BackgroundThe pain of childbirth is arguably the most severe pain that most women will endure in their lifetime. Epidural analgesia is widely used as an effective method of pain relief in labor. It provides almost complete relief of pain if administered timely, and does not affect the progress of the first stage labor.ObjectivesThe objective of this study was to determine the awareness and utilization of epidural analgesia in labor in pregnant women attending the antenatal clinic at Federal Teaching Hospital, Abakaliki (FETHA).MethodologyThis is a cross-sectional study involving 350 women attending the antenatal clinic between April 2016 and July 2016. A total of 335 questionnaires were correctly completed, and used for analysis.ResultsThe average age and parity of the respondents were 27.6±8.2 years and 2.4±1.8, respectively. About 58.2% of respondents were civil servants, 98.5% were married, and 74.6% had a tertiary level of education. About 43.3% of the respondents are aware of the use of epidural analgesia in labor, but only 7.5% had used it; 95% of these were satisfied and desired to use it again. The reasons responsible for the poor uptake were desire to experience natural labor, cost, and fear of side effects. However, 70% of those who had not used it expressed the desire to use it.ConclusionEpidural analgesia is one of the most effective methods of pain relief in labor. However, the present study indicates that knowledge and practice of epidural analgesia among parturients are low. Efforts should be made to raise awareness, dispel misconceptions, and subsidize the cost of providing this invaluable care in modern day obstetrics.

There was high level of non-compliance to standard medical waste management procedures, and lack of training on occupational safety measures. Relevant regulating agencies should step up efforts at monitoring and regulation of healthcare activities and ensure staff training on safe handling and disposal of hospital waste.

Background: The application of invasive obstetric procedures has an end point of reducing the Caesarean section rate. The declining rate of use of these procedures is one of the reasons for increasing Caesarean section rates in our environment. Objective: The aim of the study was to determine the practice of operative vaginal deliveries among obstetricians practicing in Nigeria and to evaluate the reasons for non-use of these procedures. Methodology: It was a questionnaire based study. The questionnaires were administered to practitioners of Obstetrics in the various centres in Nigeria. Data was collated and analyzed with Epi-Info statistical software version 7.0 (Center for Disease Control and Prevention, USA), and conclusions were drawn by means of descriptive statistics. Results: A total of 1200 questionnaire were distributed but 1104 were returned and used for analysis. This gave a response rate of 92%. The age distribution of the respondents showed that the 20-30 year age group had the least number of respondents 22 (2%) while 41-50 age group had the highest number of respondents 486 (4%). The majority of the respondents were males 839 (76%). In terms of duration of practice, 449 (40.7%) of the respondents had more than 6 years duration of practice while 256 (23.2) had practiced for less than 3 years. Tertiary centres had highest number of respondents 71.8%. The distribution of the respondents according to the geopolitical zones in Nigeria are; SouthEast (57.6%), South-South (19.6%), South West (11.4%), NorthWest (4.9%), NorthEast (3.8%), North-Central (2.7%).

Background: The Bartholin's gland cysts and abscesses are one of the most common vulva cyst or abscesses in gynaecological practice. Symptomatic cases give significant discomfort to sufferers and have a negative impact on their quality of life. Objective: To investigate the incidence, pattern of presentation and management of Barthholin's gland cysts and abscesses in the Federal Teaching Hospital Abakaliki (FETHA) Ebonyi State, Nigeria. Methodology: This was a four-year retrospective study of cases of Bartholin's gland cysts and abscesses in FETHA. We studied all cases of Bartholin's gland cysts and abscesses that were managed at the Federal Teaching Hospital Abakaliki from 1 st January 2012 to 31 st December 2015. Results: During the study period, there were 1015 gynaecological surgical cases of which 18 were for Bartholin's gland cysts or abscess giving an incidence of 1.78%. The mean age of the patients was 28.8 ± 5.6 years with 61% of the patients within the age range of 21 to 30 years. The commonest risk factor that was found for the occurrence of Bartholin's gland cyst or abscess was previous history of the disease in 14 (77.8%) followed by previous history of sexually transmitted diseases 8 (44.4%). Pain was the commonest presenting symptom in 14 (77.8%) of cases. The left vulva was the commonest site of disease as noted in 15 (83.3%) of patients. Escherichia coli and Staphylococcus aureus were the commonest isolates on swabs with 16 (88.9%) and 14 (77.8%) prevalence respectively. The disease presented commonly in form of abscess as observed in 10 (55.6%) of patients. All the patients had Marsupialization as the modality of treatment. Conclusion: Symptomatic Bartholin's gland cyst and abscess cause significant morbidity for the sufferers and decreased quality of life. Accurate diagnosis and treatment is advocated to prevent chronicity and complications. Although options of treatment abound, Marsupialization remains the mainstay of treatment in low resource setting like ours.

Introduction: Since the inception of our hospital in 2011, manual vacuum aspiration has been in use for the treatment first trimester miscarriages. Hence there is a need for operational review on its use. Aim: The aim of this study is to evaluate the determinants and outcome of Manual Vacuum Aspiration (MVA) use in our hospital. Method: This was a retrospective study on the use of MVA for various indications in our facility over a 5-year period. Results: There were 625 (19.7%) manual vacuum aspirations among 3179 gynaecological patients seen during the period. The age range of the women was from 15 to 48 years and the mean age was 28.5 ± 5.3 years. Incomplete abortion was the commonest indication for the use of MVA and accounted for 89.9% of cases. Other indications for the use of MVA include missed miscarriage (1.8%), and blighted ovum (1.8%). The complications were uterine perforation (0.3%), infection (3.7%) and severe anaemia (10.7%). The mean total hospital stay was 1.6 ± 0.6 days. Overall, 267 (42.7%) patients were managed as a day case. Conclusion: Manual vacuum aspiration is an effective tool in the management of early pregnancy complications. It is a safe, easily performed and possibly cost-effective procedure, with advantages for both the patient and the health care system.