FACULTY OF CLINICAL SCIENCES

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Author: search.filters.author.Arowojolu, A. O.

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    The influence of health-seeking behavior on the incidence and perinatal outcome of umbilical cord prolapse in Nigeria
    (Dovepress, 2010-06-30) Enakpene, C. A.; Odukogbe, A. T.; Morhason-Bello, I. O.; Omigbodun, A.O.; Arowojolu, A. O.
    Objectives: To determine the influence of health-seeking behavior of urban women in South- West Nigeria on the incidence and perinatal outcome of umbilical cord prolapse (UCP). Methods: A retrospective study comparing two groups of urban women using information extracted from medical records of patients who had UCP, and were managed at the University College Hospital Ibadan, Nigeria from January1st 1995 to December 31st 2005. The data was analyzed using SPSS software (version 15). Analysis included simple tabulation, proportion and comparison of incidence, perinatal morbidity, and mortality of UCP between the two groups of women using Chi-square or Fisher’s exact test. Odds ratio (OR) and 95% confidence intervals (CI) were calculated whenever necessary. P-value of 0.05 or less was statistically significant. Results: Women without prenatal care were more likely to have fetuses with UCP (54, 75%), than in women who had prenatal care (18, 25%). The risk of perinatal death from UCP was higher in women without prenatal care, as compared with those who received prenatal care (OR 3.02, 95% CI: 0.879 to 10.356; P-value = 0.061). The risk of perinatal morbidity and neonatal intensive care admission was also higher among women without prenatal care as compared with women who received prenatal care (OR 4.09, 95% CI: 1.03 to 16.30; P-value = 0.041). The overall perinatal mortality rate in the study population was 403 per 1000 total births, and this was five times more than that of the hospital perinatal mortality rate of 80 per 1000 total births during the study period. The perinatal mortality rate was higher among women without prenatal care, 463 per 1000 total births, as compared with 222 per 1000 total births in women who received prenatal care. Perinatal death before arrival at the hospital is less likely to occur in women with prenatal care when compared with women without prenatal care (OR 0.0635; 95% CI: 0.0052 to 0.776; P-value = 0.03). Conclusion: A high index of suspicion and an identification of risk factors, with early diagnosis, prompt intervention, and provision of health care facilities can reduce the incidence and poor outcome of UCP in developing countries
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    Oral misoprostol for the prevention of primary post-partum hemorrhage during third stage of labor
    (2007-12) Enakpene, C. A.; Morhason-Bello, I.O.; Enakpene, E. O.; Arowojolu, A. O.; Omigbodun, A. O.
    Aim: To assess the effectiveness of oral misoprostol compared with methylergometrine in the prevention of primary post-partum hemorrhage during the third stage of labor. Methods: This was a randomized controlled trial of 864 singleton low-risk pregnant women. The outcomes were total blood loss, duration of the third stage of labor and peripartal change in hematocrit. Comparisons were by the c2-test and Student t-test. Relative risks were calculated for side-effects profile. A P-value of less than 0.05 was statistically significant. Results: The biodata of all the participants were similar. The mean blood loss for the misoprostol and methylergometrine groups was 191.6 _ 134.5 mL and 246.0 _ 175.5 mL, respectively (95% CI: -79.3 to -39.5 mL). The mean duration of the third stage of labor was 19.6 _ 2.4 min and 9.4 _ 3.3 min in the misoprostol and methylergometrine groups, respectively (95% CI: 9.82–10.58 min). More subjects had blood loss >500 mL, 42 (9.7%) versus 6 (1.4%), and peripartal hematocrit change greater than 10%, 38 (8.8%) versus 5 (1.2%), in the methylergometrine group than in the misoprostol group, respectively. Also, more subjects received additional oxytocic in the methylergometrine group, compared to the misoprostol group (80 [18.5%] versus 33 [7.6%] patients, respectively). Conclusions: Orally administered misoprostol was more effective in reducing blood loss during the third stage of labor than intramuscular methylergometrine. However, there were more subjects in the misoprostol group in whom duration of the third stage of labor was greater than 15 min and who also had manual placental removal than in the methylergometrine group