Open Access Short Research Article

A Study to Analyze the Incidence, Risk Factors and the Treatment Outcomes in Retinopathy of Prematurity in a Tertiary Care Setup - Case Study

Mridula V. Amarnath

Asian Journal of Pregnancy and Childbirth, Page 52-55

Aim: To study the association between the incidence, risk factors and treatment outcomes in retinopathy of prematurity.

Methodology: A longitudinal observational study was done among 70 babies who fulfilled the criteria for ROP screening at a tertiary care center.

Results: Out of the 70 babies that were screened at our hospital, 25 babies developed some stage of ROP with 10 babies developing Type 1 ROP. It was noted that the mean birth weight, mean gestational age and the duration of oxygen therapy was significantly associated with the development of ROP (P= 0.045,P<0.001 and P<0.001 respectively). Of the 25 babies with ROP, zone 3 was involved in 14 babies and zone 2 was involved in 11 babies.7 babies had stage 1,10 had stage 2 and 8 babies had stage 3. Of the 25 babies with ROP, 12 babies required treatment with laser photocoagulation and all the babies showed regression of ROP following treatment.

Conclusion: Birth weight less than 1.70 kg, gestational age <32 weeks and oxygen therapy were associated with the development of ROP and ROP regressed with laser treatment.

Open Access Original Research Article

Prevalence and Ultrasound Presentations of Polycystic Ovarian Syndrome in Black African Women Presenting with Infertility: A Case of Women in Referral Health Institutions in Bulawayo, Zimbabwe

Joy Mavondo, Greanious Alfred Mavondo, Francis Farai Chikuse, Blessing Nkazimulo Mkhwanazi, Precious Mdlongwa, Bigboy Tendai Rakata

Asian Journal of Pregnancy and Childbirth, Page 1-17

Introduction: Polycystic ovarian syndrome (PCOS) is an endocrine abnormal condition in women of childbearing age with associated health risks, infertility, diabetes mellitus, endometrial hyperplasia and cardiovascular complications. Ultrasound imaging reporting incidences of PCOS requires continued exploration and updating as the disease profiles tend to continuously evolve due to fluctuating environmental factors, heterogenous population migration as seen in Bulawayo, Zimbabwe and other parts of the world. There are no known past or recent studies that have described ultrasound imaging of PCOS incidences and the prevalence of PCOS in Bulawayo. This study sought to determine the association between factors contributing to prevalence of PCOS and their association with ultrasound presentations in women with infertility in Bulawayo, Zimbabwe aimed at improving diagnostics algorithms of the disease.

Materials and Methods: Equal invitations to participate in the study were issued at hospital-based study centres. A cross-sectional survey was conducted. Informed and consenting participants from Mpilo Central Hospital, United Bulawayo Hospital and Imagegate Diagnostics Centre, who were presenting with menstrual irregularities, acne, hirsutism and infertility, were recruited. Participants age ranged from 15-45 years. All participants had their demographics collected using questionnaires. Body mass index, waist-hip ration, clinical presentations and pelvic transabdominal ultrasound scan survey were determined.

Results: Participants were grouped into age groups 15-24 years, 25-34 years, 35-44 years. Polycystic ovaries presented as 10 or more 2-9 mm ovarian follicles with mean ovarian volume ≥ 10 cm3. In establishing the diagnosis of polycystic ovaries, the criterion of 10 or more 2-9 mm ovarian follicles were found to have the highest representation in the 25-34-year age group. The study showed 30.4% of the clients had polycystic ovaries while 46.4% showed other pelvic pathology and the rest, 23.2% had normal pelvis scan results. The prevalence of polycystic ovaries was significantly higher in 25-34 year age sub-group. Acne and hirsutism were significantly associated with positive ultrasound imaging results for PCOS.

Conclusion: The study updated information on PCOS as seen on ultrasound in women in Bulawayo. All women of childbearing age presenting with infertility and clinical signs of hyperandrogenaemia (e.g. hirsutism, acne) should be screened for polycystic ovaries as part of a women wellness program. Furthermore, it is recommended that sonologists and sonographers be aware of the ultrasound criteria for polycystic ovarian syndrome in women of child-bearing age.

Open Access Original Research Article

Prevalence and Intensity of Intestinal Helminths among Pregnant Women Attending Antenatal Clinic in Ebonyi State Nigeria

C. A. Imakwu, J. C. Ozougwu, J. E. Eyo, O. P. Okeke, G. U. Amana, S. C. Eziuzor, J. E. Ekeleme, M. I. Aniekwe

Asian Journal of Pregnancy and Childbirth, Page 18-30

Aim: This present study was conducted to determine the prevalence and intensity of intestinal parasites among pregnant women attending antenatal clinics in Ebonyi State Nigeria.

Methodology: The study was carried out from April 2011 to March 2012 at two purposively selected hospitals in Ebonyi State, Nigeria. Three hundred and sixty pregnant women were randomly selected for this study. Stool samples were examined for intestinal helminths using macroscopic and the microscopic methods. The intensity of the ova was determined directly and graded. Data analysis was performed using Statistical software for social sciences version 20.

Results: Out of the 360 sampled pregnant women, 18.6% was found positive for intestinal helminthic parasites. Three intestinal helminthic parasites isolated were; A. lumbricoides (8.9%), hookworm (6.1%) and T. trichiura (3.6%). The prevalence and intensity were higher during the rainy season than the dry season. First trimester, secundigravidae and (15-20 yrs) age group had the highest prevalence of intestinal helminthic parasites. Pregnant women that ate raw vegetables had a higher prevalence of Ascariasis, trichuriasis and hookworm infection than those that ate cooked vegetables. In relation to source of drinking water, those that got drinking water from river had the highest prevalence of all the parasites. On the type of toilet used, pregnant women who use bush method had the highest prevalence 7(10.9%) for A. lumbricoides and T. trichuria was more prevalent with those who use pit toilet 6(3.8%) while hookworm 12(8.7%), was seen among women using water cistern. In relation to washing of hands after toilet, pregnant women that do not wash hands had higher prevalence of 6(11.5%), 2(3.8%) 6(11.5%) for A. lumbricoides, T. trichuria and hookworm respectively than those that do wash their hands after toilet. Those that ate raw meat had higher prevalence of A. lumbricoides 3(15.8%), T. trichuria 2(10.5%) and hookworm 3(15.79%) than those that did not eat raw meat. Those who walk barefooted had higher prevalence of A. lumbricoides 5(8.3%), T. trichuria 4(6.7%) and hookworm 8(13.3%) than those who do not walk barefooted.

Conclusion: From this study, it is concluded that helminthic parasites are still present in pregnant women at Ebonyi state, therefore there is need to control and prevent their infection so as to eradicate its effects on pregnant women. The creation of awareness on the preventive measures of helminthic infections amongst people in Ebonyi state is urgently needed. Consequently, health education in local languages should be vigorously mounted to create awareness on helminthic diseases.

Open Access Original Research Article

Newborn Resuscitation Resources in Selected Rural and Urban Primary Healthcare Centres in Enugu State, Nigeria: A Comparative Analysis

T. F. Okusanya, A. U. Chinweuba, C. I. Nweke, J. N. Esievo

Asian Journal of Pregnancy and Childbirth, Page 31-40

Introduction: Successful neonatal resuscitation involves availability of neonatal resuscitation resources in terms of material and skilled personnel; this is the first and most important step in delivering effective neonatal resuscitation. The study aimed to assess and compare newborn resuscitation resources in terms of materials (availability, types and functionality) and manpower (availability and professional status) in the urban and rural primary healthcare centres in Enugu State, South East Nigeria.

Methods: A Comparative survey design using a multistage sampling technique to select 134 PHC (67 each from both urban and rural area). Data collected by a checklist and a self-structured questionnaire filled by health personnel. Data collection lasted for 12 weeks.

Results: Mucus extractor (rural 88.1%/urban 79.1%) is the most available material for newborn resuscitation. Ventilating devices like Ambu bag, face mask, oral airway, oxygen cylinder etc. are more in the urban than rural. Although, most of the materials are analogue/manual, the urban area has more of electronically/digitally operated materials of which are either fairly or fully functional. The major personnel in both setting (urban 65.7%/rural 85.1%) are Community Health Extension Workers (CHEW); the urban had more of highly skilled professional. Although, some of the personnel in both setting (urban 50.7%/rural 38.8%) rated their skill in newborn resuscitation management as good, majority of them (urban 86.6% / rural 88.1%) had no specialized training on newborn resuscitation. Lack of material (urban 68.7% / rural 80.6%) was a major challenge in newborn resuscitation. There is no significant difference in the availability and functionality but a significant difference in the types of the material and manpower resource.

Conclusion: There is almost same variability of newborn resuscitation resources in the urban and rural area. Adequate resources (material and manpower) should be provided in the PHC in Enugu State this will bring a reduction in the neonatal mortality rate.

Open Access Original Research Article

Clients’ Assessment of Quality of Antenatal Care Services at Federal Teaching Hospital Abakaliki, Nigeria: Understanding Key Role of Health Providers

Edmund Ndudi Ossai, Chukwudiebere Ekuma Oko, Nnamdi Okafor, Chinelo Chukwudulue, Jude Uchechukwu Ukwa, Lawrence Ulu Ogbonnaya

Asian Journal of Pregnancy and Childbirth, Page 41-51

Aims: The research objective of this article sought to determine the clients' evaluation of the quality of antenatal care (ANC) at Federal Teaching Hospital Abakaliki, Nigeria.

Study Design:  A descriptive cross-sectional study design was adopted.

Place and Duration of Study: Federal Teaching Hospital Abakaliki, Nigeria. The study took place between April and May, 2018.

Methodology: A systematic random sampling technique was used to select 415 women receiving ANC at the facility. A questionnaire designed by the authors was used as an instrument for the research. A composite index of satisfaction (overall satisfaction) was derived. It was determined by proportion of clients who were satisfied with ANC services, were willing to use facility again for ANC and also recommend to others. It also included those who reported being well received at facility and were satisfied with attitude of Doctors and Nurses. A ‘Yes’ answer to these six variables was regarded as overall satisfaction.

Results: From the results of the study, mean age of respondents was 29.3±4.5 years. It was found that the major reasons for registering at the facility were quest for quality care (41.0%) and facility has trained health workers,(21.4%). Majority, 91.6% intend to deliver at the facility. It was found that majority (73.0%) had overall satisfaction with ANC services. The predictors of overall satisfaction included having attained tertiary education, (AOR=0.4; 95%CI: 0.2-0.8), being unemployed, (AOR=0.6; 95%CI: 0.3-0.9) and intention to deliver in same health facility, (AOR=2.4; 95%CI:1.2-5.1)

Conclusions: The major reasons for choosing the health facility for ANC were health worker related.  Majority of the clients had overall satisfaction with antenatal services and were also willing to deliver at the facility. Being satisfied with ANC services facilitates delivery in health facility and this is capable of improving maternal health in Nigeria. In realizing this, health providers have a prominent role to play. There is thus the need to support health workers in fulfilling this essential role and this may necessitate training health workers on quality of care.