<p><strong>Background: </strong>One of the major short comings of hysterosalpingography is discomfort and/or pain for the patient during or after the investigative modality; and this is a major cause of anxiety for many patients.<strong> </strong>Objectives were to compare the effectiveness of paracervical block with 2% lignocaine and placebo in pain reduction when undergoing hysterosalpingography.<strong></strong></p><p><strong>Methods: </strong>This randomised control trial was conducted at the radiology departments and infertility clinics of the Federal Medical Centre, Yenagoa and Niger Delta University Teaching Hospital, Okolobiri, both in Bayelsa State, Nigeria, from July 2021-February 2022. Three hundred and eighty infertile women undergoing hysterosalpingography were assigned into two groups. Women in group I received paracervical block, while the women in group II received placebo. Data were analysed using statistical product and service solutions for windows® version 25. Results were presented in frequencies and percentages for categorical variables; mean and standard deviation for continuous variables. Student’s t-test was used to compare sample means; and Chi-square for associations.<strong></strong></p><p><strong>Results: </strong>The mean pain score ± SD for group I was 3.8±2.6, while that in group II was 6.2±2.2. The difference between the means was statistically significant (t=9.77; p=0.001). While 140 (73.7%) women experienced moderate pain in group II, 70 (36.8%) women in Group I experienced moderate pain.<strong></strong></p><p><strong>Conclusions: </strong>Our study revealed that paracervical block improved the overall pain score of women undergoing hysterosalpingography, although a significant proportion of the women expressed some pain during instillation of contrast media.</p><p> </p>
Background: An important sign of congenital heart disease (CHD), myocardial dysfunction and foetal congestive cardiac failure is cardiomegaly, which is detected using the assessment of the cardiothoracic (CT) ratio. Objective: To evaluate the foetal CT ratio and its relationship with gestational age in the second half of pregnancy, and produce nomograms for the foetal CT ratio. Subjects and Methods: This descriptive, cross‐sectional study enrolled women with a normal pregnancy in their second and third trimesters at the two tertiary health facilities, one secondary facility and one radiodiagnostic facility in Bayelsa State, Nigeria. The study was conducted from April–December 2022. Pearson's correlation and logistic regression analyses were used to assess the relationship and correlation between the CT ratio, gestational age, and estimated foetal weight. The p<0.05 at 95%CI level of significance was set. Results: The mean bi-parietal diameter estimated foetal weight and CT diameter ratio was 66.5 ± 18.3 mm, 1.24 ± 0.87 kg and 0.46 ± 0.02 cm respectively. The foetal CT ratio correlates very strongly with estimated gestational age (ɼ = 0.98; p – 0.001), bi-parietal diameter (ɼ = 0.96; p – 0.001), estimated foetal weight (ɼ = 0.92; p – 0.001), Maternal age (ɼ = 0.36; p – 0.001), maternal weight (ɼ = 0.19; p – 0.001) and maternal height (ɼ = 0.20; p – 0.001). Conclusion: We have demonstrated that there does exist a very strong correlation between the foetal cardiothoracic ratio and the foetal gestational age, biparietal diameter and foetal weight, which slightly, but steadily increased throughout pregnancy.
Background: Foetal mitral annular plane systolic excursion (fMAPSE) helps in the evaluation of the left foetal cardiac function, which is key in the early diagnosis of congenital heart defects and abnormalities. Objectives: To assess foetal MAPSE in the second half of normal pregnancy, to establish reference ranges for this measurement in our environment, and to determine the relationship between foetal MAPSE and gestational age and estimated foetal weight. Materials and Methods: This descriptive cross-sectional study was conducted between March 2022 and August 2022 at the Obstetric Units and Radiology Departments of the two tertiary facilities, one secondary facility and one radiodiagnostic facility in Bayelsa State, Nigeria. Consenting pregnant women presenting to the antenatal clinics of the study centres during the second half of pregnancy were consecutively included. Obstetric ultrasound scans were was transabdominally. Data were analysed using SPSS version 25. Results: The correlation coefficient (ɼ) between fMAPSE and gestational age was 0.21 with a p-value of 0.001, reflecting a significant but weak relationship between fMAPSE and gestational age. There was a positively weak but significant relationship (ɼ = 0.29; p -0.001) between fMAPSE and estimated foetal weight. Conclusion: Our study revealed that there was a significant relationship between fMAPSE and gestational age, and between fMAPSE and estimated foetal weight, which correlates with published data around the globe.
Background: Foetal tricuspid annular plane systolic excursion (fTAPSE) in-utero helps in the evaluation of the right foetal cardiac function, which is key in the early diagnosis of congenital heart defects and abnormalities. Objectives of the study was to assess foetal TAPSE in the second half of normal pregnancy, establish reference ranges for this measurement in our environment, and to determine the relationship of foetal TAPSE with gestational age and estimated foetal weight.Methods: This descriptive cross-sectional study was conducted between March 2022 and August 2022 at the Obstetric Units and Radiology Departments of the two tertiary facilities, one secondary facility and one radiodiagnostic facility in Bayelsa State, Nigeria. Consenting pregnant women presenting to the antenatal clinic during the second half of pregnancy were consecutively included. An obstetric ultrasound scan was performed transabdominally. Data were analysed using SPSS version 25.Results: There was a very strong, positive and significant relationship between fTAPSE and gestational age (ɼ=0.81; p=0.001); and between fTAPSE and estimated foetal weight (ɼ=0.79; p=0.001). The mean fTAPSE and standard deviation from the 20th to the 23rd week of gestation were 2.10±1.11 mm, 2.43±0.95, 2.74±0.84 mm and 2.94±0.70 mm, showing a gradual increase in mean fTAPSE as gestational age increases.Conclusions: Our study revealed that there was a significant relationship between fTAPSE and gestational age; and between fTAPSE and estimated foetal weight, which correlates with published data around the globe.
Background: Hysterosalpingography is an investigative modality used in the evaluation of the uterine cavity, fallopian tubes, and adjacent peritoneal cavity following the injection of contrast material through the cervical canal. Objective: To determine the relationship between abnormal cervical findings and abnormal results at hysterosalpingography in infertile women. Materials and Methods: This descriptive, cross-sectional study conducted at the Obstetrics and Gynaecology, and Radiology Departments of four health institutions in Bayelsa State, Nigeria, between June and December, 2022. Hysterosalpingography was done for 332 infertile women, after obtaining written informed consent. Data were entered into a pre-designed proforma, and analysed using Statistical Product and Service Solutions (SPSS) version 25.0. Results were presented in frequencies and percentages for categorical variables, and mean and standard deviation for continuous variables. Results: Cervical finding was normal in only 49.7% (n=165) of the participants undergoing HSG. The abnormal cervical findings include deformed (27.7%), hyperaemic (5.7%), dull (5.7%), hard (5.7%) and short (5.4%) cervix. There was a statistically significant relationship between abnormal cervical findings during HSG and tubal blockade (ꭓ2 = 196.7; p – 0.001), presence of salpingitis (ꭓ2 = 41.1; p – 0.001), peritubal adhesion (ꭓ2 = 19.9; p – 0.001) and intrauterine adhesion (ꭓ2 = 35.62; p – 0.001). Conclusion: Intrauterine adhesion, salpingitis, tubal blockade and peritubal adhesion on HSG is associated with some abnormal cervical findings in about half of infertile women in this study. The same pathological processes responsible for injury to the upper genital tract and tubal infertility may have caused injury to the cervix in the group of women.
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