The Pattern and Spectrum of Severe Maternal Morbidities in Nigerian tertiary Hospitals.

Maternal morbidities are precursors to maternal mortality as well as potential causes of life time disability and poor quality of life. This study aimed to determine the pattern and spectrum of life-threatening maternal morbidities seen in tertiary reproductive health facilities in Nigeria. All cases of severe maternal outcome (SMO), maternal near-misses (MNM), or maternal death (MD), attending 42 tertiary hospitals across all geopolitical zones of Nigeria were prospectively identified using the WHO criteria over a period of 14 months.

Twin fetuses papyraeci in a spontaneous triplet pregnancy presenting with unexplained preterm contractions.

Fetus papyracie in a triplet pregnancy is indeed rare and can pose serious management challenges. These challenges are more pronounced where facilities for monitoring are either inadequate or nonexistent. A 39-year-old, grand multipara multipara was referred to the University of Maiduguri Teaching Hospital at 27 weeks gestation with preterm contractions.

A shortened versus standard matched postpartum magnesium sulphate regimen in the treatment of eclampsia: a randomised controlled trial.

Magnesium sulphate is currently the most ideal drug for the treatment of eclampsia but its use in Nigeria is still limited due its cost and clinicians inexperience with the drug. The purpose of this study was to determine whether a shortened postpartum course of magnesium sulphate is as effective as the standard Pritchard regimen in controlling fits in eclampsia Between January and June 2011, 98 eclamptic mothers presenting at the labour ward of the University of Maiduguri Teaching Hospital were randomised to receive either the standard Pritchard regimen of magnesium sulphate or a shortened postpartum course in which only two doses of intramuscular magnesium sulphate is given four hours apart. The maternal and fetal outcomes were compared.

Training health workers for magnesium sulfate use reduces case fatality from eclampsia: results from a multicenter trial.

Objective: To investigate the effectiveness of an intervention aimed at improving the case management of eclampsia.

Design: A multi-center intervention study.

Setting: Six teaching hospitals in Nigeria.

Birth outcome in patients presenting for hospital delivery in the second stage of labour.

Background: Even though women in labour are expected to be managed in the hospital under the care of an Obstetrician, a subset of women, who actually plan to have hospital delivery spent greater part of their labour at home without any medical assistance and only present to the labour room at full cervical dilatation.

Aim And Objectives: To compare the maternal and neonatal outcome in patients that present in the second stage of labour and those that present in the active phase of labour before full cervical dilatation.

Patients And Methods: This was a prospective case - control study comparing the maternal and neonatal outcomes of women who planned hospital delivery but presented to the labour ward of the University of Maiduguri Teaching Hospital at full cervical dilatation, following an unsupervised first stage at home.

Perforated peptic ulcer (PPU) in pregnancy during Ramadan fasting.

Background: Perforated Peptic Ulcer (PPU) is extremely rare in pregnancy. We report a case of perforated peptic ulcer in pregnancy during Ramadan fasting.

Patient And Methods: The patient is a 16 years old primigravida who presented with features of peritonitis at 28weeks of gestation while fasting during Ramadan.

The use of highly active antiretroviral therapy for the prevention of mother-to-child transmission of the human immunodeficiency virus in Nigeria.

Mother-to-child transmission of HIV accounts for 90% of paediatric HIV. The objective of this paper is to assess the outcome of preventing mother-to-child transmission of the human immunodeficiency virus (HIV), using highly active antiretroviral therapy (HAART). All pregnant women booking for antenatal care at the university of Maiduguri teaching hospital received voluntary counselling and testing for HIV.

Hydatidiform mole as seen in a university teaching hospital: a 10-year review.

Hydatidiform mole (HM), is a known cause of early pregnancy wastage and has the risk of malignant potential. This is a retrospective study of 71 patients who were managed for hydatidiform mole at the University of Maiduguri Teaching Hospital, (UMTH) Maiduguri over a 10-year period, from January 1996 to December 2005, inclusive. The objective of the study was to determine the incidence, risk factors, clinical presentations and histological types of HM.

Normal CD4 T-lymphocyte baseline in healthy HIV-negative pregnant women.

The CD4 count is frequently used as a surrogate marker for immune suppression associated with HIV infection and to monitor antiretroviral treatment. The aim of this study is to establish the normal reference values of CD4 count in healthy pregnant women in our environment. Pregnant women attending the antenatal clinic of the University of Maiduguri Teaching Hospital (UMTH) received voluntary counselling and testing for HIV.

The safety of elective caesarean section for the prevention of mother-to-child transmission of HIV-1.

The benefits of elective caesarean section (ELCS) for the prevention of mother-to-child transmission (PMTCT) of HIV are now well known. However, the benefits of such a procedure must be weighed against the risks involved. This study examines the risks of ELCS for PMTCT at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria, from January-December 2006 inclusive.

Cervical dysplasia in HIV infected women in Maiduguri, Nigeria.

The human immunodeficiency virus (HIV) infection has been shown to be a risk factor for premalignant and malignant conditions of the cervix. Patients attending the gynaecological clinic of the University of Maiduguri Teaching Hospital received voluntary counselling and testing (VCT) for HIV. All patients who were screened for HIV also had their pap smear taken.

The value of the secondary yolk sac in predicting pregnancy outcome.

One hundred and five consecutive women had transvaginal sonography (TVS) at less than 12 weeks gestation to establish the normal size and shape of the secondary yolk sac (YS) and to assess the YS measurements in predicting pregnancy outcome in the first trimester. A yolk sac diameter more or less than two standard deviation (2SD) from the mean predicted abnormal pregnancy outcome with a sensitivity of 91.4%, specificity of 66% and a positive predictive value of 88.

Caesarean morbidity and mortality at Maiduguri, Nigeria.

A total of 2456 deliveries took place at the University of Maiduguri Teaching Hospital, Maiduguri, between January 1995 and December 1996 inclusive. Two hundred and five women were delivered by caesarean giving a caesarean section rate of 8.3%.

Maternal mortality in Maiduguri, Nigeria.

Maternal mortality is an index of the standard of antenatal care in a given environment. In developed countries the level of antenatal care has risen to an extent that maternal mortality has virtually disappeared (Nylander and Adekunle, 1990). This is in sharp contrast with the situation in developing countries like Nigeria where maternal mortality is still deplorably high.

From low-lying implantation to placenta praevia: a longitudinal ultrasonic assessment.

A study of 895 consecutive pregnant women studied by transabdominal ultrasound scan showed an incidence of 14.6% of low-lying placenta at 12-14 weeks' gestation. Longitudinal follow-up of those with low-lying placenta showed that 85% of them had normally situated placenta at term.

Prevention of mother-to-child transmission of HIV at Maiduguri, Nigeria.

The human immunodeficiency virus (HIV) can be transmitted vertically through the placenta in utero, during labour and delivery and through breast milk. In Nigeria, about 5.8% of women attending antenatal clinics were HIV infected as of December 2002.

Diagnostic features of cervical incompetence among women in Maiduguri.

The study was a review of the clinical features used to diagnose cervical incompetence. One hundred and forty-one clinical records of patients who had cervical cerclage inserted for cervical incompetence at the University of Maiduguri Teaching Hospital over a 5-year period, were studied retrospectively. Previous mid-trimester abortion occurred in 80.

Transvaginal ultrasound scan versus laparoscopy in the diagnosis of suspected ectopic pregnancy.

This is a prospective study comparing the performance of transvaginal ultrasound scan with laparoscopy as the last diagnostic tool in a clinically suspected ectopic pregnancy. Both diagnostic methods have the same sensitivity of 100%. Transvaginal ultrasound scan had a specificity of 73.

Normal fetal growth pattern in a Nigerian population.

The objective of this study was to establish normal reference range values for gestational age-specific fetal weights for normal pregnancies in our population. A longitudinal prospective assessment of fetal weight in healthy pregnant women was carried out. The subjects were recruited at 20 or 22 weeks' gestation and concluded at 40 or 42 weeks' respectively.

Severe burn injury in pregnancy in Northern Nigeria.

A total of 21 cases of severe burns in pregnancy managed at the University of Maiduguri Teaching Hospital, Maiduguri, over a 10-year period, spanning January 1991-December 2000 inclusively were reviewed. The pregnancy loss was 92.9%, with the pregnancies spontaneously terminated within 10 days of sustaining the injury.

Cutaneous metastasis of gestational choriocarcinoma.

A 40-year-old woman presented with subcutaneous masses on her chest wall, abnormal vaginal bleeding and an enlarged uterus. Chest X-ray and liver ultrasound revealed metastatic disease to these sites, respectively. A urine human chorionic gonadotrophin assay was positive.

A longitudinal study of amniotic fluid index in normal pregnancy in Nigerian women.

Objective: To establish normal reference values of amniotic fluid index by week of gestation for normal pregnancies in our population.

Method: A longitudinal prospective assessment of amniotic fluid index in healthy pregnant women carrying singleton pregnancies. The subjects were recruited at 20 or 22 weeks of gestation and concluded at 40 or 42 weeks of gestation.