Gabriel O Igberase - Academia.edu (original) (raw)

Papers by Gabriel O Igberase

Cases Journal, 2008

Background Ectopic pregnancy continues to be a significant cause of maternal morbidity, mortality... more Background Ectopic pregnancy continues to be a significant cause of maternal morbidity, mortality and reproductive failure in Nigeria. Ipsilateral ectopic pregnancy occurs rarely and may be difficult to diagnose in low resource settings where there are no diagnostic tools. Few cases have been reported in the literature but none in our region. Case presentation We present an unusual case of a 22 year old female undergraduate, from the Urhobo tribe in the Niger Delta region of Nigeria who had a recurrent left ectopic pregnancy at the stump of a previous cornual resection done five years earlier. She had a left salpingo-oophorectomy done and did well postoperatively. Conclusion Ectopic pregnancy could pose a diagnostic dilemma where diagnostic facilities are not available. Every woman with a previous ectopic pregnancy would be at high risk for recurrence and that would be the condition to be ruled out if a pregnant woman presented at early gestation with abdominal pain.

Journal of Obstetrics & Gynaecology, 2006

Eclampsia is a major cause of maternal and perinatal morbidity and mortality in developing countr... more Eclampsia is a major cause of maternal and perinatal morbidity and mortality in developing countries including Nigeria. However, most studies on eclampsia have been in urban communities. The objective of this study was to determine the incidence, pattern of clinical presentation and maternal and fetal outcomes of cases of eclampsia in a rural tertiary hospital in Nigeria. A descriptive review of all cases of eclampsia seen between 1 January 1994 and 31 December 2003 in a tertiary hospital was undertaken. The incidence of eclampsia was 1 in 43 deliveries (2.3%). Most of the women (86.2%) were unbooked for antenatal care in our centre; 58.5% were nullipara, and the onset of seizures was in the ante-partum period (68.3%). Patients presenting were mostly from the traditional birth attendants (46.3%). The time interval between the onset of convulsions and hospital admission was less than 12 h in 52% of cases. The majority of the women had premonitory symptoms (78.8%) with headache being the most frequent (78%). The major route of delivery was abdominal (66.7%). The case fatality rate was 15.4%. Most of the deaths (89.5%) were in unbooked women and the most common causes of death were acute renal failure, cardiopulmonary failure, disseminated intravascular coagulopathy and cerebrovascular accident. The perinatal mortality rate was 195 per 1000 births. This study found a high incidence of eclampsia. It is recommended that community-based health education programmes should be pursued with vigour to enhance early utilisation of modern antenatal care services in rural areas. Traditional birth attendants need to be trained and integrated into the healthcare team. Appropriate mechanisms should be put in place to improve clinic referrals. The capacity of tertiary health institutions to provide intensive care for eclamptics need to be improved with continuous training of heathcare personnel and provision of necessary equipment.

Background: Anterior abdominal wall fibroid are uncommon and could be a cause of pain and discomf... more Background: Anterior abdominal wall fibroid are uncommon and could be a cause of pain and discomfort. Very few cases have been reported in the literature but none in our region. Case presentation: We present an uncommon case of a 31 year old para 2+2 trader from the Itsekiri tribe of the Niger Delta region of Nigeria who presented with a one year history of a periumbilcal mass, had surgical removal of the mass and histology revealed leiomyoma. Conclusion: Abdominal wall fibroid is a good differential diagnosis to be considered in any woman of reproductive age with an anterior abdominal mass and previous uterine surgery, including laparoscopic surgeries. Background Fibroids also called leiomyoma are said to be the com-monest benign tumour of the reproductive tract and are clinically apparent in 20 % of women of reproductive age. The may be present in as many as 70 % of uteri removed at hysterectomy [1]. The commonest site is the uterus but

Journal of the National Medical Association, 2006

Female genital mutilation (FGM) and cutting is a subject of global interest, with many countries ... more Female genital mutilation (FGM) and cutting is a subject of global interest, with many countries of the world still practicing it despite efforts by the WHO and other agencies to discourage the practice. The highest known prevalence is in Africa. To determine the knowledge, attitude and practice of FGM among nurses in the ancient metropolis of Benin in a Nigerian state where FGM is illegal. One-hundred-ninety-three nurses in the study hospital were recruited in the study out of which 182 (94.3%) appropriately filled and returned the questionnaires. The average age of respondents was 37 years, and the average duration of postgraduation experience was 14.5 years. Most respondents are of Bini (36.8%) and Esan (34.1%) ethnic origin. All respondents identified at least one form of FGM, but only 12 respondents (6.6%) could correctly identify the four types of FGM. The harmful effects of FGM identified by the majority of respondents include hemorrhage, difficult labor/childbirth, genital t...

Medical science monitor : international medical journal of experimental and clinical research, 2005

BACKGROUND The utilization of modern antenatal care is poor in most parts of Nigeria and studies ... more BACKGROUND The utilization of modern antenatal care is poor in most parts of Nigeria and studies indicate that the majority of those who present for antenatal care do so late. MATERIAL/METHODS This was a retrospective study involving 303 consecutively booked pregnant women over a 6-month period (March 1 to August 31, 2004) in a suburban tertiary hospital practice. The objectives were to determine the incidence of late booking for antenatal care and to compare the demographic and obstetric characteristics of women who booked late with those who booked early for antenatal care. The Fisher's exact test, odds ratio, and the 95% confidence interval were used for statistical analysis. RESULTS Most (79.9%) of the women booked late for antenatal care. It was found that age, parity, level of education, social class, previous fetal loss, and previous obstetric complications did not differ significantly between women who booked early and those who booked late. CONCLUSIONS The majority of t...

Nigerian Medical Journal, 2007

Introduction: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality wor... more Introduction: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality worldwide. There is at the moment no reliable marker for pre-eclampsia. Objective: To compare the serum magnesium levels in pre-eclamptic and normotensive pregnant women in Benin -City, Nigeria. Methods: A cross-sectional study of serum magnesium levels in normal and preeclamptic gestation in Nigerian women was conducted in a tertiary hospital. Results: Serum magnesium was determined in 65 pre-eclamptic and 65 normotensive pregnant women. The mean serum magnesium level in the normal pregnant women was 1.06 ± 0.33Mmol/Litre while in preeclampsia it was 0.69 ± 0.14 Mmol/l. The difference was statistically significant (P Keywords : Serum magnesium; pre-eclampsia maternal and perinatal morbidity and mortality. Nigerian Medical Journal Vol. 48 (1) 2007: pp. 21-23

Journal of Obstetrics and Gynaecology Research, 2020

To compare the effectiveness of intramuscular hyocine n‐butyl bromide (HBB) with placebo for shor... more To compare the effectiveness of intramuscular hyocine n‐butyl bromide (HBB) with placebo for shortening the duration of the first stage of labor in term pregnancies.

African Journal of Medical and Health Sciences, 2016

Management of enterocutaneous fistula has been done with a protocol of delayed surgery ranging fr... more Management of enterocutaneous fistula has been done with a protocol of delayed surgery ranging from 3 to 6 months postoffending surgery in a bid to forestall further bowel fistulae in a hostile abdomen. However, the role of early bowel diversion for source control of peritoneal fecal contamination in situations of overwhelming sepsis is illustrated with three postoperative enterocutaneous fistulas successfully managed with early bowel diversion.

Context: Traditional birth attendants (TBAs) play a pivotal role in maternity care delivery in ru... more Context: Traditional birth attendants (TBAs) play a pivotal role in maternity care delivery in rural areas where modern health facilities and personnel are scanty. Referrals to modern medical institutions are poor. Assessing the pattern and outcomes of such referrals is important to evaluate services provided by the TBAs and the ability of orthodox facilities to offer emergency obstetric care. Objectives: To examine the nature and outcomes of referred cases from TBAs to a rural hospital. Methods: Data were collected prospectively on parturients presenting from the TBAs over two years in a rural mission hospital. The hospital serves as a referral centre for the population in the host community and her neighbours. Main Outcome Measures: Maternal and perinatal morbidity and mortality among the subjects. Results: Two hundred and forty one (32.2%) of the 747 maternities were referred from the TBAs. One hundred and twenty eight of these attended antenatal clinics at the mission hospital; ...

Nigerian Journal of Surgical Sciences, 2015

Context: Immediate recognition of postpartum complications, prompt, and due management are key to... more Context: Immediate recognition of postpartum complications, prompt, and due management are key to reduction in maternal mortality ratio (MMR). Aims and Objectives: To evaluate the pattern and outcomes of postpartum referrals from traditional birth attendants (TBAs) in rural Nigeria. Materials and Methods: A prospective observational study of patients referred after delivery from TBAs to a Mission Hospital in rural Nigeria. Analysis was by Epi Info statistical software. Results: Two hundred and sixty-two patients were so referred. Perineal injury (29.4%) was the most common diagnosis followed by pyrexia (22.5%), postpartum hemorrhage (18.3%), and genital sepsis (10.3%). The MMR was 4961.8/100,000 live births with PPH accounting for the majority (53.8%). Conclusion: Delay in referral and transportation difficulties were major impediments to prompt access of care from the Mission Hospital. TBAs should be encouraged to refer all cases to well-equipped orthodox medical facilities and get paid for each case as if managed by them.

African Journal of Medical and Health Sciences, 2014

Background: Perinatal mortality is a major public health issue in Nigeria with alarming statistic... more Background: Perinatal mortality is a major public health issue in Nigeria with alarming statistics that has been given inappropriate attention both in the past and now. Materials and Methods: This is a descriptive study of all cases of perinatal deaths managed at the Baptist Medical Centre between 1 st January 1994 and 31 st December, 2003. Information was obtained from birth and labor ward registers, patients and mothers case notes and analyzed. Statistical analyses were applicable was performed with the INSTAT statistical package version 3.36 from the Statistical services center of the University of Reading. Results: There were 5,153 deliveries and 485 perinatal deaths. The perinatal mortality rate (PNMR) was 94.1/1000 deliveries, still birth rate was 53/1000 deliveries and early neonatal deaths was 41.1/1000 deliveries. There was a definite trend in PNMR during the 10 year study period marked by a steady increase. The highest perinatal deaths occurred in those greater than 35 years and those with parity ≥5 (14.1%). There were more significant perinatal deaths among the unbooked (22.4%) and this was statistically significant (P < 0.0001). Perinatal mortality decreases with increasing birth weight. Prematurity/low birth weight (LBW) (21.5%), multiple pregnancy (20.2%) and birth asphyxia (18.0%) were the chief fetal causes of perinatal mortality while obstructed labor (15.1%) and severe pre-eclampsia/eclampsia (4.1%) were the most common maternal causes of perinatal deaths. Conclusion: PNMR of 94.1/1000 was very high in this study. There was no change in the PNMR when this study period was compared to current findings in other centers. Unbooked status was a significant risk factor for perinatal mortality. The common causes of perinatal mortality were prematurity/LBW, multiple pregnancy, severe birth asphyxia, prolonged obstructed labor and severe pre-eclampsia/eclampsia. Government and all stake holders in health care delivery should ensure the provision of emergency obstetric care for all women at all levels to reduce perinatal deaths. Interventions should be aimed at preventing, antenatal, intrapartum and postpartum complications of babies.

The Internet Journal of …, 2009

Background: Infertility is prevalent in Southeast Nigeria and may impart negatively on the emotio... more Background: Infertility is prevalent in Southeast Nigeria and may impart negatively on the emotional and social wellbeing of affected couples. Aims & Objectives To assess the prevalence, pattern, misconception and sources of infertility crisis among the Igbo population of Southeast Nigeria. Materials and Methods In depth interviews with women attending infertility, over a six month period (July to December 2006). Results: Twenty four women were interviewed, 66.7% had secondary infertility. Women were held responsible for infertility and bore the burden of seeking treatment. They suffered intimate partner abuse, psychological and emotional trauma from their families, as well as isolation and stigmatization from the society Conclusion. Medical education on the physiology of infertility may play a role in the integration of men in treatment seeking process in infertility. Doctors should manage the emotional and psychological aspects of infertility.

Ebonyi Medical Journal, 2010

ABSTRACT Background: Pregnancy induced hypertension and it sequelae eclampsia are major causes of... more ABSTRACT Background: Pregnancy induced hypertension and it sequelae eclampsia are major causes of maternal and perinatal morbidity and mortality in developing countries. The aim of this study was to compare the obstetric intervention rates and maternal and fetal outcome in cases of gestational hypertension to that of normotensive women randomly selected from the general obstetric population in a tertiary hospital in Nigeria Methods: Selected measures of obstetric intervention rates and maternal and fetal outcomes in 215 cases of gestational hypertension were compared to that in 300 randomly selected low risk non cases from the general obstetric population. Univariate statistical analysis was done using the Fisher’s exact test. The 95% Confidence interval and Relative risk were also determined.Results: Women with Gestational hypertension had statistically significant higher rates of induction of labour, instrumental delivery and prolonged hospital stay beyond 6 days compared to normotensive women. There were no significant differences in the measures of perinatal outcome. Conclusion: The findings of this study suggest that prompt management of cases of gestational hypertension in a tertiary hospital is associated with reduced risk of maternal and perinatal morbidity and mortality.

Continental Journal of Tropical Medicine, 2012

African Journal of Reproductive Health, Mar 1, 2011

Teratoma is the most common ovarian tumour associated with pregnancy. The complications in pregna... more Teratoma is the most common ovarian tumour associated with pregnancy. The complications in pregnancy include torsion, rupture and malignant transformation mimicking ovarian carcinoma. Its association with intestinal obstruction is uncommon. A 35 year old gravida 5 para 4 woman with 18 week gestation was referred to our hospital with a 2 week history of abdominal pain, abdominal distension and vomiting. Initial physical examination and ultrasound scan showed bilateral ovarian masses and intrauterine singleton viable pregnancy. At surgery the right mass was observed to be adherent to a part of the small intestine. The masses were excised and confirmed grossly and histologically as benign cystic teratoma. She was well and discharged nine days post operatively. The pregnancy was managed conservatively and she was delivered of a normal male baby at term by spontaneous vertex delivery. Although intestinal obstruction due to benign cystic teratoma in pregnancy is uncommon, abrupt surgical intervention and conservative management is important for favourable outcome.

Reviews, 1996

Background Cervical cancer is the second most common cancer among women worldwide, with around 50... more Background Cervical cancer is the second most common cancer among women worldwide, with around 500,000 new diagnoses and 273,000 deaths per year. However, incidence and stage at diagnosis vary greatly between geographic areas and are largely dependent on the availability of a robust population screening programme. For example, in Nigeria, advanced-stage disease at presentation is common (86% to 89.3% of new cases), whereas in the UK, only 21.9% of women present with International Federation of Gynaecology and Obstetrics (FIGO) stage II+ disease. Women with advanced cancer of the cervix often need palliation for distressing symptoms, such as vaginal bleeding. Vaginal bleeding can be life threatening in advanced disease, with an incidence ranging from 0.7% to 100%. Bleeding is the immediate cause of death in 6% of women with cervical cancer and its management often poses a challenge. Thus, vaginal bleeding remains a common consequence of advanced cervical cancer. Currently, there is no systematic review that addresses palliative interventions for controlling vaginal bleeding caused by advanced cervical cancer. A systematic evaluation of the available palliative interventions is needed, to inform decision-making. Objectives To evaluate the efficacy and safety of tranexamic acid, vaginal packing (with or without formalin-soaked packs), interventional radiology or other interventions compared with radiotherapy for palliative treatment of vaginal bleeding in women with advanced cervical cancer. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 2, 2015; the Cochrane Gynaecological Cancer Group Trials Register; MEDLINE from 1980 to March week 3, 2015 and EMBASE from 1980 to February week 12, 2015. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of review articles and contacted experts in the field. We handsearched citation lists of relevant studies. Palliative interventions for controlling vaginal bleeding in advanced cervical cancer (Review)

Journal of the National Medical Association, 2006

Female genital mutilation (FGM) and cutting is a subject of global interest, with many countries ... more Female genital mutilation (FGM) and cutting is a subject of global interest, with many countries of the world still practicing it despite efforts by the WHO and other agencies to discourage the practice. The highest known prevalence is in Africa. To determine the knowledge, attitude and practice of FGM among nurses in the ancient metropolis of Benin in a Nigerian state where FGM is illegal. One-hundred-ninety-three nurses in the study hospital were recruited in the study out of which 182 (94.3%) appropriately filled and returned the questionnaires. The average age of respondents was 37 years, and the average duration of postgraduation experience was 14.5 years. Most respondents are of Bini (36.8%) and Esan (34.1%) ethnic origin. All respondents identified at least one form of FGM, but only 12 respondents (6.6%) could correctly identify the four types of FGM. The harmful effects of FGM identified by the majority of respondents include hemorrhage, difficult labor/childbirth, genital t...

Clinics and Practice, 2011

The aim of the study is to show that long standing forgotten intrauterine device contributes to i... more The aim of the study is to show that long standing forgotten intrauterine device contributes to infertility, reporting three cases presented at Central Hospital Warri, Nigeria, a government tertiary health center. Three cases of forgotten intrauterine contraceptive device (IUCD) contributing to infertility were seen. Two were inserted for contraceptive reasons while one was inserted while being managed for uterine synechae. Health care providers should ensure proper documentation of all procedures carried out, adequate counseling which should include taking an informed consent and also ensuring both short and long term follow up of their clients. Also all patients being evaluated for infertility and clients with past history of intrauterine device must have a speculum examination and ultrasound scan carried out.

Cases Journal, 2008

Background Ectopic pregnancy continues to be a significant cause of maternal morbidity, mortality... more Background Ectopic pregnancy continues to be a significant cause of maternal morbidity, mortality and reproductive failure in Nigeria. Ipsilateral ectopic pregnancy occurs rarely and may be difficult to diagnose in low resource settings where there are no diagnostic tools. Few cases have been reported in the literature but none in our region. Case presentation We present an unusual case of a 22 year old female undergraduate, from the Urhobo tribe in the Niger Delta region of Nigeria who had a recurrent left ectopic pregnancy at the stump of a previous cornual resection done five years earlier. She had a left salpingo-oophorectomy done and did well postoperatively. Conclusion Ectopic pregnancy could pose a diagnostic dilemma where diagnostic facilities are not available. Every woman with a previous ectopic pregnancy would be at high risk for recurrence and that would be the condition to be ruled out if a pregnant woman presented at early gestation with abdominal pain.

Journal of Obstetrics & Gynaecology, 2006

Eclampsia is a major cause of maternal and perinatal morbidity and mortality in developing countr... more Eclampsia is a major cause of maternal and perinatal morbidity and mortality in developing countries including Nigeria. However, most studies on eclampsia have been in urban communities. The objective of this study was to determine the incidence, pattern of clinical presentation and maternal and fetal outcomes of cases of eclampsia in a rural tertiary hospital in Nigeria. A descriptive review of all cases of eclampsia seen between 1 January 1994 and 31 December 2003 in a tertiary hospital was undertaken. The incidence of eclampsia was 1 in 43 deliveries (2.3%). Most of the women (86.2%) were unbooked for antenatal care in our centre; 58.5% were nullipara, and the onset of seizures was in the ante-partum period (68.3%). Patients presenting were mostly from the traditional birth attendants (46.3%). The time interval between the onset of convulsions and hospital admission was less than 12 h in 52% of cases. The majority of the women had premonitory symptoms (78.8%) with headache being the most frequent (78%). The major route of delivery was abdominal (66.7%). The case fatality rate was 15.4%. Most of the deaths (89.5%) were in unbooked women and the most common causes of death were acute renal failure, cardiopulmonary failure, disseminated intravascular coagulopathy and cerebrovascular accident. The perinatal mortality rate was 195 per 1000 births. This study found a high incidence of eclampsia. It is recommended that community-based health education programmes should be pursued with vigour to enhance early utilisation of modern antenatal care services in rural areas. Traditional birth attendants need to be trained and integrated into the healthcare team. Appropriate mechanisms should be put in place to improve clinic referrals. The capacity of tertiary health institutions to provide intensive care for eclamptics need to be improved with continuous training of heathcare personnel and provision of necessary equipment.

Background: Anterior abdominal wall fibroid are uncommon and could be a cause of pain and discomf... more Background: Anterior abdominal wall fibroid are uncommon and could be a cause of pain and discomfort. Very few cases have been reported in the literature but none in our region. Case presentation: We present an uncommon case of a 31 year old para 2+2 trader from the Itsekiri tribe of the Niger Delta region of Nigeria who presented with a one year history of a periumbilcal mass, had surgical removal of the mass and histology revealed leiomyoma. Conclusion: Abdominal wall fibroid is a good differential diagnosis to be considered in any woman of reproductive age with an anterior abdominal mass and previous uterine surgery, including laparoscopic surgeries. Background Fibroids also called leiomyoma are said to be the com-monest benign tumour of the reproductive tract and are clinically apparent in 20 % of women of reproductive age. The may be present in as many as 70 % of uteri removed at hysterectomy [1]. The commonest site is the uterus but

Journal of the National Medical Association, 2006

Female genital mutilation (FGM) and cutting is a subject of global interest, with many countries ... more Female genital mutilation (FGM) and cutting is a subject of global interest, with many countries of the world still practicing it despite efforts by the WHO and other agencies to discourage the practice. The highest known prevalence is in Africa. To determine the knowledge, attitude and practice of FGM among nurses in the ancient metropolis of Benin in a Nigerian state where FGM is illegal. One-hundred-ninety-three nurses in the study hospital were recruited in the study out of which 182 (94.3%) appropriately filled and returned the questionnaires. The average age of respondents was 37 years, and the average duration of postgraduation experience was 14.5 years. Most respondents are of Bini (36.8%) and Esan (34.1%) ethnic origin. All respondents identified at least one form of FGM, but only 12 respondents (6.6%) could correctly identify the four types of FGM. The harmful effects of FGM identified by the majority of respondents include hemorrhage, difficult labor/childbirth, genital t...

Medical science monitor : international medical journal of experimental and clinical research, 2005

BACKGROUND The utilization of modern antenatal care is poor in most parts of Nigeria and studies ... more BACKGROUND The utilization of modern antenatal care is poor in most parts of Nigeria and studies indicate that the majority of those who present for antenatal care do so late. MATERIAL/METHODS This was a retrospective study involving 303 consecutively booked pregnant women over a 6-month period (March 1 to August 31, 2004) in a suburban tertiary hospital practice. The objectives were to determine the incidence of late booking for antenatal care and to compare the demographic and obstetric characteristics of women who booked late with those who booked early for antenatal care. The Fisher's exact test, odds ratio, and the 95% confidence interval were used for statistical analysis. RESULTS Most (79.9%) of the women booked late for antenatal care. It was found that age, parity, level of education, social class, previous fetal loss, and previous obstetric complications did not differ significantly between women who booked early and those who booked late. CONCLUSIONS The majority of t...

Nigerian Medical Journal, 2007

Introduction: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality wor... more Introduction: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality worldwide. There is at the moment no reliable marker for pre-eclampsia. Objective: To compare the serum magnesium levels in pre-eclamptic and normotensive pregnant women in Benin -City, Nigeria. Methods: A cross-sectional study of serum magnesium levels in normal and preeclamptic gestation in Nigerian women was conducted in a tertiary hospital. Results: Serum magnesium was determined in 65 pre-eclamptic and 65 normotensive pregnant women. The mean serum magnesium level in the normal pregnant women was 1.06 ± 0.33Mmol/Litre while in preeclampsia it was 0.69 ± 0.14 Mmol/l. The difference was statistically significant (P Keywords : Serum magnesium; pre-eclampsia maternal and perinatal morbidity and mortality. Nigerian Medical Journal Vol. 48 (1) 2007: pp. 21-23

Journal of Obstetrics and Gynaecology Research, 2020

To compare the effectiveness of intramuscular hyocine n‐butyl bromide (HBB) with placebo for shor... more To compare the effectiveness of intramuscular hyocine n‐butyl bromide (HBB) with placebo for shortening the duration of the first stage of labor in term pregnancies.

African Journal of Medical and Health Sciences, 2016

Management of enterocutaneous fistula has been done with a protocol of delayed surgery ranging fr... more Management of enterocutaneous fistula has been done with a protocol of delayed surgery ranging from 3 to 6 months postoffending surgery in a bid to forestall further bowel fistulae in a hostile abdomen. However, the role of early bowel diversion for source control of peritoneal fecal contamination in situations of overwhelming sepsis is illustrated with three postoperative enterocutaneous fistulas successfully managed with early bowel diversion.

Context: Traditional birth attendants (TBAs) play a pivotal role in maternity care delivery in ru... more Context: Traditional birth attendants (TBAs) play a pivotal role in maternity care delivery in rural areas where modern health facilities and personnel are scanty. Referrals to modern medical institutions are poor. Assessing the pattern and outcomes of such referrals is important to evaluate services provided by the TBAs and the ability of orthodox facilities to offer emergency obstetric care. Objectives: To examine the nature and outcomes of referred cases from TBAs to a rural hospital. Methods: Data were collected prospectively on parturients presenting from the TBAs over two years in a rural mission hospital. The hospital serves as a referral centre for the population in the host community and her neighbours. Main Outcome Measures: Maternal and perinatal morbidity and mortality among the subjects. Results: Two hundred and forty one (32.2%) of the 747 maternities were referred from the TBAs. One hundred and twenty eight of these attended antenatal clinics at the mission hospital; ...

Nigerian Journal of Surgical Sciences, 2015

Context: Immediate recognition of postpartum complications, prompt, and due management are key to... more Context: Immediate recognition of postpartum complications, prompt, and due management are key to reduction in maternal mortality ratio (MMR). Aims and Objectives: To evaluate the pattern and outcomes of postpartum referrals from traditional birth attendants (TBAs) in rural Nigeria. Materials and Methods: A prospective observational study of patients referred after delivery from TBAs to a Mission Hospital in rural Nigeria. Analysis was by Epi Info statistical software. Results: Two hundred and sixty-two patients were so referred. Perineal injury (29.4%) was the most common diagnosis followed by pyrexia (22.5%), postpartum hemorrhage (18.3%), and genital sepsis (10.3%). The MMR was 4961.8/100,000 live births with PPH accounting for the majority (53.8%). Conclusion: Delay in referral and transportation difficulties were major impediments to prompt access of care from the Mission Hospital. TBAs should be encouraged to refer all cases to well-equipped orthodox medical facilities and get paid for each case as if managed by them.

African Journal of Medical and Health Sciences, 2014

Background: Perinatal mortality is a major public health issue in Nigeria with alarming statistic... more Background: Perinatal mortality is a major public health issue in Nigeria with alarming statistics that has been given inappropriate attention both in the past and now. Materials and Methods: This is a descriptive study of all cases of perinatal deaths managed at the Baptist Medical Centre between 1 st January 1994 and 31 st December, 2003. Information was obtained from birth and labor ward registers, patients and mothers case notes and analyzed. Statistical analyses were applicable was performed with the INSTAT statistical package version 3.36 from the Statistical services center of the University of Reading. Results: There were 5,153 deliveries and 485 perinatal deaths. The perinatal mortality rate (PNMR) was 94.1/1000 deliveries, still birth rate was 53/1000 deliveries and early neonatal deaths was 41.1/1000 deliveries. There was a definite trend in PNMR during the 10 year study period marked by a steady increase. The highest perinatal deaths occurred in those greater than 35 years and those with parity ≥5 (14.1%). There were more significant perinatal deaths among the unbooked (22.4%) and this was statistically significant (P < 0.0001). Perinatal mortality decreases with increasing birth weight. Prematurity/low birth weight (LBW) (21.5%), multiple pregnancy (20.2%) and birth asphyxia (18.0%) were the chief fetal causes of perinatal mortality while obstructed labor (15.1%) and severe pre-eclampsia/eclampsia (4.1%) were the most common maternal causes of perinatal deaths. Conclusion: PNMR of 94.1/1000 was very high in this study. There was no change in the PNMR when this study period was compared to current findings in other centers. Unbooked status was a significant risk factor for perinatal mortality. The common causes of perinatal mortality were prematurity/LBW, multiple pregnancy, severe birth asphyxia, prolonged obstructed labor and severe pre-eclampsia/eclampsia. Government and all stake holders in health care delivery should ensure the provision of emergency obstetric care for all women at all levels to reduce perinatal deaths. Interventions should be aimed at preventing, antenatal, intrapartum and postpartum complications of babies.

The Internet Journal of …, 2009

Background: Infertility is prevalent in Southeast Nigeria and may impart negatively on the emotio... more Background: Infertility is prevalent in Southeast Nigeria and may impart negatively on the emotional and social wellbeing of affected couples. Aims & Objectives To assess the prevalence, pattern, misconception and sources of infertility crisis among the Igbo population of Southeast Nigeria. Materials and Methods In depth interviews with women attending infertility, over a six month period (July to December 2006). Results: Twenty four women were interviewed, 66.7% had secondary infertility. Women were held responsible for infertility and bore the burden of seeking treatment. They suffered intimate partner abuse, psychological and emotional trauma from their families, as well as isolation and stigmatization from the society Conclusion. Medical education on the physiology of infertility may play a role in the integration of men in treatment seeking process in infertility. Doctors should manage the emotional and psychological aspects of infertility.

Ebonyi Medical Journal, 2010

ABSTRACT Background: Pregnancy induced hypertension and it sequelae eclampsia are major causes of... more ABSTRACT Background: Pregnancy induced hypertension and it sequelae eclampsia are major causes of maternal and perinatal morbidity and mortality in developing countries. The aim of this study was to compare the obstetric intervention rates and maternal and fetal outcome in cases of gestational hypertension to that of normotensive women randomly selected from the general obstetric population in a tertiary hospital in Nigeria Methods: Selected measures of obstetric intervention rates and maternal and fetal outcomes in 215 cases of gestational hypertension were compared to that in 300 randomly selected low risk non cases from the general obstetric population. Univariate statistical analysis was done using the Fisher’s exact test. The 95% Confidence interval and Relative risk were also determined.Results: Women with Gestational hypertension had statistically significant higher rates of induction of labour, instrumental delivery and prolonged hospital stay beyond 6 days compared to normotensive women. There were no significant differences in the measures of perinatal outcome. Conclusion: The findings of this study suggest that prompt management of cases of gestational hypertension in a tertiary hospital is associated with reduced risk of maternal and perinatal morbidity and mortality.

Continental Journal of Tropical Medicine, 2012

African Journal of Reproductive Health, Mar 1, 2011

Teratoma is the most common ovarian tumour associated with pregnancy. The complications in pregna... more Teratoma is the most common ovarian tumour associated with pregnancy. The complications in pregnancy include torsion, rupture and malignant transformation mimicking ovarian carcinoma. Its association with intestinal obstruction is uncommon. A 35 year old gravida 5 para 4 woman with 18 week gestation was referred to our hospital with a 2 week history of abdominal pain, abdominal distension and vomiting. Initial physical examination and ultrasound scan showed bilateral ovarian masses and intrauterine singleton viable pregnancy. At surgery the right mass was observed to be adherent to a part of the small intestine. The masses were excised and confirmed grossly and histologically as benign cystic teratoma. She was well and discharged nine days post operatively. The pregnancy was managed conservatively and she was delivered of a normal male baby at term by spontaneous vertex delivery. Although intestinal obstruction due to benign cystic teratoma in pregnancy is uncommon, abrupt surgical intervention and conservative management is important for favourable outcome.

Reviews, 1996

Background Cervical cancer is the second most common cancer among women worldwide, with around 50... more Background Cervical cancer is the second most common cancer among women worldwide, with around 500,000 new diagnoses and 273,000 deaths per year. However, incidence and stage at diagnosis vary greatly between geographic areas and are largely dependent on the availability of a robust population screening programme. For example, in Nigeria, advanced-stage disease at presentation is common (86% to 89.3% of new cases), whereas in the UK, only 21.9% of women present with International Federation of Gynaecology and Obstetrics (FIGO) stage II+ disease. Women with advanced cancer of the cervix often need palliation for distressing symptoms, such as vaginal bleeding. Vaginal bleeding can be life threatening in advanced disease, with an incidence ranging from 0.7% to 100%. Bleeding is the immediate cause of death in 6% of women with cervical cancer and its management often poses a challenge. Thus, vaginal bleeding remains a common consequence of advanced cervical cancer. Currently, there is no systematic review that addresses palliative interventions for controlling vaginal bleeding caused by advanced cervical cancer. A systematic evaluation of the available palliative interventions is needed, to inform decision-making. Objectives To evaluate the efficacy and safety of tranexamic acid, vaginal packing (with or without formalin-soaked packs), interventional radiology or other interventions compared with radiotherapy for palliative treatment of vaginal bleeding in women with advanced cervical cancer. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 2, 2015; the Cochrane Gynaecological Cancer Group Trials Register; MEDLINE from 1980 to March week 3, 2015 and EMBASE from 1980 to February week 12, 2015. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of review articles and contacted experts in the field. We handsearched citation lists of relevant studies. Palliative interventions for controlling vaginal bleeding in advanced cervical cancer (Review)

Journal of the National Medical Association, 2006

Female genital mutilation (FGM) and cutting is a subject of global interest, with many countries ... more Female genital mutilation (FGM) and cutting is a subject of global interest, with many countries of the world still practicing it despite efforts by the WHO and other agencies to discourage the practice. The highest known prevalence is in Africa. To determine the knowledge, attitude and practice of FGM among nurses in the ancient metropolis of Benin in a Nigerian state where FGM is illegal. One-hundred-ninety-three nurses in the study hospital were recruited in the study out of which 182 (94.3%) appropriately filled and returned the questionnaires. The average age of respondents was 37 years, and the average duration of postgraduation experience was 14.5 years. Most respondents are of Bini (36.8%) and Esan (34.1%) ethnic origin. All respondents identified at least one form of FGM, but only 12 respondents (6.6%) could correctly identify the four types of FGM. The harmful effects of FGM identified by the majority of respondents include hemorrhage, difficult labor/childbirth, genital t...

Clinics and Practice, 2011

The aim of the study is to show that long standing forgotten intrauterine device contributes to i... more The aim of the study is to show that long standing forgotten intrauterine device contributes to infertility, reporting three cases presented at Central Hospital Warri, Nigeria, a government tertiary health center. Three cases of forgotten intrauterine contraceptive device (IUCD) contributing to infertility were seen. Two were inserted for contraceptive reasons while one was inserted while being managed for uterine synechae. Health care providers should ensure proper documentation of all procedures carried out, adequate counseling which should include taking an informed consent and also ensuring both short and long term follow up of their clients. Also all patients being evaluated for infertility and clients with past history of intrauterine device must have a speculum examination and ultrasound scan carried out.