Open Access Original Research Article

Satisfaction and Time to Obtain Blood Products in Obstetric Emergency Situations at Sylvanus Olympio Teaching University Center of Lome

Akila Bassowa, Baguilane Douaguibe, Dede Ajavon, Kodjo Fiagnon, Samadou Aboubakari, Koffi Akpadza

International Journal of Research and Reports in Gynaecology, Page 1-8

Objective: It was to evaluate the satisfaction and delay in obtaining blood products during obstetric emergencies at the Sylvanus Olympio University Hospital Center.

Methodology: This is a prospective study conducted from June 2017 to May 2018, including 252 pregnant women and women who had received a blood transfusion in a context of genital haemorrhage or anaemia. Our data were captured and processed with CSPRO and IBM SPSS 25 software.

Results: The mean age of the patients was 30 +/- 8 years old. The paucigales and pauciparas were the most transfused respectively in 63% and 48%, followed by primigest (32%) and nulliparous (32%). Seventy-four per cent (74%) of the patients were referred, 26% were self-referred. Indications for transfusion were dominated by haemorrhagic abortion (26.6%) and postpartum haemorrhage (20.6%), followed by retroplacental hematoma (13.9%), uterine rupture (12.3%). Hemorrhagic placenta previa (10.7%) ruptured GEU (10.3%), sickle cell disease (3.2%) and malaria (2.4%). Cutaneo-mucous pallor was observed in all patients. Asthenia was present in 41.30%, vertigo 34.10%, shock state 31%, oedema 2.38% and coma 1.60% of cases. The pre-transfusion haemoglobin level was achieved in 73% and post-transfusional in 96%. CNTS was the most popular blood supply centre at 81.3%, followed by CHU-SO in 6.3%.

Conclusion: Blood transfusion in obstetric emergencies is a maternal rescue act. But the absence of a blood bank at the maternity ward delays the care.

Open Access Original Research Article

Effect of Chronic Exposure to Gas Flaring on Sex Hormones and Some Antioxidant Parameters of Men from Ebocha, Niger Delta Area of Nigeria

I. P. Mokelu, G. O. C. Onyeze, L. A. Nwaogu, C. U. Igwe

International Journal of Research and Reports in Gynaecology, Page 9-19

Aim: The effect of pollution due to gas flaring on men native to Ebocha, in the Niger Delta Area of Nigeria was investigated.

Materials and Methods: Blood specimens from twenty approximately healthy men from Ebocha community within the age groups 30-34, 35-39, 40-44, 45-49, 50-54 years were screened. Control blood specimens were obtained from twenty approximately healthy men from Uzi, Owerri (a location with no history of petroleum hydrocarbon pollution) with the same age bracket. Standard analytical procedures were used to determine the concentrations of male sex hormones; testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH). Some antioxidant parameters; glutathione and ascorbic acid (vitamin C) were also determined. The activity of lactate dehydrogenase (LDH) was also assayed.

Results: Results obtained revealed that there was a significant (p < 0.05) decrease in testosterone concentrations of men from Ebocha within the age groups of 35-39, 45-49 and 50-54 in contrast to those within the age groups of 30-34 and 40-44 when compared to the control. There was a significant (p < 0.05) increase in the concentration of  LH of only men from Ebocha within the age group 45-49 when compared to those from Owerri. There was no significant (p < 0.05) difference in the concentration of FSH of men within the age groups from both sites. However, there was a significant (p < 0.05) decrease in the concentrations of GSH for all age groups in men from Ebocha when compared to those from the control sites. The same trend was observed for ascorbic acid concentrations in men from Ebocha for all the age groups from 30-54 years old. There was a significant (p < 0.05) increase in LDH activity of men from Ebocha among all the age groups when compared to those from Owerri.

Conclusion: These findings show that testosterone, glutathione, ascorbic acid concentrations and lactate dehydrogenase activity in the blood specimens of men from Ebocha were affected and it is possibly due to the chronic exposure to gas flaring in the environment.

Open Access Original Research Article

Impact of Eliozu Port Harcourt Landfill Leachate on Some Reproductive Hormones in Female Wistar Rats

Green, I. Kinikanwo, Oriji, K. Vadunume, Weleh, I. Ikechukwu

International Journal of Research and Reports in Gynaecology, Page 20-24

Pollution of water sources by leachate and the toxicity that ensues have been reported globally. However, there is still need to evaluate its effects on reproductive hormones; considering the influence of environment on reproduction and the increasing number of infertility cases in the society. In this study therefore, the effect of landfill leachate at Eliozu in Port Harcourt Nigeria on some female reproductive hormones were evaluated using Wistar rats as experimental model. Twenty-five rats were grouped divided into five groups with five rats each. Group 1 served as control and received 1 ml of commercially bottled water, group 2 received 1ml of water from borehole about 1 km from the landfill; while groups 3, 4 and 5 received 1ml of 10%, 50% and 100% concentrations of leachate once daily for 30 consecutive days. All administrations were through oral gavage and animals were handled in line with guidelines for experimental animal care and handling. At the end of 30-days administrations, the animals were anaesthetized and about 4 ml of blood was collected through cardiac puncture; serum obtained was used to determine the serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, progesterone and estrogen. Results showed that leachate exposure at various concentrations caused a significant decrease in FSH, LH and prolactin p≤0.05; and a significant increase in progesterone and estrogen compared with the control group p≤0.05. This study therefore concludes that leachate could alter female reproductive hormones.

Open Access Original Research Article

Factors Associated with Utilization of Antenatal Care Services among Women of Child Bearing in Osogbo, Nigeria

Christiana A. Oluwamotemi, Elizabeth E. Edoni, Chidinma E. Ukoha, Ademola L. Adelekan

International Journal of Research and Reports in Gynaecology, Page 32-42

Aims: To explore the factors associated with the utilization of ANC services among women of child bearing in Osogbo, Nigeria.

Study Design: A descriptive cross-sectional mixed-methods design was used for this study and both quantitative and qualitative methods were used for data collection.

Setting: Osogbo and Olorunda Local Government Area, Osogbo, Osun state.

Methodology: Ten in-depth interviews (IDIs) were conducted among pregnant women while three hundred questionnaires were also administered among women of child bearing age. Data analysis was done using descriptive statistics and Chi-Square. For the qualitative data, they were transcribed, sorted, categorized and analysed thematically.

Results: Respondents mean age was 28.8 ± 9.3 years, 78.7% were from Yoruba ethnic group and 76.0% were Muslims. The overall mean knowledge score of the respondents was 5.2 ± 2.0 and 90.7% had a poor knowledge of ANC. Few of the IDI respondents mentioned traditional birth attendant and auxiliary nurses as skilled personnel that can offer ANC to pregnant women. Majority (78.0%) of the respondents reportedly have access to ANC services and 78.0% utilised ANC service during the last pregnancy. Most of the qualitative respondents’ reported a current use of ANC and some also reported the use during their previous pregnancy. Reasons adduced for utilization of ANC were influence from family members, fear of maternal mortality and still birth.

Conclusion: The study showed that majority of the respondents had poor knowledge of ANC and many did not know that pregnant women should commence ANC as soon as pregnancy is confirmed. It is therefore recommended that ANC education intervention be carried out to educate women on the importance and the numerous advantages of ANC.

Open Access Case Report

Laparoscopic Sacrocolpopexy for Treatment of Vaginal Vault Prolapse in a Patient with Severe Pelvic Adhesions: A Case Report

Marco Gentile, Pietro Catapano, Antonio Costanza, Mariaconcetta Zinna

International Journal of Research and Reports in Gynaecology, Page 25-31

Aims: Pelvic organ prolapse (POP) regards an increasing number of women. The gold standard procedure for the POP is abdominal sacrocolpopexy. Adhesions often occur after pelvic surgery, with a lower incidence after laparoscopy. We present a laparoscopic sacrocolpopexy in a patient with severe pelvic adhesions.

Presentation of Case: A 52-years-old woman presented to our hospital with fourth degree vaginal vault prolapse after hysterectomy. Laparoscopic bilateral oophorectomy and sacrocolpopexy were proposed to woman. During operation multiple pelvic adhesions were observed; and left ovary, affected by a cyst detected during preoperative assessment, was not visible. The adhesions were removed and bilateral oophorectomy and sacrocolpopexy were performed.

Discussion: POP is often a multicompartmental disorder. Some authors recommended abdominal sacrocolpopexy with mesh as optimal surgical treatment for vaginal vault prolapse. Recent literature showed significant improvements about symptoms using minimally invasive techniques and it reported 78.26% of patients with improvement in defecatory function, 55% in urinary symptomatology and 93.75% in symptoms related to the first compartment. The incidence of intraoperative complications is low and the most common complication is bladder injury with an occurrence of 2%. In the literature a preponderance of evidence (7 of 12 studies) sustained benefits of laparoscopy in reducing adhesions.

Conclusion: Laparoscopic surgical procedures for the treatment of POP are effective and safe techniques and prevent the formation of adhesions, but complex adhesions cases can increase the difficult of surgical procedures.