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Item Mid-trimester maternal serum placental growth factor (PLGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) combined with fetal Doppler studies in prediction of preeclampsia.(2022) Bankole, A. O.; Oluwasola, T. A. O.; Olayemi, O.; Akinmoladun, J. A.; Suleiman, B. K.Background: There have been many studies on prediction of preeclampsia but there is no single test which has demonstrated sufficient predictive value. Combination of maternal biomarkers with fetal Doppler studies are the promising predictors. Objective: The purpose of this study was to evaluate midtrimester maternal serum PLGF, sFlt-1 and fetal Doppler studies in predicting preeclampsia. Methodology: This is a cohort study of 120 consenting pregnant women between the gestational ages of 18–24weeks had blood sample collected for PLGF and sFlt-1and Doppler obstetrics Ultrasound scan was performed at recruitment. The women were followed up longitudinally throughout pregnancy. Standard statistics methods were adopted as applicable. The level of statistical significance was set at 5% (P-value <0.05). Results: A total of 115 participants had complete data for analysis and 16 (13.9%) developed preeclampsia. There was a statistically significant difference in the serum level of sFlt-1 and the sFlt-1/PLGF in those that developed preeclampsia with P-values of 0.009 and 0.014 respectively. There was a significant statistical difference in those with abnormal uterine artery PI and RI, Umbilical artery PI and RI among those that developed preeclampsia. Combining sFlt-1 and sFlt-1/PLGF with uterine and umbilical arteries PI and RI on Receiver operating characteristics (ROC) curve yielded an Area under the curve (AUC) of 0.925 with a sensitivity of 93.8% at a specificity of 65.7%. Conclusion: The combination of the serum PLGF, sFlt-1 and fetal doppler in the midtrimester had highest sensitivity in predicting preeclampsia compared to when they are used singly, and this will form a valuable tool in predicting preeclampsia in those presenting late in second trimester.Item Awareness and knowledge of birth defects among antenatal Clinic attendees at the University College Hospital Ibadan, South-West, Nigeria.(2021) Akinmoladun, J. A.; Uchendu, O.; Lawal, T. A.; Oluwasola, T. A. O.OBJECTIVES: This study assessed the knowledge of risk factors and prevention of birth defects among ante-natal clinic attendees at the University College Hospital, Ibadan, Oyo State, Nigeria METHODS: This was a cross sectional study among 415 mothers who presented at the antenatal clinic, A semi-structured questionnaire was used to obtain information on respondents socio-demographic profile, pregnancy, birth history, knowledge on prevention and risk factors for birth defects. Descriptive statistics was used to present results, independent t-test and ANOVA were used to determine the factors associated with mean of overall knowledge of birth defects. Test statistics was done at a 5% level of statistical significance. RESULTS: The mean age of the women was 31.7 + 4.8 years Overall, 93 (22.4%) of the women were above 35 years, 118 (29.9%%) were skilled workers and 343 (84.9%) had tertiary education. More than half (219, 52.8%) of the respondents had good knowledge of birth defects (56.4%a had good knowledge of prevention and 66.0% had good knowledge of risk factors) Antenatal clinic attendees in their first trimester had higher mean overall knowledge score (8.3 t 4.9) compared to those in second (7.9 + 4.5) and third (7,9 + 4,9) trimesters but this was not statistically significant (p=0.873). However, respondents in skilled/ semi-skilled occupation (8_62) had a significantly higher mean knowledge score compared with those in unskilled occupation/ unemployed (7,33) (p=0.005) CONCLUSION: Knowledge of birth defects is relatively low among women. To reduce the occurrence and severity of birth defects, there is a need to educate mothers on the knowledge, prevention and importance of screening for birth defects.Item Transvaginal ultrasound during pregnancy: perception and acceptability of antenatal clinic attendees at the University College Hospital, Ibadan.(2017) Akinmoladun, J. A.; Oluwasola, T. A. O.Introduction: There has been a tremendous increase in the use of transvaginal ultrasound (TVS) in pregnancy. With the use of high resolution transducers, the transvaginal probe has proved to be particularly useful for finding the location and dating of early pregnancies when compared with transabdominal sonography (TAS). It has also been shown to be a reliable method for confirming complete miscarriage. This study aims at determining the perception and acceptability of TVS in pregnancy. Materials and Methods: This is a descriptive cross sectional study of 424 consenting pregnant women attending the antenatal clinic at the University College Hospital, Ibadan. Using a self administered questionnaire, we obtained information on their socio demographic characteristics, awareness of ultrasound and TVS and opinion about TVS including acceptability and perceived complications. Results: The mean age of the respondents was 31.6 ± 4.7 years. Majority (410; 96.7%) had heard about ultrasound scanning, and 395 (93.2%) had undergone at least one type. Approximately two fifth (177; 41.7%) had heard about TVS, mostly from antenatal clinic, with two third having a good knowledge. Only 90 (21.2%) had personal experiences, and 144 (34%) believed it is harmful; however, about three fifths (256; 60.4%) were willing to do TVS if indicated. Perceived complications of TVS included abortion, infection and bleeding. Awareness and perception were strongly associated with acceptability of TVS but not with education or previous experience. Conclusion: This study shows that the perception and acceptability of TVS by pregnant women is dependent on their level of awareness. There is an urgent need for proper information dissemination on the usefulness, safety and advantages of TVS in pregnancy.Item Routine prenatal ultrasound anomaly screening program in a Nigerian university hospital: redefining obstetrics practice in a developing African country(2015-08) Akinmoladun, J. A.; Ogbole, G. I.; Lawal, T. A.; Adesina, O. A.Background: Congenital anomalies are among the leading causes of fetal and infant morbidity and mortality worldwide. Prenatal ultrasound (US) screening has become an essential part of antenatal care in the developed world. Such practice is just evolving in die developing countries such as Nigeria. The aim of this article is to present our initial experience and demonstrate the effectiveness of a prenatal US screening program in detecting congenital malformation in a developing country. Materials and Methods: This was a prospective evaluation of the prenatal .US screenings conducted at a major referral hospital in Southwestern Nigeria All pregnant women referred to the antenatal clinic for mid-trimester screening during the period of study were assessed. Results: Two hundred and eighty-seven pregnant women (5 with twin gestations) were presented for fetal anomaly scan during the study period. Twenty-nine anomalies (9.9%) were detected among the scanned population. Sixteen of the anomalies were followed to delivery/termination with a specificity of 93.5%. The commonest malformations were demonstrated in the genitourinary tract (34.5%) followed by malformations within the central nervous system (27.6%). Six (20.6%) of the anomalies were lethal. Five of the anomalies were surgically collectable. Conclusion: Institutions and hospitals across Nigeria and other low- and middle-income countries need to develop policies and programs that would incorporate a standardized routine screening prenatal US in order to improve feto-maternal well-being and reduce the high perinatal mortality and morbidity in developing nations.