Obstetrics. & Gynecology
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Item 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 Profile of women seeking fetal gender at ultrasound in a Nigerian obstetric population(British Medical Ultrasound Society, 2008) Ekele, B. A.; Maaji, S. M.; Bello, S. O.; Morhason-Bello, I.O.Objective: To determine the proportion of women that wanted to know fetal gender at ultrasound, characterize them and document reasons for wanting to know fetal gender. Methodology: A cross-sectional study on consecutive pregnant women at 20 weeks or more gestation that presented for prenatal ultrasound at a private hospital in Nigeria from May to December 2005. Results: Of the 1135 women, 167 (14.7%) sought to know the fetal gender. Significant independent factors included ethnic group, as women from the predominant Hausa–Fulani were less likely when compared to those of other ethnic groups (OR: 0.4, 95% CI: 0.2–0.7). Women with tertiary education were 6.6 times (OR: 6.6, 95% CI: 3.3– 13.2) more likely. Women with a previous male baby were 30.6 times more likely (OR: 30.6, 95% CI: 13.6–68.5), while those with previous female baby were 54.3 times more likely (OR: 54.3; 95% CI: 23.4–125.8) to seek fetal gender. Main reasons for seeking fetal gender were preference for a particular fetal gender (57%); what wears to buy for the baby (24%) and curiosity (18%). Conclusion: About 15% of the study group requested to know fetal gender and it was associated with ethnic group, maternal educational level and gender of the previous baby. The most common reason for wanting to know fetal gender was the desire for a particular genderItem 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 Maternal tetanus at the university college hospital in Ibadan Nigeria: a 15-year retrospective analysis(2008-03) Roberts, O. A.|; Morhason-Bello, I.O.; Adedokun, B. O.; Adekunle, A. O.Objective To determine the characteristics of women with maternal tetanus, pattern of presentation and outcome of management. Methods A total of 19 women were managed with maternal tetanus between 1990 and 2005 from the University College Hospital in Ibadan Nigeria. A retrospective study was performed. The medical records of all women managed as a case of maternal tetanus were retrieved from the central record department of the hospital. The pattern of presentation, characteristics of women, the duration of hospital admission, tetanus toxoid immunization, and outcome of care were measured. Results The records of 18 women managed were analyzed. The mean age at presentation was 25.2 ± 5.3 years. The patients were mostly single, nulliparous and had primaryschool education. The maternal tetanus cases seen mainly complicated induced abortion while 5 and 2 other cases were due to childbirth complication and leg wound respectively. The portal of entry of the remaining 3 cases could not be ascertained. None of the patient managed had complete immunization schedule. The average duration of admission was 11.2 ± 6.7 d. Five women had intensive care with 3 of them requiring ventilatory support. The case fatality rate was 66.7%. The only factor that significantly improved survival was presence of generalized spasm at presentation (P=0.006) Conclusion The occurrence of maternal tetanus is a reflection of low quality of health care delivery and lack or inefficient routine immunization coverage in any communityItem Awareness and desirability of the Nigerian antenatal women about analgesia use during childbirth(2007-12) Oladokun, A.; Morhason-Bello, I.O.; Eyelade, O. R.; Adedokun, B. O.; Akinycmi, J O.; Adewole, I. F.Item Local anesthesia: An appropriate technology for simple fistula repair(Elsevier Ireland Ltd., 2007) Ojengbede, O.A.; Morhason-Bello, I.O.Objectives: To assess the efficacy of local infiltrative anesthesia with lidocaine hydrochloride in patients undergoing the surgical repair of a simple vesico-vaginal fistula. Methods: The study was carried out with 21 patients undergoing the repair of a simple midvaginal vesico-vaginal fistula. The patientsT perception of pain was evaluated intraoperatively. Results: Most patients indicated that the anesthetic agent provided adequate analgesia, and all fistulas were repaired successfully without postoperative complications. Conclusion: Repairing simple vesico-vaginal fistulas is feasible with a local infiltrative anesthetic