Background: Fetomaternal haemorrhage may occur during pregnancy or at delivery and may lead to allo-immunization to the D antigen if the mother is Rhesus (Rh) negative and the baby is Rh-positive. Objectives: To determine the incidence, socio-demographic characteristics and pregnancy outcomes of Rh negative pregnant women in a Nigeria Tertiary health care institution. Methods: A review of the clinical records of all Rh-negative pregnant women, managed at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-east Nigeria between 1st January 2009 and 31st December 2013 was done. Data were entered into Excel Spread sheet and analysed using computer Epi-Info 2013 version 7. Results: There were a total of 5561 deliveries and 117 Rh negative pregnancies during the period, given an incidence of 2.1%. Of the 117 Rh negative pregnancies, only 89 (76.1%) case files were available for analysis. Majority, 55.1% of the women were of ABO Blood Group O while ABO blood group discordance occurred in 33.7% of male partners. Seventy-one (79.8%) of the women have had previous pregnancies and only 33(46.5%) of these received anti-D prophylaxis in the previous pregnancies. Sixty-three (70.8%) of the pregnancies were booked and 48 out of 63 (76.2%) of them booked after 20 weeks of gestation. Indirect Coombs test was done in 61 out of 63 (96.8%) women that were booked but only one (1.6%) woman tested positive. None of the women had a follow-up testing. Only the woman that tested positive for indirect Coombs test had her antibody titre subsequently determined. Forty-five (50.6%) pregnancies were carried beyond date while 88.5% of the women that had postdate were delivered via caesarean section (p<0.001) with the commonest indication being fetal distress (42.9%). Sixty-one (68.5%) babies were tested post-delivery while 49 (80.3%) of 61 babies were rhesus incompatible with the mother. Only 40 (81.6%) of the incompatible mothers had Rh anti-D immunoglobulin administered after delivery. Neonatal jaundice occurred in 21.3% of the babies. There were 14 (15.7%) perinatal deaths. Conclusions: The incidence of Rhesus negative pregnancies was 2.1% while Rh isoimmunization rate was 1.6% and the uptake of Rhesus Anti-D immunoglobulin is suboptimal. Rh negative primigravida's tend to be unbooked and had significantly higher still births than their multigravid counterparts. Rhesus negative pregnancies carried beyond their dates had a significantly higher caesarean section rates than those delivered at term or before the expected date of delivery. There is need for further studies to clearly explore these trends.
Background: Fetomaternal haemorrhage may occur during pregnancy or at delivery and may lead to allo-immunization to the D antigen if the mother is Rhesus (Rh) negative and the baby is Rh-positive. Objectives: To determine the incidence, socio-demographic characteristics and pregnancy outcomes of Rh negative pregnant women in a Nigeria Tertiary health care institution. Methods: A review of the clinical records of all Rh-negative pregnant women, managed at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-east Nigeria between 1st January 2009 and 31st December 2013 was done. Data were entered into Excel Spread sheet and analysed using computer Epi-Info 2013 version 7. Results: There were a total of 5561 deliveries and 117 Rh negative pregnancies during the period, given an incidence of 2.1%. Of the 117 Rh negative pregnancies, only 89 (76.1%) case files were available for analysis. Majority, 55.1% of the women were of ABO Blood Group O while ABO blood group discordance occurred in 33.7% of male partners. Seventy-one (79.8%) of the women have had previous pregnancies and only 33(46.5%) of these received anti-D prophylaxis in the previous pregnancies. Sixty-three (70.8%) of the pregnancies were booked and 48 out of 63 (76.2%) of them booked after 20 weeks of gestation. Indirect Coombs test was done in 61 out of 63 (96.8%) women that were booked but only one (1.6%) woman tested positive. None of the women had a follow-up testing. Only the woman that tested positive for indirect Coombs test had her antibody titre subsequently determined. Forty-five (50.6%) pregnancies were carried beyond date while 88.5% of the women that had postdate were delivered via caesarean section (p<0.001) with the commonest indication being fetal distress (42.9%). Sixty-one (68.5%) babies were tested post-delivery while 49 (80.3%) of 61 babies were rhesus incompatible with the mother. Only 40 (81.6%) of the incompatible mothers had Rh anti-D immunoglobulin administered after delivery. Neonatal jaundice occurred in 21.3% of the babies. There were 14 (15.7%) perinatal deaths. Conclusions: The incidence of Rhesus negative pregnancies was 2.1% while Rh isoimmunization rate was 1.6% and the uptake of Rhesus Anti-D immunoglobulin is suboptimal. Rh negative primigravida's tend to be unbooked and had significantly higher still births than their multigravid counterparts. Rhesus negative pregnancies carried beyond their dates had a significantly higher caesarean section rates than those delivered at term or before the expected date of delivery. There is need for further studies to clearly explore these trends.
Background: Postpartum contraception enables the nursing woman recover from the effects of pregnancy and childbirth before embarking on another pregnancy. It also promotes child welfare. The assessment of the desire by pregnant women to take up postpartum contraceptive service will help the planning of good delivery of this service.Methods: A cross-sectional study of antenatal clinic attendees at Chukwuemeka Odumegwu Ojukwu Teaching Hospital, Awka was done using a pretested interviewer-administered questionnaire. Data was analyzed with IBM SPSS version 20 software and associations between variables were tested with Chi square. Level of significance was set at P ≤0.05.Results: A total of 262 antenatal women were interviewed. The mean age of the respondents was 29.1±6.1 years while the mean parity was 2.5±1.5. Two hundred and one of the study women (76.7%) had the desire to practice postpartum contraception after the index pregnancy while only 9 (3.4%) were unsure whether they had the desire or not. Multiparous women are more likely to desire postpartum contraception (P <0.01). Also, previous use of contraception (P<0.01), desired index pregnancy (P=0.01) and being married or single (P=0.02) are all significantly associated with the desire to practice postpartum contraception.Conclusions: There was a high level of desire to practice postpartum contraception among antenatal clinic attendees at Awka. Parity, marital status, desired index pregnancy and previous practice of contraception all influence this desire.
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