Should obstetric mortality be an inalienable right?

Background: Obstetricians often times find themselves in a conflict of right and duty with their patients, when these patients refuse recommended treatment. On the one hand, the obstetrician, aiming to fulfil the duty of care, recommends a treatment in the best interest of the woman. The woman, on the other hand, exercising her right of self-determination and autonomy, declines the recommended treatment.

A Study to Evaluate the Practice and Training in Obstetric Ultrasound at Accredited Obstetrics and Gynaecology Training Institutions in Nigeria.

Background: There is a global trend towards domiciling Obstetric and Gynaecologic ultrasound scan services and training within the Obstetrics and Gynaecology Department. This requires readiness on the part of the Obstetrics and Gynaecology residency programmes to offer hands-on training and mentorship to its trainees. This study aims to assess the services and training potential of these centres in Obstetrics and Gynaecology ultrasound in Nigeria.

A modern-day experience with Brunschwig's operation: Outcomes associated with pelvic exenteration.

Objective: To evaluate postoperative and oncologic outcomes associated with pelvic exenteration for non-ovarian gynecologic malignancies.

Methods: This was a retrospective review of patients who underwent pelvic exenteration for non-ovarian gynecologic malignancies at our institution from 1/1/2010-12/31/2019. Palliative exenteration cases were excluded from survival analysis.

Nigerian resident doctors' work schedule: A national study.

Background And Aim: The deleterious effects of Resident Doctors' (RDs') long duty hours are well documented. Driven by concerns over the physician's well-being and patient safety, the RDs' duty hours in many developed countries have been capped. However, in Nigeria and many African countries, there are no official regulations on work hours of RDs.

Eight-hour versus 24-h urethral catheter removal following elective caesarean section for reducing significant bacteriuria: A randomized controlled trial.

Background: There is no consensus on the preferred time to remove urethral catheter post caesarean section.

Aim: To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section.

Methods: A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted.

Pelvic exenteration for recurrent or persistent gynecologic malignancies: Clinical and histopathologic factors predicting recurrence and survival in a modern cohort.

Objectives: To explore pre-operative factors and their impact on overall survival (OS) in a modern cohort of patients who underwent pelvic exenteration (PE) for gynecologic malignancies.

Methods: A retrospective review was performed for all patients who underwent a PE from 1/1/2010 through 12/31/2018 at our institution. Inclusion criteria were exenteration due to recurrent or progressive carcinoma of the uterus, cervix, vagina or vulva, with histologically confirmed complete surgical resection of the malignancy.

Nigerian Surgical Trainees' Work Schedule: It is Time for a Change!

Background: Unregulated work schedules have deleterious effects on trainees' productivity and patients' safety. For these reasons, duty hours have been capped in many developed countries. Such regulations, however, appear to be lacking in many parts of Africa, and the effects of unregulated work hours in this part of the world have only been scantily documented.

Severe Maternal Outcomes Associated with Abortion-Related Sepsis at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria: Experience from the Last Decade of Millennium Development Goal Era.

Background: Abortion-related sepsis contributes significantly to reproductive morbidity and preventable mortality in Nigeria. Effective strategies to combat the associated Severe Maternal Outcomes (SMO) requires reliable statistics and an understanding of the immediate contributors.

Methods: A retrospective review of women managed for abortion-related sepsis between September, 2006 and August, 2015 at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.

Antenatal Dexamethasone for Early Preterm Birth in Low-Resource Countries.

Background: The safety and efficacy of antenatal glucocorticoids in women in low-resource countries who are at risk for preterm birth are uncertain.

Methods: We conducted a multicountry, randomized trial involving pregnant women between 26 weeks 0 days and 33 weeks 6 days of gestation who were at risk for preterm birth. The participants were assigned to intramuscular dexamethasone or identical placebo.

Normative references and clinical correlates of fetal umbilical artery Doppler indices in southwestern Nigeria.

Objective: To derive normative references for umbilical artery (UA) Doppler indices, including pulsatility index (PI), resistance index (RI), and systolic/diastolic (SD) ratio, for singleton pregnancies in Ile-Ife, Nigeria, and compare them with reference values from other populations.

Methods: A longitudinal study involving 415 women with a singleton fetus at 26-40 gestational weeks attending Obafemi Awolowo University Hospital, Ile-Ife, between July 2015 and March 2019. Fetal UA PI, RI, and SD ratio were measured every 4 weeks until delivery.

Ovarian Cancer After Prophylactic Salpingectomy in a Patient With Germline BRCA1 Mutation.

Background: Women with germline BRCA1 or BRCA2 mutations have a lifetime risk of ovarian cancer of up to 46%. Opportunistic salpingectomy has been advocated as a risk-reducing strategy owing to increasing recognition of tubal origin, yet evidence of efficacy in this high-risk population is limited.

Case: This is the case of a woman with a BRCA1 mutation who underwent prophylactic mastectomy and bilateral salpingectomy with ovarian retention before the age of 40 years.

A prospective study of severity of complications associated with use of misoprostol and other abortion methods in South West Nigeria.

Objectives: To assess the severity of complications following misoprostol used to induce abortion compared with other methods among women admitted for postabortion complications.

Methods: A cross-sectional study of women who presented with complications of induced abortion at nine secondary and tertiary hospitals in South West Nigeria between April 1, 2013 and May 31, 2014. Face-to-face interviews were conducted and information on the current admission was extracted from patient records.

Narratives of women presenting with abortion complications in Southwestern Nigeria: A qualitative study.

Unsafe abortion continues to impact negatively on women's health in countries with restrictive abortion laws. It remains one of the leading causes of maternal mortality and morbidity. Paradoxically, modern contraceptive prevalence remains low and the unmet need for contraception continues to mirror unwanted pregnancy rates in many countries within sub-Saharan Africa.

Prevalence and obstetric outcome of women with red cell antibodies in pregnancy at the Leeds Teaching Hospitals NHS Trust, West Yorkshire, England.

Objective: The prevalence of red cell antibodies in pregnancy varies with ethnicity and geographical location, while the obstetric outcome depends on the available standard of care. Despite being the tertiary fetal medicine centre in West Yorkshire, the prevalence of red cell antibodies, and the outcome of pregnancies associated with these antibodies at the Leeds University Teaching Hospitals Trust remains unreported. This article aims to provide this information for the purpose of patient education and counselling.

Trends in misoprostol use and abortion complications: A cross-sectional study from nine referral hospitals in Nigeria.

Objective: The study aimed to assess the use of misoprostol and complications associated with abortions in referral hospitals in Nigeria, a country with restrictive abortion laws.

Methods: A cross-sectional study at nine referral hospitals in South-west Nigeria. Nine years' data were retrieved from medical records, including 699 induced abortions.

Pregnancy-related acute kidney injury requiring dialysis as an indicator of severe adverse maternal morbidity at a tertiary center in Southwest Nigeria.

Objective: Despite being a Critical Intervention in the WHO Near-miss concept, the indications and clinical outcomes of patients with Pregnancy-Related Acute Kidney Injury (PRAKI) requiring dialysis at the Obafemi Awolowo University Teaching Hospitals Complex, Nigeria remain unknown. This retrospective review was conducted to facilitate counselling, prognostication and introduction of preventative measures by providing contemporary data on the aetiology and clinical outcomes of women with PRAKI.

Study Design: A retrospective review.

Factors associated with the desire for companionship during labor in a Nigerian community.

Objective: To determine preferences for companionship during labor and to identify associated factors.

Methods: The present prospective cross-sectional survey was conducted at a university teaching hospital in Nigeria between September 1, 2011, and February 28, 2012. Participants included women who underwent the first stage of labor and delivery at the facility, male partners, and healthcare workers from the maternity unit.

Maternal mortality in the last triennium of the Millennium Development Goal Era at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

Unlabelled: The maternal mortality ratio (MMR) of Nigeria remains high. This retrospective study aims to suggest evidence-based strategies towards achieving the sustainable development goal target 3.1 at the Obafemi Awolowo University Teaching Hospital (OAUTHC), Nigeria by providing contemporary data on MMR between October 2012 and September 2015.

Clinical correlates of leiomyoma estrogen and progesterone receptors among Nigerian women.

Objective: To compare the expression of estrogen receptor α (ERα) and progesterone receptor (PR) in myometrium and leiomyomata tissue, and to correlate their expression with symptoms of uterine leiomyomata.

Methods: In a cross-sectional study, intraoperative biopsy samples of leiomyomata and adjacent myometrial specimens were obtained from premenopausal women with uterine leiomyomata treated at a center in Nigeria between September 2013 and August 2014. Immunohistochemistry for ERα and PR expression was performed on the samples.