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.

Drotaverine to shorten the duration of labour in primigravidas: a randomised, double-blind, placebo-controlled trial.

Background: Drotaverine, a spasmolytic, has been found to have potential to achieve a reduction in the duration of labour and prevent prolonged labour.

Objective: To compare the effects of intravenous drotaverine hydrochloride with placebo for shortening the duration of active phase of labour in primigravidas.

Methods: A double-blind, placebo-controlled randomized trial of 246 primigravidas in active phase of labour at term was conducted.

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.

Pentazocine Alone Versus Pentazocine Plus Diclofenac for Pain Relief in the First 24 Hours after Caesarean Section: A Randomized Controlled Study.

Introduction: Postoperative pain is one of the main postoperative adverse outcomes following caesarean section. Its management still remains a challenge especially in a low resource setting.

Aim: To compare the efficacy of intramuscular pentazocine alone and combined intramuscular pentazocine with diclofenac for pain relief within 24 hours after caesarean section.

Rates and determinants of peripartum and puerperal anemia in Enugu, Nigeria.

Background: Anemia in the peripartum or postpartum period could pose a significant risk for maternal morbidity and mortality during and after delivery.

Aims: To determine the rates of anemia at term and in the puerperium and describe the determinants of puerperal anemia among a cohort of women with both normal and cesarean deliveries, following uncomplicated term singleton pregnancies in Enugu, Nigeria.

Methods: A prospective longitudinal study involving women with uncomplicated singleton pregnancies who were recruited at term at two tertiary maternity centers and were followed up with the determination of hemoglobin and ferritin concentrations till 6 weeks after delivery.

Rate and predictors of low serum ferritin levels among healthy parturient women in Enugu, Nigeria.

Background: Low serum ferritin levels signify low iron stores and this could predispose to iron deficiency anemia.

Objective: To determine the rate and predictors of low serum ferritin levels during the puerperium in Enugu, Southeast Nigeria.

Study Design: A hospital-based prospective longitudinal study involving parturient women who delivered singleton fetuses at term.

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.

Cervical cancer awareness and cervical screening uptake at the Mater Misericordiae Hospital, Afikpo, Southeast Nigeria.

Background: Cervical cancer is the most common genital tract malignancy among women in developing countries.

Objective: To assess the awareness of cervical cancer among Igbo women in a rural population of Southeastern Nigerian and determine their uptake of cervical screening services.

Materials And Methods: A questionnaire-based descriptive cross-sectional study.

Predicting mode of delivery using mid-pregnancy ultrasonographic measurement of cervical length.

Background: It has been recognized that preterm labor is related to short cervical length and that poor progress in labor is a major indication for cesarean section at term. We therefore hypothesize that long cervix is not associated with increased risk of cesarean delivery during labor at term.

Objectives: The objective is to determine the relationship between cervical length at mid-pregnancy and mode of delivery and preterm delivery.

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.