Is to determine the prevalence and predictors of placental malaria among pregnant women. Methodology: The study was cross-sectional in design. It was carried out over six months. We administered Pretested questionnaire to 300 eligible subjects. The researchers took maternal peripheral blood for malaria parasites while cord and placental blood sample at delivery for neonatal packed cell volume (PCV) and Malaria parasite. Data were analyzed using STATA 10. Result: One hundred and forty-four (48%) participants had placental malaria parasitemia, while 173 (57.7%) had peripheral malaria parasitemia. Maternal age less than 20 years (P=0.008), low parity, and hemoglobin type AA (P=0.002) were significantly associated with a higher prevalence of placental parasitemia. Maternal secondary and tertiary education (P=0.013), perceived susceptibility to placental malaria and IPT use (p=0.014) were significantly associated with lower prevalence. Conclusion: This study has shown that placental parasitemia is a significant problem in pregnancy as it is strongly associated with certain maternal factors. There is the need to intensify control efforts aimed at reducing malaria in pregnancy in Nigeria, and mothers with increased risk factors should receive more focused attention.
<p class="abstract">Abdominal pregnancy is a rare form of extra-uterine gestation in which implantation occurs in the peritoneal cavity, unlike this case it rarely reaches advanced gestation and viability of fetal outcome are not commonly documented. Abdominal pregnancy accounts for about 1-2% of ectopic gestation. It is associated with poor fetal outcome and great morbidity and mortality due to heamorrhage especially in a low resource setting. We present an undiagnosed advanced case of abdominal pregnancy of a 30 yr old unbooked G2P1+0 (1A) with early ultrasound estimation of 37 weeks and 6 days. She presented with (abdominal) labour pains and ultrasound diagnosis of breech presentation, suspicion of a bicornuate uterus and intrauterine growth restriction. She was planned for emergency cesarean delivery on this basis but found advanced abdominal pregnancy, and subsequently on delivery had good maternal and fetal outcome. Abdominal pregnancy with live fetus is extremely rare, and requires a high index of suspicion, to avoid high risk of maternal morbidity and mortality and it is also imperative for all healthcare givers to localized pregnancy whenever they get in contact with a woman who has recently missed her period.</p>
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Background: Literature on the antenatal and perinatal management and outcomes of COVID-19 infection in pregnancy in Nigeria and sub-Saharan Africa is gradually emerging but sparse. There is an urgent need to build up the knowledge base of COVID-19 infection in Nigerian pregnant women. The objective of the current study was to determine the clinical characteristics and management outcomes of COVID-19 infection in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.Methods: A one-year retrospective review of all cases of COVID-19 infection in pregnancy managed at the OAUTHC. Relevant data were extracted from the case records of all cases managed using a purpose-designed proforma. Data collected was analysed using IBM-SPSS, version 24. Associations between categorical variables were assessed using chi square, with level of significance set at <0.05.Results: A total of 22 cases were managed. Majority (15, 68.2%) of the women were either asymptomatic or had mild symptoms. The commonest symptom was cough (8, 36.4%). The mean duration of admission was 6.6±4.2 days. The most common maternal and perinatal complication was preterm delivery/birth (3, 13.6%). There was no maternal mortality. The mean birth weight of the babies was 3226g±597g, with mean 1- and 5- minutes Apgar scores of 8.0±1.3 and 9.5±0.6 respectively.Conclusions: Although COVID-19 infection in pregnancy is an asymptomatic or mild infection in the majority of cases in Ile-Ife, Nigeria, it is associated with adverse maternal and perinatal outcomes. Further studies are recommended to determine transplacental transmission of COVID-19 infection and antibodies.
Context: Peritoneal adhesions unlike other immediately recognizable complications of the surgery may produce long-term consequences, which include infertility and intestinal obstruction. Aims: The study aimed to determine the prevalence, the determinants, and the outcomes of laparoscopic surgery associated with intraperitoneal adhesion findings. Settings and Design: This was a retrospective observational study. Materials and Methods: The study included all laparoscopic gynecological surgeries done between January 2017 and December 2021. Adhesion severity was graded, using the peritoneal adhesion index (PAI), by Coccolini et al . Statistical Analysis: The data were analyzed using the SPSS version 21.0. Binary logistic regression was used to assess the factors associated with adhesion finding during laparoscopy. Results: There were 158 laparoscopic surgeries with 26.6% prevalence of peritoneal adhesions. The prevalence of adhesions among women with previous surgery was 72.7%. Previous peritoneal surgery was a significant determinant of occurrence of adhesions (odds ratio = 8.291, 95% confidence interval [CI] = 4.464–15.397, P < 0.001), and such patients had significantly ( P = 0.025, 95% CI = 0.408–5.704) more severe adhesions (PAI = 11.16 ± 3.94) than those without prior surgery (PAI = 8.10 ± 3.14). Abdominal myomectomy (PAI = 13.09 ± 2.95) was the most important primary surgical determinant of adhesion formation. There was no significant relationship between adhesion occurrence and conversion to laparotomy ( P = 0.121) or mean duration of surgery ( P = 0.962). Greater adhesion severity was, however, observed in individuals with operative blood loss <100 ml (PAI = 11.73 ± 3.56, P = 0.003) and those hospitalized for ≤2 days (PAI = 11.12 ± 3.81, P = 0.022). Conclusion: The prevalence of postoperative adhesions during laparoscopy in our center is comparable to what has been earlier reported. Abdominal myomectomy is associated with the greatest risk and severity of adhesions. Laparoscopy in patients with more severe adhesions resulted in less blood loss and shorter duration of hospitalization, suggesting an association of better outcomes with a cautious approach to adhesions.
<p class="abstract">A true umbilical cord knot (TUCK) is a rare event, complicating 0.3-1.3% of all pregnancies. Prenatal diagnosis is not usual, as it is mostly discovered at delivery, when the knot is identified. True cord knots are mostly asymptomatic, but can be associated with adverse perinatal outcomes such as birth asphyxia and foetal demise, owing to compression of the umbilical vessels within the knot. This compression, however, is largely dependent on how tightly the knot is formed. We report a 30-year-old booked gravida 2, para 1, with a living child, who had spontaneous vaginal delivery of a healthy male baby at term, with incidental finding of a single loose TUCK at delivery. The umbilical cord was 81 cm long. The baby weighed 3600 g at birth, with 1- and 5-minutes Apgar scores of 9 and 10 respectively, and no adverse perinatal occurrence.</p>
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