Obstetrics. & Gynecology

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    Guidelines and standard of care manual for managing gynaecological cancers.
    (Ibadan University Press, 2014) Odukogbe, A. A.; Awolude, O. A.; Oluwasola, T. A. O.; Adewole, I. F.; Omigbodun, A. O.
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    Use of amniotic fluid lactate concentration in prediction of dysfunctional labour at the University College Hospital, Ibadan.
    (2023) Tsele, T. A.; Oluwasola, T. A. O.; Bello, F. A.; Yusuf, B. O.; Odukogbe, A. A.
    Introduction: Dysfunctional labour is a common indication for instrumental vaginal delivery or cesarean section. Raised myometrial lactate level following prolonged uterine activities has been shown to cause inhibition of contractions (poor or uncoordinated) and lack of progress or dysfunctional labour. Therefore, determining the amniotic fluid lactate concentration (AFLC) in labour may be a potential biochemical marker for labour dystocia and a good predictor of labour outcome. Methodology: We recruited booked, consenting parturients in active phase of labour into a cross-sectional study between September 2014 and March 2015. Amniotic fluid samples were taken twice – at initial vaginal examination or during artificial rupture of membranes and at delivery while the AFLC was determined using a primed lactate meter. Results: The main outcome measure was the mean AFLC. Of the 113 parturients with mean age of 30.49 ± 4.37 years, the overall mean AFLC was 18.94 ± 4.84 mmol/L while 10 (8.8%) had dysfunctional labour. Mean AFLC for parturients who had vaginal delivery was 18.76 ± 4.90mmol/L and 17.42 ± 5.26 mmol/L at first and second samplings while for those who had cesarean deliveries, mean AFLCs were 20.80 ± 2.75 and 18.24 ± 3.59 at the two samplings respectively. The cut–off for AFLC that best discriminated between normal and dysfunctional labour was 19.80 mmol/L. Conclusion: High levels of AFLC may play a role in predicting dysfunctional labour among pregnant women in labour.
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    Bilateral ovarian serous cystadenocarcinoma in a teenager: a case report.
    (2017) Oluwasola, T. A. O.; Abdusalam, R. A.; Okolo, C. A.; Odukogbe, A. A.
    Background: Genital Chlamydial trachomatis infection, though often asymptomatic, is an established indirect causative agent of female infertility via its activities on the tubal physiology. Many risk factors are postulated for its acquisition and the main thrust of this study was to establish the organisms’ correlates among infertile women attending gynaecologic clinic in Ibadan. Methods: A systematic sampling technique was used on each selected day to recruit women who met the inclusion criteria into the study using a sampling frame of 2. Interviewer-administered questionnaires were used to obtain attributes considered as risk factors for acquiring genital Chlamydia trachomatis infection from 150 consenting infertile women between January and November 2015. These attributes included sexual history, social status, alcohol intake and past history of sexually transmitted infections (STIs). Blood samples and endocervical swabs were subsequently taken for detection of C. trachomatis infection using polymerase chain reaction (PCR). Data analysis was done using SPSS version 20.0. Results: The mean age of the respondents was 34.1±5.6 years and 7.30% were positive for C. trachomatis. Chlamydia trachomatis infection was significantly associated with past history of gonorrhoea, history of multiple sexual partners, husband that has other sexual partners and lifetime sexual partners greater than one. Conclusions: The prevalence of asymptomatic C. trachomatis among infertile women indicated the pathogen as a potential aetiologic agent of female infertility and supported the asymptomatic nature of the infection. The risk factors found to be associated with the organisms’ infection lend out further support to the sexual transmissibility of C. trachomatis.
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    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.
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    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.
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    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.
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    Utility of serum cystatin C as a predictive marker for preeclampsia in pregnant Nigerian women
    (Society of Gynaecology and Obstetrics of Nigeria (SOGON), 2019) Oluwasola, T. A. O.; Adedapo, K. S.; Odukogbe, A. A.; Olayemi, O. O.
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    Germ cell tumours
    (G-Pak Limited, Accra., 2017) Odukogbe, A. A.; Oluwasola, T. A. O.
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    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.
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    Serum adiponectin levels in normotensive and pre-eclamptic women at the University College Hospital, Ibadan, Nigeria
    (College of Medicine, University of Ibadan, Nigeria, 2018) Akinpelu, O. M.; Bello, F. A.; Awolude, O. A.; Adetayo, C. O.; Akinwunmi, B. O.; Odukogbe, A. A.
    Background: Adiponectin is a hormone produced mainly by adipocytes. The levels of adiponectin are inversely related to insulin resistance, hypertension and obesity. Physiological insulin resistance is exaggerated in pre-eclamptic women. The objective of the present study was therefore to compare serum adiponectin levels in pre-eclamptic patients and normotensive patients. Methods: This prospective study was conducted among one hundred and twenty women. Purposive sampling technique was used to select all consenting participants, consisting of sixty pre-eclamptic patients as cases and sixty normotensive pregnant women at comparable gestational age as control. Concentration of serum adiponectin was measured by using enzyme linked immunosorbent assay (ELISA) method. Results: Serum levels of adiponectin were significantly higher in the pre- eclamptic group(p<0.001). Body mass index was also significantly higher in women with pre eclampsia (p<0.01).In the pre-eclamptic patients, serum levels of adiponectin showed a weak negative correlation with BMI (r= -0.16, p= 0.22) and no correlation was found in normotensive patients. Conclusion: This study showed a clear distinction in the serum adiponectin concentration between preeclamptic and normotensive pregnant women. The impact of BMI on serum adiponectin in both groups also differs. Therefore, serum adiponectin may be useful in predicting pre-eclampsia.