Open Access Case Report

Successful Management of Multi-Drug Resistant TB in Pregnancy: A Case Report

E. C. Iwuoha, E. O. Ezirim

Asian Journal of Pregnancy and Childbirth, Page 23-26

Multi-drug resistant Tuberculosis (MDRTB) affects persons of all ages including women of child bearing age. The management of Multidrug resistant TB in pregnancy is controversial. However current guidelines for programmatic management of MDRTB include commencing pregnant women on treatment after the first trimester. Possible side effects of the drugs especially teratogenicity has been the major concern on whether or not to commence pregnant mothers.

We present a case of a 35 years old multi-gravida Nigerian woman who was managed for MDRTB during pregnancy. The patient was a previously drug sensitive TB patient who was treated for TB but lost to follow-up. At presentation pregnancy which was singleton was estimated at 19 weeks by Abdominal Ultra sound scan. Patient was treated with second line anti-Tb drugs and delivered at 38 weeks gestation; a healthy female baby with a birth weight of 2.5 kg.

Conclusions: Pregnant MDRTB patients can have successful outcomes if commenced on treatment after first trimester.

Open Access Original Research Article

Trends on Prevalence of Teenage Pregnancy and Age-specific Fertility Rates in a Caribbean Country: A Call for Regional Intervention

Anderson Ikeokwu, Rebecca Lawrence, Daniel Osieme, Janet Funmilayo, Olamide Zainab Sadik, Adedeji Okikiade

Asian Journal of Pregnancy and Childbirth, Page 1-10

Introduction: Adolescents in the Caribbean region continue to experience poor reproductive health outcomes, including high rates of first birth before the age of 20 years. Teenage pregnancies are a worldwide cause of concern. According to the World Health Organization (WHO), about 16 million girls from the ages of 15 to 19 years and about one million girls younger than 15 years of age give birth every year. This can negatively affect their psychosocial development, which in turn leads to poor health outcomes and increased risk of morbidity and of maternal mortality which is the second leading cause of death amongst girls from the ages of 15 to 19 years worldwide. This paper aimed at addressing how patterns of adolescent first births which includes; prevalence and age-specific fertility (ASFR) rates amongst adolescents have changed from 2013-2019 in Saint Vincent and the Grenadines (SVG).

Methodology: The study utilized a retrospective population-based study which consists of secondary data derived from the Family Planning Unit of the Ministry of Health and the Population and Demographic Health Survey (DHS) from 2013-2019 which are cross-sectional surveys conducted every year, compiled by the Statistical Office of the Government of SVG. Data analysis was done using Statistical Package for Social Sciences, (SPSS) version 23.0.

Result: From a baseline prevalence of 17.6% in 2013 in SVG, the prevalence of teenage pregnancy amongst adolescent aged 10-19 years and a reduction to 14.6% by 2019. Amongst adolescents from the ages of 10-14 years old showed negligible reduction from a baseline of 2.5 ASFR per 1000 women in 2014, the ASFR had only reduced to 1.1 by 2018. However, among 15-19 years old showed a steady reduction from a baseline of 67.9 ASFR per 1000 women aged in 2014, the ASFR had reduced to 45.1 by 2018. There was no statistically significant association in trends across regions in the country (p>0.05).

Conclusion: Teenage pregnancy has still remained a major public health concern, specifically amongst those <15 years of age. This finding gives a clear indication of possible cases of statutory rape due to the minimum age of consent for sexual activity for girls being 15 years (and 16 years for boys) in SVG. Efforts are needed to be geared towards a comprehensive health education and youth friendly reproductive health services, as well as introduce and enforce legislation to provide effective protection from abuse or exploitation.

Open Access Original Research Article

Male Partner Involvement in Maternal Health: Perspective of Female Clients Accessing Care at a Tertiary Health Institution in Nigeria

Chinomnso C. Nnebue, Femi C. Yusuf, Uwe E. Uwe, Chika G. Bekee, Chika F. Ubajaka, Chigozie O. Ifeadike

Asian Journal of Pregnancy and Childbirth, Page 11-22

Background: The import of gender roles and support in maternal health is fast gaining global recognition. Gender- based power relations, dimensions of health inequalities and overall maternal survival are linked to levels of partner involvement.

Objective: To assess male partner involvement in maternal health from the perspective of: female clients accessing obstetrics care at a federal medical center (FMC) in Nigeria.

Materials and Methods: Multistage sampling technique were used in enrolling 378 female clients at the Obstetrics clinics FMC Owerri Nigeria, into this health facility based cross-sectional descriptive study. Consenting participants completed via exit- interview, a semi- structured questionnaire designed from relevant literatures. Statistical analysis was done using Statistical Package for Social Sciences version 22 with Chi square and Fishers tests at p<0.05.

Results:  Majority, 360 (95.2%) of respondents had good knowledge on role of male partners in maternal health, 311 (82.1%) had good perceived knowledge on role by male partners. while 161 (42.6%) reported good level of partner involvement. There are associations between extent of male involvement and age (p= 0.000), marital status (p= 0.044) and highest level of educational attainment (p=0.000) among male partners

Conclusions: This study reveals that despite apparently good level of knowledge on role of males in maternal health by participants and their male partners, there was poor partner involvement, which had associations with age, marital status and highest level of educational attainment. There is need to sustain adequate knowledge of roles in maternal health and ensuring effective male partner involvement via quality couple- based attitudinal change education on maternal health.

Open Access Original Research Article

Knowledge of Hepatitis B Virus and Vaccination Uptake among Pregnant Women in Rural North Gonja of the Savanah Region, Ghana

Inusah Abdul-Wahab, Shamsu-Deen Ziblim, Sufyan Bakuri Suara

Asian Journal of Pregnancy and Childbirth, Page 27-39

Purpose: Hepatitis B viral(HBV) infection is a global public health challenge. Mother to child transmission is the leading cause of HB Vinfection in high endemic countries. The objective of this study was to examine pregnant women’s knowledge of HBV and their vaccination uptake in the North Gonja District of the Savanah Region of Ghana.

Methods: A facility-based cross-sectional study was conducted in five Health centres and five Community-based Health Planning and Services(CHPS) compounds.Data was collected from April to June 2020 using a structured questionnaire. Data on socio-demographic characteristics,HBV Knowledge, testing and vaccination uptake among 310 pregnant women attending ante-natal clinics (ANC) were collected using a simple random sampling method. The data was analyzed using Microsoft Excel version 2019 and IBM SPSS v25. Results were presented as frequencies, percentages, tables and figure. A chi-square test of associations was performed and a P-value of <0.05 was considered statistically significant.

Results: In all, 43.25% of the respondents had excellent knowledge, 21.94% had good knowledge whilst 34.84% had poor knowledge. There was a statistical association between educational level (p=0.002), ANC visit (p<0.001), ethnicity (p<0.001), occupation(p<0.011) and knowledge of HBV. HBV testing and vaccination uptake were only 35.5% and close to 33% respectively. Educational level (p<0.001), previous HBV screening (p<0.001), occupation (p<0.001), knowledge of HBV(p<0.001), ANC visit(p=0.002) were significantly associated with Hepatitis B virus vaccination uptake.

Conclusion: Pregnant women were knowledgeable of HBV. However, HBV testing and vaccination uptake were low.  Pregnant women attending ANC should be screened for hepatitis B. Vaccination of pregnant women against HBV should be introduced into the EPI program.

Open Access Original Research Article

Thyroid Stimulating Hormone Concentration and Pregnancy Outcomes during Intra-Cytoplasmic Semen Injection Cycle

Hanan Eljabu, Ismail Elfortia, Awatif Andisha, Najwa Khalil, Eman Elmhjoub, Sorour Alsager, Sukina Al-Husain, Rabaa Abokail

Asian Journal of Pregnancy and Childbirth, Page 40-47

Background: The development in the reproductive medicine and revolution of Assisted Reproductive Technology (ART) have made significant changes in the global infertility science. There are many factors affecting the ovarian function (ovulation); thyroid disorders have made part of it.

Objective: This study aims to evaluate the prevalence of thyroid disorder and its effect on oocyte quality, implantation rate and pregnancy outcome.

Materials and Methods: This is a prospective study was conducted in the Libya National Fertility Centre. All participants were undergoing Intra-Cytoplasmic Semen Injection (ICSI). The inclusion criteria included cases with age less than 40 years and fresh embryo cycles. Cases with premature ovarian failure, endometriosis, Poly-Cytic Ovaries (PCO) and past history of ovarian surgery were excluded from the study.

Results: This study involved 627 cases. The cutoff value for Thyroid Stimulating Hormone (TSH) level (depending on the pregnancy rate, oocyte maturation and embryo quality) was 2.4 mIU/L. the participants were divided into two groups: TSH ≤2.4 mIU/L group (n=333) and TSH >2.4 mIU/L group (n=294).  In the TSH ≤2.4 mIU/L group (36.69%) women achieved clinical pregnancy, while in the TSH >2.4 mIU/L group (31.37%) women achieved clinical pregnancy (P=0.038). No significant differences were observed between the two groups in pregnancy outcomes; Live Birth Rate (LBR) and abortion rate (P=0.052, P=0.258). With regard to oocyte maturation, women with TSH ≤2.4 mIU/L have a significant high chance to achieve better oocyte maturation in compare with another group (P=0.043).

Conclusion: The level of TSH (>2.4 mIU/L) is associated with poorer pregnancy outcome (low LBR and high miscarriage rate) and has determinantal effect on oocyte and embryo qualities. So, its recommended to prescribe the thyroxin therapy to infertile patients have TSH level (>2.4 mIU/L) before implementing ICSI cycle.