Open Access Minireview Article

Poisson Regression Modeling of Pregnancy Related Death in Oyo State, Nigeria

Obubu Maxwell, Afeez Mayowa Babalola, Chukwudike Nwokike

Asian Journal of Pregnancy and Childbirth, Page 1-5

Worldwide, Over 600,000 maternal deaths are recorded annually. Many women die due to pregnancy associated complications in Nigeria. Thus, this paper seeks to explore the application of poisson models in the study of incidence of pregnancy related death in Oyo state, Nigeria. The paper explores the application of poisson models in the study of maternal deaths. Understanding the incidence of maternal deaths may provide useful information to policy makers for the development of actionable plan to improve maternal health policies and its implementations. The analysis was based on data sourced from the records unit of the hospital for the period of 2009-2018. Within the 10 year period, a total of 1121 maternal death was observed, with the years 2016 and 2017 recording the highest deaths of 136 and 148 respectively. Also, the mean incidence of maternal deaths remained approximately the same over the period. Based on the result from our analysis, we recommend that management and government reevaluate all existing intervention programs for reducing maternal deaths since they seem not to have yielded the expected results over the past ten years (2009 - 2018) reference to this general hospital.

Open Access Original Research Article

Prevalence of Abortion and Neonatal Death and Its Relation to Congenital TORCH Infections in the Departments of Gynaecology and Obstetrics and Neonates of Benghazi Medical Centre from 2014 to 2018

Samia Abd-elgawad, Huda Mohamed

Asian Journal of Pregnancy and Childbirth, Page 1-9

Background: TORCH infection is responsible for the major of maternal and fetal morbidity and mortality in the pregnancy because of their ability to generate congenital defects. It transmits to foetus from the mother during gestation or delivery time and leads to serious complication to the foetus. It can lead to abortion, congenital anomalies and intrauterine fetal death. In fact, the most effective way to prevent the infection is a regular hand washing, particularly when caring for infected women and babies. The aim of this study is to assess the relationship between the rate of abortion and foetus death and TORCH infection as a major cause.

Methods: The data was collected from neonatal death certificates from the departments of gynaecology, obstetrics and neonates at Benghazi Medical Centre, which includes age groups, and causes of death, the data included all certificates from October 2014 to December 2018.

Results: The current study had showed that there was a significant elevation in the fetal and infant mortality rates from 2014 to 2018, and these numbers were increasing throughout the years without any medical reasons. High foetus death was observed at gestational period 33 -40 weeks, while the neonatal death was higher at age 1 to 30 days. Furthermore, this study reported that head and brain congenital anomalies were the most common between foetus and neonates and these findings were assumed that the death of the foetus and neonate could be caused by any of TORCH infections when compared to the previous studies.

Conclusion: Elevation rates of neonates and foetus were an obvious issue that must be of major concern, so that, the findings of this study emphasizing on the demand for doing TORCH test for all pregnant women at the first of pregnancy to early recognizing the infection. In addition, it is ensuring the demands of doing the TORCH test with the required HIV and hepatitis C tests before delivery to guide the staff take further attention. In addition, it emphasizes the need to focus on the effectiveness of hand hygiene, cleaning and disinfection in the department to reduce the rate of infection.

Open Access Original Research Article

An Uncommon Cause of Antepartum Haemorrhage: A Case Study

John Osaigbovoh Imaralu, Atinuke Olukemi Olaleye, Adeola Ajose, Kolawole Aramide

Asian Journal of Pregnancy and Childbirth, Page 1-6

Aim: To highlight the potential for benign lesions of the cervix uteri to present in bizarre unexpected ways during late pregnancy and the need for cautious evaluation to ensure optimal treatment is given, especially when life-altering decisions need to be made.

Presentation of Case: We present here a literature review and a case of 25 year old primigravida with twin gestation and antepartum hemorrhage (APH) initially thought to be due to cervical cancer but which turned out to be caused by chronic cervicitis.

Discussion: Obstetric hemorrhage remains the commonest cause of maternal mortality and morbidity in Nigeria. The occurrence of APH portends grave risks to the fetus and mother. A high risk of prematurity exists when bleeding occurs before term; a further risk of caesarean hysterectomy exists when a diagnosis of cervical cancer is suspected in women with APH. Infective cervical lesions such as cervicitis have been reported as causes of antepartum hemorrhage, but they are not significant enough to determine or affect obstetric outcome. Chronic cervicitis presenting as heavy antepartum hemorrhage leading to preterm delivery is a rare occurrence.

Conclusion: Infective lesions of the cervix are important benign causes of antepartum hemorrhage; the ability of chronic cervicitis to mimic exophytic cervical cancer is a consequence of physiologic changes in pregnancy which should be considered during patient evaluation. Cautious patient assessment should be done to ensure optimal care is given without undue risk to the fetus or mother.

Open Access Original Research Article

Is There a Relationship between Repeat Induced Abortion and Current Use of Contraception among Women in the Reproductive Age? A Study in Ghana

Michael Boah, Timothy Adampah, Dominic Achinkok

Asian Journal of Pregnancy and Childbirth, Page 1-11

Aims: Some women in the developing world use abortion to regulate fertility and space childbearing. However, repeat induced abortion has become common and it’s linked to increased risk of adverse outcomes in future pregnancies. The aim of this study was to determine the relationship between repeat induced abortion and current use of contraception among women in Ghana.

Study Design: A secondary analysis of cross-sectional survey data.

Place and Duration of Study: The study was conducted in Ghana between July 2019 and August 2019.

Methodology: Data on a weighted sample of 4595 women aged 15-49 years with a lifetime history of induced abortion from the 2017 Ghana Maternal Health Survey were analysed using Chi-square (χ2) test and multivariable survey logistic regression in STATA/IC 15.0. Statistical significance was set at the 5% level. The adjusted odds ratio was estimated.

Results: Out of 4595 women, 1591 (34.6%) experienced repeat-induced abortion. Current use of contraception was 36.7% (CI: 34.7-38.7). The majority used modern contraceptives (78%). The commonly used methods were injectables (20.3%), implants (19.7%), pills (16.6%) and rhythm (16.2%). After adjusting for potential confounding, repeat induced abortion was not significantly associated with current use of contraception. However, age, marital status, place of residence and ecological zone of residence were associated with current use of contraception. For instance, rural women with a history of repeat induced abortion were 1.3 times (AOR=1.27, 95% CI: 1.02-1.59, p=0.036) more likely to be on contraception compared to urban women.

Conclusion: Women’s previous abortion experience was not independently associated with their current use of contraception. Other factors were significantly associated with women’s use of contraception post-abortion. Further research is recommended to clearly understand this phenomenon among Ghanaian women in the reproductive age group.

Open Access Original Research Article

Determinants of Quality Antenatal Care in a Peri-Urban Hospital, Ghana: An Application of the Content and Timing of Care in Pregnancy (CTP) Tool

Janet Vanessa Baafi, Michael Rockson Adjei, Annick Nouffan Gladzah, Maurice Kofi Dola, Frederick Duah, Timothy Sewornu Letsa, Alfred Yawson

Asian Journal of Pregnancy and Childbirth, Page 1-10

Aims: To assess the quality of antenatal care and determine factors influencing access to quality care at the Holy Family Hospital, Nkawkaw in the Kwahu West Municipality of Ghana.

Study Design: A facility-based cross-sectional study.

Place and Duration of Study: Postnatal clinic of Holy Family Hospital, Nkawkaw, from July to September 2016.

Methodology: Four hundred postnatal clinic attendants age 15-49 years were selected consecutively for the study. Quality of antenatal care was classified according to the Content and Timing of care in Pregnancy (CTP) tool developed by Beekman et al (2011). Logistic regression was used to determine predictors of acceptable quality care. Results were presented as adjusted odds ratio at 95% confidence level.

Results: Approximately 66% of respondents received acceptable quality of care. Being a trader (AOR=4.1, 95%CI: 1.7-10.0); having had three or four births (AOR=2.0, 95%CI: 1.1-3.6) and having a partner with secondary education (AOR=4.6, 95%CI: 1.9-11.0) were significantly associated with receiving acceptable quality of care.

Conclusion: Although 66% of the respondents accessed acceptable quality of care, the hospital has the capacity to provide quality care to all women attending its antenatal clinic. Community-based Health Planning and Services; mobile phone text messaging to remind pregnant women of appointments; and domiciliary midwifery services could be part of effective strategies to address gaps in quality antenatal care.