Obstetrics. & Gynecology

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Author: search.filters.author.Adesina, O. A.End date: 2009

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    Emergency obstetric patients in a developing country and prevalence of HIV infection
    (2009) Awolude, O. A.; Oladokun, A.; Adesina, O. A.; Mutiu, W. B.; Adewole, I. F.
    The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HTV positive patients were post-test counselled and offered single dose nevirapine tablet (200mg) in labour with syrup given to the baby at birth at 2mg/kg followed by syrup zidovudine for 6 weeks: The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were H3V positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4,7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.
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    Complete hydatidiform mole co-existing with a twin live fetus
    (2001) Obisesan, K. A.; Adesina, O. A.; Awolude, O. A.
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    Rectovaginal and vesicovaginal communications following coital injury
    (2001) Odukogbe, A. A.; Onifade, R. A.; Adewole, I. F.; Adesina, O. A.; Awolude, O. A.
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    Screening for premalignant lesion of the cervix: determinants of patients’ practices
    (2005) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Adewole, I. F.
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    Repair of spontaneous perineal laceration at delivery, a cultural taboo: a case report
    (2006) Morhason-Bello, I. O.; Adesina, O. A.; Okunlola, M.A.; Oladokun, A; Onibokun, A.A.; Ojengbede, O.A.
    Although genital trauma is a recognized maternal complication of vaginal birth, the presence of skilled birth attendants at delivery and judicious use of episiotomy has been shown to reduce this risk to the barest minimum. Prompt repair of these traumas averts the resultant complications that may arise. A case of a booked 18-year-old nulliparous Guinea-Conakry woman with a second-degree perineal tear who declined repair due to a cultural reason is presented. The need for supervised delivery as well as immediate and long-term health implications of her decision is discussed
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    Emergency obstetric patients in developing countries and prevalence of HIV infection
    (College of Medicine, University of Ibadan, Ibadan, 2009) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Adewole, I. F.
    The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HIV positive patients were post-test counselled and offered single dose nevirapine tablet (200 mg) in labour with syrup given to the baby at birth at 2 mg/kg followed by syrup zidovudine for 6 weeks. The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were HIV positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4.7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.
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    Polymerase chain reaction assay of ureaplasma strains isolated from high vaginal swabs of women in Ibadan, Nigeria
    (College of Medicine, University of Ibadan, Ibadan, 2008) Agbakoba, N. R.; Adetosoye, A. I.; Adesina, O. A.; Adewole, I. F.
    Human ureaplasma previously had one species known as Ureaplasma urealyticum but was recently separated into 2 species, U. urealyticum and U. parvum. This study was carried out to separate the ureaplasma strains isolated from women attending a tertiary-care hospital in Nigeria. Thirty (30) Ureaplasma strains isolated from the vaginal tracts of 13 pregnant and 17 non-pregnant women were assayed. The polymerase chain reaction (PCR) technique was employed using two primer pairs: UMS-170/UMA-263 specific for U. urealyticum and UMS-57/UMA-222 specific for U. parvum. The positivity bands of the primer pairs were 476 bp and 326 bp for U. urealyticum and U. parvum respectively. All isolates were found to be U. urealyticumn (100%). Eleven (84.6%) of the 13 U. urealyticum from pregnant women were from asymptomatic women while from the non-pregnant women; 6 (35.3%) were from women with complaint of infertility problems; 5 (29.4%) from those who complained of vaginal discharge, one (5.9%) was asymptomatic while the remaining 5 (29.4%) had various other complaints. U. urealyticum is thus the prevalent species of Ureaplasma among pregnant and non-pregnant women in the study population and this to the best of our knowledge is a pioneer study to speciate human ureaplasmas in this country.
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    A survey of preference of parturients in labor
    (Nigerian Medical Association, Akwa Ibom State Branch, 2007-02) Oladokun, A.; Adesina, O. A.; Odukogbe, A. A.; Morhason-Bello, I. O.; Kolawole, K.; Adewole, I. F.
    Background: There is a growing concern among parturient women to have labour management modified to accommodate some of their preferences based on their previous experience of information obtained from others. Objectives: As service care providers, we sought to identify women's attitude to some important aspects of childbirth, namely: the preferred place or environment of delivery; reasons for dislike of modem labour management; as well as attitudes (cognitive, affect and behaviour) to operative delivery, particularly caesarean delivery. Methods: A survey of women's attitude to some important aspects of childbirth was carried out with the use of questionnaires among women attending antenatal clinic at the University College Hospital, Ibadan, Nigeria. Results: The study showed a great desire by women to have someone they already know in labour (spouses 58.80%; mother/mother figure 88.68%). Forty percent of those who prefer to deliver outside hospital settings would do so due to unfriendly attitudes of doctors and midwives. Conclusion-There is the need to appropriately train doctors and midwives who attend to women in labour as regards the anxieties and needs of the women in labour.
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    A comparative study of two surgical management methods for cervical incompetence at the University College Hospital, Ibadan
    (Nigerian Medical Association, Akwa Ibom State Branch, 2007-02) Oladokun, A.; Adesina, O. A.; Odukogbe, A. A.; Morhason-Bello, I. O.; Adewole, I. F.
    Incompetence of the internal uterine cervical os is associated with recurrent pregnancy loss. Different surgical techniques are in practice to correct the defect. The objective of this study therefore was to review the outcome of pregnancies following cervical using either of the two procedure among patients diagnosed as having incompetence of the cervix. A comparative study of 2 standard methods of cerclage used in our hospital, McDonald & Shirodkar, in a group of 80 patients was done. All the patients had cervical cerclage insertion done between the 14 & 16 weeks of gestation using either of the two methods. There was no significant morbidity with either of the 2 methods. The overall success rates, as measured by continuation of the pregnancy to term, were similar. Both methods of cervical cerclage are equally effective in producing the desired outcome, but since the McDonald method is technically simpler to perform, it may be desirable to adopt this approach more frequently.
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    Repair of spontaneous perineal laceration at delivery, a cultural taboo: a case report
    (Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2006-12) Morhason-Bello, I. O.; Adesina, O. A.; Okunlola, M. A.; Oladokun, A.; Onibokun, A. A.; Ojengbede, O. A.
    Although genital trauma is a recognized maternal complication of vaginal birth, the presence of skilled birth attendants at delivery and judicious use of episiotomy has been shown to reduce this risk to the barest minimum. Prompt repair of these traumas averts the resultant complications that may arise. A case of a booked 18-year-old nulliparous Guinea-Conakry woman with a second-degree perineal tear who declined repair due to a cultural reason is presented. The need for supervised delivery as well as immediate and long-term health implications of her decision is discussed.