Ethical challenges in obstetric emergencies in low- and middle-income countries.

Obstetric emergencies are challenging, requiring implementation of a rapid sequence of interventions in a very short time to optimize clinical outcome. Managing obstetric emergencies could evoke ethical dilemmas for the obstetrician because of limited time to adequately educate the patient about her condition; impaired consciousness of the patient to give consent; nonexistent prior patient -doctor relationship and the need to consider both the patient and the fetus. In Low- and middle-income countries (LMICs), poor access to appropriate emergency care, structural and financial barriers and a largely uneducated and a deeply cultural population contribute to the ethical challenges.

Pre-operative Vs. Post-operative Vaginal Cleansing with Povidone-iodine and Post-caesarean Infectious Morbidity: A Randomized Controlled Study.

Background: Post-caesarean maternal infectious morbidity is still a big challenge despite prophylactic antibiotics use and other modalities adopted to prevent it. Pre-operative or post-operative vaginal cleansing with povidone-iodine may have effect on post-caesarean maternal infectious morbidity.

Aim: The aim of this study was to compare the effectiveness of pre-operative vs.

Prevalence and risk factors for low back pain during pregnancy among women in Abakaliki, Nigeria.

Introduction: low back pain (LBP) during pregnancy is an important health concern among women globally. The prevalence and risk factors for LBP in pregnancy vary from and within sub-regions and have implications in preventive and treatment strategies. In West African sub-region, there is scanty data on LBP during pregnancy.

Tuberculosis (TB) in pregnancy - A review.

Tuberculosis (TB) is a common infectious pathology especially in low-income countries, which may complicate pregnancy. Although pulmonary TB is more common in pregnancy than extra pulmonary TB (EPTB), EPTB is becoming more common especially in those living with human deficiency virus (HIV) co infection or have other comorbidities. The diagnosis of TB may be delayed in pregnancy due to the masking of its symptoms by those of pregnancy.

Maternal near-miss and death associated with abortive pregnancy outcome: a secondary analysis of the Nigeria Near-miss and Maternal Death Survey.

Objective: To investigate the prevalence of life-threatening complications related to pregnancies with abortive outcome and the associated health service events and performance in Nigerian public tertiary hospitals.

Design: Secondary analysis of a nationwide cross-sectional study.

Setting: Forty-two tertiary hospitals.

Profile and microbiological isolates of asymptomatic bacteriuria among pregnant women in Abakaliki, Nigeria.

Background: Detecting and treating asymptomatic bacteriuria (ASB) prevents urinary tract infection and its consequences. The cost-effectiveness of routine screening for ASB in pregnancy is controversial. In populations with high prevalence, however, it is worthwhile and justifiable.

Contraceptive prevalence and preference in a cohort of south-east Nigerian women.

Background: Rates of fertility, population growth, and maternal deaths in Nigeria are among the highest in the world, with an estimated 4% of all births being unwanted and 7% mistimed. These are caused mainly by nonuse, inappropriate choice, and difficulty in accessing contraceptive commodities. The purpose of this study was to determine the prevalence and factors influencing the choice and sources of contraceptive options among market women in Ebonyi State, Nigeria.

When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country.

Objective: To investigate the burden and causes of life-threatening maternal complications and the quality of emergency obstetric care in Nigerian public tertiary hospitals.

Design: Nationwide cross-sectional study.

Setting: Forty-two tertiary hospitals.

Perception of assent in biomedical research among medical specialists and trainees in Abakaliki, Nigeria.

Background: Assent is the child's affirmative agreement to participate in research. Consent from parents and assent from children are required in research involving children.

Objective: To determine the knowledge, perception, and level of practice of assent in children among medical specialists and trainees in research work as well as the level of ethical norms observed during research.

Global Bioethics and Culture in a Pluralistic World: How does Culture influence Bioethics in Africa?

Bioethics principles and practice can be influenced by different cultural background. This is because the four globally accepted bioethics principles are often based on basic ethical codes such as autonomy, beneficence, nonmaleficence and justice. Beneficence/nonmaleficence requires us to maximize possible benefits, while minimizing possible harms and consequently secure the well-being of others by refraining from harming them.

Outcomes of asymptomatic malaria parasitaemia in neonates in a tertiary hospital, southeast Nigeria.

Background: Malaria infestation during pregnancy is mostly asymptomatic and untreated especially in unbooked pregnancies. It presents with almost all the fetal complications of overt malaria in pregnancy. The aim of this study was to determine the effect of asymptomatic malaria parasitaemia on the neonates of unbooked parturients delivered at term at the Federal Teaching Hospital, Abakaliki.

Prevalence, pattern and consequences of intimate partner violence during pregnancy at abakaliki southeast Nigeria.

Background: Intimate partner violence (IPV) is the most common type of violence against women. It is a major public health problem and violates the fundamental human rights of women.

Aim: To determine the prevalence, pattern and consequences of IPV during pregnancy in Abakaliki, Southeast Nigeria.

Antibiotic sensitivity pattern of uropathogens from pregnant women with urinary tract infection in Abakaliki, Nigeria.

Background: Urinary tract infection (UTI) is a common bacterial infection during pregnancy and a significant cause of perinatal and maternal morbidity and mortality. The causative bacteria have remained virtually the same although with variations in individual prevalence. There has been an increasing resistance by these bacteria to the commonly available antibiotics.

Ethical Dilemma and Management of Infertility in HIV Seropositive Discordant Couples: A Case Study in Nigeria.

The traditional African society places an invaluable premium on procreation and, in some communities, a woman's place in her matrimony is only confirmed on positive reproductive outcome. Infertility is rife in Nigeria, and HIV/acquired immunodeficiency syndrome (AIDS) infection is a global pandemic, which has led to a drop in life expectancy across the world. In Nigeria, a number of cultural norms relating to gender roles and power dynamics constitute a serious barrier to issues of sexuality and infertility.

Investigating maternal mortality in a public teaching hospital, abakaliki, ebonyi state, Nigeria.

Background: Maternal mortality in sub-Saharan Africa has remained high and this is a reflection of the poor quality of maternal services.

Aim: To determine the causes, trends, and level of maternal mortality rate in Abakaliki, Ebonyi.

Materials And Methods: This was a review of the records of all maternal deaths related to pregnancy over a ten-year period, that is, January 1999 to December 2008.

Awareness and Practice of Breast Self-Examination among Market Women in Abakaliki, South East Nigeria.

Background: Breast cancer is the most common female malignancy and commonly associated with high levels of morbidity and mortality in developing countries due to late presentation. Breast self-examination (BSE) can help in early detection of the disease.

Aims: This study aims to determine the awareness and practice of BSE among market women in Abakailiki, Southeast Nigeria.

Experiences with provision of post-abortion care in a university teaching hospital in south-east Nigeria: a five year review.

The objective of the study was to review the implementation of Post Abortion Care and effective linkage to other post abortion services in Ebonyi State University Teaching Hospital, Abakaliki, Nigeria. Data on PAC over a five year period (July, 2004 to June, 2009) were analyzed and a standardized questionnaire was administered to 45 direct PAC service providers. Abortion complications constituted 41.

Risk factors and perinatal outcome of umbilical cord prolapse in Ebonyi State University Teaching Hospital, Abakaliki, Nigeria.

Aim: The goal of this study was to identify risk factors associated with umbilical cord prolapse and to document the perinatal outcome of cases of cord prolapse.

Materials And Methods: During the period of the study (from July 1, 2001 and June 30, 2007), forty-six cases of umbilical cord prolapse were identified from the labor ward record and analyzed retrospectively. Associations between cord prolapse and potential risk factors were evaluated by means of the odds ratio.

Bilateral tubal ligation in a rural hospital in the Niger Delta, Nigeria.

Background And Objective: To document bilateral tubal ligation (BTL) rates and highlight the need to improve on the rates.

Materials And Methods: A retrospective review of BTLs done in a five-year period from January 2000 to December 2004 constituted the study group.

Results: There were a total of 103 BTLs, 58 were Caesarean BTLs, six were cases of BTL with repair of uterine rupture and 39 had BTL from mini-laparotomy.

The incidence, pattern and management outcomes of early pregnancy losses at the Ebonyi State University Teaching Hospital, Abakaliki.

Background: Early pregnancy losses are a source of deep emotional trauma to any woman, her family and the attttending Gynaecologist. This study evaluated the prelence, pattern and management outcomes of such losses at a tertiary Health Institution.

Methods: Data of all women who suffered early pregnancy losses between 1st January, 2002 and 31st December, 2004, were reviewed in a descriptive study.

Higher-order multiple births in Abakaliki, Southeast Nigeria.

Introduction: Higher-order multiple births have implications for perinatal and maternal morbidity and mortality. This study aimed to determine the incidence and outcomes of higher-order multiple pregnancies in a rural area in Southeast Nigeria.

Methods: The study reviewed the data on all higher-order multiple deliveries conducted in two tertiary health institutions in Abakaliki over a seven-year period from January 2000 to December 2006.

Cervical cytology profile of infertility patients in Abakaliki, South-eastern Nigeria.

Cervical cancer is of public health importance in developing countries. High risk sexual behaviour is a risk factor. This cross-sectional study aimed at establishing the cervical cytology profile of infertile women in Abakaliki, Nigeria.

Perception of intimate pelvic examination by gynaecological clinic attendees in rural Southeast Nigeria.

Context: Intimate gynaecological examinations are part of the necessary retinue in gynaecological consultation and management.

Objective: To evaluate women's perception of digital and speculum vaginal examinations in rural Southeast Nigeria.

Methods: This was a prospective descriptive study.