Obstetrics. & Gynecology
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Item The role of ethnicity on pain perception in labour among parturients at the University College Hospital(2009-04) Olayemi, O.; Morhason-Bello, I. O.; Adedokun, B. O.; Ojengbede, O. A.Aims: In developing countries, the major mechanism by which parturients cope with labor pain is psychological. This study aims to assess the effect of ethnicity on the perception of pain by parturients in labor at the University College Hospital, Ibadan. Materials and Methods: The study was conducted between the 1 November 2006 and the 30 March 2007 at the University College Hospital Ibadan. The main outcome measure was pain perception assessed by the Box Numerical Scale (BNS). Univariate analysis was by t-test for continuous variables and c2 test for categorical variables. The multiple linear regression method was utilized for multivariate analysis. The level of statistical significance was set at P < 0.05. Results: The lowest adjusted mean BNS score was found in theYoruba ethnic group: they had scores lower than the mean scores for the other ethnic groups (-0.636 [95% confidence interval (CI) -0.959, -0.313]). The presence of a doula also reduced the mean BNS scores significantly (-0.533 [95% CI -0.844, -0.222]. Increasing parity also reduced pain scores (-0.182 [95% CI -0.342, -0.022]). Increasing educational attainment increased pain scores in labor (0.189 [95% CI 0.017, 0.361]). The influence of increasing age was not statistically significant in this model. In conclusion, ethnicity of the parturient relative to that of the predominant ethnicity in the place of birth has a significant effect on the perception of labor pain by the parturient. In our resource-challenged environment, trained doulas may help make labor less painful for the parturientItem Uncomplicated midvaginal vesico-vaginal fistula repair in Ibadan: a comparison of the abdominal and vaginal routes(2008-12) Morhason-Bello, I. O.; Ojengbede, O. A.; Adedokun, B. O.; Okunlola, M. A.; Oladokun, A.Background: Obstetric fistula is a resultant effect of prolonged obstructed labour. The best surgical management of simple uncomplicated fistula determines the outcome of care. Objective: To compare outcome of uncomplicated mid-vaginal fistula between vaginal and abdominal route of repair. Materials and Method: This was a hospital based retrospective study conducted at the University College Hospital, Ibadan from January, 2000 till December, 2006. Result: Of the 71 midvaginal fistulae managed, 40.8% had abdominal repair while the remainder were through vaginal approach. The overall repair success rate was 79.2% with comparable outcome in both groups-78.3% for the abdominal and 80% for the vaginal group (p=0.999). The duration of hospital stay did not differ significantly between the groups (p=0.972). Post operative complications were found in 41.4% of the abdominal group compared to none in the vaginal group (p<0.001). The complications were failed repair (20.7%) and urinary tract infection (20.7%). The mean estimated blood loss was 465.5ml in the abdominal group compared to 332.9ml for the vaginal group (p=0.303). Conclusion: Despite the comparable surgical repair outcome of the two methods, the vaginal approach is associated with lesser blood loss and lower risk of post-operative complications. It is recommended that the vaginal route should be employed in the repair of uncomplicated midvaginal fistula unless there are other compelling reasons to the contraryItem Contraceptive practice and commodity sources amongst female undergraduates in Ibadan, Southwest Nigeria(2008-09) Okunlola, M. A.; Morhason-Bello, I. O.; Adekunle, A O. .Objective: To determine the pattern of contraceptive use, and its sources among female undergraduates of the University of Ibadan. Methodology: A cross-sectional study design using self administered questionnaire. The study was conducted from November 2005 till March 2006. Results: The result of one thousand six hundred and thirty respondents were analysed out of 1800 interviewed. The commonest age group was 21-25years and about half were in their second and third undergraduate training year. They were mostly single, Christians and of the Yoruba ethnic group. Among those interviewed, 84% admitted to previous sexual activity. However, only a third had ever used any form of modern contraception. The commonest method of contraception ever used was male condom (82.0%) and the least was implantable contraception (1.4%). Other methods used included spermicides, oral contraceptive pills, and injectables. Of those that used contraception, 59.0% procured the service/commodity from pharmacy shops and patent medicine outlet. Other sources mentioned included; non-governmental organization private hospitals, and friends/relatives. Some did not indicate the source of procurement. Conclusion: The study revealed that students in Nigeria engage in risky sexual practices which may be detrimental to the future reproductive activities. Even those that claim to use contraceptives may not have been properly counseled prior to use. We recommend that safer sexual practices should be encouraged and some emphasis on abstinence. Advocacy on appropriate sources of contraceptives commodities should be pursuedItem Sexual behaviour of in-school adolescents in Ibadan, South-West Nigeria(2008) Morhason-Bello, I. O.; Oladokun, A.; Enakpene, C. A.; Fabamwo, A .O.; Obisesan, K.A.; Ojengbede, O. A.This study was a crossectional survey conducted among 716 senior secondary school adolescents in Ibadan from March to August 2005. The result of 695 that was analyzed revealed that the mean age of 15±2.6years. 28.3% of the respondents had previous sexual exposure with higher proportions being male (p=0.00043). Majorities’ first sexual exposure was unplanned. Family settings and educational level do not have significant influence on the previous sexual exposure. The methods of sexual activity were mainly through vagina route while some had also practiced oral and anal sex. Most of those that are sexually exposed had more than one partner. About half of the respondents learn about sex from their friends while others through their parents and media. We conclude that in-school adolescents practiced unsafe sexual activity and they are therefore predisposed to STI/HIV and other reproductive health risksItem Uterus bicornis unicollis; occurrence of consecutive viable pregnancies in separate horns(2007) Morhason-Bello, I. O.; Ojoko, I. E.; Owonikoko, K. M.; Olayemi, O.; Omigbodun, A.O.A case of two-consecutive viable pregnancies in separate horns of bicornuate unicollis uterus of a Nigerian is presented. The problem of misdiagnosis associated with the anomaly is noted. This case further demonstrates that women with such anomaly may not have unhindered reproductive carrier and antenatal care will improve their chanceItem Comparative evaluation of haemoglobin estimation amongst pregnant women in Ibadan: Hemocue – B Haemoglobin analyzer versus haemiglobincyanide (Standard) method as the gold standard(2008-08) Ojengbede, O.A.; Okonkwo, S. N.; Morhason-Bello, I. O.This was a comparative crossectional study that was conducted among 557 antenatal women at the University College Hospital, Ibadan, Nigeria between 1st April and 30th May 2006. The study compared the accuracy of haemoglobin estimation using an automated HemoCue B analyzer kit with a standard laboratory method (haemogloincyanide) as the gold standard. The result showed a positive correlation of HaemoCue haemoglobin results when compared with the standard methods (Pearson’s correlation coefficient = 0.892; p value = 0.000). We concluded that the use of the automated HemoCue kit for haemoglobin estimation gives an objective assessment which overcomes the challenge of extra skilled manpower or power outages in rural areas thereby enhancing access to quality of care in resource poor countriesItem Attitude and preferences of Nigerian antenatal women to social support during labour(Cambridge University Press, 2007) Morhason-Bello, I. O.; Olayemi, O.; Ojengbede, O.A.; Adedokun, B. O.; Okuyemi, O. O.; Orji, B.This was a hospital-based cross-sectional study of 224 randomly selected antenatal women receiving care at the University College Hospital, Ibadan, Nigeria. The study aimed to seek the attitude and preferences of respondents about social support during childbirth and also identify variables that may influence their decisions. Seventy-five per cent of respondents desired companionship in labour. Approximately 86% preferred their husband as companion while 7% and 5% wanted their mother and siblings as support person respectively. Reasons for their desire for social support were emotional (80•2%), spiritual (17•9%), errands (8•6%) and physical activity (6•8%). Socio-demographic variables found to be statistically significant on logistic regression analysis for the desire of a companion in labour were nulliparity (OR 3•57, 95% CI 1•49–8•52), professionals (OR 3•11, 95% CI 1•22–7•94) and women of other ethnic groups besides Yoruba (OR 2•90, 95% CI 1•02–8•26), which is the predominant ethnic group in the study area. Only those with post-secondary education were found to want their husbands as doula (OR 2•96, 95% CI 1•08–8•11). More than half of the respondents wanted information about labour prior to their experience. It is important that Nigerian women are allowed the benefit of social support during childbirth, particularly as there is a lack of one-to-one nursing care and other critical services, including epidural analgesia in labour, at many of the health care facilities in Nigeria. Men could play a pivotal role in the process of introducing support in labour so as to improve the outcome for both the mother and her newbornItem 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 discussedItem Discontinuation pattern of norplant among implant acceptors at the family planning clinic, University College Hospital, Ibadan, Nigeria(2006) Okunlola, M. A.; Owonikoko, K.M; Adekunle, A O. .; Morhason-Bello, I. O.This is a retrospective study of 136 Norplant acceptors. We assessed the reasons for the discontinuation during the prescribed 5-year period of use. The continuation rates for the first, second and third years were 94.1%, 83.8%, and 79.4% respectively. The commonest reason for discontinuation was menstrual irregularities (40.43%) of clients followed by the desire for pregnancy in 29.79%. Contraceptive failure as a reason for discontinuation of Norplant use was not recorded in any of the clients in this series. In conclusion, ii is our belief that to sustain high continuation rates of Norplant use the clients require proper and effective counselling and support on the side effects of irregular bleeding patterns, which when occurs will be better coped withItem Assessment of tubal factor contribution to female infertility in a low resource setting (southwest Nigeria): hysterosalpingography vs laparoscopy(2005) Okunlola, M. A.; Adebayo, O. J.; Odukogbe, A. A.; Morhason-Bello, I. O.; Owonikoko, K. M.