Background and objective: A decision-to-delivery interval (DDI) of 30 minutes for emergency Caesarean sections (CS) has been widely recommended, but there is little evidence to support it. Recent studies however, have questioned not only the practicability of this target but also its anticipated beneficial effect on neonatal outcome and medico-legal implications. Our objective in this study was to find out the time between decision-delivery interval and perinatal outcome of emergency caesarean section at a tertiary care institution in Nigeria Methods: This was a retrospective study of cases of emergency Caesarean section performed over a 12-month period. Relevant data were collected from the labour ward and theatre records and case files of the University of Benin Teaching Hospital, Benin City, Nigeria between January 1 and December 31, 2012. Results: A total of 352 emergency Caesarean sections done during the period were reviewed. Only 20 (5.7%) of these were performed within the recommended 30 minutes DDI. The mean DDI was 106.3 + 79.5 minutes and there was no significant correlation between DDI and perinatal outcome. The major causes of delay were anaesthetic delay and busy theatre suits. Conclusion: This study demonstrated a lack of correlation between DDI and perinatal outcome, which may indicate decision delivery interval of 30 minutes or less may not be applicable to all emergency CS, especially in developing countries with infrastructural challenges. However when faced with acute or catastrophic foetal or maternal conditions, expedited delivery is indicated.

Plasma vitamin C was found to be lower in women with PPROM. Low plasma vitamin C concentration may thus be an associated risk factor for PPROM. Hence improved dietary or drug supplements may be a useful adjunctive strategy to reducing the incidence of PPROM and its attendant adverse sequelae. While this intervention is advocated, further multicentre investigation of the effects of vitamin C on risk of preterm PROM is suggested.

Objective:To determine the serum calcium-magnesium ratio in pre-eclampsia and compare with normotensives. Methods:A case-control study was conducted in a tertiary hospital between October 2017 and March 2018 among 81 pregnant women (27 cases and 54 controls matched for age, gestational age, and parity). An interviewer-administered questionnaire was used to obtain data on demography/clinical history. Venous blood was collected without stasis and sent for biochemical analysis. Statistical analysis used IBM SPSS 21.0. Results: The levels of serum Ca 2+ (7.73 + 1.24 vs 9.17 + 0.77; P<0.001), Ca 2+ -Mg 2+ ratio (3.36 + 0.60 vs 3.83 + 0.41; P=0.001), and Mg 2+ (2.35 + 0.35 vs 2.41 + 0.16; P=0.469) were lower among cases. Serum Ca 2+ level correlated negatively with systolic (r=0.45, P=0.05) and diastolic blood pressure (r=0.50, P=0.010) among the cases. Hypocalcemia was a risk factor (adjusted odds ratio [AOR] 7.63, 95% confidence interval [CI] 1.64-35.37) while social classes 2 and 3 were protective factors (AOR 0.01, 95% CI 0.00-0.46 and AOR 0.01, 95% CI 0.00-0.24, respectively) against pre-eclampsia. Conclusion:The result of this research supported the implication of micronutrients in pre-eclampsia and may help to understand the pathophysiological process of pre-eclampsia. It will also help to establish and enhance existing preventive strategies for the condition. The recommendation by WHO on calcium supplementation in pregnancy as a step in preventing the occurrence of pre-eclampsia should be practiced.

High cost and delay in service purchase are major contributory factors to the decline of utilization of maternity services at the UBTH.

Chlorpheniramine (CP), a histamine H1-receptor antagonist, enhances the efficacy of chloroquine (CQ) in acute uncomplicated falciparum malaria. The effects of this combination therapy on the pharmacokinetic disposition of CQ is, however, unpredictable. A standard treatment with 25 mg CQ base per kg bodyweight was orally administered over 3 days, alone or in combination with CP, to 17 semi-immune Nigerian children with Plasmodium falciparum parasitaemia attending hospital in Lagos, Nigeria, and observed for 28 days. Whole-blood CQ concentrations were monitored 14 times during the follow-up by high-performance liquid chromatography analysis of blood dried on filter paper. Parasitaemia was determined on thick blood films stained with Giemsa, and treatment failures were established following the WHO classification for CQ resistance. Our pharmacokinetic data showed that the peak whole-blood CQ concentration was significantly increased (P < 0.05) by CP administration, and the time to achieve the peak was reduced in the presence of CP. The area under the first-moment drug-concentration-time curve was also significantly increased (P < 0.05) by CP administration. Treatment with CQ-CP combination resulted in a shorter parasite clearance time (2.0 +/- 0.5 days) and a higher cure rate (87.5%) compared to treatment with CQ alone (3.5 +/- 0.5 days; 66.7%). Our data suggest that CP enhanced the efficacy of CQ against resistant P. falciparum in acute uncomplicated malaria by increasing the uptake/concentration of CQ in resistant parasites.