BackgroundProlonged and obstructed labor is a significant cause of maternal morbidity and mortality in Nigeria, one of the six countries contributing significantly to the global maternal mortality crisis. The use of the partograph would engender a remarkable reduction in the number of these deaths since abnormal markers in the progress of labor would be identified early on.ObjectiveThis study aimed to evaluate the non-physician obstetric caregivers’ (OCGs) knowledge of partograph use, assess the extent of its use, determine the factors that impede its usage, and unravel the relationship between years of experience and partograph use among the respondents (OCGs) in General Hospital, Calabar, Nigeria.MethodologyUsing a self-administered semi-structured questionnaire, a cross-sectional descriptive study was conducted among 130 purposely selected and consenting OCGs working in the General Hospital, Calabar, Nigeria.ResultsThe majority of the respondents (70.8%) had good general knowledge of the partograph but lacked detailed and in-depth knowledge of the component parts of the partograph. Knowledge of partograph (χ2=12.05, P=0.0001) and partograph availability (χ2=56.5, P=0.0001) had a significant relationship with its utilization. Previous training (χ2=9.43, P=0.002) was significantly related to knowledge of partograph. Factors affecting utilization were: little or no knowledge of the partograph (85.4%), nonavailability (70%), shortage of staff (61.5%), and the fact that it is time-consuming to use (30%).ConclusionLack of detailed knowledge of the partograph, nonavailability of the partograph, poor staff numbers, and inadequate training are factors that work against the effective utilization of the partograph in the study facility. Usage of this tool for labor monitoring can be enhanced by periodic training, making partographs available in labor wards, provision of reasonable staff numbers, and mandatory institutional policy.

This work was carried out in collaboration among all authors. Authors TUA and UA conceived and framed the questionnaire, wrote the introduction and appropriate literature search and were fully involved in the discussions. Authors IBO and UEA were involved in data collection while data analysis was handled by authors AOO and MMO were involved in data entry and drafting the manuscript. Author EM did the final editing. All the authors read and approved the manuscript before it was forwarded for publication.

BackgroundD-dimer levels have been reported to increase progressively during pregnancy, but how this affects Nigerian women is not well known.ObjectiveThis study aims to determine the D-dimer concentration and its relationship to other coagulation parameters among pregnant women in Port Harcourt, Nigeria.MethodIn a cross-sectional observational study conducted in Port Harcourt, Nigeria, 120 pregnant women and 60 nonpregnant controls, drawn from a tertiary health institution in the Niger Delta, Nigeria, were assessed, using the standard procedures, for the following parameters: D-dimer concentration, prothrombin time, activated partial thromboplastin time, platelet count, hemoglobin, and packed cell volume.ResultsThe median D-dimer concentration of 153.1 ng/mL in the pregnant group was found to be significantly elevated when compared with the control value of 118.5 ng/mL (t = 2.348, P = 0.021). Conversely, there was a marked depression in the platelet count among pregnant women (193.5 × 109/L) when compared with 229.0 × 109/L in the control group (t = 3.424; P = 0.001). There was no statistically significant difference in the values for the prothrombin time and the activated partial thromboplastin time between pregnant and nonpregnant women. D-dimer values correlated positively and significantly with gestation (r = 0.36; P < 0.01) and negatively with international normalized ratio values (r = −0.281; P < 0.05). About 63.3% of the pregnant women had normal D-dimer values (0–200 ng/mL), 26.7% of the pregnant women had elevated D-dimer levels (201–499 ng/mL), while 10.0% of the pregnant women were found to be at risk of thrombosis (D-dimer > 500 ng/mL). A linear relationship was found to exist between D-dimer and gestation (y = 8.355x + 36.55; R2 = 0.130; P < 0.005).Conclusion10% of the pregnant women in this population had elevated D-dimer levels over 500 ng/mL, and through comparison with what has been reported in the literature, there is the possibility that this group may be at risk of thrombosis. Further studies, incorporating other diagnostic parameters, may be needed before a more logical conclusion can be drawn, since the D-dimer is not a specific test.

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