Open Access Minireview Article

Genitourinary Syndrome of Menopause (GSM)- Pap Test and Gram Findings

José Eleutério Junior, Renata Mírian Nunes Eleutério, João Victor da Silva Bezerra, Armanda do Carmo Ponce de Leão Lins, Marina Helena da Silva Lopes, Ana Katherinne Silveira Gonçalves

International Journal of Research and Reports in Gynaecology, Page 193-196

The loss of ovarian function, prematurely or due to menopause, causes a decrease of the vaginal epithelium trophy. However, with the end of the menstrual cycle and the consequent hypoestrogenism, the epithelial thickness also decreases, with only the parabasal and basal layers remaining with low glycogen reserves.  A thinner epithelial thickness associated with a pH greater than 4.5 and a microbiota without protective bacteria (Lactobacillus sp) can lead to an inflammatory condition not necessarily related to the action of a pathogen but mainly the atrophy itself.  Atrophic vaginitis is often confused with genitourinary syndrome of menopause (GSM). Laboratory findings do not necessarily coincide with symptoms but could help in diagnosing. Examinations such as bacterioscopy of vaginal smear (Gram) and cytology (Pap test or cytology in liquid medium) have findings that may suggest a picture of intense hypoestrogenism. However, the clinical-laboratory correlation is essential.

Open Access Original Research Article

Feto-Maternal Outcome of Pregnancies Complicated by Abruptio Placentae in the University of Port Harcourt Teaching Hospital, Nigeria

G. Bassey, B. S. Kpurunee

International Journal of Research and Reports in Gynaecology, Page 1-7

Background: Abruptio placentae contributes significantly to maternal and perinatal morbidity and mortality globally particularly in the developing world. The role of prevention, early detection and prompt management in reducing morbidity and mortality associated with this condition cannot be overemphasized.

Objective: To determine the incidence and feto-maternal outcome of pregnancies complicated by abruptio placenta in the university of Port Harcourt teaching hospital (UPTH).

Materials and Methods: This was a retrospective study involving all pregnant women who had abruptio placenta from January 1, 2014 to December 31, 2018. Data on sociodemographic characteristics, risk factors and fetal and maternal morbidity and mortality were extracted from patients’ case notes for analysis.

Results: The mean age of the subjects was 31.34  3.7 years. The incidence of abruptio placenta was 0.9%. Multiparity was the most important risk factor seen in 73.8% of cases. Birth asphyxia was the major perinatal morbidity and occurred in 27.9% of babies whereas 29.5% were stillbirths. There were 21 perinatal deaths giving a perinatal mortality rate of 344 per 1000 births. The Caesarean section rate was 78.7%. Thirty-seven (60.7%) had blood transfusion, 28 cases (45.9%) had postpartum haemorrhage and 26.2% had postpartum anaemia. There was one maternal death giving a case specific fatality rate of 1.6%.

Conclusion: Abruptio placentae is associated with adverse maternal and fetal outcome. Lack of antenatal care, increasing maternal age and multiparity are independently associated with abruptio placentae and this has significant impact on the fetomaternal outcome. Early diagnosis and prompt management will significantly improve fetomaternal outcome.

Open Access Original Research Article

Effectiveness of Nurse Led Intervention on Premarital Genetic Counseling in Terms of Knowledge and Attitude among the Unmarried Girls in Selected Rural Area, Rajkot

Mansi Patel, Neha Parmar

International Journal of Research and Reports in Gynaecology, Page 8-15

Introduction: A genetic disorder is an illness caused by abnormalities in gene on chromosome, especially a condition that is present from before birth.

Objective: (1) To assess the pre-test & Post-test level of the knowledge and attitude regarding premarital genetic counselling among unmarried females in the selected rural area, Rajkot. (2)To find out the effectiveness of nurse led intervention on premarital genetic counselling among unmarried females. (3) To find out the co-relation between post-test knowledge and attitude regarding premarital genetic counselling among unmarried females (5) To find out association between the level of knowledge and attitude regarding premarital genetic counselling among unmarried females with the selected demographic variables.

Methods: Quantitative research design was used with one group pre-test post-test. The researcher used Non-probability convenience sampling technique for selecting 40 samples.

Tool: knowledge questioner & 5 points Likert’s scale was used to assess the Knowledge & attitude. The reliability of structured knowledge questionnaire was 0.72 and 5 point likert’s attitude scale was 0.79 determined by using Karl Pearson’s formula.

Data Analysis and Results: Descriptive and Inferential statistics was used to analyze the data. ‘The obtain‘ t’ value for knowledge was 12.75 & for attitude scale was 13.81which was significant at 0.05. The findings of the study shows that nurse led intervention is effective in improvement of knowledge and change the unfavourable attitude in to favourable attitude.

Conclusion: There is that most of the females had poor knowledge and unfavourable attitude in the pre-test and they improved to good knowledge and favourable attitude after applying nurse led intervention on premarital genetic counselling.

Open Access Original Research Article

Domestic Violence amongst Infertile Women Attending Gynaecological Clinic at the University of Port Harcourt Teaching Hospital

Preye Owen Fiebai, Kinikanwo Innocent Green, Aborlo Kennedy Nkporbu, Solace Amechi Omoruyi

International Journal of Research and Reports in Gynaecology, Page 16-22

Globally, regardless of socioeconomic or educational levels of couples, domestic violence affects the quality of life of millions of women with infertility. In many cultures the premium on childbearing is considerably high, yet most times women are the ones constantly held responsible for a couple’s infertility and is often punished socially and economically as a consequence. Infertility has been associated with domestic violence, especially with the intimate partner.

This study was carried out to determine the prevalence and pattern of domestic violence among women who attended the Gynecology clinic of the University of Port Harcourt Teaching Hospital for infertility.

A cross-sectional questionnaire-based study involving 372 women diagnosed with infertility and attending the gynecological clinic at the University of Port Harcourt Teaching Hospital from May 1, 2021 to November 31, 2021.

The prevalence of domestic violence among these infertile women was 32.26%. Among these participants 48 (12.9%) had experience physical violence, and 84 (22.58%) experienced emotional abuse. Also, 72 (19.35%) of the participants answered ‘Yes’ to husband as source of abuse while in each of 60 (16.13%) participants the violence was from Mother and Sister in-law respectively.

It is concluded that women infertility suffer emotional, physical, psychological and even sexual violence. These acts of violence are commonly perpetrated by husband, mother and sister in-laws.

Open Access Original Research Article

Early Initiation of Breastfeeding and Prelacteal Feeding among Women Attending Postnatal Clinic in the University of Port Harcourt Teaching Hospital

Kinikanwo Innocent Green, Atochi Prince Woruka

International Journal of Research and Reports in Gynaecology, Page 23-30

One of the World Health Organization and the United Nations Children’s Fund recommendations for improved feeding of infants and young children is breastfeeding. This study aimed to investigate the knowledge of breastfeeding, the practice of early initiation of breastfeeding and the practice of prelacteal feeding in Port Harcourt, Rivers state.  This cross-sectional study was conducted among 249 women attending the six-week postnatal clinic in Port Harcourt, Rivers State South-South Nigeria. The data collection was done using a questionnaire. The Statistical Product and Services Solutions version 25.0 was used for data analysis. A total of 167 (67.1%) knew that breastfeeding should be commenced within one hour of birth and 73 (29.3%) knew prelacteal feeding should not be practiced. Breastfeeding together with prelacteal feeding was commenced within one hour of birth by 59 (23.7%) of respondents. The prevalence of prelacteal feeding in this study was 30.9%. The practice of prelacteal feeding was significantly associated with early initiation of breastfeeding (p=0.022; X2=7.655), mode of delivery (p=0.008; X2=9.691), and baby’s birth weight (p=0.005; X2=10.779). In conclusion, there is poor practice of early initiation of breastfeeding and    high prevalence of prelacteal feeding. Interventions should focus on encouraging                  women to initiate breastfeeding early and educating them on the disadvantages of prelacteal feeding.

Open Access Original Research Article

Ivoirian Molecular Profile of High-risk Human Papillomavirus: Preliminary Study of 250 Cases in a Single Center in Abidjan

Apollinaire Horo, Edele Aka, Mamorou Kone

International Journal of Research and Reports in Gynaecology, Page 31-40

Background: The carriage of high-risk papillomavirus (HR-HPV) differs between countries and regions of the world. There is not enough data on the genotyping of this virus in Côte d'Ivoire and in Abidjan particularly.

Aim: to illustrate the genotypes of prevalent HR-HPV in the city of Abidjan.

Materials and Methods: Descriptive cross-sectional study, carried out over a period of 2 months at the Teaching Hospital of Yopougon. It involved endocervical swabbing of 250 sexually active women. The HPV genotyping was performed by real-time PCR. A logistic regression made it possible to determine the factors associated with the carriage of HPV.

Results: The mean age of the population was 43.33 and a prevalence of 34% was found. HPV 68 was the most prevalent (18.1%) followed respectively by HPV 52 (17.2%), HPV 56 (13.8%), HPV 35 (8.6%), HPV 45 (7.0%). As for genotypes 16 and 18, they only represented 2.5% and 5.1% respectively. The prevalence of multiple infections was 24.6%. The associated factors to the HPV infection were the educational level OR= 0.45; IC 95% [0.24-0.85] and the marital status OR = 0.40; IC 95% [0.20-0.79].

Conclusion: The prevalence of HPV was high, and the genotypes identified are different from those targeted by the currently available prophylactic vaccines. The management with an appropriate vaccine is therefore necessary for these West African countries.

Open Access Original Research Article

Outcomes of Abdominal Myomectomy in Rivers State University Teaching Hospital, Port Harcourt: A 5-Year Retrospective Study

R. S. Iwo-Amah, B. O. A. Altraide, N. J. Kwosah, S. C. Amadi, D. H. John, D. A. Okoh, Awopola Jumbo

International Journal of Research and Reports in Gynaecology, Page 41-45

Background: Abdominal myomectomy is a common surgical option for the treatment of symptomatic uterine fibroids in women who wish to preserve their uterus. This study highlights the outcomes of abdominal myomectomies done in the Rivers State University Teaching Hospital (RSUTH).

Methods: This was a retrospective cross-sectional study of all abdominal myomectomies done in this RSUTH between January 2017 to December 2021. Records from the theatre register, anaesthetic charts, patients' case notes and gynaecological ward were reviewed and the data obtained were analyzed using SPSS version 20.

Results: A total of 540 women had surgery for uterine fibroids. Of these 512 (94.8%) had an abdominal myomectomy while 28 (5.2%) had a hysterectomy. A total of 315 (61.5%) fibroid cases had myomectomy due to infertility/ recurrent miscarriages, 129 (25.2%) for menorrhagia, 52 (10.2%) for huge abdominal/pelvic mass, and 16 (3.1%) for pressure symptoms. A total of 212 (41.4%) had satisfactory outcomes while 300 (58.6%) had complications. The majority (78%) of the perioperative complications were wound sepsis/dehiscence 127 (42.3%) and anaemia 108(36.0%). Other less common complications were fever, massive intraoperative haemorrhage (>1.5L), intestinal obstruction (paralytic ileus), iatrogenic bowel injury and anaesthetic complications. No death was recorded.

Conclusion: Abdominal myomectomy is one of the most common treatments for symptomatic uterine fibroids. It generally has a favourable outcome, though significant perioperative complications can occur. Hence appropriate precautions should be taken to minimise these complications.

Open Access Original Research Article

Prospective Comparison of Rectal Misoprostol versus Oxytocin Infusion for Prevention of Post-Caesarean Section Primary Postpartum Hemorrhage

Ozori E. S, Addah A. O, Isa I. A, Oyeyemi. N

International Journal of Research and Reports in Gynaecology, Page 46-55

Background: The drug of choice recommended by the WHO for the prevention of primary postpartum hemorrhage after vaginal or post Caesarean delivery is oxytocin. However, oxytocin is labile in hot tropical climates as in Africa with reduced efficacy. Misoprostol may be an alternative as it has most properties of oxytocin.

Aim: The aim of the study is to compare the efficacy and safety of rectal misoprostol with oxytocin in preventing primary postpartum haemorrhage after Caesarean delivery.

Study Design: This study was a double blind, randomized controlled trial - non-inferior                design.

Methodology: One hundred and forty women who were suited for Caesarean delivery were randomly selected into two groups of 70 parturients each. One arm of the study had 40 IU of oxytocin in 1 litre of normal saline and the other arm had 600 ug of rectal misoprostol after Caesarean section, to prevent primary postpartum haemorrhage.

The 24-hours blood loss per vaginam was collected and compared between the study arms, as the primary outcome measure.

Analysis: All data extracted were entered into SPSS version 25.0 and analyzed. The statistical significance was set at p-value of 0.05.

Results: There was no statistically significant difference between the Misoprostol and Oxytocin groups in preventing primary postpartum hemorrhage after Caesarean section. (106.8 ± 48.6 ml vs. 131.7 ± 161.4 ml, p= 0.839). 

Conclusion: Rectally administered misoprostol was as effective as oxytocin infusion in the prevention of primary postpartum hemorrhage after vaginal or Caesarean delivery, giving Obstetricians choices of drugs to use.

Open Access Original Research Article

Practices and Outcomes of Aboriginal Plant used by Parturients

Bangaisa Kasambia Ambassy, Wembodinga Utshudienyema Gilbert, Omanyondo Ohambe Marie-Claire, Dimoke Okito Franck, Masika Vinywasiki Henriette, Kuda Ebubutuy Bienvenu, Assani Ramazani Raymond

International Journal of Research and Reports in Gynaecology, Page 56-67

Introduction: The conduct of this study led us to the objectives of measuring the hospital frequency of use of aboriginal plants by parturients and recording maternal-fetal outcomes among aboriginal plant users at Bengamisa General Referral Hospital during the period 28 July to 25 November 2018.

Methods: The design is descriptive of the type of cohort that allowed us to select as cases 206 parturients who used aboriginal plants and 201 parturients who did not use them (control). Data were obtained through a literature review and a semi-structured interview. All statistical analyses were performed using the Chi-2 test at a significance level of p = < 0.05.

Results: The frequency of use of aboriginal plants by parturients was 50.6%. Factors associated with plant use during parturition were low education [7.8, (95% CI; 0.256-0.785), p-value=0.000], low income [RR=4.521; 95% CI (1.132-20.942), p-value=0.033], irregularity at antenatal visits [RR=11.1; 95% CI (0.229-0.681), p-value=0.001]. The plants involved were: okra, wild broom leaves and roots, sweet potato leaves, green tea and Sida cordifolia. Maternal-fetal outcomes were associated with shorter duration of labour [RR=119;95%; CI (14.889-48.427), p-value=0. 000], maternal [RR=12.268; 95% CI (0.210-0.644, p-value=0.000)], fetal [RR=27.620; 95% CI (0.104-0.357, p-value=0.000] and maternal death [(RR=5.042; 95% CI=0.034-0.795, p-value=0.025)] complications

Conclusion: The use of herbs during pregnancy is a topic that needs to be addressed by health professionals, as its frequency is high in women during labour.

Open Access Original Research Article

Implication of Lipid and Fasting Blood Glucose in Hypertensive Pregnant Women in Nigeria

Funmilola Comfort Oladele, Mabel Ayebatonyo Charles-Davies, Oladosu Akanbi Ojengbede, Emmanuel Olubolaji Agbedadna

International Journal of Research and Reports in Gynaecology, Page 68-77

Background: Dyslipidemia in the early stages of pregnancy raises the risk of preeclampsia. When compared to women who had a normal pregnancy, those who have a history of preeclampsia have significantly different lipid profiles and are more vulnerable to lipoprotein oxidation. According to reports, a key contributing factor to preeclampsia-related hypertension is disorders in lipoprotein metabolism.

Aim: Therefore, the purpose of this study was to determine how fat and glucose may contribute to hypertensive disorders of pregnancy (HDP) in Nigerian women.

Methodology: The study's methodology used a prospective cohort design. Pregnant women receiving antenatal treatment at four different tertiary health centers in Nigeria comprised the participants. The study included 521 patients in all, of whom 34 acquired various forms of HDP. After an overnight fast, participants without HDP at baseline, in the second, third, or at the moment of developing hypertension had around 12 milliliters of venous blood sample taken aseptically from the antecubital vein. The lipid profile and fasting blood sugar levels were measured.

Results: Fasting plasma glucose and lipid profile mean values rose in the second and third trimesters, respectively, in hypertensive women. While fasting plasma glucose decreased significantly from the first to the third trimester in normotensive women, the mean values of triglycerides gradually increased. The median levels of total cholesterol, HDL-C, and LDL-C gradually increased beginning in the first trimester, peaked in the second, and then decreased in the third.

Conclusion: The findings of this study demonstrated that changes in lipid profiles and fasting blood sugar levels were related to hypertensive problems during pregnancy in Nigerian women. In women with systolic blood pressure 130 mmHg and diastolic blood pressure 80 mmHg at the first antenatal appointment, early estimate of fasting plasma glucose and lipid profile may be helpful in predicting the development of hypertensive problems in the future.

Open Access Original Research Article

Therapeutic Potential of Parkia biglobosa Seed against Potassium Bromate-induced Testicular Toxicity

E. O. Ezirim, C. L. Uche, I. O. Abali, C. E. Iwuoha, N. M. Chika-Igwenyi, C. A. Onyeaghala, S. F. Orji, C. N. Ugwu, N. I. Ugwu, C. Igwenyi, A. I. Airaodion

International Journal of Research and Reports in Gynaecology, Page 78-89

Aim: This study was aimed at assessing the therapeutic potential of Parkia biglobosa (P. biglobosa) seed against potassium bromate-induced testicular toxicity.

Methodology: P. biglobosa was extracted with soxhlet extractor with ethanol as the solvent. Twenty-four adult male Wistar rats were acclimatized under laboratory conditions and were randomly grouped into A, B, C and D. Group A was given distilled water orally. Animals in groups B, C and D were administered 100 mg/kg body weight of potassium bromate, but groups C and D were also treated with 100 and 200 mg/kg body weight of P. biglobosa respectively. Both potassium bromate and P. biglobosa were freshly prepared on daily basis and administered to rats by oral gavage. After 28 days of treatment, the animals were sacrificed under mild diethyl ether anaesthetization 24 hours after cessation of last treatment. The testes were removed homogenized in the ice cold 0.25 M sucrose solution. The homogenates were centrifuged at 5000 ×g for 10 minutes in a refrigerated centrifuge. The supernatant was collected and stored frozen for further analysis. The parameters were measured using standard methods.

Results: When compared to animals in the control group, animals intoxicated with KBrO3 had lower testicular concentrations of total cholesterol, total protein, glycogen, sialic acid, MDA, and GSH, as well as higher levels of ALP, SOD, and CAT activity. Additionally, it was shown that as compared to the animals in the control group, KBrO3 boosted the testicular ACP's activity. However, P. biglobosa treatment of intoxicated rats reduced these alterations in a dose-dependent manner.

Conclusion: The results of this investigation demonstrated that potassium bromate caused testicular toxicity, and that P. biglobosa treatment counteracted this effect. Thus, it is recommended that these results be investigated in clinical trials in human volunteers.

Open Access Original Research Article

Incidence and Clinical Manifestations of Posterior Reversible Encephalopathy Syndrome (PRES) in Patients with Eclampsia. 2017-2021 Data from a High Specialty Medical Unit, Mexico City

Juan Gustavo Vázquez-Rodríguez, María Teresa Salas-Magaña, Juan Serrano-Rodríguez

International Journal of Research and Reports in Gynaecology, Page 90-97

Aims: To identify the incidence of posterior reversible encephalopathy syndrome (PRES) on Tomography scan of the skull (CT) and/or Magnetic Resonance Imaging (MRI) and its clinical manifestations in patients with eclampsia.

Study Design: Observational, cross-sectional, retrospective and descriptive study.

Place and Duration of Study: Patients with eclampsia admitted to the Intensive Care Unit (ICU) of a High Specialty Medical Unit (Hospital de Gineco-Obstetricia No. 3. Centro Médico Nacional “La Raza”. Instituto Mexicano del Seguro Social) in Mexico City between 2017 to 2021.

Methodology: We studied a series of 25 cases with eclampsia admitted to the ICU. Their files were consulted to know the incidence of PRES on CT, MRI or both, as well as the signs and symptoms that accompanied the eclampsia. The data was analyzed with descriptive statistics using the statistical package SPSS version 20.

Results: Age 26.2±7.13 years, parity (median) 1, gestational age 34.4±5.05 weeks, comorbidities 12%, prepartum eclampsia 72% (n=18), intrapartum 4% (n=1) and postpartum 24% (n= 6). Imaging studies were performed only in 68% (n=17), the most used was CT (n=16). They found normal findings in 52.94%, PRES 29.41% (n=5), generalized edema 5.88%, Fisher class IV subarachnoid hemorrhage 5.88%, and parenchymal hemorrhage communicated to the IV ventricle 5.88%. The most frequent symptom was headache 40% and the most frequent sign was hyperreflexia 48%.

Conclusion: The incidence of PRES was 29.41%. CT was performed most frequently. The most frequent symptom was headache and the most frequent sign was hyperreflexia.

Open Access Original Research Article

Occurrence of Chlamydial Infection Based on Clinical Symptoms and Clinical History among Pregnant Women Attending Clinics in Zaria Metropolis, Kaduna State, Nigeria

Shango Patience Emmanuel Jakheng, Emmanuel Ifeanyi Obeagu, Emmanuel William Jakheng, Onyekachi Splendid Uwakwe, Gloria Chizoba Eze, Getrude Uzoma Obeagu, S. Vidya, Sunil Kumar

International Journal of Research and Reports in Gynaecology, Page 98-105

Chlamydia trachomatis also known as the “Silent Epidemic” is a major threat to the reproductive health of women in Africa. This study was aimed at determining the seroprevalence of Chlamydia trachomatis based on clinical symptoms and clinical history among women attending clinics in Zaria metropolis, Kaduna State. Each participant completed a researcher-devised questionnaire and quasi design was used in the selection of hospitals. Subsequently about 5mls of peripheral blood for serological analysis was obtained after informed consent. Presence of antibodies to Chlamydia trachomatis was determined using Enzyme Linked Immunosorbent Assay (ELISA) to detect IgG. Out of the two hundred and seventy (270) samples collected, 32(11.9%) were positive for Chlamydia trachomatis IgG of the total population. There was no significant association between chlamydial infection and based on clinical symptoms. Hence, there is an urgent need for a national policy on routine screening for Chlamydia trachomatis as treatment is cheap and effective, while the attendant morbidity resulting from delayed diagnosis is more difficult to manage and associated with severe sequelae.

Open Access Original Research Article

Comparison of Healthcare Resource Utilization (HcRU) Between Age Groups of Women Diagnosed with Gynecological Cancers in the United States

Godwin Okoye, Henry Antwi, Kenechukwu C. Ben-Umeh, Rachel Vincent

International Journal of Research and Reports in Gynaecology, Page 106-114

Objective: Previous studies have shown that older women are more likely to be diagnosed with gynecological cancers (GC) setting precedent for more attention to be given to older women than younger women with GC. This study sought to compare nationally representative healthcare use among younger women and older women diagnosed with gynecological cancer in the United States.

Methods: A retrospective cross-sectional repeated measures design was used to make comparisons between baseline characteristics of two age groups of women diagnosed with gynecological cancers. Data were extracted from the National Health Interview Survey (NHIS). A weighted sample of 2633569 responses who reported having at least one kind of GC was included from 2015 to 2018. GC was defined as those who reported having uterine, cervical, or ovarian cancer. Characteristics of patients were compared across two age groups. 1. Women less than 50 considered to be most likely premenopausal. 2. Women more than 50 considered to be most likely postmenopausal. Nine health services use were also quantified between both age groups and a multivariable logistic regression model was used to determine the likelihood of health care use among both age groups with the older women being the reference group.

Results: Among the baseline characteristics, alcohol use and smoking were seen to be most prevalent among the younger women with the following proportions 88% and 79.93% for alcohol use and 59.79% and 50.26% for smoking at p<0.01. Younger women had higher obstetrics and gynecologic visits Odds Ratio (OR) 2.13 (1.59-2.84), Emergency room visits OR 1.55 (1.17-2.06), Hospitalization OR 1.57 (1.15-2.14), Preventive care OR 2.49 (1.88-3.31). Adjusting for Alcohol use and smoking yielded similar odds ratio. Patterns of hospitalization increased over time for younger women and use of surgery and surgical procedures was not statistically significant among both age groups.

Conclusion: Based on this study, younger women tend to use comparable healthcare services as older women diagnosed with gynecologic cancer. Therefore, more studies should be conducted with the inclusion of younger women.

Open Access Original Research Article

The Incidence and Risk Factors of Peripartum Hysterectomy at the Georgetown Public Hospital Corporation (GPHC)

Darshanie Seekumarie, Radha R. Sookraj

International Journal of Research and Reports in Gynaecology, Page 115-127

Aim: To assess the incidence and risk factors of peripartum hysterectomy at the Georgetown Public Hospital Corporation over a period of five years.

Background: A hysterectomy carried out at the time of delivery or within 24 hours of it is referred to as a "peripartum hysterectomy" (WHO). Postpartum hemorrhage (PPH) is a potentially fatal condition that needs to be treated right away. Over time, numerous medications and surgical procedures have been created, particularly to protect the uterus. However, as a last resort to save a woman's life, an emergency peripartum hysterectomy must occasionally be carried out1. Uterine atony, abnormal placental implantation (accreta, previa, etc.), uteroplacental apoplexy, uterine rupture due to cicatricial uterus, advanced maternal age, increased parity, birth weight less than 4,000 g, and prior uterine surgery are the most significant risk factors that result in Emergency Peripartum Hysterectomy (EPH).

Objectives: This study sought to identify the risk factors and indications for peripartum hysterectomy at GPHC, as well as to analyze the complications and outcomes of peripartum hysterectomy performed in GPHC from January 2016 to January 2020. It also sought to provide insight into the incidence of peripartum hysterectomy after medical and surgical management for the management of bleeding during or after delivery was exhausted.

Methods: Retrospective chart reviews of patients who underwent peripartum hysterectomy in Georgetown Public Hospital Corporation's Department of Obstetrics and Gynecology over a five-year period from January 2016 to January 2020 were the goal of this study. The medical record department was contacted to obtain the medical history of every woman who had a peripartum hysterectomy. Risk factors, intrapartum and peripartum notes, operative notes and findings, complications, surgery time, blood loss, and outcomes were all carefully examined in each case file.

Results: A total of 6,130 caesarean deliveries were recorded in GPHC during the study period. There were 26 peripartum hysterectomies performed in total during the study period, making the incidence of this procedure 4.2 per 1,000 births. Maternal age greater than 30, prior caesarean deliveries, and multiparity were the main risk factors for peripartum hysterectomies. Early pregnancy loss with prolonged bleeding (31%) and abnormal placentation (which accounted for 27% of patients who underwent peripartum hysterectomy) were noted as the main indications for the procedure.

Conclusion: According to the data, abnormal adherent placentation is what leads to peripartum hysterectomy most frequently. The data also show how the likelihood of needing an emergency peripartum hysterectomy increases significantly with parity, particularly when multiparity, a placenta previa, or a previous cesarean section, are factors. Despite the continued high levels of maternal morbidity, no maternal deaths occurred.

Open Access Original Research Article

Investigating the Incidence of Fetal Macrosomia at Georgetown Public Hospital Corporation (GPHC) during the Period January- June 2021

Sheena Chin, Ravindra Hardyal

International Journal of Research and Reports in Gynaecology, Page 128-140

Background: Fetal macrosomia is a well-researched topic across the world but there is very little research done on this topic in Guyana. This condition impacts the morbidity and mortality of pregnant women significantly and this research paves a way to improve the overall health of women.

Objectives: This study aimed to determine the incidence of fetal macrosomia at GPHC during the study period, to identify the maternal risk factors, the mode of delivery, and the maternal and neonatal outcomes of patients with fetal macrosomia.

Methods: A retrospective cohort study design was conducted. Permission was granted from the relevant personnel and a data collection spreadsheet using Microsoft Office Excel 2007 was created. Data were further analyzed using (SPSS®) software version 26.0.

Results: The incidence of fetal macrosomia at GPHC was found to be 4.3%. Male gender was the most common risk factor (62.9%) while post-term accounted for the least (2.6%). It was also found that the majority of mothers (55.2%) delivered via lower segment cesarean section (LSCS) while (44.8%) delivered via vaginal delivery (VD). The majority of macrosomic babies had no complications associated with their birth weights (59.1%). However, the least common complication was noted to be humeral fractures (1.6%) in the study population. Birth weights >4000g contributed to the majority of mothers resulting in an LSCS delivery (55.2%). The least common maternal outcomes were 3rd& 4th-degree lacerations (0.9% each).

Conclusion: The incidence of fetal macrosomia in this study was found to be 4.3%. Male sex, advanced maternal age, grand multiparity, the presence of diabetes, and being late and post-term were all significant risk factors associated with this condition. 

Open Access Original Research Article

Prevalence and Pattern of Aphrodisiac Use among Adult Population in Sokoto Metropolis, Northwest Nigeria

H. Adamu, A. A. Adamu, B. Cletus, L. Marafa, M. Abdulmalik

International Journal of Research and Reports in Gynaecology, Page 141-152

Aims: To determine the prevalence and pattern of aphrodisiacs use and associated side effects among adult population in Sokoto metropolis, Sokoto state Nigeria.

Study Design: A cross sectional study.

Place and Duration of Study: The study was conducted between February and August 2021, in Sokoto metropolis, Sokoto state, Nigeria.

Methodology: We sampled 207 adults living in Sokoto metropolis via a multistage sampling technique. Data was collected using semi-structured questionnaire and were analyzed using IBM SPSS version 23.

Results: The mean age of respondents was 35.23 ±12.4 years. The prevalence of aphrodisiacs use among adults in Sokoto metropolis was 138(67.6%) and up to 64(46.2%) of them have used it within the past one month. More than half (53.1%) of the respondents’ partners knew they were using aphrodisiacs; 49(66.3%) of their partners were in support of it and 101(73.2%) expressed satisfaction with the sexual performance of the respondents. Up to 61.6% of the aphrodisiacs consumed were local herbs and the major route of administration was oral route. Gender, marital status, level of education and occupational status were significantly associated with the use of aphrodisiacs (p<0.05).

Conclusion: Prevalence of aphrodisiacs use is high among men and women in Sokoto metropolis and it is associated with gender, marital status and education. Government and health workers at all levels should intensity efforts to educate the masses about the use and associated side effects through the media such as radio, television and the internet. Communication between couples should be encouraged rather than the use of the substances.

Open Access Original Research Article

Carriage of Group B Streptococcus in Pregnant Women in Dakar, Senegal: Prevalence and Associated Factors

Babacar Ndiaye, Abdoulaye Seck, Abdou Diop, Assane Dieng, Khadim Diongue, Thierno Abdoulaye Diallo, Chantal Mahou, Lauriane Koko Marcel Koumondji, Awa Cheikh Diop, Fatou Binetou Rassoul Dieye, Philippe Dubrous

International Journal of Research and Reports in Gynaecology, Page 153-160

Background: Beta-hemolytic group B streptococcus (GBS) is a germ responsible for vaginal carriage which can be responsible for serious maternal-fetal disorders. The frequency, intermittency and consequences of this carriage are the main reasons for its research in pregnant women. The objective of this study was to assess this carriage and identify associated factors.

Method: A vaginal sample was taken from 158 pregnant women and inoculated on GRP.B STREP_DIFF.AGAR (Granada) chromomeric medium from Beckton Dickinson (BD) and then incubated in an oven at 37°C. The reading took place at 24 and 48 hours. Group B Streptococcus appears in orange colonies. The data were collected, entered by Excel (version 2010) then analyzed by the SPSS software. 20.0. Chi-square test was used to analyze contingency tables with a significant difference if p <0.05.

Results: In sum, 158 pregnant women were included with a median age of 32 years. The carry rate was 25.7%. This carriage was variable according to the age of the patients (28.5% between 20 and 29 years and 21.0% after 40 years), the gestational age (27.4% in the second trimester and 27.2% in the third trimester), flora balance (39.3% intermediate flora and 24.1% unbalanced flora or vaginosis), parity (25.2% in nulliparas and primiparas), vulvovaginal candidiasis (25.5%) and a history of vaginal infections (26.0%). However, no significant difference was found between carrying GBS and these latter situations.

Conclusion: The intermittent nature and the potential complications of this carriage of GBS require its screening at the end of pregnancy in order to prevent any maternal-fetal disease.

Open Access Original Research Article

Determinants of Low Birth Weight in the Nabdam District of the Upper East Region, Ghana

Dorcas T. Ndebire, Keren-Happuch Twumasiwaa Boateng

International Journal of Research and Reports in Gynaecology, Page 172-180

Background: The incident of low birth weight and its associated implication has become a great public health concern. Low birth weight is the birth weight of a child less than 2.5 kg. several factors have been implicated in the development of low birth weight. The purpose of the study was to assess the determinant of low birth weight.

Methods: A quantitative cross-sectional design was conducted with a sample size of 183 post-natal women who had delivered 12 months and below in the district. The participants were interviewed using structured questionnaire. Purposive sampling technique was used in recruiting the participants for the study and ethical approval sought from the Nabdam District Health Directorate. An SPSS version 20 was used to process the data and generated the descriptive statistics such as frequencies, percentages, mean, mode and standard deviations.

Results: Out of 183 new born babies, 146 (79.8%) were normal whiles 37 (20.2%) had low birth weight. The impact of marriage, education, place of stay, planned pregnancy employment and health insurance were significant with a p-value of < 0.001. Maternal and obstetric factors such as parity, gestational age at delivery and mode of delivery had p-values of <0.001 which were significant. The effect of gestational age at ANC, number of ANC visits anemia in pregnancy, religion and age had no association with low birth weight.

Conclusions: This study shows that among babies born to mothers with increased parity, low level of education, unemployed and short gestational ages were at risk of low birth weight. Therefore, in order to reduce the high prevalence of low birth weight in the community, every pregnant woman should be encouraged to obtain the national health insurance cards that will enable them attend regular antenatal clinics.

Open Access Original Research Article

Effect of Hydromethanolic Fruit Pulp Extract of Azanza garckeana (Malvaceae) on Sexual Behavior, Sex Hormones and Histology of Female Wistar Rats

Aisha Ahmad, Ibrahim Suleiman, Jimoh Abdulazeez, Tanko Yusuf

International Journal of Research and Reports in Gynaecology, Page 181-192

Aim: To evaluate the effect of hydromethanolic fruit pulp extract of Azanza garckeana on sexual behavior, sex hormones and histology of female Wistar rats.

Study Design: Twenty-five female Wistar rats and five (5) male Wistar rats were used for the study, the female animals were randomly divided into 5 groups (n= 5): Group I served as normal control and received 1 ml/kg distilled water, group II served as positive control and received 100 µg estradiol valerate and 50 µg progesterone 48 hr and 5 hr respectively before the sexual behavioral test, while group III, IV and V received 250 mg/kg, 500 mg/kg and 1000 mg/kg body weight of the extracts respectively for 14 days.

Place and Duration of Study: Department of Human Physiology (animal house), Ahmadu Bello University, Zaria, between September 2021 and November 2021.

Methodology: Sexual behavioral tests were performed with sexually experienced male rats 1:1 after the treatment period in a unilevel pacing chamber and the process videotaped for proper scoring. Proceptive behaviors and Lordosis was extrapolated as index for the level of proceptivity and receptivity respectively in the female animals. The proximity time of the female to the male was also recorded. At the end of the experiment, the rats were anaesthetized with combined doses of ketamine and diazepam injection 0.4 mg/kg. Blood sample was collected for hormonal assays which was done using ELISA kit. The ovaries were dissected out and fixed in 10% formalin for histological examination. Phytochemical screening was also carried out on the extract to determine the presence and absence of secondary metabolites.

Results: The hormonal assay result revealed significant (p =.000) increase in the serum Estradiol levels across the treatment groups but no significant change in progesterone level except at 500 mg/kg dose where it was significantly increased when compared to both negative and positive control. Receptivity and proceptivity in the extract treated groups and positive control groups increased significantly when compared with the negative control group, indicating enhanced sexual behaviour. The proximity time also significantly increased (p =.000) in the extract treated groups when compared to negative control. The histological sections of ovaries revealed increased follicle development in the treated groups when compared to negative control. The presence of flavonoid and saponin in the fruit pulp extract could be the reason for the high aphrodisiac activity.

Conclusion: This study has demonstrated that A. garckeana fruit extract possesses significant aphrodisiac potentials in female Wistar rats.

Open Access Original Research Article

Severe Obstetric Morbidity and Quality of Maternal Healthcare at a Tertiary Level Health Facility in Southern Nigeria

Justina Omoikhefe Alegbeleye, Celestine Osita John

International Journal of Research and Reports in Gynaecology, Page 197-211

Background: In most women, pregnancy is often uncomplicated and will bring about the delivery of healthy babies at term. However, in some women, severe complications may occur during pregnancy, labour, or the postpartum period, which may be life-threatening for either the mother, baby, or both, thereby necessitating certain interventions to prevent morbidity or mortality.

Aim and Objectives: To evaluate the critical interventions, process indicators, as well as pregnancy outcomes of severe obstetric morbidity at the University of Port Harcourt Teaching Hospital (UPTH).

Materials and Methods: A retrospective cross-sectional study carried out at the department of Obstetrics and Gynaecology of the University of Port Harcourt Teaching Hospital. Stratified sampling method was used to select the folders of 610 women who were managed during pregnancy, labour or postpartum period, abortion and ectopic pregnancy between January 1, 2018, and December 31, 2020. Data collection tool was used to obtain information from folders and SPSS 25 used for analysis. Mean and standard deviation were used to summarize descriptive data, while test for association was done using chi square test and logistic regression.      

Results: Blood transfusion was the most common 65 (52.9%) critical intervention. Process indicators were all optimal (100%) except for corticosteroid therapy (60%). Maternal near miss morbidity was significantly associated with prolonged hospital stay (p=0.001), preterm delivery (p=0.000), perinatal death (p=0.001), low birth weight (p=0.002), Special Care Baby Unit (SCBU) admission (p=0.002) and birth asphyxia (p=0.001).

Conclusion: Transfusion of blood and blood products was the most common critical interventions instituted for maternal near miss. Process indicators were all optimal, except for corticosteroid therapy for preterm births less than 34 weeks.  It was also noted that interventional radiology was not performed. Caesarean delivery was the most common mode of delivery. Maternal near miss was associated with preterm birth, perinatal death, low birth weight, admission into SCBU, and severe birth asphyxia.

Open Access Original Research Article

An Analysis of Unwanted Births in Bangladesh: A Major Public Health Concern

Md. Jalal Uddin, Sazin Islam, Oasim Ghosh, Ripon Biswas, Mosammat Sabrina Sibli, Sharmin Akter, Md. Shariful Islam

International Journal of Research and Reports in Gynaecology, Page 212-223

Background: In Bangladesh, on average, a woman has 2.3 births, with around 30% of them being undesired. For the well-being of families and the regulation of population growth, it is crucial to reduce unwanted births. In-depth study of the variables influencing the shift in unplanned childbearing is necessary for this decrease. This research looks at how population structure, outside influences including family planning programs, and their interactions affected the percentage of women who gave birth unintentionally between 2007 and 2017, as well as between 2014 and 2017.

Methods: The idea of standardization is used in this research to compare the impact of family planning programs and non-program variables on unintended pregnancies. We use the aggregate and detailed three-fold decomposition techniques to break down variations in the percentage of undesired births into the contributions of the three main causes using data from the Bangladesh Demographic and Health Survey. We use logistic regression estimates to break out the changes.

Results: 15.4% of women in 2007 gave birth unintentionally. This proportion slightly rises to 15.6 in 2011 and falls by 12.8 percent from that year to 2014, a three-year span. In 2017, this proportion dropped even further, to 10.4, a 23.8 percent decrease from 2014. The estimated absolute changes (i.e., total effects) in the proportion of women having unwanted birth from 2007 to 2011, 2011 to 2014 and 2014 to 2017 are, respectively, 0.002 (or 0.2 percentage points), -0.020 (or -2 percentage points), and -0.032, according to the aggregate decomposition analysis results (or -3.2 percentage points). While changes in that percentage over the other two decades are determined to be statistically significant, the change in that proportion from 2007 to 2011 is found to be statistically non-significant.

Conclusions: In Bangladesh, a considerable reduction in population structure combined with family planning initiatives that are not diminishing lowers the percentage of unintended pregnancies, whereas simultaneous reductions in population structure and initiatives produce a more dramatic decrease.

Open Access Review Article

Hypovitaminosis D in Pregnancy: Implication for the Risk of Development of Pregnancy Complications

Ayobola A. Sonuga, Oyebola O. Sonuga, Oluwagbenga A. Oyeyemi, Ayokunle D. Makanjuola

International Journal of Research and Reports in Gynaecology, Page 161-171

Vitamin D, a prohormone known traditionally to be involved in the metabolism of the bone  and teeth has over recent years been the focus of many scientific researches. Scientific evidence have shown that Vitamin D insufficiency is global problem and has been linked with several disease conditions, acute or chronic. Vitamin D has been shown to be involved in the control of endocrine and immune pathways, gene regulation and balance of various body metabolic processes. In fact its deficiency had been linked with chronic metabolic disorders and major pregnancy complications increasing fetal and maternal morbidity and mortality. Recent works have proven that Vitamin D might be a promising therapeutic and preventive tool in the management of these complications. Therefore, this review discusses the possible mechanisms in which Vitamin D deficiency or insufficiency can contribute to the development of pregnancy complications in order to encourage more studies even at molecular level to find probable solutions.