Objective: To compare the effectiveness and side effect of two different dosage regimes of oral Nifedipine in the treatment of preterm labour Methods: A double blinded randomized controlled trial in which 86 pregnant women with preterm labour were randomized to receive either the low or high dose regimen of Nifedipine for tocolysis. Low dose of 10 mg of oral Nifedipine then 5mg every 15min for 1hr 10mg 6hly for 48hrs, while the high dose was 20 mg of oral Nifedipine followed by 10 mg every 15 minutes for 1hr then 20mg 6hourly for 48 hours. The primary outcome was defined by mean uterine quiescence time and fetomaternal side effect were compared between the groups. Results: The mean uterine quiescence time for the low dose and high dose regime were comparable 13.60±11.69 hours versus 12.16±8.90 hours (P = 0.747) respectively, there was no statistical significance difference. None of the patients in both groups needed rescue treatment. Forty patients (93%) versus 41 patients (95%) (P = 0.506) of low and high dose respectively where able to achieve uterine quiescence within 48hours, there was no statistical significant difference. Maternal headache was higher in the high dose compared to the low dose but not statistically significant {19% vs 5% (p = 0.08)} None of the women in both groups had fetal heart rate abnormality. Discussion: The high dose regimen of oral Nifedipine for tocolysis does not have any advantage over the low dose regime in terms of effectiveness for tocolysis and infact low dose had a lower maternal side effect.
Background: Dyslipidemia is one of the most perplexing metabolic consequences in polycystic ovary syndrome (PCOS). Obesity, insulin resistance (IR), and hyperandrogenism, the pervasive features of PCOS, play significant pathophysiological roles in the lipidemic aberrations associated with the syndrome. Objective: This study aimed to assess the diagnostic utility of triglyceride (TG) and triglyceride to high-density lipoprotein-cholesterol (TG/HDL-C) ratio as surrogate markers for identifying IR in infertile Nigerian women with PCOS. Materials and Methods: Eighty-seven infertile women with PCOS were selected according to the Androgen Excess Society criteria and categorized into two groups. After anthropometric measurements, fasting blood samples were assayed for plasma glucose, serum insulin, total cholesterol, TG, HDL-C while lipoprotein ratios were calculated. Homeostasis model assessment for IR (HOMA-IR) was used in defining IR. The areas under the receiver operating characteristic (ROC) curve analysis were used to compare the power of the serum markers, and to obtain the optimal cutoffs of TG and TG/HDL-C with HOMA-IR. Results: TGs correlated significantly with HOMA-IR in the obese PCOS women. However, the areas under the ROC of potential markers showed no significant marker for HOMA-IR. The highest area under the curve of ROC for TG belongs to the obese group with a sensitivity of 56% and specificity of 53% (TG ≥ 92.5mg/dL) as a marker of IR in obese PCOS women. Conclusion: TG and TG/HDL-C would not be reliable markers of IR, and a concerted approach in finding surrogate markers will benefit future investigations.
Background: Planned induction of labor for various indications has become an established part of modern Obstetric practice. While the efficacy of misoprostol, a prostaglandin E1 analog as a cervical ripening labor induction agent has been established, the appropriate route and dosage are still objected to ongoing research. Objective: This study aims at comparing the efficacy of vaginally administered with sublingual misoprostol for cervical ripening and labor induction. Methodology: One hundred (100) pregnant women at term who fulfill the inclusion criteria were equally randomized into the two arms of the study to receive either 25 μg of misoprostol sublingually or 25μg vaginally. The induction delivery interval and fetal outcomes were compared in the two arms of the study. Results: The vaginal group required more doses of misoprostol than the sublingual group (1.68 ± 0.74 versus 1.26 ± 0.44, P = 0.005). Time from the administration of the first dose of misoprostol to the achievement of a Bishop score of 7 or active phase labor was shorter in the sublingual group than the vaginal route group (5.04 ± 1.77 hours versus 6.32 ± 1.36 hours, P = 0.001). Induction-delivery interval was shorter in the sublingual group than the vaginal route (10.02 ± 2.37 hours versus 11.12 ± 3.97 hours) although the difference was not statistically significant (P = 0.098). The mean Apgar scores at 1 min and 5 min were slightly better in the vaginal group than the sublingual group but the difference did not assume statistical significance (Apgar scores at 1 minute: 7.62 ± 0.83 versus 7.72 ± 0.88, at 5 minutes: 8.94 ± 1.23 versus 9.22 ± 0.46 for the sublingual versus the vaginal group, respectively, P = 0.561). Conclusions: The two routes of sublingual and vaginal administration showed comparable safety and effectiveness for cervical ripening and induction of labor in low-risk pregnancies at term. However, the sublingual route appears to be superior in terms of easy administration and patients' satisfaction.
Background: Evidence shows that compliance with surgical antibiotic prophylaxis (SAP) among obstetricians and gynecologists is poor. This study evaluates the knowledge and perceptions regarding SAP among doctors in Obstetrics and Gynecology units. Methods: This was a cross-sectional study conducted among physicians in the Department of Obstetrics and Gynecology in two public tertiary hospitals in Nigeria. Data was collected using a 30-item validated and pre tested self-administered questionnaire, and analyzed using SPSS. Results: A total of 41 respondents (response rate: 68.3%) returned the survey with a male preponderance (61%). Medical officers (Senior Registrars and Registrars) constituted almost two-third (63.4%) of the respondents. Only 26.8% had attended a workshop, seminar, conference or clinical meeting regarding SAP. Most respondents were not aware of the most common organism that causes surgical site infection and the appropriate time and duration of SAP. However, majority (90%) knew that the inappropriate use of SAP could lead to antibiotic resistance. More than two-third agreed that SAP malpractices were due to the lack of knowledge about SAP and poor awareness regarding antibiotic resistance. More than 90% agreed that education, audit and feedback, and guidelines would improve compliance with SAP. Respondents with 6–10 years working experience had significantly higher knowledge score than those with 1 –5 years experience. Respondents who had not attended any workshop or course pertaining to SAP had more positive perception. Conclusion: Respondents demonstrated inadequate knowledge of SAP and most of them were aware that inappropriate use of SAP could lead to antibiotic resistance.
Introduction: Soil-transmitted helminth infection is a major contributor to anemia which is associated with morbidity and mortality during pregnancy in endemic regions like Nigeria. This study assessed the predictors of helminthic infections among pregnant women attending Antenatal clinics in the Federal Medical Center (FMC), Abeokuta, Ogun State. Methodology: A cross-sectional study was conducted among pregnant women attending the Antenatal (ANC) of the Department of Obstetrics and Gynecology, FMC, Abeokuta. Systematic random sampling was used for selecting study participants and semi-structured self-administered questionnaire was employed for data collection. Stool samples were collected from the participants and formol-ether concentration technique was used for stool examination. Besides, eggs of helminths were identified and quantified. Data were analyzed using statistical package for social sciences (SPSS) version 22. Associations were tested using the Chi-square test. Predictors of helminths infection were determined using the logistic regression analysis. Level of significance was set at 5%. Result: One hundred and seventy-four (174) women participated in the study. The mean age (SD) of the pregnant women was 30.44 (4.87) years. The majority (81.6%) had a tertiary level of education. The prevalence of intestinal helminth infection among the respondents was 21.8%. Ascaris lumbricoides (9.2%) was the most prevalent helminth, followed by hookworm infestation (7.5%) and Trichuris trichuria infestation (3.4%). The predictors for helminthic infestation among the respondents were aged 30 years and below (1.000; 0.23–1.20), pregnant women who had primary education and below (1.74; 0.72–3.06), and use of pit latrine and bush as waste disposal method (2.31; 0.86–6.21. Respondents who practiced handwash were less likely to have a helminthic infection (0.98; 0.11–9.08). Conclusion:Ascaris lumbricoides is the most commonly found helminth among the study population. Low education and poor hygiene were significant risk factors for helminthic infection among pregnant women.
