International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (4), pp. 001-012, April, 2023. © International Scholars Journals

Review

Asthma and pregnancy: Coexisting and Comorbid Conditions

Sandra N. Gonzalez-Diaz¹*, Claudia I. Gallego Corella², Gabriela Galindo Rodríguez², Lucia Leal Villarreal², Alfredo Arias Cruz² and José Antonio Buenfil López²

¹Head and professor of Regional Centre of Allergy and Clinical Immunology, University Hospital, Monterrey, Mexico.

²Professor of Allergy and Clinical Immunlogy, Regional Centre of Allergy and Clinical Immunology, University Hospital, Monterrey, Mexico.

Accepted 03 December, 2022

Abstract

Asthma is the most prevalent chronic disorder to complicate pregnancy. Epidemiologically the females are 10% more likely than males to be diagnosed as having asthma in their lifetime. Asthma has been reported to affect 3.7 to 8.4 percent of pregnant women, and higher than 12% in women between 18-24 years. Asthma is considered the most common serious medical problem that could complicate pregnancy. During pregnancy the severity of asthma often changes, hence the patients need close follow up and monitoring exacerbations. The focus of asthma treatment in pregnant women is achieved the control of symptoms and maintenance of normal lung function. Poorly controlled of asthma can have an adverse effect on the fetus, resulting in increased perinatal mortality, increased prematurity and low birth weight. Acute exacerbations should be treatment aggressively in order to avoid fetal hypoxia. Treatment should include supplement oxygen, β-2 agonist and systemic corticosteroids. The evidence suggests that the risks of uncontrolled asthma are greater than any known risks from medication. The overall perinatal prognosis for children born to women with asthma that is well-controlled during pregnancy is comparable to that for children born to women without asthma.

Keywords:  asthma, pregnancy, pregnant medication, delivery, fetal growth, fetal risk.

International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (4), pp. 001-006, April, 2023. © International Scholars Journals

Full Length Research Paper

Relationships between pregnant women's body image and their decision to continue breastfeeding after giving birth

Chiejina EN* and Odira CC

Department of Nursing Science, Nnamdi Azikiwe University, Nnewi Campus, Anambra State.

Accepted 08 October, 2022

Abstract

The study examined the correlates of body image among pregnant women and their decision to breastfeed after childbirth. The population of the study was prenatal women in their third trimester selected from three Hospitals and one Health Centre in Anambra State of Nigeria, and the sample size was 200. Two research questions and two null hypotheses guided the study. The instrument used for data collection was questionnaire on Body Image and Decision to Breastfeed (QBIDBF). Mean scores, standard deviation (SD) and Spearman Rank Correlation co-efficient (rho) were used to answer the research questions while Wilcoxon Rank Sum test statistics was adopted in testing the null hypotheses at 0.01 Level of significance. The result indicated significant correlation between pregnant women’s body image and the body satisfaction they derive from decision to breastfeed. Social influence and residential location were found to have significant impact on expectant women’s body image with regard to their decision to breastfeed. It also showed that marital status of pregnant women was not significantly related to their body image with regard to their decision to breastfeed.

Keywords: Body image, Body satisfaction, Marital status, Residential location, Social influence, Pregnant women, Decision to breastfeed.

International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (3), pp. 001-004, March, 2023. © International Scholars Journals

Full Length Research Paper

Access to postnatal care in rural regions being improved by community-health workers: field project report

Garba M. Ashir¹*, Mustapha G. Modu¹, Babagana Bako², Mustapha Bello¹, Adamu I. Rabasa¹, Alhaji M. Arab¹, Yusuf A. Yusufari³, Eric E. Amuah³, Mohammed Liman⁴, Baaba B Hafsat⁵

¹Department of Paediatric, University of Maiduguri, Nigeria.

²Department of Obstetrics and Gynaecology, University of Maiduguri, Nigeria.

³PRRINN-MNCH Program, Damaturu, Yobe state Nigeria.

⁴State Ministry of Health, Damaturu, Yobe state, Nigeria.

⁵Department of O&G, State Specialist Hospital Maiduguri, Maiduguri, Borno State.

Accepted 16 January, 2023

Abstract

Access to quality postnatal care (PNC) services remain poor in Nigeria. According to the 2008 Nigeria Demographic and Health Survey, the national coverage of PNC visits was only 44% and more than 70% of mother’s who give birth at home do not see any healthcare provider during the postnatal period at all. Community-based intervention aimed testing the impact of integrated maternal newborn and child health (MNCH) outreach services by community health extension worker (CHEW). A community-CHEW partnership was formed. Serials of competency-based training on essential of newborn care were given to the CHEW. The impact of this model on PNC was evaluated. Significantly more intervention newborns received PNC by CHEWs within 48hrs of birth and at least 3 PNC visits during the first week of life [89% Vs 5%; p=0.00 and 94% Vs 11%;p=0.00 respectively]. Similarly, treatment and referral percentages for neonatal sepsis is significantly high in the intervention group [20% Vs 6%; p=0.00 and 38% Vs 0%; p=0.00 respectively]. Community Health Extension Worker-driven outreach was successful in improving the PNC coverage of a vulnerable group of remote newborns. The partnership model is easily adapted to our primary health system.

Keywords: Community-Health Worker, Postnatal Care, Nigeria.

International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (3), pp. 001-005, March, 2023. © International Scholars Journals

Full Length Research Paper

A 3-year study on the treatment of ectopic pregnancy at Aminu Kano Teaching Hospital in Kano, Nigeria

Yakasai IA, Abdullahi J and Abubakar IS

Department of Obstetrics and Gynaecology Bayero University Kano/Aminu Kano Teaching Hospital Kano, Nigeria

Accepted 27 January, 2023

Abstract

Ectopic Pregnancy is one of the commonest causes of first trimester maternal death. In addition subsequent morbidity including reproductive challenges can be distressing. The risk of severe morbidity and mortality is related to gestational sac rupture. The study aimed to evaluate the pattern of presentation and management of ectopic pregnancy in our hospital as well as identify challenges and proffer suggestions to improve overall patient care. A retrospective review of the case records of women who had emergency laparotomy based on a clinical diagnosis of ectopic pregnancy in our department between 1^st November 2008 and 31^st October 2011 was done. Ectopic pregnancy represented 4.26% of all deliveries, 5.55% of all gynaecologic admissions and 26.01% of all gynaecological surgeries. The mean age of the patients was 27.8 years with a range of 15-41years. The highest frequency occurred in the 25-34 year age groups (61.39%). The commonest presenting symptoms were abdominal pain in 98 (97.03%), amenorrhoea in 74 (73.27%) and vaginal bleeding in 65(64.36%). Thirteen patients (12.87%) presented in shock had prompt resuscitation and surgery. The main site of occurrence was tubal 89 (88.12%) and all patients had laparotomy. Salpingectomy was done in 87 (86.14%) while 1 (0.99%) each had “milking out” and linear salpingostomy respectively. Excision and reconstruction was done for the 5 (4.95%) women with ovarian pregnancies. Laparotomy was negative in 5 (4.95%) of the women and only 2 (1.98%) had a diagnostic laparoscopy prior to laparotomy. The majority of the surgery was done by the senior resident (67.33%), followed by the Registrar (29.70%) and the consultant (2.97%). Eighty six (85.15%) of the surgeries were done during call hours. Ruptured ectopic pregnancy is the main mode of presentation in our setting and laparotomy with salpingectomy is the main stay of management. However, majority of the women are haemodynamically stable at presentation and operative laparoscopy could have been a viable alternative.

Keywords: Ectopic Pregnancy, Laparotomy, Laparoscopy, Salpingectomy, Kano.

International Journal of Obstetrics and Gynecology ISSN: 2736-1594 Vol. 11 (2), pp. 001-008, February, 2023. © International Scholars Journals

Full Length Research Paper

The use of a linear cutting stapler for hysterotomy during cesarean hysterectomy for patients with placenta accreta spectrum

¹Hoang Yen Nguyen, MD, ²Yevgeniya Ioffe, MD, ²Linda Hong, MD,¹Alyssa Sanchez, BS, ¹Andrea Cragoe, MD,¹Alexander Thomas, MD, ³Ruofan Yao, MPH, MD

¹Department of Gynecology and Obstetrics, ²Department of Gynecologic Oncology,³Department of Maternal-Fetal Medicine

Loma Linda University School of Medicine, CA, Loma Linda University Children’s Hospital, Loma Linda, CA.

Accepted 13 October, 2022

Abstract

During a cesarean hysterectomy surgery for placenta accreta spectrum, two procedures contributed to the total surgical blood loss, the uterine hysterotomy portion for fetal delivery and the hysterectomy portion. Previous studies had aimed at decreasing blood loss with techniques targeting the hysterectomy portion. We aimed to evaluate the impact of performing hysterotomy utilizing a linear cutting stapler in minimizing blood loss during cesarean hysterectomy compared to the classical hysterotomy technique with scalpel in patients with suspected placenta accreta spectrum disorders. This was a single-center retrospective cohort study including a total of 95 patients undergoing cesarean hysterectomies over a period of 8 year between January 2014 and January 2022. 31 patients in the intervention group underwent hysterotomy performed with a linear cutting stapler. 64 patients in the control group underwent the classical hysterotomy performed with scalpel. The primary outcomes were quantitative total blood loss, units of red blood cell transfusion, length of postoperative stay, and intensive care unit admission. Compared to the classical hysterotomy group, the linear stapler hysterotomy group was associated with a significant reduction in surgical blood loss (1000mL vs 2553mL (p<0.001)), units of red blood cell transfused (1 vs 3 units (p<0.001)), and postoperative length of stay (3 vs 4 days (p<0.001)). The rates of surgical blood loss of >2000ml in the linear stapler hysterotomy group was 22.6% vs 48.4% (adjusted odd ratio 0.23 [0.06-0.79]). The rate of transfusion of >4unit of pRBC in the linear stapler hysterotomy group was 16.1% vs 48.4% (adjusted odd ratio 0.26 [0.07-0.97]). The method of performing hysterotomy utilizing a linear cutting stapler was associated with a significant reduction in surgical blood loss, units of red blood cell transfusions, and postoperative length of stay compared to the classical hysterotomy method via scalpel in patients undergoing cesarean hysterectomy for suspected placenta accreta spectrum.

Keywords: Placenta accreta, placental disorders, cesarean hysterectomy, linear stapler, hysterectomy, blood loss, blood transfusion.

International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (2), pp. 001-007, February, 2023. © International Scholars Journals

Full Length Research Paper

Hepatitis B and C virus co-infection in pregnancy at a Tertiary Hospital, Yenagoa, Bayelsa State, Nigeria

Kotingo E. L.* and Allagoa D.O.

Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.

Accepted 08 October, 2022

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a reasonable proportion of liver diseases worldwide. Co-infection with the two viruses is not uncommon because the two viruses share similar modes of transmission. The primary concern with HBV/HCV co-infection is that it can lead to more severe liver disease and an increased risk for progression to Hepatocellular cancer. The objective is to determine the Hepatitis B and C virus co-infection in pregnancy, their seroprevalence and clinico-epidemiological correlates. This is a descriptive cross sectional study. Two hundred and twenty (220) consecutive healthy pregnant women attending the antenatal booking clinic of the hospital who met the inclusion criteria were recruited into this study after pretest counselling and obtaining consent from them. This was tested for both HBsAg and anti-HCV antibodies with commercially available in vitro diagnostic kits (one step test strips). Data was collected via a questionnaire. Data entry and analysis was done using SPSS (statistical package for social sciences) 22 statistical package (SPSS Inc., Illinois, U.S.A). P value less than 0.05 was taken as being significant. The mean age of the pregnant women studied was 28.8 years ± 5.2 while the mean parity was 1.20 ± 1.16. Of the 220 recruited pregnant women, 4.6% (n=10) were seropositive for hepatitis B surface antigen (HBsAg) while 2.7% (n=6) were seropositive for hepatitis C viral (anti-HCV) antibodies. There was 0% Hepatitis B and C virus co-infection in pregnancy. Multiple sexual partners and Female circumcision were the significant risk factors for HBsAg seropositivity (p<0.05). None of the risk factors were significantly associated with hepatitis C viral antibody seropositivity. Hepatitis B and C virus co-infection rate in pregnancy is infinitesimal in our obstetrics population. Routine screening for Hepatitis B virus infection and advocacy for active and passive immunization to infants of seropositive pregnant women is however recommended.

Keywords: Hepatitis B virus, Hepatitis C virus, Hepatitis in pregnancy.