Obstetrics. & Gynecology
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Item Pregnancy outcomes in women with sickle cell disease at a tertiary hospital in Nigeria: a five-year retrospective study(Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, 2024) Olukunle, T. A.; Ogunbode, O. O.; Abdus-salam, A. A.Background: Sickle cell disease (SCD) in pregnancy constitutes a high-risk pregnancy, associated with increased risk of adverse outcomes. Objective: To describe the outcome of pregnancy in SCD women managed at the University College Hospital, Ibadan, Nigeria. Materials and Methods: A retrospective review of the health records of sixty-three SCD pregnant women managed between January 1, 2016, and December 31, 2020. The information extracted included sociodemographic and obstetric characteristics, clinical presentations, mode of delivery, maternal and fetal outcomes. The data was analyzed using the IBM Statistical SPSS Statistics for Windows, version 23.0. The test of association was done using Chi-square and level of significance was p<0.05. Results: Prevalence of SCD in pregnant women was 0.65%. Mean age was 28.8±4.1years, 63.5% were haemoglobin SS while 36.5% were haemoglobin SC. Most of the women had tertiary education (61.8%) and booked for antenatal care (ANC) (60%). About 72.4% delivered at term while 46.1% had caesarean delivery. Most common complication was anaemia (79.4%) while vaso-occlusive crisis was the most common type of crisis (55.6%). Most of the women (92.5%) had live-birth with 15.2% of neonates requiring Neonatal Intensive Care Unit (NICU) admission. Maternal death rate was 6.3%. Good maternal and fetal outcomes occurred in 71.4% and 61.9% of participants respectively. Good maternal outcome was significantly associated with tertiary education(p=0.01). Good fetal outcome was associated with tertiary level of education(p=0.04) and multigravida status(p=0.03). Conclusion: SCD pregnant women have good fetal-maternal outcomes, however not receiving ANC and lower level of education were associated with poor pregnancy outcomes. Health education, access to ANC, prompt diagnosis, treatment of complications and multi-disciplinary team management will improve the pregnancy outcomes.Item Intravenous acetaminophen in a faith-based hospital in Nigeria: A randomized trial of a labor analgesic.(Association of Fetomaternal Medicine Specialists of Nigeria (AFEMSON), 2024) Oyeyiola M. P.; Ogunbode O. O.; Ogunbode A. M.; Arowojolu A. O.Background: The undesirable maternal and neonatal side effects of opioid analgesics, and less ready availability and affordability of epidural analgesia in resource poor settings has necessitated the search for a safe, efficacious, affordable and readily available labor analgesic. Aim: To determine the efficacy, safety and acceptability of intravenous acetaminophen as an intra partum analgesic. Methods: A randomized controlled double-blinded study involving 162 consenting pregnant women in labor, assigned to two groups, each receiving either 900mg of intravenous acetaminophen or an equal volume of normal saline. The Numeric Rating Scale and Likert scale were used to measure the degree of pain experienced and the level of acceptability. Data was analyzed using IBM SPSS Statistics for Windows, version 24.0. The student’s T-test, Chi-square test (χ2), Hazard ratio and Mann-Whitney U test were used to test associations with level of statistical significance set at p < 0.05. Results: At 15, 60-, 120-, 180- and 240-minutes post-administration of medications, there was a statistically observed significant difference between the pain scores of women in the two groups (t = 3.71, 7.58, 9.45, 9.48, and 9.18 respectively, p < 0.001). The participants in the acetaminophen group had better pain relief than those in the placebo group (Hazard ratio = 0.51; 95% CI: 0.35 – 0.73; p < 0.001). There was no significant difference between the two groups in terms of side effects of administered agents. The difference between the maternal level of acceptability of acetaminophen and placebo as labor analgesia was found to be statistically significant (χ2 = 72.981, p < 0.001). Conclusions: In poor resource settings, intravenous acetaminophen is an effective alternative labor analgesic agent with no adverse maternal and neonatal side effects.Item Male involvement and factors influencing choice of contraception among market traders in an urban city in Southwest Nigeria(College of Health Sciences, University of Ilorin, Nigeria, 2024) Fakorede, E.O.; Ogunbode, O.O.; Ogunbode, A.M.; Okunlola, M.A.The study assessed the determinants of contraceptive choice and use as well as to examine the perceived impact of male involvement in contraception among market traders. A mixed method cross-sectional study conducted among 489 traders in four Local Government areas in Ibadan, Nigeria, using a structured questionnaire developed by the researchers and in-depth interviews with multi-staged sampling technique. The mean age of participants was 36.1 +8.4 years, with mean parity of 3.8± 1.5. Female traders represented 49.3% (241) while 50.7% (248) were males. Most, two hundred and twenty participants (45.0%) were from Bodija market. Majority (84.1%) were married and consisted mostly of Yoruba (92.4%) ethnic group. Awareness of contraception was high (89.9%) and the most common source was the health facility (366; 74.9%), however, only 41.1% were using modern contraception. Ease of use was the primary determining factor (48.2%) while partner's refusal (28.1%) was the major reason against use of contraception. Among the female participants, 119 (49.4%) stated that their partner had stopped them from using contraceptives in the past and 124(51.1%) reported positive male involvement and support for contraceptive use. There was high level of awareness of contraception, yet uptake and utilization are low. Also, men play a significant role in determining choice so there is need for health education on family planning targeted towards men.Item Antenatal care utilisation among adolescent mothers in Ngozi Province, Burundi(Wolters Kluwer ‑ Medknow, 2024) Iradukunda, L. I.; Ogunbode, O. O.; Arulogun, O. S.Background: Globally pregnancy and childbirth complications are the leading cause of death among adolescents, with evidence showing that antenatal care (ANC) is a very effective preventive intervention. In Burundi, there is limited information on the extent to which pregnant adolescents utilise such services. Objective: To assess the ANC utilisation and factors associated with its use among adolescent mothers in Ngozi Province, Burundi. Materials and Methods: A cross-sectional, health facility-based study among 216 adolescent mothers who had given birth within two years preceding this study, using structured questionnaires and records from previous ANC booklets. A multistage random sampling technique was used to select respondents while the utilisation of ANC was determined by the frequency of ANC visits and the time when the women enrolled for the first ANC visit. Results: The majority (98.1%) of adolescent mothers in Ngozi Province used ANC services. Most respondents (64.8%) initiated ANC services within the first trimester while 57.8% attained the minimum of four recommended ANC visits. Marital status (P = 0.001), geographical location (P = 0.009), occupation of the partner (P = 0.002) and type of the last pregnancy (P = 0.012) were associated with ANC initiation within the first trimester while marital status (P < 0.001), respondent’s employment (P = 0.003) and type of last pregnancy (P < 0.001) were associated with appropriate ANC frequency. Conclusion: This study revealed a high use of ANC services among adolescent mothers, although more than one-third attended ANC late. There is therefore the need to put more effort into improving early booking for ANC.Item Prevalence of precancerous lesions and other cervical abnormalities among internally displaced women in Benue State Nigeria(Pan African Medical Journal(PAMJ), 2024) Ngwibete, A.; Ogunbode, O.; Swende, L. T.; Agbada, M. M.; Omigbodun, A.Introduction: visual inspection is a low-cost screening strategy that can be used to prevent cervical cancer in women. These techniques can improve screening health outcomes for internally displaced women (IDW) who have poor sexual and reproductive health and rights' behaviors and outcomes. This study aimed to determine the prevalence of precancerous lesions and other clinical features using a visual inspection with acetic acid (VIA) technique during a cervical cancer screening campaign in two internally displaced people (IDP) camps in Benue State, Nigeria. Methods: this was a cross-sectional study of 166 IDW who voluntarily participated in the study during a VIA cervical cancer screening campaign in two IDP camps in Benue State, Nigeria the screening was done by a group of qualified and trained healthcare workers and data was collected using a structured, pretested questionnaire. Results: a total of 99(60%) of the women had a first sexual experience at 16 years, while 78(47%) had more than 5 full-term pregnancies. Although only 72(43.4%) of the women acknowledged having more than one sexual partner, over 70% of the women stated that their sexual partner had another sexual partner. The prevalence of precancerous lesions among women was 10.8%. Smoking(p=0.003), age at menarche (p≤ 0.001) and sexual behaviors (p=0.009, p=0.004) were factors that had a statistically significant relationship with the presence of a precancerous lesion among the IDW. The study also highlights the high rate (95%) of cervicitis among the women and the relatively high rate (5.4%) of leukoplakia. Conclusion: the majority of IDW had sociodemographic and lifestyle characteristics that predisposed them to developing cervical cancer More targeted interventions aimed at improving the sociodemographic and lifestyle characteristics of IDW are recommended. In addition, there is a need to create awareness about cervical cancer among IDW and make screening available in camp facilities for early detection and management.Item Serum copper, zinc an selenium levels in women with unexplained infertility in Ibadan Nigeria: a cross-sectional analytical study(Wolters Kluwer - Medknow, 2023) Adeniyi, A. A.; Ogunbode, O. O.; Adeyanju, A. S.; Oladokun, A.Background: Infertility is a global public health issue affecting couples. Trace metals have been implicated in effective reproductive functions in males but less studied in females. Objective: To compare the serum levels of copper (Cu), zinc (Zn), selenium (Se) and copper/zinc ratio in women with unexplained infertility and fertile women. Subjects and Methods: This was a cross-sectional analytical study that compared 75 consenting women who had unexplained infertility with 74 fertile women that were controls. Both groups were seen within 1 year of delivery and were recruited from the family planning unit, at the University College Hospital, Ibadan. Data were obtained through a semi-structured questionnaire, after which 10 mL of venous blood was collected. Analysis of selected trace elements were done by atomic absorption spectrophotometry. IBM SPSS version 23 was utilized for data analysis and the levels of statistical significance was set at <0.05. Results: The mean (±SD) serum concentrations of Cu (93.11 ± 16.55 μg/dL), Zn (72.04 ± 15.03 μg/dL) and Se (28.28±8.33 μg/dL) amongst the women with unexplained infertility were lower when compared to the control group (all with P<0.001). The serum Cu/Zn ratio was higher among the fertile women, though not statistically significant (P<0.62). Age of <35 years was associated with normal serum levels of Cu (P<0.01), while women with normal body mass index had low serum concentrations of Cu (P=0.04), amongst the fertile group. Conclusion: Serum copper, zinc and selenium concentrations are significantly lower in women with unexplained infertility, therefore diets or supplements containing these trace elements may be helpful in their management.Item Reproductive health challenges among women in internally displaced camps in Benue State: a protocol for a community-based health education interventional study.(Women's Health and Action Research Centre (WHARC), 2023-10) Ngwibete, A.; Ogunbode, O.O.; Oluwasola, T. A. O.; Omigbodun, A. O.Sexual and reproductive health (SRH) services are a necessity for marginalized persons such as the displaced. The protocol describes an intervention that can contribute to overcoming challenges associated with SRH service delivery of three selected reproductive health (RH) services: HIV/AIDS, contraception, and cervical cancer screening. A pre-and post-intervention approach will be used to evaluate the effect of an intervention with trained Community-Based Reproductive Health Personnel (CBRHP) and/or mHealth technology within the selected IDP camps. Three (3) months of health education through the CBRHP and/or via mHealth technology will be provided. Using a questionnaire, interviews, and Focus Group Discussion (FGD) guide, the researcher will assess the suitability of this intervention to attain the objectives. Data analysis will be done with SPSS version 26. Univariate analysis will include mean and standard deviation, bivariate analysis will include a chi-square test of goodness for the association of variables, and McNemer’s test to evaluate the effect of the intervention by comparing consistency in response across the variables under study. Multivariate analysis will be used to assess if sociodemographic, knowledge and health service impacts access and use of RH services. For qualitative analysis, findings will be grouped into themes. The outcomes of each theme will be used to complement the findings of the quantitative analysis. The primary outcome measures will include the level of knowledge of SRH, the number of people who want to access RH services and which RH services are most sought by the respondents. If the use of CBRHP is successful, there will be an increase in knowledge and use of HIV/AIDS, contraception and cervical cancer services. Challenges associated with access and uptake of RH services will also be assessed. (Afr J Reprod Health 2023; 27 [10]: 133-144).Item Displaced women and sexual and reproductive health services: exploring challenges women with sexual and reproductive health face in displaced camps of Nigeria.(Hamadan University of Medical Sciences., 2023) Ngwibete, A.; Ogunbode, O.O.; Mangalu, M.A.; Omigbodun, A.O.Background: Displaced women are affected by sexual and reproductive health (SRH) challenges, often exacerbated by poor living conditions, limited access to healthcare, and cultural norms. The aim of this study was to explore SRH issues, the effects of displacement into camps on women’s SRH, and challenges with accessing and utilizing SRH services among women in camps for the displaced in Benue State, Nigeria. Methods: A qualitative phenomenological approach was employed to gain an in-depth understanding of the women’s SRH challenges, based on 12 focus group discussions between women of different age groups and eight in-depth interviews. The data were collected using tape recorders and notes. Data analysis followed a thematic approach. Ethical approval and appropriate consent were obtained for the study. Results: The majority of research participants stated that sexually transmitted disease/human immunodeficiency virus was the most serious SRH issue in the camp. Their stay in camp enhanced the women’s vulnerability and exposed them to sex in exchange for basic needs/palliatives, increasing their SRH challenges. Access to and use of SRH services were impacted by their migratory lifestyle, cultural and religious views, lack of SRH knowledge, and other difficulties. Short-term approaches to intervention, health providers’ poor communication, and attitudes were reported to affect SRH service use. Conclusion: There is an urgent need for comprehensive interventions to address SRH challenges among women in displaced settings, including proper coordination of humanitarian services, education on transactional sex, encouragement of men to participate in SRH initiatives, and expansion of access to services, as well as the training and hiring of culturally competent healthcare providers.Item Consequences of type-2 diabetes mellitus and malaria co-morbidity on sperm paraters in men: a case-control study in a district hospital in the Ashanti region of Ghana(Public Library of Science (PLOS), 2023-09) Abdulai, R.; Akwetey, S. A.; Ogunbode, O.O.; Aboagye, B.Type-2 diabetes mellitus (T2DM) and malaria infection are highly prevalent in Africa particu- larly, in the Sub-Saharan Region. A greater number of people in the Ghanaian population who have T2DM are also reported to harbor malaria parasites. This study aimed to investi- gate the influence of T2DM & Malaria co-morbidity on sperm parameters among patients in the Ashanti Region of Ghana. This hospital-based cross-sectional analytic case-control study comprised 254 adult male study participants comprising 80 T2DM & Malaria co-mor- bidity, 80 T2DM only, and 94 normal controls. A blood sample (10mL) was drawn from each participant to measure FBG, HbA1c levels, Testosterone levels, Total cholesterol, and determination of Malaria parasite density. Seminal fluid was also collected from each partici- pant for semen analysis. Sperm kinetics of the T2DM & Malaria co-morbidity group particu- larly; total motility, rapid progressive motility, and slow progressive motility were negatively affected compared to both T2DM only (p<0.0001) and the Normal control (p<0.0001). Nor- mal sperm morphology was significantly affected in the co-morbidity group compared to T2DM only (p<0.0001). Sperm vitality was also statistically significantly reduced in the T2DM & Malaria co-morbidity than in T2DM only (t (4)=-8.62; p<0.001). There was a signifi- cant decline in testosterone levels in the T2DM & Malaria co-morbidity group than in the T2DM only (p<0.0001) and the control (p <0.0001). In conclusion, T2DM and malaria infec- tion have a stronger propensity to alter sperm morphology and lower sperm motility and vitality.Item Knowledge, attitude and readiness to use contraceptives among postpartum women at a tertiary hospital in Southwest Nigeria(Zambia Medical Association, 2023) Olukunle, T.A; Ogunbode, O.O.; Abdus-salam, A.A.Background: Postpartum family planning is vital in the prevention of unintended pregnancy and closely spaced pregnancies in the first year post-delivery. This study was designed to examine the postpartum women's knowledge, attitude, belief and readiness to contraceptive use. Methods: This descriptive cross-sectional study was conducted among one hundred and ninety-four consenting women, six weeks post-delivery, at the University College Hospital, Ibadan, Nigeria using an interviewer-assisted structured questionnaire. Data was analysed using IBM Statistics for Windows Version 23.0. Tests of association was done using chi-square and statistical significance was set at p-value of < 0.05. Results: Many of the respondents (60.8%) were in the age group 30-39 years and the majority (90.3%) had tertiary level of education. Most of the respondents got their information from health talks at antenatal clinic (42.8%) and health workers (42.3%).The majority (82.5%) of respondents were aware of contraception and 157(80.9%) intended to use contraceptives. The most preferred contraceptive methods were implants (19.1%). Respondents with three or more children alive(p=0.001), had statistically significant associations with prior use of contraception while those with the tertiary level of education(p=0.001), of the Christian religion (p=<0.001) and had contraceptive counselling during pregnancy (p=0.031)had statistically significant associations with good knowledge of contraception. Conclusion: The knowledge and readiness to use contraceptives was high but only about half were willing to adopt contraception post-delivery. There is therefore the need for the enactment of government policy and legislation that will ensure wide coverage and availability of contraception counselling among pregnant women.