with pattern in early l... more Background: To compare the pattern of vaginal microflora during pregnancy with pattern in early labour using Nugent scoring and determine the effect of these changes on fetal outcome. Design: A prospective longitudinal study. Setting and Population: Pregnant women attending antenatal clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria between June 2017 and May 2018. Methods: Consenting pregnant women who attended antenatal clinics were recruited. Vaginal secretions were obtained for Nugent scoring during pregnancy and at presentation in labour. Main Outcome Measures: Prevalence of abnormal vaginal flora in pregnancy and early labour, birth outcome, birth weight, gestational age at delivery, APGAR scores, need for neonatal ward admission. Results: Sixty-seven (33.3%) of pregnant women had abnormal flora which was consistent with bacterial vaginosis.At the presentation of these women in labour, 14.4% of them had bacterial vaginosis thus indicating a significant r...

Research paper thumbnail of Abruptio Placenta: A retrospective analysis in a tertiary hospital, Sagamu, Nigeria

Tropical Journal of Obstetrics and Gynaecology

Context: Abruptio placenta is an important contributor to perinatal and maternal morbidity and mo... more Context: Abruptio placenta is an important contributor to perinatal and maternal morbidity and mortality in Nigeria. Although the primary etiology remains unknown, there are many associated risk factors, some of which are preventable or treatable. Aim: To determine the prevalence, sociodemographic characteristics, risk factors, and feto-maternal outcome of abruptio placenta in Olabisi Onabanjo University Teaching Hospital Sagamu. Materials and Methods: This was a retrospective study involving all pregnant women who had abruptio placenta from January 1, 2012, to December 31, 2016. Data on sociodemographic characteristics, risk factors, and fetal and maternal morbidity and mortality were extracted from patients' case notes for analysis. Results: The mean age of the subjects was 33.4 ± 6.3 years. The prevalence of abruptio placenta was 1.03%. Hypertensive disorder was the most important risk factor, seen in 53.1% of the subjects. Birth asphyxia was the major perinatal morbidity and was found in 42.9% of the babies, whereas 46.9% were still births. The caesarean section rate was 63.3%. Forty subjects (81.6%) had blood transfusion, 17 subjects (34.7%) had postpartum hemorrhage, and 40.8% had postpartum anemia. There were two maternal deaths giving a case-specific fatality rate of 4.1%. Conclusion: Abruptio placenta is an important pregnancy complication in Olabisi Onabanjo University Teaching Hospital Sagamu, Nigeria. Good antenatal care services will enable caregivers to identify women at risk who may benefit from targeted management aimed at reducing the adverse outcomes associated with the condition.

Research paper thumbnail of Labour pain perception: experiences of Nigerian mothers

Pan African Medical Journal

Introduction: Labour pain perception is influenced by a variety of factors; hence women experienc... more Introduction: Labour pain perception is influenced by a variety of factors; hence women experience and cope with labour pain differently. This study was designed to assess labour pain perception among parturient. Methods: A cross-sectional study involving 132 pregnant women who had vaginal delivery at two tertiary hospitals in south west Nigeria. A structured questionnaire was administered to women within 24 hours of delivery to record details of labour and delivery. Labour pain perception was assessed using the Visual Analogue Score (VAS). Data analysis were done using IBM-SPSS Statistics for Windows version 21.0 (IBM Corp., Armonk, NY, USA). Results: The mean age of the parturients was 30.6±4.8 years. The mean pain perception of the parturients as assessed by VAS was 7.0 with range of 1.2-10.0. Sixty-six (50%) parturients rated labour pain to be severe (VAS > 7.1). Majority of the respondents 114(86.4%) desired some form of pain relief. The Body Mass Index (BMI) of respondents and birth weight of their babies had statistically significant association with pain perception (p = 0.010; p = 0.038 respectively). Factors associated with increased odds of having severe pain perception include unbooked status, secondary level education, BMI < 30, and gestational age ≥ 37 weeks. Conclusion: Women in south west Nigeria perceived labour pain as severe and many desired pain relief during labour. Occupation, BMI, gestational age and baby's birth weight were significant mediating variables in women's experience of labour pain. Modern methods of labour analgesia should be offered to parturients who express desire for it. This will lead to improvements women's childbirth experience.

Research paper thumbnail of Abdominal pregnancy: A case report of a viable nondysmorphic fetus

Nigerian Medical Journal

Abdominal pregnancy is a rare form of ectopic gestation. It accounts for about 0.4% of all cases ... more Abdominal pregnancy is a rare form of ectopic gestation. It accounts for about 0.4% of all cases of ectopic pregnancy, and often associated with significant morbidity and mortality. Clinical presentation varies, and diagnosis is commonly challenging. Although ultrasound is helpful in early gestation, this could be unsatisfactory at advanced gestational age. Hence, a high index of suspicion is required in the diagnosis. We present a case of secondary abdominal pregnancy in a 27-year-old gravida 2 para 0 + 1 at an estimated gestational age of 33 weeks and 5 days. She had ultrasound scan done at 9 weeks and 2 days confirming the diagnosis, but declined surgery to seek spiritual intervention. She subsequently presented with generalized abdominal pain and fainting attack. She had exploratory laparotomy with delivery of a live female baby with no congenital anomaly. The placenta was attached to the left infundibulopelvic ligament and was delivered wholly without remnants. She was discharged on the 8th postoperative day, and the baby was discharged after 14 days from the neonatal intensive care unit. Accurate diagnosis and prompt intervention with evaluation of placenta attachment is vital to prevent adverse consequences.

Research paper thumbnail of 15 The ability and safety of community-based health workers to initiate lifesaving therapies for pre-eclampsia in Ogun State, Nigeria: An analysis of 294 community treatments with MGSO4 and/or methyldopa

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2016

Introduction Pre-eclampsia and its associated complications are the leading cause of maternal dea... more Introduction Pre-eclampsia and its associated complications are the leading cause of maternal death in Nigeria. Many of these deaths occur at home or in primary health centres. Nevertheless, management of pre-eclampsia is limited to secondary and tertiary facilities. In Nigeria, community-based health workers serve as a bridge between the community and health facilities; therefore, these providers may be key in reducing the incidence of adverse pregnancy outcomes by way of early detection and treatment. Objectives This study aimed to assess the ability of community-based health workers to safely administer methyldopa, magnesium sulphate, and complete referral to a higher level facility when indicated. Methods The Community Level Intervention for Pre-eclampsia (CLIP) study was implemented by community-based health workers in Ogun State, Nigeria. These providers (i.e., Community Health Extension Workers, Health Assistants, midwives and nurses) utilized a mHealth platform to guide antenatal and postnatal visits, pre-eclampsia treatment with oral methyldopa (one dose = 750 mg) and intramuscular magnesium sulphate (one dose = 10 mg) prior to referral, based on evidence-based practice and the miniPIERS (Pre-eclampsia Integrated Estimated of RiSk) model. Results Findings of this study indicate that community-based health workers in Nigeria safely administered 137 doses of magnesium sulphate; this resulted in no infections or hematomas. Fifty-one doses of magnesium sulphate were given by community health extension workers, while nurses administered sixty-four: the high rate of administration by nurses can be explained by turf protection as well as their seniority within the health system. In addition, there were 139 doses of methyldopa administered, and a total of 127 urgent referrals completed. No safety concerns were reported. Conclusion These findings confirm the ability of community-based health workers to safely administer magnesium sulphate for severe pre-eclampsia with appropriate training; this is a big step towards reducing the negative impact of pre-eclampsia in Nigeria. The use of task-sharing, therefore, could drastically reduce the three delays (triage, transport and treatment) associated with high maternal mortality and morbidity in rural communities in low and middle-income countries.

Research paper thumbnail of Progestogen-only injectable contraceptive: Acceptor prevalence and client experience at Sagamu, Nigeria

Nigerian Postgraduate Medical Journal

Context: Progestogen-only injectable contraceptive is a long-lasting contraceptive given at inter... more Context: Progestogen-only injectable contraceptive is a long-lasting contraceptive given at interval of two or 3 months. It is effective, safe and convenient. Menstrual irregularity is a recognised side effect. Aims: This study aims to determine the acceptor prevalence and clinical experience of women using progestogen-only injectable contraceptive at Olabisi Onabanjo University Teaching Hospital, Sagamu. Methods: This was a retrospective study of new acceptors of progestogen-only injectable contraceptives between 1 January, 2010, and 31 December, 2014. Relevant information was retrieved from the family planning clinic records using a purpose-designed data capture sheet. Data analysis was done using IBM-SPSS windows version 21. Results: Out of a total of 623 new acceptors of contraceptives during the study period, 162 opted for progestogen-only injectable contraceptives giving an acceptor prevalence of 26%. The mean age of new acceptors was 32.69 ± 5.94 years. Majority 108 (66.7%) used depot medroxyprogesterone acetate. Child spacing was the most common indication for use. Ninety-seven clients (59.9%) had not used any previous contraceptive method. Menstrual irregularity was the most common side effect, occurring in 73 (45.1%) of the clients. Continuation rate after the fifth dose was 27.1%. No pregnancy complication was reported. Conclusions: Acceptor prevalence and continuation rate of progestogen-only injectable contraceptive are low. There is need for more enlightenment campaigns to encourage women to use this effective method of contraception.

Research paper thumbnail of Eclampsia: A five-year retrospective review in Sagamu, South-West Nigeria

Nigerian Journal of Medicine, 2020

Context: Eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality... more Context: Eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in developing countries. This is the result of poor health-seeking behavior of pregnant women and inadequate comprehensive emergency obstetric services. This study reviewed the presentation and management of eclampsia in Sagamu over a 5-year period. Aims: This study aims to determine the prevalence, pattern of clinical presentation and fetomaternal outcomes of eclampsia. Settings and Design: This was a retrospective study conducted in Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun state. Subjects and Methods: Relevant information was retrieved from case notes of all patients who presented with eclampsia from January 2014 to December 2018. Data were analyzed using SPSS version 21. Results: Out of the 4656 deliveries, there were 45 cases of eclampsia giving a prevalence of 0.97%. The modal age was 20–24 years. Majority were unbooked 41 (91.1%) and 29 (64.4%) of the women were ...

Research paper thumbnail of Effect of hyoscine‐N‐butylbromide on labor duration among nullipara in a southwestern Nigerian teaching hospital: A randomized controlled trial

International Journal of Gynecology & Obstetrics, 2020

To assess the effectiveness of hyoscine‐N‐butylbromide on the duration of the first stage of labo... more To assess the effectiveness of hyoscine‐N‐butylbromide on the duration of the first stage of labor among nulliparous women.

Research paper thumbnail of Vaginal Candida infection in pregnancy and its implications for fetal well-being

Vaginal Candida infection is one of the most common genital tract infections reported in pregnant... more Vaginal Candida infection is one of the most common genital tract infections reported in pregnant women. This study was designed to determine the prevalence of vaginal Candida infection and pattern of Candida species isolates in the genital tract of pregnant women during antenatal period and in early labour; and the associated fetal outcome. The study was conducted at the antenatal clinic and labor ward of Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun State, Nigeria. High vaginal swabs were collected from 408 pregnant women at the antenatal clinic and repeated in early labour. The samples were processed to isolate Candida species. Data were analysed using Statistical Package for Social Science (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA). Prevalence of Candida infection was significantly higher in early labour (46%) than during antenatal period (38%) (P=0.02). Candida albicans was the predominant isolate, followed by Candida glabrata and Candida tropicalis. ...

Research paper thumbnail of The ability and safety of community-based health workers to safely initiate lifesaving therapies for pre-eclampsia in Ogun State, Nigeria: An analysis of 260 community treatments with MgSO4 and/or methyldopa

Research paper thumbnail of Lifestyle modification adherence among patients attending diabetes clinics in selected hospitals in Remo zone Ogun State, Nigeria

Babcock University Medical Journal (BUMJ)

Objective: Lifestyle modification is an essential component of self-management of diabetes mellit... more Objective: Lifestyle modification is an essential component of self-management of diabetes mellitus. This study assessed adherence to diet and exercise recommendations and elucidated the factors that influence adherence in patients living with diabetes. Method: A cross-sectional study involving 300 patients attending diabetes clinics in some selected hospitals in Ogun State, Nigeria. Structured questionnaires were used to obtain information on the socio-demographic characteristics, and PRECEDE factors of lifestyle-modification adherence in the study participants. Pearson’s correlation and Chi-square test were used to assess the association between the variables, while binary logistic regression was used to determine the predictors of adherence to dietary recommendations. Results: The mean age of the study respondents was 62.7 years. The proportion of respondents who adhered to dietary and exercise recommendations were 87.8% and 45.6% respectively. There were no statistically signifi...

Research paper thumbnail of Hypertensive disorders of pregnancy: A five-year review in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

Babcock University Medical Journal (BUMJ)

Objective: To determine the prevalence and outcome of hypertensive disorder of pregnancy in Babco... more Objective: To determine the prevalence and outcome of hypertensive disorder of pregnancy in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State Nigeria Method: This was a retrospective descriptive study of all documented cases of hypertensive disorder of pregnancy between the 1st of June 2012 and 31st May, 2017. Information such as age, parity, booking status, level of education, blood pressure at presentation, urinalysis at presentation, gestational age at presentation, and delivery, mode of delivery, baby’s birth weight was extracted from patients’ case files. Result: There were 1,118 deliveries during the study period out of which 55 (4.9%) patients had hypertensive disorders in pregnancy. The mean age was 31.5years ±48.1 and mean parity, 1.2± 1.1. The mean systolic and diastolic blood pressures were 180.4 ± 1.88mmHg and 105.1± 1.5mmHg, respectively. Thirty-four (75.5%) of the women had preeclampsia/ eclampsia, while 7 (15.5%) had gestational hypertension. Most women ...

Research paper thumbnail of Breastfeeding Practices among Mothers in Southwest Nigeria

Ethiopian Journal of Health Sciences

BACKGROUND፡ This study was conducted to determine the breastfeeding practices among parous antena... more BACKGROUND፡ This study was conducted to determine the breastfeeding practices among parous antenatal attendees in two teaching hospitals in Southwest Nigeria.METHODS: A cross-sectional study was carried out on 340 parous antenatal clinic attendees in two teaching hospitals in Ogun State, Nigeria. A structured questionnaire was used to obtain data on breastfeeding practices. Data were analyzed using Statistical Package for Social Sciences (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA).RESULTS: Out of a total of 340 women, 319 (93.8%) breastfed their last babies. The median duration of breastfeeding was 15 months. One hundred and thirty two women (38.8%) initiated breastfeeding within 30 minutes of delivery, and 200 women (58.8%) exclusively breastfed their babies for six months. The majority of the women, 299(87.9%k) did not report any problem associated with breastfeeding. Logistic regression analysis showed that women who had no breastfeeding problems were more likely to ...

Research paper thumbnail of Bacterial vaginosis in pregnancy and early labour using Nugent scoring and the implication on foetal outcome

Ghana Medical Journal

Background: To compare the pattern of vaginal microflora during pregnancy with pattern in early l... more Background: To compare the pattern of vaginal microflora during pregnancy with pattern in early labour using Nugent scoring and determine the effect of these changes on fetal outcome. Design: A prospective longitudinal study. Setting and Population: Pregnant women attending antenatal clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria between June 2017 and May 2018. Methods: Consenting pregnant women who attended antenatal clinics were recruited. Vaginal secretions were obtained for Nugent scoring during pregnancy and at presentation in labour. Main Outcome Measures: Prevalence of abnormal vaginal flora in pregnancy and early labour, birth outcome, birth weight, gestational age at delivery, APGAR scores, need for neonatal ward admission. Results: Sixty-seven (33.3%) of pregnant women had abnormal flora which was consistent with bacterial vaginosis.At the presentation of these women in labour, 14.4% of them had bacterial vaginosis thus indicating a significant r...

Research paper thumbnail of Abruptio Placenta: A retrospective analysis in a tertiary hospital, Sagamu, Nigeria

Tropical Journal of Obstetrics and Gynaecology

Context: Abruptio placenta is an important contributor to perinatal and maternal morbidity and mo... more Context: Abruptio placenta is an important contributor to perinatal and maternal morbidity and mortality in Nigeria. Although the primary etiology remains unknown, there are many associated risk factors, some of which are preventable or treatable. Aim: To determine the prevalence, sociodemographic characteristics, risk factors, and feto-maternal outcome of abruptio placenta in Olabisi Onabanjo University Teaching Hospital Sagamu. Materials and Methods: This was a retrospective study involving all pregnant women who had abruptio placenta from January 1, 2012, to December 31, 2016. Data on sociodemographic characteristics, risk factors, and fetal and maternal morbidity and mortality were extracted from patients' case notes for analysis. Results: The mean age of the subjects was 33.4 ± 6.3 years. The prevalence of abruptio placenta was 1.03%. Hypertensive disorder was the most important risk factor, seen in 53.1% of the subjects. Birth asphyxia was the major perinatal morbidity and was found in 42.9% of the babies, whereas 46.9% were still births. The caesarean section rate was 63.3%. Forty subjects (81.6%) had blood transfusion, 17 subjects (34.7%) had postpartum hemorrhage, and 40.8% had postpartum anemia. There were two maternal deaths giving a case-specific fatality rate of 4.1%. Conclusion: Abruptio placenta is an important pregnancy complication in Olabisi Onabanjo University Teaching Hospital Sagamu, Nigeria. Good antenatal care services will enable caregivers to identify women at risk who may benefit from targeted management aimed at reducing the adverse outcomes associated with the condition.

Research paper thumbnail of Labour pain perception: experiences of Nigerian mothers

Pan African Medical Journal

Introduction: Labour pain perception is influenced by a variety of factors; hence women experienc... more Introduction: Labour pain perception is influenced by a variety of factors; hence women experience and cope with labour pain differently. This study was designed to assess labour pain perception among parturient. Methods: A cross-sectional study involving 132 pregnant women who had vaginal delivery at two tertiary hospitals in south west Nigeria. A structured questionnaire was administered to women within 24 hours of delivery to record details of labour and delivery. Labour pain perception was assessed using the Visual Analogue Score (VAS). Data analysis were done using IBM-SPSS Statistics for Windows version 21.0 (IBM Corp., Armonk, NY, USA). Results: The mean age of the parturients was 30.6±4.8 years. The mean pain perception of the parturients as assessed by VAS was 7.0 with range of 1.2-10.0. Sixty-six (50%) parturients rated labour pain to be severe (VAS > 7.1). Majority of the respondents 114(86.4%) desired some form of pain relief. The Body Mass Index (BMI) of respondents and birth weight of their babies had statistically significant association with pain perception (p = 0.010; p = 0.038 respectively). Factors associated with increased odds of having severe pain perception include unbooked status, secondary level education, BMI < 30, and gestational age ≥ 37 weeks. Conclusion: Women in south west Nigeria perceived labour pain as severe and many desired pain relief during labour. Occupation, BMI, gestational age and baby's birth weight were significant mediating variables in women's experience of labour pain. Modern methods of labour analgesia should be offered to parturients who express desire for it. This will lead to improvements women's childbirth experience.

Research paper thumbnail of Abdominal pregnancy: A case report of a viable nondysmorphic fetus

Nigerian Medical Journal

Abdominal pregnancy is a rare form of ectopic gestation. It accounts for about 0.4% of all cases ... more Abdominal pregnancy is a rare form of ectopic gestation. It accounts for about 0.4% of all cases of ectopic pregnancy, and often associated with significant morbidity and mortality. Clinical presentation varies, and diagnosis is commonly challenging. Although ultrasound is helpful in early gestation, this could be unsatisfactory at advanced gestational age. Hence, a high index of suspicion is required in the diagnosis. We present a case of secondary abdominal pregnancy in a 27-year-old gravida 2 para 0 + 1 at an estimated gestational age of 33 weeks and 5 days. She had ultrasound scan done at 9 weeks and 2 days confirming the diagnosis, but declined surgery to seek spiritual intervention. She subsequently presented with generalized abdominal pain and fainting attack. She had exploratory laparotomy with delivery of a live female baby with no congenital anomaly. The placenta was attached to the left infundibulopelvic ligament and was delivered wholly without remnants. She was discharged on the 8th postoperative day, and the baby was discharged after 14 days from the neonatal intensive care unit. Accurate diagnosis and prompt intervention with evaluation of placenta attachment is vital to prevent adverse consequences.

Research paper thumbnail of 15 The ability and safety of community-based health workers to initiate lifesaving therapies for pre-eclampsia in Ogun State, Nigeria: An analysis of 294 community treatments with MGSO4 and/or methyldopa

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2016

Introduction Pre-eclampsia and its associated complications are the leading cause of maternal dea... more Introduction Pre-eclampsia and its associated complications are the leading cause of maternal death in Nigeria. Many of these deaths occur at home or in primary health centres. Nevertheless, management of pre-eclampsia is limited to secondary and tertiary facilities. In Nigeria, community-based health workers serve as a bridge between the community and health facilities; therefore, these providers may be key in reducing the incidence of adverse pregnancy outcomes by way of early detection and treatment. Objectives This study aimed to assess the ability of community-based health workers to safely administer methyldopa, magnesium sulphate, and complete referral to a higher level facility when indicated. Methods The Community Level Intervention for Pre-eclampsia (CLIP) study was implemented by community-based health workers in Ogun State, Nigeria. These providers (i.e., Community Health Extension Workers, Health Assistants, midwives and nurses) utilized a mHealth platform to guide antenatal and postnatal visits, pre-eclampsia treatment with oral methyldopa (one dose = 750 mg) and intramuscular magnesium sulphate (one dose = 10 mg) prior to referral, based on evidence-based practice and the miniPIERS (Pre-eclampsia Integrated Estimated of RiSk) model. Results Findings of this study indicate that community-based health workers in Nigeria safely administered 137 doses of magnesium sulphate; this resulted in no infections or hematomas. Fifty-one doses of magnesium sulphate were given by community health extension workers, while nurses administered sixty-four: the high rate of administration by nurses can be explained by turf protection as well as their seniority within the health system. In addition, there were 139 doses of methyldopa administered, and a total of 127 urgent referrals completed. No safety concerns were reported. Conclusion These findings confirm the ability of community-based health workers to safely administer magnesium sulphate for severe pre-eclampsia with appropriate training; this is a big step towards reducing the negative impact of pre-eclampsia in Nigeria. The use of task-sharing, therefore, could drastically reduce the three delays (triage, transport and treatment) associated with high maternal mortality and morbidity in rural communities in low and middle-income countries.

Research paper thumbnail of Progestogen-only injectable contraceptive: Acceptor prevalence and client experience at Sagamu, Nigeria

Nigerian Postgraduate Medical Journal

Context: Progestogen-only injectable contraceptive is a long-lasting contraceptive given at inter... more Context: Progestogen-only injectable contraceptive is a long-lasting contraceptive given at interval of two or 3 months. It is effective, safe and convenient. Menstrual irregularity is a recognised side effect. Aims: This study aims to determine the acceptor prevalence and clinical experience of women using progestogen-only injectable contraceptive at Olabisi Onabanjo University Teaching Hospital, Sagamu. Methods: This was a retrospective study of new acceptors of progestogen-only injectable contraceptives between 1 January, 2010, and 31 December, 2014. Relevant information was retrieved from the family planning clinic records using a purpose-designed data capture sheet. Data analysis was done using IBM-SPSS windows version 21. Results: Out of a total of 623 new acceptors of contraceptives during the study period, 162 opted for progestogen-only injectable contraceptives giving an acceptor prevalence of 26%. The mean age of new acceptors was 32.69 ± 5.94 years. Majority 108 (66.7%) used depot medroxyprogesterone acetate. Child spacing was the most common indication for use. Ninety-seven clients (59.9%) had not used any previous contraceptive method. Menstrual irregularity was the most common side effect, occurring in 73 (45.1%) of the clients. Continuation rate after the fifth dose was 27.1%. No pregnancy complication was reported. Conclusions: Acceptor prevalence and continuation rate of progestogen-only injectable contraceptive are low. There is need for more enlightenment campaigns to encourage women to use this effective method of contraception.