Background: A significant gap exists in understanding the efficacy and safety of oral immediate-release nifedipine and intravenous hydralazine in the control of severe hypertension in pregnancy within the context of randomised control trials. Objectives: To compare the efficacy and safety of oral immediate-release nifedipine and intravenous hydralazine for controlling severe hypertension in pregnancy. Methods: Randomised, double-blind, 2-arm, single center non-inferiority trial in pregnant women with confirmed severe hypertension in pregnancy who were randomised in a 1:1 ratio to receive oral immediate-release Nifedipine (n=35) or intravenous hydralazine (n=35) was done from 20th June 2019 to 20th December, 2019. The primary outcome was the mean time required to achieve target blood pressure. Secondary outcomes included the mean number of anti-hypertensive doses needed, proportions requiring crossover or rescue therapy, frequency of maternal side effects, fetal heart rate abnormalities, maternal complications, neonatal birth asphyxia, and mode of delivery. Results: The baseline socio-demographic parameters were similar between the two groups. The mean durations taken to reach the target blood pressure for patients that received oral immediate-release nifedipine versus intravenous hydralazine were 48.29min±31.95 and 41.20min±26.98 respectively (P=0.320). The mean dose used before target blood pressure was reached, the proportion of participants that crossed over to another treatment allocation, and the proportion that required a rescue antihypertensive (labetalol) to achieve the target blood pressure were similar between the two groups (P >0.05). None of the participants that received oral immediate-release nifedipine had maternal or neonatal side effect while one participant (2.9%) that received intravenous hydralazine had nausea and vomiting Conclusion: Oral immediate-release nifedipine is as effective as intravenous hydralazine in controlling severe hypertension in pregnancy. Both have remarkable materno-fetal safety profile and its non-invasive nature makes it an appealing modality especially in resource poor countries. More robust studies are encouraged to increase the evidence for its use as first line anti-hypertensives, especially in low and middle-income countries. Trial Registration: Pan African Clinical Trial registry, PACTR201906662822573, registration date: 19th June, 2019.

BackgroundThe periods of pregnancy are critical for the mental well-being of women. HIV positive pregnant women are especially vulnerable to experiencing depression and anxiety.AimTo determine the prevalence and determinant of depression and anxiety among HIV-positive and HIV negative pregnant women in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Nigeria.Materials and methodsBetween January 1 and May 30, 2024, 342 HIV-positive pregnant individuals and an equivalent number of HIV-negative prenatal attendees participated in a cross-sectional survey conducted at NAUTH in Nnewi. A structured questionnaire, the Generalized Anxiety Disorder Assessment, and the Patient Health Questionnaire were used to interview the subjects. IBM Statistical Package for Social Science version 26 was used to analyze the data, and a significance level of less than 0.05 was chosen.ResultsThe research involved 684 participants, all of whom screened positive for anxiety and depression. The average scores for anxiety in HIV-positive and HIV-negative women were 16.8 ± 3.8 compared to 8.7 ± 2.3; P <0.001, while for depression the scores were 11.1 ± 4.3 versus 3.1 ± 3.3; P < 0.001, respectively. A significant presence of major depressive and anxiety disorders was discovered among HIV-positive women, with moderate and severe depression affecting 47.7% and 21.9%, respectively, while moderate and severe anxiety were observed in 21.3% and 73.6% of the women. The majority of women in the control group exhibited mild mental health disorders. For HIV-positive women, the significant factors influencing depression included being 30 years old or younger, having a gestational age of 30 weeks or less, possessing a lower educational level, being employed, and being married; for anxiety, key factors were being para 0-3, experiencing psychological IPV, and being married. Among HIV-negative women, significant determinants of depression included being 30 years old or younger, having a low educational level, and being married.ConclusionThe prevalence of mental health disorders in the study group is extremely high. The rate is unacceptably elevated among pregnant women who are HIV-positive. This emphasizes the need to integrate mental health services into standard maternal healthcare for all women, especially those living with HIV.

Background: Ovarian cancer (OC) is the sixth most common malignancy among women worldwide and the eighth leading cause of cancer-related deaths. In Nigeria, it is the second most prevalent gynaecological malignancy after cervical cancer. Early diagnosis remains challenging due to the absence of an effective screening tool and vague, non-specific symptoms that mimic benign gynaecological conditions. Objectives: This study aimed to determine the prevalence, sociodemographic characteristics, clinical features, and treatment modalities of patients with ovarian cancer managed at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. Methods: A retrospective cross-sectional study of all histologically confirmed ovarian cancer cases managed at NAUTH between January 1, 2017, and December 31, 2021, was conducted. Data were extracted using a structured proforma and included patient demographics, clinical presentation, histopathological findings, treatment modalities, and outcomes. Cases without histological diagnosis were excluded. Ethical approval was obtained from the NAUTH Ethics Committee. Data were analysed using IBM SPSS version 26.0 (Armonk, NY, USA). Results: The prevalence of ovarian cancer was 2.0%. The mean age of patients was 57.6 ± 5.2 years, with majority (55.5%) in their sixth and seventh decades of life. The leading identifiable risk factors were age >50 years (70.4%) and obesity (40.7%), whereas only 13% reported a history of smoking. The predominant presenting complaint was weight loss (96.3%), and abdominal distension was the most common clinical feature (94.4%). The majority of patients (79.6%) were diagnosed at advanced stages, with epithelial ovarian cancer representing 96.3% of histological subtypes. Surgery combined with chemotherapy was the main treatment modality (79.6%), while the overall mortality rate was 38.9%. Conclusion: Ovarian cancer remains a major cause of gynaecological morbidity and mortality in South-East Nigeria. Most patients presented at advanced stages with epithelial-type tumours. There is an urgent need for public health initiatives to promote awareness, early detection, and affordable screening strategies to improve patient survival.

Objectives To determine seroprevalence, seroconversion, and mother-to-child transmission (MTCT) rates for dual and triplex infections of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among pregnant women. Methods A multicentre prospective cohort study was conducted in six randomly selected tertiary hospitals from six geopolitical zones of Nigeria. Consenting participants were tested at recruitment for triplex infections and followed-up till delivery. Retests were performed at delivery for those who tested negative for all three infections/positive for only one. Polymerase chain reaction was used for validation while rapid test kits were employed for initial screening. Results Of the 2775 participants recruited, 13 (0.47%; 95% CI: 0.25%–0.80%) and 4 (0.14%; 95% CI: 0.04%–0.37%) were seropositive for dual and triplex infections, respectively. Dual infections revealed seroprevalences of 0.22% for HIV-HBV (6/2775; 95% CI: 0.08%–0.47%), 0.14% for HIV-HCV (4/2775; 95% CI: 0.04%–0.37%), and 0.11% for HBV-HCV (3/2775; 95% CI: 0.02%–0.32%). Multivariable analysis highlighted significant associations between HIV/HBV co-infection and religion (adjusted odds ratio (aOR): 0.068, 95% CI: 0.006–0.757) and house ownership (aOR): 1.65 × 10 –9 , 95% CI: 1.60 × 10 –9 –1.70 × 10 −9 ). Continuing our follow-up until delivery for 2403 initial participants, 2386 did not have dual or triplex infections at the start. Upon retesting at delivery, three of these women were seropositive for a dual infection of HIV and HBV, giving a seroconversion rate of 0.12% (95% CI: 0.03% to 0.37%). MTCT rate stood at 0% at 6-week post-delivery. Conclusion We observed a relatively low seroprevalence and seroconversion rates for dual and triplex infections of HIV, HBV, and HCV among pregnant women in Nigeria and no MTCT.

Background: Pregnancy following ovarian cancer treatment is rare but increasingly reported due to delayed childbearing and the predominance of ovarian germ cell tumours among women of reproductive age. Fertility preservation has therefore become a critical component of management in selected cases. Case Presentation: We report the case of a 28-year-old Nigerian nulliparous woman (P0+0) previously diagnosed with a mixed germ cell ovarian tumour (embryonal carcinoma and yolk sac tumour). She underwent right ovarian cystectomy and left salpingo-oophorectomy, followed by five cycles of adjuvant chemotherapy. Remarkably, she later achieved a spontaneous conception. The pregnancy was complicated by placenta accreta spectrum disorder (placenta previa-increta), and uterine atony. She underwent an elective caesarean section at term, during which conservative surgical management of obstetric haemorrhage was successfully performed, resulting in a favourable maternal and fetal outcome. Conclusion: Previous ovarian cancer treatment, including surgery and chemotherapy, may increase the risk of abnormal placentation, while its association with uterine atony remains unclear. This case demonstrates that successful pregnancy is possible after fertility-preserving treatment for ovarian germ cell tumours, though close monitoring for placental complications is essential. Further research and long-term follow-up are needed to clarify these risks.

Background:Primary postpartum haemorrhage (PPPH) is a leading cause of maternal morbidity and mortality in low-resource settings, with evolving aetiological patterns and contextual risk factors. However, current data from Nigerian obstetric populations are limited. Objectives:This study evaluated the current prevalence, causes and predictors of PPPH among parturients in Nnewi, southeastern Nigeria. Methods:This pilot analytical cross-sectional study was conducted at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from 1 April to 30 September 2025. Postpartum women were consecutively recruited and provided data through structured KoboToolbox-assisted questionnaires and medical record review. The primary outcome was PPPH prevalence, defined as blood loss ≥500 mL following vaginal birth or ≥1000 mL following caesarean delivery within 24 hours. Secondary outcomes assessed aetiologies and associated factors. Binary logistic regression identified predictors, reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs), with significance set at p < 0.05. Results:Among 352 participants, 8.8% (95% CI: 6.0-12.5%; n = 31) experienced PPPH. The overall median estimated blood loss was 320 (55-2150) mL. Genital tract trauma (58.1%; 95% CI: 34.4-91.8%) was the leading cause, followed by uterine atony (32.3%; 95%CI: 15.5-59.3%). Increasing parity (aOR=1.46; 95% CI: 1.0-2.1; p= 0.03) and antepartum haemorrhage (aOR =5.39; 95% CI: 1.3-21.9; p=0.02) were significant predictors of PPPH. Conclusion:This pilot study demonstrates a shift from uterine atony to genital tract trauma as the predominant cause of PPPH in this setting. Increasing parity and antecedent antepartum haemorrhage were independent predictors. This reinforces the importance of enhanced intrapartum monitoring, trauma-focused prevention strategies and skilled obstetric care.

OBJECTIVE To investigate the validity and reliability of the Birth Satisfaction Scale – Revised (BSS-R) Igbo version. MATERIALS AND METHODS A cross-sectional study was done among 500 women who delivered at Alex Ekwueme Federal University Teaching hospital Abakaliki between 1st March 2019 and 31st August 2019. The BSS-R questionnaire was used for data collection in the postnatal ward. Data obtained were analyzed using SPSS version 20. The properties of the scale were tested by conducting reliability and validation analyses. The level of significance is a P-value of <0.05. RESULTS The mean age of the women was 28.8±4.7 years; the majority (230, 46.0%) were between the age group of 30 – 40 years. More than 90% of the study participant had formal education. The majority (460, 92.0%) were multipara and had delivered mostly (326, 65.2%) at Full Term. Three Component loading was identified in the Scale. Examination of the pattern matrix showed three components/themes: support by staff during labour (I felt well supported by staff during my labour and birth (r = 0.875); parturient confidence during labour (I felt out of control during my birth experience (r = 0.714) and distraught during labour (I was not distressed at all during labour (r = 0.821). Communality value (r2) mostly ranged between 0.507 and 0.801. The scale had a Cronbach’s alpha coefficient of 0.62. This increased to 0.70 following the removal of “I was not distressed at all during labour” responses from the analysis. CONCLUSION The Igbo version of BSS-R has good internal consistency. It is a valid and reliable scale to be employed in assessing maternal satisfaction among Igbo-speaking women in the study area and Nigeria in general.

Schistosomiasis, a neglected tropical disease, affects approximately 40 million women of reproductive age contributing to preventable anaemia during pregnancy, intrauterine growth retardation and low birth weight. In spite of the high prevalence rate of this disease among school aged children in Abakaliki, no study in Abakaliki has looked at the burden of Schistosomal infection in pregnancy with a view to determining maternal and neonatal outcomes. To determine the association between schistosomal infection and maternal anemia, low birth weight, and other neonatal outcomes in Abakaliki. This was a prospective cohort study involving 94 randomly selected pregnant women with schistosomal infection and 94 matched controls without schistosomal infection. Pregnant women included were at 34 to 36 weeks of gestation. The Kato–Katz technique was used for identification and quantification of the S. mansoni, and S. japonicum, parasites in the stool, while the Ziel–Neilson stain was used for detection of the S. haematobium parasites in the urine. The patients were followed up until delivery to determine maternal and neonatal outcomes. The data were analysed using IBM SPSS version 20. The level of significance is at P – value < 0.05. The prevalence of schistosomiasis in the study area was (94/968) 9.71 =0.0001). Neonates of women infected with schistosomiasis had low birth weight compared with the control group (2.91 ±0.70kg vs. 3.20±0.60kg, P = 0.002). Placental mass was lower in cohort of women with the disease compared with the control (0.49±0.08kg vs. 0.52±0.09kg, P = 0.02). All the cohort of women with schistosomiasis were anaemic (28±1.9 vs. 30 ±2.1, P = < 0.0001). Burden of maternal anaemia was very high among cohort with heavy infection compared with those that had light infection (OR = 2.4 95

Background: Obesity has adverse effects on pregnancy outcomes, including macrosomia. Both have adverse synergistic effects on each other. Aim and Objectives: To determine the association between Maternal weight, BMI, and birth weight. Methods: This was a cross-sectional comparative study carried out over months. The case (experiment) group included neonates with macrosomia and their mothers. The control group was neonates with normal birth weight and their mothers. The maternal weight, height and body mass index were measured at booking and before delivery and categorized using the WHO obesity classification. The Data was analyzed using Stata statistical package version 14. Continuous variables, including age, birth weight, and mean leptin levels, were summarized by mean± standard deviation. There was a test of associations between variables to determine a significant relationship at a p-value of < 0.05. A total of 45 mother-neonate pairs that completed the study were used in the analysis. The study participants include 23 mother -neonate pair with normal weight and 22 mother-neonate pair with macrosomia. The mean birth weight was 3.78±0.05. The mean age of the women was 29.93±5.32, with the 25-29 age group being the modal age group. Only 2(9.09%) out of the 22 women with macrosomia had normal BMI at booking. There was a significant relationship between WHO Obesity class at booking and macrosomia (p-value=0.03). The mean maternal weight at delivery was 88.93±15.28. There was a significant association between the mean maternal weight before delivery and birth weight (83.17 for normal weight and 94.95±12.42 for macrosomia) p-value=0.004. The mean maternal serum leptin was 4.90±1.82. The value was higher but not statistically significant in women that gave birth to macrosomic babies. Conclusion: Maternal prenatal weight indices showed a significant association with macrosomia. As recommended by the World Health Organisation, pregnant women should be counselled on the need for proper weight gain during pregnancy and interventions should be instituted to make sure they achieve appropriate weight gain. Early booking should also be encouraged for proper counselling, dietary interventions and follow up.

Objectives: To compare the efficacy and safety of intravenous and intramuscular oxytocin in preventing atonic primary postpartum haemorrhage in the third stage of labour. Methods: A double-blind randomised clinical study on consenting women without risk factors for primary postpartum haemorrhage in labour at term. Two hundred and thirty-two women were randomly allotted into intravenous ( n = 115) and intramuscular ( n = 117) oxytocin groups in the active management of the third stage of labour. All participants received 10 IU of oxytocin, either IV or IM, and 1 ml of water for injection as a placebo via a route alternate to that of administration of oxytocin within 1 min of the baby’s delivery. The primary outcome measures were mean postpartum blood loss and haematocrit change. Trial Registration No.: PACTR201902721929705. Results: The baseline socio-demographic and clinical characteristics were similar between the two groups ( p > 0.05). There was no statistically significant difference between the two groups with regards to the mean postpartum blood loss (254.17 ± 34.85 ml versus 249.4 ± 39.88 ml; p = 0.210), haematocrit change (2.4 (0.8%) versus 2.1 (0.6%); p = 0.412) or adverse effects ( p > 0.05). However, the use of additional uterotonics was significantly higher in the intravenous group (25 (21.73%) versus 17 (14.53%); p = 0.032). Conclusion: Although oxytocin in both study groups showed similar efficacy in terms of preventing atonic primary postpartum haemorrhage, participants who received intravenous oxytocin were more likely to require additional uterotonics to reduce their likelihood of having an atonic primary postpartum haemorrhage. However, both routes have similar side effect profiles.

Background Speculum lubrication may help to reduce the pain experienced during Pap-smear collection and hence increase uptake of cervical cancer screening and repeat testing, but there are fears of its interference with cytological results. Aim To determine and compare the adequacy of cervical cytology smears and the mean pain scores of women undergoing cervical cancer screening with or without speculum lubrication. Methods This was a randomised controlled study of 132 women having cervical cancer screening at a tertiary hospital in Nigeria. Sixty-six participants were randomly assigned to the ‘Gel’ and ‘No Gel’ groups, respectively. Pap smears were collected from each participant with a lubricated speculum (‘Gel group’) or a non-lubricated speculum (‘No Gel group’). The primary outcome measures were the proportion of women with unsatisfactory cervical cytology smears and the mean numeric rating scale pain scores, while the secondary outcome measures were the proportion of women who were willing to come for repeat testing and the cytological diagnosis of Pap-smear results. Results The baseline socio-demographic variables were similar in both groups. There was no significant difference in the proportion of unsatisfactory cervical smear results between the two groups (13.6% vs. 21.2%, p = 0.359). However, the mean pain scores were significantly lower in the gel group than in the no gel group (45.04 vs. 87.96; p<0.001). An equal proportion of the participants in each group (90.9% vs. 90.9%; p > 0.999) were willing to come for repeat cervical smears in the future. Conclusion Speculum lubrication did not affect the adequacy of cervical smears but significantly reduced the pain experienced during pap smear collection. Also, it did not significantly affect the willingness to come for repeat cervical smears in the future. Trial registration The trial was registered with the Pan-African Clinical Trial Registry with a unique identification and registration number: PACTR2020077533364675.

Background:Vaccination against COVID-19 is one of the global strategies to the containment of the disease. This global effort is being hampered by vaccination hesitancy which is more worrisome in low-resource countries like sub-Saharan Africa.Objectives:The objectives of this study are to evaluate the awareness of COVID-19 disease, COVID-19 vaccine uptake and its determinants in a rural Nigerian setting.Materials and Methods:It is a cross-sectional study of 460 participants recruited at random between 1st August and 30th of September 2021 in a rural hospital in Anambra state, Nigeria. The participants were interviewed using pre-tested structured questionnaire. Data obtained were represented using frequency table, percentages, bar chart, and odds ratio. The level of significance was at P value < 0.05.Results:The majority were aware of COVID-19 disease; and mass media was the major source of information. Seven percent (7.0%) of the participants had received COVID-19 vaccine. A significant number (216/460, 15.9%) were afraid of the vaccine. Reasons adduced for poor uptake included vaccination center being far, cost of transportation, and non-availability of vaccine. Vaccine uptake was significantly affected by participants' age [aOR= 3.69 95% CI (1.63-13.14); P = 0.044], and a family member being already vaccinated [aOR=11.27 95% CI (1.60-78.78); P = 0.015].Conclusion:The uptake of COVID-19 vaccine is very low among the study population. This highlights the need for healthcare providers in the study population to reeducate and provide better information to the population on the importance of COVID-19 vaccination.

Background and objectives:Coronavirus disease 2019 (COVID-19) is a pandemic that has become a major source of morbidity and mortality worldwide, affecting the physical and mental health of individuals influencing reproduction. Despite the threat, it poses to maternal health in sub-Saharan Africa and Nigeria, there is little or no data on the impact it has on fertility, conception, gestation and birth. To compare the birth rate between pre-COVID and COVID times using selected months of the year. Materials and methods:This was a secondary analysis of cross-sectional analytical study data from the birth registries of three tertiary hospitals, comparing two years [2019 (Pre-COVID)] versus [2020 (COVID era)] using three months of the year (October to December). The data relied upon was obtained from birth registries in three busy maternity clinics all within tertiary hospitals in South-East Nigeria and we aimed at discussing the potential impacts of COVID-19 on fertility in Nigeria. The secondary outcome measures were; mode of delivery, booking status of the participants, maternal age and occupation. Results:There was a significant decrease in tertiary-hospital based birth rate by 92 births (P = 0.0009; 95% CI: -16.0519 to -4.1481) among mothers in all the three hospitals in 2020 during the COVID period (post lockdown months) of October to December. There was a significant difference in the mode of delivery for mothers (P = 0.0096) with a 95% confidence interval of 1.0664 to 1.5916, as more gave birth through vaginal delivery during the 2020 COVID-19 period than pre-COVID-19. Conclusion:Tertiary-hospital based birth rates were reduced during the pandemic. Our multi-centre study extrapolated on possible factors that may have played a role in this decline in their birth rate, which includes but is not limited to; decreased access to hospital care due to the total lockdowns/curfews and worsening inflation and economic recession in the country.

Objectives: To compare Premaquick biomarkers (combined insulin-like growth-factor binding protein 1 and interleukin-6) and cervical length measurement via transvaginal ultrasound for pre-induction cervical evaluation at term among pregnant women. Methods: A randomized clinical trial of consenting pregnant women at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. The women were randomized equally into Premaquick group (n = 36) and transvaginal ultrasound group (n = 36). The cervix was adjudged ‘ripe’ if the Premaquick test was positive or if the trans-vaginal measured cervical length was less than 28 mm. The primary outcome measures were the proportions of women who needed prostaglandin analogue for cervical ripening and the proportion that achieved vaginal delivery after induction of labour. The trial was registered in Pan African clinical trial registry (PACTR) registry with approval number PACTR202001579275333. Results: The baseline characteristics were similar between the two groups (p > 0.05). There was no statistically significant difference between the two groups in terms of proportion of women that required prostaglandins for pre-induction cervical ripening (41.7 versus 47.2%, p = 0.427), vaginal delivery (77.8 versus 80.6%, p = 0.783), mean induction to delivery interval (22.9 ± 2.81 h versus 24.04 ± 3.20 h, p = 0.211), caesarean delivery (22.2 versus 19.4%, p = 0.783), proportion of neonate with birth asphyxia (8.30 versus 8.30%, p = 1.00) and proportion of neonate admitted into special care baby unit (16.7 versus 13.9%, p = 0.872). Subgroup analysis of participants with ‘ripe’ cervix at initial pre-induction assessment showed that the mean induction to active phase of labour interval and mean induction to delivery interval were significantly shorter in Premaquick than transvaginal ultrasound group. Conclusion: Pre-induction cervical assessment at term with either Premaquick biomarkers or transvaginal ultrasound for cervical length is effective, objective and safe with similar and comparable outcome. However, when compared with women with positive transvaginal ultrasound at initial assessment, women with positive Premaquick test at initial assessment showed a significantly shorter duration of onset of active phase of labour and delivery of baby following induction of labour.

Objective:Various patients needing organ or systemic support and close monitoring are routinely managed in the intensive care unit. This includes patients that emanate from various sources, like the trauma unit, emergency department, inpatient wards, and post-anesthesia care unit. Admissions into the intensive care unit due to medical conditions have not been analyzed in our environment to determine the common indications and the outcome. We aimed to determine the pattern of medical admissions and outcomes in the intensive care unit.Method:A retrospective study of all patients admitted to the intensive care unit of Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria, from January 1, 2014 to December 31, 2020, with medical diagnosis was conducted. Data were retrieved from the intensive care unit admission and discharge registers and analyzed using the Statistical Package for Social Sciences (SPSS) Version 20 (IBM Corp., Chicago, Illinois, USA).Results:Eighty-nine medical patients were admitted, which accounted for 7.63% of the total intensive care unit admissions of 1167 patients during the period, with a preponderance of males (57.3%). The most common medical condition for intensive care unit admission (31.5%) was a cerebrovascular accident. The mean length of stay was found to be 5.13 ± 3.42 days. Mortality following medical intensive care unit admission was 56.18%, which contributed to about 11.4% of the total ICU mortality.Conclusion:When compared to all other reasons for admission to a general intensive care unit, medical conditions account for a small percentage. The most frequent illness was a cerebrovascular accident.

Objectives: To systematically review literature and identify mother-to-child transmission rates of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among pregnant women with single, dual, or triplex infections of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Nigeria. PRISMA guidelines were employed. Searches were on 19 February 2021 in PubMed, Google Scholar and CINAHL on studies published from 1 February 2001 to 31 January 2021 using keywords: “MTCT,” “dual infection,” “triplex infection,” “HIV,” “HBV,” and “HCV.” Studies that reported mother-to-child transmission rate of at least any of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women and their infant pairs with single, dual, or triplex infections of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Nigeria irrespective of publication status or language were eligible. Data were extracted independently by two authors with disagreements resolved by a third author. Meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce summary mother-to-child transmission rates in terms of percentage with 95% confidence interval. Protocol was prospectively registered in PROSPERO: CRD42020202070. The search identified 849 reports. After screening titles and abstracts, 25 full-text articles were assessed for eligibility and 18 were included for meta-analysis. We identified one ongoing study. Pooled mother-to-child transmission rates were 2.74% (95% confidence interval: 2.48%–2.99%; 5863 participants; 15 studies) and 55.49% (95% confidence interval: 35.93%–75.04%; 433 participants; three studies), among mother–infant pairs with mono-infection of human immunodeficiency virus and hepatitis B virus, respectively, according to meta-analysis. Overall, the studies showed a moderate risk of bias. The pooled rate of mother-to-child transmission of human immunodeficiency virus was 2.74% and hepatitis B virus was 55.49% among mother–infant pairs with mono-infection of HIV and hepatitis B virus, respectively. No data exists on rates of mother-to-child transmission of hepatitis C virus on mono-infection or mother-to-child transmission of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among mother–infant pairs with dual or triplex infection of HIV, hepatitis B virus and HCV in Nigeria.

Background: Pregnancies complicated with antepartum-haemorrhage is high risk pregnancies associated with adverse maternal, fetal-and-perinatal-outcomes. It contributes significantly to fetal and maternal mortality especially in the developing countries. Proper antenatal care and prompt intervention is necessary to forestall adverse and improve outcome. Objective: To determine the prevalence, sociodemographic characteristics, risk factors, fetomaternal outcome of pregnancies with antepartum haemorrhage. Methods: The case files of the patients were retrieved from the medical records department. The total number of deliveries within the study period was obtained from the labour ward records. The feto-maternal-outcome-measures were; prevalence of caesarean-section, postpartum-haemorrhage, hysterectomy, need for blood-transfusion, maternal-death, prematurity, need for admission in intensive-care-unit and still births. The data was analysed using SPSS version 21. Chi-square was used to test for significance. Results: Within the 5-year period under review, out of a total of 6974 deliveries, 234 had antepartum-haemorrhage (3.4% prevalence rate). Abruptio-placentae was the commonest cause and accounted for 69.5% of the cases (prevalence of 2.1%) while placenta praevia accounted for 28.2% of the cases (prevalence rate of 0.9%). The mean age of the women was 31.8±5.3 years. The mean parity was 3.4±1.7 and majority (63.8%) of the women were unbooked. The commonest identifiable risk factors were multiparity and advanced maternal age. One-hundred-and sixty-six (77.9%) women were delivered through the abdominal route. Postpartum-haemorrhage occurred in 22.1% (47) of the cases while prematurity was the commonest fetal complications. Maternal mortality was 0.47% (1) while still birth was 44.1% (94). Conclusion: There is high prevalence of antepartum-haemorrhage in our environment. Abruptio-placentae was the commonest cause and associated with significant adverse fetomaternal-outcome when compared with placenta-praevia. Thus, good and quality antenatal care as well as high index of suspicion, prompt diagnosis and treatment remain the key to forestall these complications and improve fetomaternal-outcome.

Background: Maternal mortality is a preventable public health challenge in sub-Saharan Africa including Nigeria. Reporting of its trend and causes is important in auditing of care. Objectives: The study is aimed at evaluating the trends, causes, and maternal mortality rate in Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Ebonyi State, Nigeria. Materials and Methods: This is a 9-year retrospective review of case note of maternal deaths (MDs) in AEFUTHA. All pregnancy-related deaths of patients managed at the hospital were included in the study. Data obtained were analyzed using IBM SPSS Statistics version 20. Results: The maternal mortality ratio (MMR) was 1,114 per 100,000 live births. The MMR remained high at above 1,100 per 100,000 live births between 2012 and 2016; and a sharp decline was seen between 2017 and 2020. The lowest MMR was in 2018 (512 per 100,000 live births). Most of the MDs occurred in unbooked (85.4%) and grand multiparous (43.4%) women. Obstetric hemorrhage was the leading cause of death (28.0%), followed by hypertensive disorders of pregnancy. Less than 3% of MD was caused by Lassa fever. Women with low socioeconomic status, lower level of education, and rural place of abode were major contributors to MD. Conclusion: Our study shows that MD is unacceptably high in the hospital. The burden of MD is borne by unbooked and grand multiparous women. Obstetric population should be educated on the importance of antenatal care and the need for family size reduction via the use of modern method of contraception.