Obstetrics. & Gynecology
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Item Knowledge and perception of pregnant women to episiotomy in Ibadan.(2017) Oluwasola, T. A. O.; Bello, F. A.Background: Episiotomy is the most common obstetric procedure for prevention of perineal laceration during childbirth. In order to further involve women in the decision-making process for their care, understanding their perception of common obstetric procedures will contribute to practical discussions on the gaps that need to be filled. Methods: Cross-sectional descriptive survey of consenting pregnant women attending antenatal clinic at the University College Hospital, Ibadan. Information on their socio-demographic data, knowledge and perception about episiotomy was obtained using an interviewer-administered questionnaire. Data analysis was done with SPSS version 18.0. Results: A total of 304 women were interviewed, of which 199 (65.5%) had ever heard about episiotomy. Among those ever heard, 62 (31.2%) have had personal experience with 10 (16.1%) reporting sexual dysfunction as complication. Only 60 (19.7%) are ever willing to accept episiotomy while 172 (56.6%) will advise friends and relatives against acceptance. Only parity is significantly associated with knowledge (X2 – 15.08, p<0.001) while age is associated with previous experience (X2 – 22.92, p<0.001). Previous experience had no effect on willingness to accept repeat episiotomy (OR = 1.24; 95% CI: 0.63 – 2.44). Health workers are the main source of information. Conclusion: Parturients in our environment are yet to accept episiotomy due to inadequate information as many of them believed it is unnecessary. Sessions on intrapartum interventions in obstetrics need to be further integrated into our antenatal care services.Item Awareness and practice of dual contraception among female tertiary institution students in Ibadan, Nigeria.(2016) Bello, O. O.; Oluwasola, T. A. O.; Bello, F. A.Introduction: Preeclampsia is a common complication of pregnancy and a major cause of maternal morbidity. Pathogenetic explanations for preeclampsia include: Maladaptation of the immune system to paternal antigens and exaggerated maternal inflammatory response to trophoblastic tissue. Immune deficiency, induced by human immunodeficiency virus (HIV) or any other cause, could, therefore, inhibit a tendency to immune hyper‑reactivity and thus theoretically prevent the development of preeclampsia. The study aims to explore the role of the immune theory of preeclampsia by comparing the prevalence of preeclampsia among HIV‑positive and HIV‑negative pregnant women. Materials and Methods: The study was a cross‑sectional survey of pregnant women, beyond 28 weeks gestation, who delivered at the University College Hospital, Ibadan between 1st October 2011 and 31st December 2011. Data was collected using a prespecified proforma. The analysis was performed using SPSS version 17.0 and P value was set at <0.05. Results: A total of 766 women who gave birth during the study met the inclusion criteria. Among the cohort, HIV prevalence rate was 7.2% whereas preeclampsia was 10.7%. None of the HIV‑positive women had preeclampsia. Conclusion: This study suggested that the prevalence and perhaps, risk of developing preeclampsia is reduced among HIV positive women. This is similar to other studies done in various countries in the world. There is a need for further study as it may prove valuable in the management and prevention of preeclampsia.Item Decision-to-Delivery intervals and perinatal outcome following emergency cesarean delivery in a Nigerian tertiary hospital.(2016) Bello, F. A.; Tsele, T. A.; Oluwasola, T. A. O."Objective: To determine the decision-to-delivery interval (DDI) for emergency cesarean deliveries (CDs) at a tertiary center in Nigeria, to evaluate causes of delay, and to assess the effects of delays on perinatal outcomes. Methods: Between September and November 2010, a prospective, observational study was undertaken at University College Hospital, Ibadan. Events that occurred after a decision to perform an emergency CD were recorded. Associations between outcomes and the DDI were analyzed. Results: Among 235 emergency CDs included,5 (2.1%) occurred within 30 minutes and 86 (36.6%)within 75 minutes. The mean DDI was 119.2±95.0minutes. Among CDs with a DDI of more than 75 minutes, logistic factors were the reason for delay in 65 (43.6 %) cases. No significant associations were recorded between DDI and the 5-minute Apgar score, admission to the special-care baby unit, or perinatal mortality (P N 0.05 for all). In multivariate analysis, neonates delivered after 75 minutes were significantly less likely to die during the perinatal period than were those delivered within this period (odds ratio 0.13, 95% confidence interval 0.03–0.66; P = 0.01). Conclusion: Institutional delays in CDs need to be addressed. However, the DDI could be less important for perinatal outcome than are some other factors, such as the severity of the indication. "Item The woman trial: overview and progress(Onemedia Studios, Bodija, Ibadan., 2011) Bello, F. A.; Aimakhu, C. O.; Ogunbode, O. O.; Adeyemi, A. B.; Oluwasola, T. O. A.; Olayemi, O.; Fawole, A. O.Item Endometriosis and associated symptoms among nigerian women(Elsevier Ireland Ltd, 2015) Adeniran, O. F.; Bello, F. A.; Ogunbode, O.; Odukogbe, A. A.; Nkwocha, G. C.; Nnoaham, K. E.; Zondervan, K. T.; Akintan, A.; Abdus-Salam, R. A.; Okunlola, M. A.Objective: To determine the prevalence of endometriosis and identify associated symptoms among Nigerian women. Methods: A cross-sectional study was conducted at a center in Ibadan, Nigeria, between October 2008 and December 2010. All women aged 18–45 years scheduled for their first diagnostic laparoscopy for gynecologic indications were enrolled. Participants completed a previously validated self-administered questionnaire. Endometriosis was diagnosed on the basis of visual evidence. Results: Among 239 women analyzed, 115 (48.1%) had endometriotic lesions. Endometriosis was more common among women reporting dysmenorrhea and pelvic pain than among those not reporting these symptoms (20/28 [71.4%] vs 95/211 [45.0%]; P = 0.009). Women who reported dysmenorrhea were significantly more likely to have endometriosis than were those without dysmenorrhea (90/171 [52.6%] vs 25/68 [36.8%]; P = 0.027). The risk of endometriosis was not significantly increased in women with one pain symptom (odds ratio [OR]1.69; 95% confidence interval [CI] 0.67–4.27), but was significantly increased in women with two (OR 2.70; 95% CI 1.13–6.52) or three (OR 4.87; 95% CI 1.88–12.82) pain symptoms (χ2 trend = 15.5; P b 0.001). In a multivariate logistic regression model, only pain other than dysmenorrhea or dyspareunia independently predicted endometriosis (P=0.017). Conclusion: Endometriosis is fairly common among Nigerian women. Efforts to increase the awareness of endometriosis among the public, researchers, and clinicians are needed.Item Informed consent for caesarean section at a nigerian university teaching hospital: patients' perspective(Journalgurus, 2015-04) Ogunbode, O. O.; Oketona, O. O.; Bello, F. A.Background: Caesarean section is one of the commonest obstetrics surgery and has become increasingly safer compared with the early 20th century. The practice of informed consent has also become universally adopted for surgical procedures. However, with increasing knowledge about ethics and rights, issues on consent is one of the frequent grounds for litigation and malpractice claims. Aims and Objectives: To audit the process of informed consent for emergency and elective caesarean section in a Nigerian tertiary health care setting. Methodology: This was a descriptive cross-sectional study involving 150 patients who had caesarean delivery at the study site within the study period. Results: The mean age of the respondents was 32±1.8 years with 118(79%) of the surgeries being emergency Cesarean sections. The consent for CS were mostly given by the patients (96, 64.0%) and husbands (43, 28.6%). Majority of the respondents 123(81.5%) had the consent obtained in the labour ward with profuse bleeding (86.0%) and blood transfusions (88.7%) being the most commonly discussed risks. Many of the respondents expressed satisfaction with the consent form and felt it was well written (75.3%), attractive (76.0%) and simple to read (75.3%). Conclusion: This study found out that although patients were satisfied with the consent process for caesarean section, only information about major risks was commonly discussed. There is therefore the need for customized and detailed consent forms to be adopted for different surgical procedures.Item Sexual violence against female undergraduates in a nigerian tertiary institution(Journalgurus, 2014-04) Ogunbode, O. O.; Bello, F. A.; Ogunbode, A. M.Background: Worldwide, violence against women is becoming an increasingly recognized pandemic issue necessitating eradication and elimination. It occurs in various forms with resultant physical, sexual or psychological consequences. However, there is still denial and paucity of literature about the magnitude and pattern of this problem in Nigeria. Objective: This study was designed to determine the patterns of sexual violence among female undergraduates including their perceptions and attitude. Methods: It was a descriptive cross-sectional questionnaire based study involving 388 female undergraduates of the University of Ibadan, Ibadan, Nigeria. Multistage sampling technique using their halls of residence was used to select participants. The results were analyzed using statistical package for SPSS software version 16.0. The p-value was set at 0.05. Results: The mean age of respondents was 20 years and 382 (98.5%) of them were single. Only 31.2% were sexually exposed and the average age of sexual debut was 18 years. Most (78, 64.1%) cases of the first sexual intercourse occurred voluntarily. Two hundred and sixty two (67.6%) respondents had experienced at least one form of sexual abuse in the past. The commonest coercive sexual behaviour experienced was unwanted touching (53.4%). The perpetrators were mostly casual friends (63.7%) and most reported these incidences to friends. The respondents demonstrated good knowledge but poor attitude about sexual abuse. Eighteen (10.7%) admitted to prior rape which was mainly perpetrated by strangers with half admitting it adversely affected their relationship with the opposite sex. Conclusion: Sexual violence occurs in this environment but mainly goes unreported. There is good knowledge about the issues of sexual violence but there is need for improved attitude and reporting by victims.Item Acceptability of counselling and testing for HIV infection in women in labour at the University College Hospital, Ibadan, Nigeria(The Faculty of Medicine, Makerere University, 2011-03) Bello, F. A.; Ogunbode. O. O.; Adesinsa, O. A.; Olayemi, O.; Awonuga, O. M.; Adewole, I. F.Background: Many patients are referred to labour ward as emergencies, and therefore do not benefit from the antenatal HIV counselling and testing and treatment offered to registered patients. Objective: To assess the acceptability and suitability of offering HIV counselling and testing to women of unknown HIV status presenting in labour. Methods: A cross-sectional study comprising counselling and obtaining consent for HIV testing among 104 unregistered patients who presented in labour over a 3-month period. Rapid and enzyme-linked immunosorbent assay screening was performed for 90 consenting respondents. Reactive results were confirmed by Western blot. Appropriate therapy was instituted. Results: Acceptance rate for HIV testing was 86.5%, prevalence of HIV was 6.7%. Women of lower educational status were more likely to accept testing in labour (OR: 0.3; 95% CI: 0.1-0.7; p=0.01); age, parity, occupation and knowledge of HIV had no influence. Most women (66.3%) had satisfactory knowledge of HIV. No one admitted to feeling coerced to test in fear of being denied care. Most refusals for screening were to avoid needle pricks (28.6%). Compared to ELISA screening test, specificity of the rapid test was 100%, sensitivity 85.7%, positive predictive value 100% and negative predictive value 98.8%. Attitude to testing was maintained on post-partum re-evaluation. Conclusion: The prevalence of HIV amongst unregistered parturients showed the importance of offering point-of-care HIV testing and intervention, especially in an environment where antenatal clinic attendance is poor. Rapid testing appeared to be acceptable and feasible in labour to prevent the mother-to-child transmission of HIV.Item Attitude to caesarean section amongst antenatal clients in Ibadan, Nigeria(College of Health Sciences, University of Ilorin, 2011-01) Bello, F. A.; Olayemi, O.; Ogunbode, O. O.; Adekunle, A. O.This was a cross-sectional study carried out on 372 clients receiving antenatal care at a rural, suburban and urban centres, in order to assess the acceptance of caesarean delivery amongst them and the factors influencing their attitude. Caesarean section was acceptable to 65.7%. Many respondents will refuse the surgery, because they do not think abdominal delivery is natural or necessary. However, if indicated by their health caregiver to be necessary to save life, 78.3% would comply. Others would leave for a religious healing home, another hospital, a traditional birth attendant or be delivered at home. The cultural reasons why some women decline include feeling that caesarean delivery is due to “spiritual attacks”, retribution for maternal infidelity and failure of a woman to fulfil her reproductive function. Respondents were more likely to accept the surgery if they had heard of it before or had a previous caesarean delivery. They were less likely to accept it if they were Christians or attended the rural health centre. Age, parity and educational level had no influence. Only 4% of the respondents would request a caesarean section for non-medical reasons. Health education needs to be carried out in the community, as well as during antenatal classes, to address the cultural beliefs. Means of involving religious bodies in enlightenment campaigns to improve women's attitude should be explored.Item Perception and practice of emergency contraception among female Undergraduates of the University of Ibadan, Nigeria(Elsevier, 2009) Bello, F. A.; Olayemi, O.; Fawole, A. O.; Ogunbode, O. O.; Sobukunola, T.; Adesina, O. A.; Aimakhu, C.; Okunola, A.Objective To assess perception and level of proper utilization of emergency contraception (EC) among female undergraduates. Methods Cross-sectional questionnaire study was performed on 383 female undergraduates in Nigeria in June 2006. Data analysis was with χ-square test and logistic regressions (P<0.05). Results One hundred and five (48.2%) had been sexually exposed. Only 32 (30.5%) used regular contraception. Seventy-three (24.3%) female undergraduates were aware of EC. Only 29 (7.6%) had used EC before. Most would not use emergency contraceptive drugs in future due to lack of awareness (64.8%), and fear for future fertility and of drugs being injurious to health. Use of EC was associated with awareness of correct interval for use (OR=9.1; 95%CI: 2.1-39.9). Conclusion There is poor knowledge about EC and poor use, while significant need remains. Most knowledge was acquired from peers and inaccurate. Peer educators are important and professionals’ knowledge needs improvement.