Obstetrics. & Gynecology
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Item 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.Item The challenges of single-short spinal anaesthesia for caesarean section in a morbidly obese patient: a case report(2005-10) Danladi, K. Y.; Sotunmbi, P. T.; Awolude, O. A.; Obisesan, K. A.An unusual case of morbid obesity, severe hypertension and twin gestation at 36weeks in an unbooked multigravid patient was presented for cesarean section. She was referred from a private clinic to the obstetric emergency unit of the University College Hospital, Ibadan with history of hypertension in pregnancy. She was a known hypertensive for ten years and her blood pressure was poorly controlled due to non-compliance with medications and medical check-up. She had been having progressive visual loss over the ten year period and had lost three, previous pregnancies. Following comprehensive clinical and radiological evaluation, she had a carefully planned single-shot spinal anaesthesia for cesarean delivery of a set of twin which was performed on a double operation table. She remained stable throughout the procedure and post operative period.
