Obstetrics. & Gynecology
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Item Obstetrics outcomes of women with sickle cell disease in a tertiary institution in Ibadan – a 10-year review(2024) Oluwasola, T. A. O; Ogunkuade, M. F.; Bello, O. O.Background: Pregnancy in sickle cell disease (SCD) patients is associated with increased risk of fetomaternal morbidity and mortality. With improvements in management, education, awareness, and nutrition, more patients with SCD are maximizing their reproductive potential. Objectives: This review examined the pattern of complications and obstetrics outcomes of patients with SCD in a tertiary health facility. Materials and Methods: A descriptive retrospective study of 106 pregnant SCD patients who delivered at the University College Hospital, Ibadan between 1st January 2008 and 31st December 2017. Information on their demographic, medical and obstetrics characteristics, complications and outcome were obtained from their case notes using a pre-designed proforma. Data were analyzed using SPSS version 23. Results: Of the 106 cases reviewed, 64 (60.38%) had sickle cell anaemia (haemoglobin SS), 39 (36.79%) had haemoglobin SC and 3 (2.83%) had haemoglobin CC. The mean maternal age was 29.6±4.7 years. Majority, 83(78.3%), booked for antenatal care at mean gestational age (GA) of 19.4±8.7 weeks while the mean GA at delivery was 39.0±1.73 weeks. Bone pain crisis (38.8%) was the commonest non-obstetrics complication with 63.2% occurring among the HBSS genotype. The common obstetrics complications were preterm contraction, intrauterine fetal death (IUFD), and preeclampsia (each occurring among 27.3%). Overall, there were 84.9% live births and the overall fetomaternal outcome was satisfactory in 38.7%. Conclusion: Sickle cell disease in pregnancy has remained associated with increased risk of bone pain crises as well as preterm contractions, IUFD and preeclampsia. A multidisciplinary team approach is essential in ensuring a positive pregnancy outcome.Item Management outcome of premature rupture of membranes in a tertiary facility in South Western Nigeria. Annals Ibadan(2021) Suleiman, B. K.; Bello, O. O.; Tijani, A. M.; Oluwasola, T. A. O.Background: Pre-labour rupture of membranes (PROM) contributes immensely to the potential risk of maternal morbidity and mortality. Objective: To explore the incidence and management outcome of PROM at Ladoke Akintola University of Technology Teaching Hospital (LTH), Ogbomoso, Nigeria Methods: A retrospective study of 61 cases of PROM managed at LTH, Ogbomoso over a 3-year period. Information on the socio-demographics and obstetrics characteristics, management instituted, and outcomes were obtained using a structured proforma. Data were analysed using SPSS version 20. Level of significance was set at <0.05 and 95% confidence interval. Results: The incidence of PROM was 4.1% with a perinatal mortality rate of 0.18 per 1000 deliveries. Twenty (33%) were pre-term while 41 (67%) were term PROM with 10% of the perinatal death occurring among those with preterm PROM. The mean age of the women was 36.9 (SD=2.1) years and median parity of 1(range 1-5) children. There was a significant association between the women’s gestational age at which PROM occurred with the latency period (p< 0.001). Fetal birth weight, apgar score and neonatal intensive care unit (NICU) admission were all significantly associated with the gestational age at which PROM occurred (p<0.05). There was a significant difference between the intervention instituted and mode of delivery (p=0.009). Conclusion: The incidence of PROM at term was high and conservative/ expectant management was effective. The latency period and fetal outcomes such as birth weight, apgar score and NICU admission were determined by the gestational age at which PROM occurred.Item COVID-19 and its implication for obstetrics and gynaecology practice in Africa.(2021) Oluwasola, T. A. O.; Bello, O. O.Having to cope with corona virus disease 2019 (COVID-19) is likely to create imbalances in health care provision in the obstetrics and gynecology practices in Africa where most countries still battle with high rate of maternal morbidities and mortalities as well as poor or inadequate quality gynecological care. COVID-19 has spread to the continents of the world including all African nations since it was first reported in Wuhan, China in December 2019. Its impact and implications on the obstetrics and gynecology practice in Africa are yet to be fully explored. Routine essential services are being disrupted; therefore, giving rise to the need to redeploy the already limited health personnel across health services in Africa. This is an attempt to discuss the potential implications for obstetrics and gynaecologic practice in Africa.Item Clinical and psychosocial outcomes of obstetrics Fistulae in Sub-Saharan Africa: a review of Literature.(2020) Oluwasola, T. A. O.; Bello, O. O.Obstetrics fistulae are preventable and treatable diseases of immense public health importance which render women debilitated and devastated with physical, mental, psychological, economic and social problems. It is prevalent among the less privileged with limited access and utilization of reproductive health services which reflect the state of health care delivery especially emergency obstetric care in a country. Over the years, the impact of obstetrics fistulae has led to several studies on the prevalence, clinical outcome and experiences of affected women, but there is paucity of information on the psychosocial and economic impact of obstetrics fistulae in developing countries. This review is therefore an attempt to bridge this gap and hopefully point attention to the need to consider these impacts when designing further interventions for patients with Obstetrics fistulae.Item Pattern of infertility at LAUTECH teaching hospital, Ogbomoso, Nigeria.(2019) Suleiman, B. K.; Bello, O. O.; Tijani, A. M.; Oluwasola, T. A. O.Background and Objectiver Infertility is a socially destabilising health problem, which remains a cause of stigma and threat to couples desirous of conception in Nigeria. This sludy aimed to ecxamine the pattern of presentation and management outcome of infertility at LAUTECH Teaching Hospital (LTH), Ogbomoso. Methods A descriptive retrospective study of infertile couples attending the gynaecological clinicovera 3-yearpe-riod was conducted. Intonation on sociodemographic and gynaccological characteristics, medical history and management outcome was obtained from the medical reconls of the patients using a stctured proforma Data was analysed using SPSS version 20.0. Results The incidence of infertility was 34.30ol The mean age of the infertile women was 6.44 4.7 ycars. Secondary infertility/ accounted for the majority of the cases (73.0") with the_ mean duration of infertility being3,92 1 years. Male factor was identified in 10.4 of cases while female factor wasscen in 4L6"ot cases Both partners contributed to infertility in 34% while there was no identifiable cause in 14%. The commonest causes of infertility in the women were inadequate coital exposure, previous abnormal vaginal discharge and previous induced abortion representing 39.5%, 37.1%, and 33.7% respectively. Pregnancy was achieved in 3.0% of the women following treatment Conclusion The institutional incidence of infertility was high with a preponderance of secondary infertility. Pregnancy rate following conventional treatment was poorItem Lassa fever in pregnancy – report of 2 cases seen at the University College Hospital, Ibadan.(2017) Bello, O. O.; Akinajo, O. R.; Odubamowo, K. H.; Oluwasola, T. A. O.Lassa fever (LF), an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in West Africa countries with up to 15% case fatality rate. Though a rodent-borne infection, it can also be transmitted from person to person during the care of sick relations or more commonly in health care settings as a nosocomial infection. Vertical transmission from mother to child has been documented. We report 2 cases of LF among pregnant women which were managed at the University College Hospital, Ibadan, between September and October 2014. Both patients were in their early 20s with only one surviving the disease. Both had supportive therapy but none had antiviral therapy. This report emphasized the importance of early presentation, high index of suspicion, prompt diagnosis, and early commencement of supportive therapy in the management of patients suspected with LF especially in the era of other viral haemorrhagic infections.Item Awareness of and attitude towards HPV and its vaccines among market women in Bodija market. Ibadan.(2016) Bello, O. O.; Oluwasola, T. A. O.; Odukogbe, A. A.BACKGROUND Cervical cancer, commonest among cancers of the female genital tract continued to pose major challenge to women of reproductive age in developing countries though infection by its causative agent, human papilloma virus (HPV) is preventable. This study aimed to assess awareness and attitude of market women concerning HPV and its vaccines in prevention of cervical cancer. MATERIALS AND METHODS A cross sectional study involving 329 market women, using multistage sampling technique. Instrument was an Interviewer--administered questionnaire on socio-demographic characteristics, knowledge and awareness of HPV and its vaccine, sexual history and attitude towards HPV vaccines. Data analysis was done using SPSS version 20.0 with statistical significance level set at p<0.05. RESULTS Mean age of respondents was 29.49±3.65 years. All respondents were sexually active with majority (94.8%) having multiple sexual partners. Awareness of HPV vaccine and Pap smear test was among 1.2% and 9.4% respectively. Attitude towards HPV vaccination was good in 304 (92.4%) with 302 (91.8%) willing to take the HPV vaccines. There was significant association between attitude towards HPV vaccine and willingness to take HPV vaccine CONCLUSIONS Awareness of HPV and its vaccines is low among market women in our community. Policies and actions to step up information dissemination are urgently needed in order to stem the scourge of cervical cancer in our society.Item Prevalence of rectovaginal group B streptococcus (GBS) among pregnant women at University College Hospital, Ibadan, Nigeria.(2016) Bello, O. O.; Kehinde, A. A.; Oluwasola, T. A. O.; Odukogbe, A. A.Context: Group B Streptococcus (GBS) or Streptococcus agalactiae, a Gram-positive bacterium causes disease primarily in infants, pregnant or postpartum women. It is associated with up to 50% neonatal mortality and significant morbidity. GBS is responsible for adverse pregnancy outcomes such as premature rupture of membranes(PROM), preterm labour, low birth 'eight and chorioamnionitis. Objectives: To determine the prevalence of CBS carriage among pregnant women and identify the risk factors for colonization. Study Design: This is a prospective cohortstudy in which two hundred and forty consenting pregnant women were screened for GBS from 35 - 40 weeks. ""Vaginal and rectal swab specimens were collected from the mothers and examined using standard bacteriological methods -CHROMagar StreptB agar plate (CHROMagarLtd, Paris, France). All GBS positive isolates were tested for antibiotic sensitivity. Results: The prevalence of vaginal and rectal GBS colonization among pregnant women in University College Hospital (UCH), Ibadan was 9.6%. 0f the 23 pregnant women with GBS colonization, 60.9% (14) were vaginal cartiers,30.4% (7) were rectal carriers while 8.7% (2) had both. GBS colonization is significantly associated with previous Preterm birth, abnormal vaginal discharge in current preenancy and preterm PROM but not with maternals sociodemographic characteristics: age, parity and gestational age. Conclusion: GBS colonization of vagina and rectum has potential risks for pregnant women and their neomates. These call for screening of women during pregnaney so as to offer intrapartum antimicrobial prophylaxis to those who are carriers.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 Comparative effectiveness of 50g glucose challenge test and risk factor based screening in detection of gestational diabetes mellitus in Ibadan, Nigeria.(2015) Bello, O. O.; Oluwasola, T. A. O.; Adeleye, J. O.; Adedapo, K. S.; Maxwell, O.; Odukogbe, A. A.Context: Gestational diabetes mellitus (GDM) complicates 3-5% of pregnancies. Prompt diagnosis helps to prevent its subsequent complications and one-step effective screening method is desirable for our environment. Objective: To compare the effectiveness of 50g glucose challenge test (GCT) with risk factors alone in screening for GDM. Study Design: Prospective study of booked, consenting pregnant women with no previous history of diabetes mellitus. Fasting sample of venous blood was obtained for plasma glucose, followed by administration of SOg oral glucose and collection of blood sample an hour later. The process was repeated after a week using 7Sg oral glucose; each patient serving as her own control. Threshold blood glucose of 140mg/dl was used for both post-ingestion tests. Statistical analysis was done using SPSS version 17. Results: All the seventy-nine study participants completed the 2 arms. Mean maternal and gestational ages at recruitment were 30.8+1.2 years and 24.2+1.6 weeks respectively. Among the respondent, 3S( 44.3%)were nulliparous while24(30.3%) had positive risk factors for GDM. The 50g GCT was abnormalin 10 patients (12.7%) while GDM was confirmed in 2 patients giving an incidence rate of2.5%. The 50g GCT was normal in 89.6% of women withnormat75g OGTT and it was more predictive of GDM (Positive Predictive Value, PPV -20%) compared to risk factors only (PPV-11.1 %). Conclusion: Using 50g GCT will enhance selection of patients for confirmatory test for GDM as compared to risk factors alone. It would therefore be of great benefit in this environment.