Browsing by Author "Adewale, Folorunsho"
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Item Clinical profile of patients with uterine rupture at a tertiary facility in North Central Nigeria(College of Health Sciences, University of Port Harcourt, 2019-01) Adewale, Folorunsho; Adeniran, Abiodun; Ijaiya, MunirdeenBackground: Uterine rupture is a major obstetric emergency and an important cause of maternal and perinatal morbidity and mortality. Aim: To determine the prevalence, clinical presentation, management options and pregnancy outcomes following uterine rupture. Methods: It is a 5-year, descriptive, retrospective study of parturients who had uterine rupture between 1 January 2011 and 31 December, 2015, at Federal Medical Centre, Bida, North Central Nigeria. The case files of all parturients who had uterine rupture during this period were retrieved from the Medical Records department, and relevant information including maternal age, risk factors for uterine rupture, presenting symptoms, site of rupture and the definitive treatment as well as maternal and neonatal outcome using a data collection sheet was entered into a computer with SPSS version 20.0, which was also used for the analysis. Results: The prevalence of uterine rupture was 1 in 202 deliveries (48/9,718); of these, 24 (50.0%) were aged 36–40 years and 28 (58.3%) were grandmultipara (parity ≥5); 42 (87.5%) cases had previous uterine scar, whereas 15 (31.3%) had labour augmentation with oxytocin while attempting vaginal birth after caesarean section. The common presenting complaints were intrapartum vaginal bleeding (24; 50%) and abdominal pain (10; 20.8%). The most common site of rupture was anterolateral (24; 50.0%), while the most common surgical intervention was uterine repair with bilateral tubal ligation (30; 62.5%). The case fatality rate was 18.8% (9/48), neonatal survival rate was 12.5% (6/48) and perinatal mortality rate was 875/1000 deliveries (42/48). Conclusion: Uterine rupture remains an important cause of poor pregnancy outcomes in low-income settings. Previous caesarean delivery is the most common risk factor; women attempting vaginal birth after caesarean delivery should be managed by skilled health personnel in facilities with provision for emergency surgical intervention.Item Obstetric performance of mothers with fetal macrosomia in Bida, North Central Nigeria(College of Health Sciences, University of Ilorin, 2017-10) Adewale, Folorunsho; Adeniran, Abiodun; Ijaiya, Munirdeen; Babalola, AFetal macrosomia remains an important determinant of perinatal outcome and a contributor to neonatal morbidity and mortality due to its possible attendant complications. The aim of the study was to determine the maternal characteristics, as well as neonatal and maternal outcome following delivery of macrosomic babies. A descriptive study of deliveries that resulted in the delivery of macrosomic babies at the Federal Medical Centre, Bida, Nigeria was conducted over a five year period. The list of eligible parturient was compiled from the delivery registers, the case files were retrieved and relevant information extracted. Statistical analysis was with SPSS version 20.0 and p<0.05 was significant. Out of 8141 deliveries, macrosomia occurred in 500 (6.1%); among the 480 cases analyzed, 345(71.9%) mothers of macrosomic babies were <35 years of age, the mean maternal weight at term was 89.42kg±2.50 while 297(61.9%) mothers had previous delivery of macrosomic babies. Also, 337(70.2%) women had vaginal delivery while maternal risk factors for fetal macrosomia were not statistically significant relative to the mode of delivery (p0.857). Maternal complications included perineal lacerations [90(18.8%)] and primary postpartum haemorrhage [82(17.1%)]. Maternal booking status (p0.001), male fetal gender (p0.001) and birth weight less than 4500g (p0.002) were significant predictors of vaginal delivery while maternal complications were significantly higher following vaginal delivery (p0.001). Low APGAR scores were higher following vaginal deliveries (p0.732); the perinatal mortality rate was 31/1,000 live birth (15/480) but there was no maternal death. This study revealed a high incidence of fetal macrosomia and vaginal delivery was associated with a high maternal and perinatal morbidity.