International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 7 (2), pp. 001-010, February, 2019. © International Scholars Journals

Full Length Research Paper

Method of birth in nulliparous women with single, cephalic, term pregnancies: The WHO global survey on maternal and perinatal health, 2004 – 2008

Margo S Harrison¹, Ana Pilar Betrán², Joshua P Vogel^2,3, Robert L Goldenberg⁴ and A Metin Gülmezoglu²

¹University of Colorado School of Medicine, Aurora, Colorado, USA.

²UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.

³Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.

⁴Maternal and Child Health Program, Burnet Institute, Melbourne, Australia.

⁵Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, USA.

Accepted 06 February, 2019

Abstract

To determine risk factors associated with cesarean birth in nulliparous women with single, cephalic, term pregnancies in spontaneous labor, also known as the Robson Group 1 population. We used the facility-based, multi-country, cross-sectional WHO Global Survey of Maternal and Perinatal Health conducted in 2004 – 2008 to examine the association between woman-, labor/obstetric-, and facility-level characteristics and cesarean birth among Robson Group 1 women using adjusted bivariate comparisons and multivariable logistic regression. We analyzed outcomes of 82,280 women in Robson Group 1, 82% of whom gave birth vaginally (67,698 women) and 18% of whom gave birth by primary cesarean (14,578 women). In adjusted analyses, woman-level factors associated with cesarean birth included age greater than 18 years old, above-normal body mass index (overweight or obese), being married or cohabitating, having attended four or more prenatal visits, and being medically high-risk (p < 0.01). Women who were obstetrically high-risk, were referred during the course of labor, or were at 39 weeks or more gestational age were also more likely to undergo cesarean birth (p-value < 0.001). The facility-level variables associated with method of birth was birth at a facility that had anesthesia service in the facility 24/7, was a teaching facility, required fees for cesarean birth, had electronic fetal monitoring available, and had providers skilled in operative vaginal birth (p < 0.01). Strategies to reduce the frequency of cesarean rates globally include avoidance of medically unnecessary primary cesarean birth. Our analysis of Robson Group 1 women who are at risk of primary cesarean birth highlights the importance of maintaining a healthy pre-pregnancy and pregnancy weight, optimizing management of women with medical problems, and ensuring clear referral mechanisms that ensure women are transferred earlier in the labor course (when warranted). Consideration of removing or reducing fees for cesarean birth warrants further exploration.

Keywords: cesarean birth, low- and middle-income countries, Robson group 1.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 7 (2), pp. 001-008, February, 2019. © International Scholars Journals

Full Length Research Paper

The impact of antenatal voluntary counseling and testing for HIV on future fertility intentions, desired family size and contraception in Uganda

B.  C. Businge^{1, 2}, B. M. J. Nannozi^{3, 4}, C. Biryabarema⁵, T. Mutyaba², J. Wandabwa¹, F. Mirembe², C. Kigundu⁵ and B. Longo-Mbenza¹*

¹Faculty of Health Sciences, Walter Sisulu University, South Africa Republic.

²Department of Obstetrics and Gynaecology, Makerere Medical School, P. O. Box 7072, Kampala, Uganda.

³Makerere University School of Public Health, Kampala, Uganda.

⁴Mengo Hospital Kampala, Uganda.

⁵Department of Obstetrics and Gynaecology, Mulago Hospital, Kampala, Uganda.

Accepted 23 October, 2018

Abstract

This study aimed is at assessing the impact of voluntary counseling and testing for HIV on family planning in a setting of high HIV prevalence and high TFR. An intervention study was conducted between January and March 2004 among women who had been counseled about HIV, STI and contraception during pregnancy followed with voluntary HIV testing. 121 HIV positive and 206 HIV negative attending antenatal clinic aged 24.6 ± 5.4 years (range 17 - 36 years) participated in this study. The independent and significant (P < 0.01) determinants of future fertility after current pregnancy were HIV sero-negative status (OR = 7.9 95% CI 4 - 16.1), monogamy (OR = 2.795 CI 1.2 - 5.5), ideal family size as ≥ 4 children (OR = 2.7 95% CI 1.3 - 5.5) and current number of live children = 0 (OR 5.8 95% CI 3.1 - 10). Knowledge of HIV serostatus had significant impact on ideal family size, but no impact on the choice of contraception method.

Key words: Uganda, HIV/AIDS, contraception, family planning.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 7 (2), pp. 001-005, February, 2019. © International Scholars Journals

Full Length Research Paper

Desire for pain relief in labour in Northeastern Nigeria

Bala Audu¹, Usman Yahaya², Mohammed Bukar¹*, Aliyu El-Nafaty², Hadiza Abdullahi¹ and Othman Kyari¹

¹Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.

²Department of Obstetrics and Gynaecology, Federal Medical Centre, Gombe, Gombe State, Nigeria.

Accepted 15 September, 2018

Abstract

Labour pain is a distressing and psychologically traumatizing experience to the parturient but little data exist in the Northeastern part of Nigeria regarding pain relief in labour, despite its many advantages. To determine the knowledge, desire and access to pain relief in labour as well as perception of labour pain. This is a cross sectional study of two hundred and fifty five women in two tertiary institutions in north-eastern Nigeria. Patients attending the antenatal clinics or staying in the lying in ward of the hospital after delivery were interviewed and questionnaires filled. One hundred and ninety (74.5%) were undelivered while 65(25.5%) were in the immediate postpartum period. One hundred women were interviewed at the University of Maiduguri Teaching Hospital (UMTH) while 155 were interviewed at the Federal medical Centre Gombe. The interviews centred on their perception of pain and duration of labour. The mean age and parity were 27.6 ± 5.7 and 2.8 ± 2.1 respectively. About 80% of those interviewed rated labour pain as severe to agonizing, 82% had no knowledge of pain relief in labour while 81.6 and 78.8% would like pain relief and recommended same, respectively. Only 11% of those interviewed were given pain relief in labour. The majority of women, 64.7% considered their labour as not prolonged. Parity (P = 0.0002), ethnicity (P = 0.020) and duration of labour (P = 0.00017) significantly influenced pain perception in labour while education (P = 0.25) and age (P = 0.4) had no significant influence on pain perception in labour. Although many of the women were not aware of pain relief in labour, the overwhelming majority would want and have recommended pain relief in labour.

Key words: labour pain, knowledge, desire.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 7 (2), pp. 001-004, February, 2019. © International Scholars Journals

Full Length Research Paper

Perception and use of contraceptive amongst female secondary school students in Lagos, Southwest Nigeria

Adetokunbo Tayo¹*, Oluwarotimi Akinola¹, Abiola Babatunde¹, Adeniyi Adewunmi¹, Dele Osinusi¹ and Lukeman Shittu²

¹Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Ikeja, Lagos.

²Department of Anatomy, Benue State University, Makurdi, Nigeria.

Accepted 19 December, 2018

Abstract

The high maternal mortality and morbidity rate in Nigeria is a major concern for every stakeholder in the health sector and unsafe abortion is a major cause. As a remedy, it was suggested that active efforts to promote sexuality education and contraceptive use should be intensified among Nigerian adolescents. In this regard, we studied the level of contraceptive knowledge and use among adolescents in three secondary schools in Lagos between January to March 2010. Results showed that 5% of 1155 students with knowledge of contraception are users, 85% of sexually active respondents were non-users while condom is the most common contraceptive method used. Also, nearly 45% of respondents obtained knowledge about contraception from their parents. We believe that there is a need for aggressive advocacy on adolescent reproductive health (ARH) before initiation of sexual activity and dissemination of information on family planning methods among the teenage.

Key words: Contraceptive knowledge and usage, sexual behaviour, adolescent, Nigeria.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 7 (2), pp. 001-006, February, 2019. © International Scholars Journals

Full Length Research Paper

A study of mobile phones used by motor vehicle drivers in Trinidad and Tobago

Abiodun Olukoga*, George Legall and Abayomi Odekunle

Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad, West Indies.

Accepted 11 November, 2018

Abstract

A cross-sectional study to determine the pattern of mobile phone use by drivers in Trinidad and Tobago. Data were obtained using a self-administered questionnaire that was completed by 1150 drivers. Data analysis was done using descriptive statistics, Chi square test and multinomial logistic regression analysis. Overall, 91% of the drivers use a mobile phone while driving. Amongst these drivers, 86% use hand-held and 14% use hands-free mobile phones. The phone calls by the drivers were reported as routine (70%) and emergency (30%). The calls were of general nature (58%), family matters (23%) and work-related (19%). The drivers believe that using a mobile phone while driving is extremely dangerous (50%) and moderately dangerous (31%). But, 25% of the drivers make no change in their driving behaviour when using a mobile phone while driving, 53% reduce their speed, 10% drive on the road shoulder and only a mere 2% stop the vehicle. There is a high level of mobile phone use by drivers in Trinidad and Tobago with the attendant challenges for road safety. There is a need for public education in Trinidad and Tobago on the hazards of mobile phone use while driving, and a concurrent need for the enactment and enforcement of legislation to curb this practice.

Key words: Hand-held, hands-free, mobile phone use, drivers, Trinidad and Tobago, West Indies.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 7 (1), pp. 001-004, January, 2019. © International Scholars Journals

Full Length Research Paper

A study of the age at menarche and menstrual cycle pattern among schoolgirls in Kassala, Sudan

Abdel Aziem A. Ali¹, Duria A. Rayis², Mona Mamoun¹ and Ishag Adam²*

¹Faculty of Medicine, Kassala University, Sudan.

²Department of Obstetrics and Gynecology, Faculty of Medicine, University of Khartoum, Sudan.

Accepted 18 December, 2018

Abstract

A cross-sectional school survey was carried out during January to February 2010 in 8 schools to investigate the age at menarche, menstrual cycle pattern among school girls in Kassala, eastern Sudan. Structured questionnaires were used to gather the socio-demographic data, age at menarche, regularity of the menstrual cycle and associated symptoms. Out of 900 schoolgirls investigated their age ranges between 9 to 19 with mean ± SD of 14.0 ± 4.7 years. Only 73% experienced menarche by the time of interview. The mean age ± SD of 13.07 ± 1.0 years, which was 0.9 year younger in the urban girls. The majority of girls (76.4%) experienced delayed menarche. The period was regular in 68.5% of these girls with the cycle length ranges between 21 to 35 days the mean ± SD duration of blood flow was 4 ± 1.2 days. The overall prevalence of dysmenorhea was 83.1 and 59.8% of the subject experienced premenstrual symptoms. In conclusion the menarcheal age was delayed in our study, it varies with residence, dysmenorrhea was a common health problem among the school girls.

Key words: Menarche, menstrual cycle, school girls, Sudan.