Background: Anemia in pregnancy is an important public health problem worldwide. Despite the efforts of government and health bodies, maternal anemia continues to be a common cause of morbidity and mortality. This suggests that other factors contribute to the high prevalence of anemia in pregnancy despite the intervention efforts. Objective: This study sought to determine the prevalence and anemic status of pregnant women at booking, to assess their knowledge of anemia and attitude to anemia prevention measures. And to determine associated risk factors for anemia and if there is a correlation between anemic status and level of knowledge/attitude to anemia prevention Methodology: An institutional-based, cross-sectional study was carried out. 322 consenting participants between 18-48 years were interviewed at booking using a structured questionnaire. Information on socio-demographic characteristics; their knowledge on causes, symptoms, prevention, and complications of anemia in pregnancy; and information on attitude towards anemia prevention strategies were collected. The PCV and HIV results of the women were retrieved. Data were entered into an Excel spreadsheet and analyzed with SPSS version 20. Associations between different variables were determined using Fisher's exact test or Chi-square test, as appropriate, and logistic regression was used to test statistical significance at P<0.05. Results: Their mean age±SD was 31.65±4.72 years and the median parity was 1.Of the 322 women, 194(60.2%) were anemic, with 186(57.8%) having mild anemia. There was no significant association between anemia and age, marital status, education, employment, parity, pregnancy interval and socio-economic status, but there was a significant association between gestational age and HIV status, with only gestational age remaining significant after logistic regression. The relationship between anemia and knowledge and attitude was not significant, but the higher educational status was significantly related to knowledge of anemia and its prevention. Conclusion: The prevalence of anemia in this study was high. Despite good knowledge and attitude to anemia prevention, late booking for ANC caused a significant association with the occurrence of anemia. Efforts are needed to encourage early booking and early commencement of iron and folic acid supplements.
Intrauterine death of a single fetus in a twin pregnancy during the second or third trimester is an uncommon complication and poses management challenge to the obstetrician. It also causes psychological stress and concern for the patient and her partner. We report a case of single fetal demise in a twin pregnancy, managed conservatively with a favourable outcome. A 31 years old lady, Para 1+1, referred from a cottage hospital, at a gestational age of 27 weeks, on account of demise of the leading twin, made on ultrasonography, following complaint of reduction in fetal movement of one-week duration. The patient was counselled and admitted to hospital for close monitoring. However, at 33 weeks gestation, six weeks following admission, she went into spontaneous labour and was subsequently delivered vaginally of a dead female leading twin (papyraceus) and a live female second twin. They weighed 300g and 2100g respectively, with a diamniotic-dichorionic placentation. Mother and baby were discharged home in stable state. The primary concern for single fetal demise in a twin pregnancy is its effect on the surviving fetus and mother. Regular antenatal care and routine ultrasonography in pregnancy are needed to make a diagnosis. Close monitoring of the wellbeing of the surviving twin and coagulation profile of the mother are crucial to manage possible complications.
Background: Labour dystocia is the commonest indication for emergency caesarean section in nulliparas, and occurs when the progress of labour is abnormally slow. Labour dystocia may be caused by abnormalities in uterine contractions, slow cervical dilatation, or mechanical disproportion between the foetal presenting part and the maternal pelvis. Augmentation of labour with oxytocin is the traditional management for labour dystocia as it enhances uterine contractions. At times, despite good uterine contractions, dystocia persists due to cervical smooth muscle spasms or mechanical factors, thereby increasing the caesarean section rate. Drotaverine is a musculotropic antispasmodic and can relieve smooth muscle spasms. Aim/objective: This study compared the caesarean section rate in term nulliparas with labour dystocia that were augmented with oxytocin and placebo versus with oxytocin and drotaverine Methods: This study was a single-blinded randomized clinical trial conducted between January and August 2021. It involved 156 term nulliparous women with labour dystocia that were randomized into two groups for augmentation of labour. Each group had 78 parturients that were managed with either oxytocin with a placebo or oxytocin with drotaverine. They were monitored till delivery and the caesarean section rate in both groups was compared. Data obtained were analysed with SPSS version 23 software. The level of significance was set at 0.05, P< 0.05 was statistically significant. Results: The two groups were similar in their sociodemographic characteristics. In this study 21(13.5%) women had emergency caesarean section while 135(86.5%) had vaginal delivery following augmentation. The caesarean section rate in the oxytocin-placebo was similar to the oxytocin-drotaverine group (10 (12.8%) vs 11 (14.1%), p=0.82). The majority, 14 (67%) of the caesarean sections were due to mechanical factors, 4 (19%) were due to functional dystocia and 3(14%) were due to foetal distress. Conclusion: The use of drotaverine with oxytocin in managing labour dystocia did not improve the caesarean section rate as the majority of the cases had mechanical dystocia.
Background: Prevention of malaria is a major priority for the roll back malaria partnership which recommends three-pronged approach for reducing the burden of malaria among pregnant women. The WHO framework for malaria prevention during pregnancy in areas of stable malaria transmission recommends IPT, use of ITN, and case management of malaria illness. Objective: This study sought to determine the knowledge of malaria and its preventive measures among pregnant women, assess their utilization of malaria preventive measures and attitude to treatment. To ascertain whether there exists any relationship between their knowledge and practice of prevention. Methodology: An institutional based, cross-sectional study was carried out. 385 consenting participants, between 18-48 years, were interviewed using a structured questionnaire. Information on socio-demographic characteristics, knowledge of malaria and its preventive measures, use of IPT and ownership/use of ITN, and attitude to treatment were recorded. Data were entered into Excel spreadsheet and analyzed with SPSS version 20. Associations between different variables were determined using Fisher’s exact test or Chi-square test, as appropriate, and logistic regression used to test statistical significance at P<0.05. Results: Of the 385 women, 307 (79.7%) had excellent (18.7%) and good (61%) knowledge, while 78 (20.3%) had average (16.6%) and poor (3.6%) knowledge. There was no difference in association of Knowledge with age, marital status, education, occupation, and parity. Of the 385 women, 61.3% were using IPT for chemoprophylaxis, 66.2% were using insecticide spray or repellants and 71.4% owned mosquito net; of these, 84% owned insecticide treated nets, but only 65.8% were using it in this current pregnancy. Reasons for not using nets ranged from unavailable 49.0%, discomfort due to heat 32.9%, fear of suffocation 6.9%, Spouse’s disapproval 3.9% and 1.0% ineffective. There was statistically significant difference between knowledge and use of IPT, ITN and insecticide sprays. Conclusion: There was adequate knowledge of malaria in pregnancy and its preventive measures, but utilization of these measures needs improvement. Efforts should be made to address barriers to utilization.
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