Background: To evaluate the perinatal status of neonates delivered by assisted vaginal delivery (AVD) versus second-stage caesarean birth (CS). Methods: A 5-year retrospective study was conducted in a tertiary hospital. Data was analyzed with IBM SPSS® version 25.0 statistical software using descriptive/inferential statistics. Results: A total of 559 births met the inclusion criteria; AVD (211; 37.7%) and second-stage CS (348; 62.3%). Over 80% of the women were aged 20-34 years: 185 (87.7%) for the AVD group, and 301 (86.5%) for the second-stage CS group. More than half of the women were parous: 106 (50.2%) for the AVD group, and 184 (52.9%) for the second-stage CS group. The commonest indication for intervention in both groups is delayed second stage: 178 (84.4%) in the AVD group, and 239 (68.9%) in the second-stage CS group. There was a statistically significant difference in decision to delivery interval (DDI) between both groups: 197 (93.4%) women in the AVD group had DDI of less than 30 min and 21 women (6.0%) in the CS group had a DDI of less than 30 min (p < 0.001). During the DDI, there were 3 (1.4%) intra-uterine foetal deaths (IUFD) in the AVD and 19 (5.5%) in the CS group (p = 0.023). After adjusting for co-variates, there were statistically significant differences between the AVD and CS groups in the foetal death during DDI (p = 0.029) and perinatal deaths (p = 0.040); but no statistically significant differences in severe perinatal outcomes (p = 0.811), APGAR scores at 5th minutes (p = 0.355), and admission into the NICU (p = 0.946). After adjusting for co-variates, use of AVD was significantly associated with the level of experience of the care provider, with resident (junior) doctors less likely to opt for AVD than CS (aOR = 0.45, 95% CI: 0.29-0.70). Conclusion: Second-stage CS when compared with AVD was not associated with improved perinatal outcomes. AVD is a practical option for reducing the rising Caesarean delivery rates without compromising the clinical status of the newborn.

No abstract

Objectives Nigeria account for a significant proportion of adverse perinatal outcome. Nigerian studies assessing impact of time of delivery on perinatal outcome are scarce. This study evaluates any associations between time of delivery and perinatal outcome. Methods This was a cross-sectional study at the Federal Teaching Hospital, Abakaliki from 01 January 2016 to 30 June 2018. Data were analysed with IBM SPSS version 25.0. Results A total of 4,556 deliveries were analysed. Majority (72.2%) delivered on week days and 27.8% on weekends. Over 90% had 1 st and 5 th minutes Apgar scores ≥7. There was statistical difference in NICU admission between morning and evening hours (p = 0.009) but not between morning and night hours (p = 0.795). ENND during evening was twice higher (1.2%) than morning (0.5%); p = 0.047 and night hours (0.6%); p = 0.623.There was no difference in the risk of fresh stillbirths between morning and evening (p = 0.560), as well as morning and night hours (p = 0.75), there was also no difference in fresh stillbirths between week days and weekends (p = 0.895). There was no difference in low Apgar scores at 1 st minute between morning and evening (p = 0.053) and night (p = 0.221), and between weekdays and weekends (p = 0.524). Similarly, there was no difference in low 5 th minute Apgar scores between morning and evening (p = 0.165) and night (p = 0.944), as well as between week days and weekends (p = 0.529). However, ENND was twice (p = 0.085) and 1.3 times higher (p = 0.526) for evening and night hours respectively, while there was no difference between weekends and week days (p = 0.652). Conclusion NICU admission and ENND were commoner during evening hours. However, work hours did not affect the rate of stillbirth and low Apgar scores during weekdays and weekends. It is pertinent for each obstetric unit to identify and modify factors responsible for unfavourable outcomes during various shifts, with the aim of improving perinatal health.

Background: The signs and symptoms of Lassa fever are initially indistinguishable from other febrile illnesses common in the tropics and complications of pregnancy. Surviving Lassa fever during pregnancy is rare. Only few cases have been documented. The antiviral drug of choice is ribavirin. Case description: A 25-year-old multigravida farmer with fever who was initially thought to have malaria in pregnancy at 29 weeks gestation. Further changes in her clinical state and laboratory tests led to a confirmation of Lassa fever. The Liver enzymes were markedly deranged and the packed cell volume was 27%. She commenced on ribavirin and subsequently was delivered of a live male neonate who was RT PCR negative for Lassa fever virus. Her clinical state improved, repeat RT PCR on day 15 was negative and she made full recovery. Discussion: The case reported had similar clinical features of fever and abdominal pain and resulted in the initial diagnoses of Malaria in pregnancy. When she failed to respond to antimalarial and antibiotics treatments, a strong suspicion of viral hemorrhagic fever was made. At this time the patient was in advanced stage of the disease with bleeding from vagina and puncture sites. On the third day of admission she was delivered of a live male neonate who remained negative after 2 consecutive RT PCR tests for Lassa fever virus. Lassa fever carries a high risk of death to the fetus throughout pregnancy and to the mother in the third trimester. Mothers with Lassa fever improved rapidly after evacuation of the uterus by spontaneous abortion, or normal delivery. She was clinically stable following delivery. Her laboratory investigations were essentially normal. Throughout her management transmission based precautions were observed. None of the six close contacts developed symptoms after been followed up for 21 days. Conclusion: This report adds to the body of literature that individuals can survive Lassa fever during pregnancy with good maternal and fetal outcome.

Background: COVID-19 is a major Public Health challenge that has affected the world’s economy. Assessment of the knowledge, attitude and practices of Healthcare workers (HCWs) towards COVID-19 can improve or sustain the successes recorded by relevant agencies in the fight against COVID-19.Methods: a cross-sectional survey was done using semi-structured questionnaires and simple sampling technique. Data collected were analyzed using SPSS version 22.Results: Out of the 368 respondents, 205 were doctors while 150 were nurses. Others were clerical workers, administrative officers and maintenance workers. Knowledge of COVID-19 was generally high amongst respondents recording a correct response to questions about knowledge of COVID-19 in more than 90% of the case. However, the attitude and practice of COVID-19 infection, prevention and control protocols were poor. Out of the respondents, 41.8% would not stay at home if they had minor COVID-19 like symptoms; only 39.4% would take responsibility to ensure people around them follow good respiratory hygiene. Respondents who would keep social distancing while talking with co-workers, ensure safe disposal of personal protective equipment (PPEs) and safe waste management of PPEs were 56%, 39.9% and 53.8% respectively.Conclusions: Knowledge of COVID-19 prevention protocols is high but attitude/practice of these laid out protocols still desires a lot of effort from HCWs. There is need for training/retraining of HCWs on COVID-19 infection, prevention and control strategies to ensure the success being recorded against the disease is sustained while preventing the possibility of a second wave of infection.

Introduction: Since the inception of our hospital in 2011, manual vacuum aspiration has been in use for the treatment first trimester miscarriages. Hence there is a need for operational review on its use. Aim: The aim of this study is to evaluate the determinants and outcome of Manual Vacuum Aspiration (MVA) use in our hospital. Method: This was a retrospective study on the use of MVA for various indications in our facility over a 5-year period. Results: There were 625 (19.7%) manual vacuum aspirations among 3179 gynaecological patients seen during the period. The age range of the women was from 15 to 48 years and the mean age was 28.5 ± 5.3 years. Incomplete abortion was the commonest indication for the use of MVA and accounted for 89.9% of cases. Other indications for the use of MVA include missed miscarriage (1.8%), and blighted ovum (1.8%). The complications were uterine perforation (0.3%), infection (3.7%) and severe anaemia (10.7%). The mean total hospital stay was 1.6 ± 0.6 days. Overall, 267 (42.7%) patients were managed as a day case. Conclusion: Manual vacuum aspiration is an effective tool in the management of early pregnancy complications. It is a safe, easily performed and possibly cost-effective procedure, with advantages for both the patient and the health care system.

No abstract

No abstract