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 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 Emergency obstetric patients in a developing country and prevalence of HIV infection(2009) Awolude, O. A.; Oladokun, A.; Adesina, O. A.; Mutiu, W. B.; Adewole, I. F.The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HTV positive patients were post-test counselled and offered single dose nevirapine tablet (200mg) in labour with syrup given to the baby at birth at 2mg/kg followed by syrup zidovudine for 6 weeks: The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were H3V positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4,7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.Item Emergency obstetric patients in developing countries and prevalence of HIV infection(College of Medicine, University of Ibadan, Ibadan, 2009) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Adewole, I. F.The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HIV positive patients were post-test counselled and offered single dose nevirapine tablet (200 mg) in labour with syrup given to the baby at birth at 2 mg/kg followed by syrup zidovudine for 6 weeks. The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were HIV positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4.7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.