Browsing by Author "Ijaiya, Munirdeen"
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Item Attitudes to female genital mutilation/ cutting among male adolescents in Ilorin,Nigeria(South Africa Medical Association, 2016-08) Adeniran, Abiodun; Ijaiya, Munirdeen; Fawole, Adegboyega; Balogun, Olayinka; Adesina, Kikelomo; Olatinwo, Abdulwaheed; Olarinoye, Adebunmi; Adeniran, PeaceBackground. The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C). Objectives. To determine knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it. Methods. A cross-sectional survey among male adolescent students in Ilorin, Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM, USA). A p-value of <0.05 was taken as significant. Results. Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years, range 14 - 19), 1 184 (77.1%) were aware of FGM/C, 514 (33.5%) supported female circumcision, 362 (23.6%) would circumcise their future daughters, 420 (27.3%) were of the opinion that FGM/C had benefits, mostly as a necessity for womanhood (109, 7.1%), and 627 (40.8%) perceived it as wickedness against females; 546(35.5%) were aware of efforts to eradicate FGM/C, and 42.2% recommended education as the most important intervention to achieve this. Conclusion. Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C.Item Bacteria vaginosis: prevalence and associated risk factors among non-pregnant women of reproductive age attending a Nigerian tertiary hospital(University of Malawi and Malawi Medical Association, 2017-12) Abdulateef, Rasheedat; Ijaiya, Munirdeen; Fadeyi, Abayomi; Adeniran, Abiodun; Idris, HarunaAim To determine the prevalence and risk factors associated with bacterial vaginosis (BV) among non-pregnant women of reproductive age group. Methods A cross-sectional study among non-pregnant asymptomatic women aged 19 to 45 years, attending the gynaecological clinic at University of Ilorin Teaching Hospital, Ilorin, Nigeria. Participants were counselled and an informed consent was obtained. This was followed by vaginal swabs for microscopy, culture and sensitivity. Diagnosis of BV was by Nugent’s criteria. Data analysis was by Statistical Package for Social Sciences (SPSS) version 20.0. Chi-square and Yates corrected chi-square were calculated, and p value <0.05 was significant. Results Among the 212 participants, prevalence of BV was 40.1%; it was common among women aged 25-34 years (50; 58.8%), the married (77; 90.6%) and those with tertiary education (39; 45.9%). The risk factors for BV were common among women with laboratory evidence of the infection, however statistically significant risk factors were the use of intrauterine device (OR 1.61, 95%CI 0.543-4.759; p0.020) and previous voluntary termination of pregnancy (OR 1.04, 95%CI 0.600-1.808; p0.047). Conclusion There was high prevalence of bacterial vaginosis in the study population. Universal screening and treatment of cases may assist in lowering the associated morbidity.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 Comparing perioperative vaginal misoprostol with intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy: A randomized controlled trial.(Turkish-German Gynecological Association, 2019) Afolabi, Muhibat; Ezeoke, Grace; Saidu, Rakiya; Ijaiya, Munirdeen; Adeniran, AbiodunObjective: To compare the effectiveness of perioperative vaginal misoprostol with intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy. Material and Methods: A randomized controlled trial involving women with uterine leiomyoma who underwent abdominal myomectomy was conducted at a tertiary facility in Nigeria. Participants were recruited after they gave informed consent and randomized into group I (single dose 400 μg vaginal misoprostol one-hour before surgery) and group II (intraoperative pericervical hemostatic tourniquet). Eighty participants (40 in each group) were recruited. Uterine size was measured in centimeters above the pubic symphysis, and blood loss estimation involved direct volume measurement and gravimetric methods. The main outcome measures were intraoperative blood loss, blood transfusion, and recourse to hysterectomy. Ethical approval and trial registration were obtained; the data were analyzed using the SPSS software version 21.0; p<0.05 was considered significant. Results: Participants in group I had higher mean intraoperative blood loss (931.89±602.13 vs 848.40±588.85 mL, p=0.532), intra-operative blood transfusion rates (60 vs 55%; p=0.651) and mean units of blood transfused (1.30±1.20 vs 1.20±1.30; p=0.722) compared with group II. The mean uterine size (19.50±6.93 vs 20.05±6.98 cm; p=0.725) and number of fibroid nodules (11.25±7.99 vs 11.45±8.22; p=0.912) were comparable. The change in post-operative hematocrit was 2.66±2.21% vs 3.24±2.85% (p=0.315) and post-operation blood transfusion was 2.5 vs 5% (p=0.556). There was no recourse to hysterectomy in either of the study groups. While adverse effects of misoprostol occurred in 5 (12.5%) participants of group I. Conclusion: The effectiveness of perioperative vaginal misoprostol is comparable to intra-operative hemostatic pericervical tourniquet in reducing blood loss during abdominal myomectomy. (J Turk Ger Gynecol Assoc 2019; 20: 23-30)Item Current features of urethral mucosa prolapse among children in Ilorin, Kwara State, Nigeria(The Nigerian Journal of General Practice, 2014-03) Adeniran, Abiodun; Okpara, Enoch; Fawole, Adegboyega; Ijaiya, Munirdeen; Abdul, Ishaq; Adesina, Kikelomo; Ezeoke, GraceSetting: Urethral mucosa prolapse is a benign gynaecological condition which is commoner among young black children. Objective: To evaluate the presentation, management, outcome and current status of urethral mucosa prolapse at atertiary centre. Design/ methods: A retrospective descriptive study of49 patients managed at the Obstetrics and Gynaecology department of the University of Ilorin Teaching Hospital, Ilorin. The case files of all patients who were managed from 1st January 2001 to 31st December 2010were retrieved from the medical records department and relevant information extracted. the results were expressed in tables and compared with an earlier study from the centre. Results: A total of 49 patients were managed, the prevalence of urethral mucosa prilapse 1.3% of all gynaecological admissions; all were Nigerians aged 3 to 12 years. The commonest presenting complaint was blood stain on underwear in 37[75.5%], 28[57.1%] presented with multiple symptoms and 32[65.3%] had failed medical treatment prior to presentation. Surgical management was 100% successful, minor post operative complications occurred in eightpatients [16.6%] and the commonest was urinary retention in 5[10.2%] patients. The results were generally similar to a previous study conducted a decade earlier in this centre. Conclusion: Urethral mucosa prolapse is not a common conditioninthis environment; medical and conservative management with higherfailure should be discouraged while surgical management which was curative with no longterm complication is highly recommened as the treatment choice.Item Duration of labour with spontaneous onset at University of Ilorin Teaching Hospital (UITH), Ilorin Nigeria(Medknow, 2011-06) Ijaiya, Munirdeen; Adesina, Kikelomo; Raji, Hadijat; Aboyeji, Peter; Olatinwo, Abdulwaheed; Adeniran, Abiodun; Adebara, Idowu; Isiaka-Lawal, SalamatBackground/Objective: Duration of labor varies from one pregnancy to another and a period of less than 12 hours is regarded as normal. Modern obstetric practice involves active management of labor with the aim of preventing prolonged labor and its sequelae. The main objective of this study was to determine and compare the average duration of labor of spontaneous onset between nulliparas (Po) and multiparas (P 1) and to determine factors affecting duration of labor. Materials and Methods: This study was a prospective study carried out between 15 May and 14 June 2004 at the Labor Ward of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Two hundred and thirty-eight women who satisfi ed the inclusion criteria were studied. The inclusion criteria were term pregnancy with vertex presentation, labor with spontaneous onset, live fetus at presentation and spontaneous vertex delivery. Results: The mean ± SD admission–delivery interval in labor ward was shorter (3.77 ± 2.88 hours) among multiparas than that of nulliparas (5.00 ± 3.17 hours) (P = 0.235). The mean ± SD duration of labor (from the onset of labor to delivery) was shorter among multiparas (8.73 ± 4.17 hours) than that of nulliparas (11.23 ± 4.29 hours) (P = 0.426). The differences were not signifi cant (t-test, P > 0.05). Maternal age and individual parity had signifi cant correlation with the duration of labor in this study (Pearson correlation = −0.019, −0.027, respectively, P < 0.05). Conclusion: Interestingly, duration of labor was not signifi cantly different among multiparas and nulliparas although it was shorter. Correlation existed between duration of labor and maternal age and individual parity.Item Eradicating Female Genital Mutilation: Case series Evaluating the Effect of the Interventions(University of Mauritius, 2014-11) Adeniran, Abiodun; Aboyeji, Abiodun; Balogun, Olayinka; Ijaiya, MunirdeenFemale genital mutilation (FGM) remains a source of abuse to females despite efforts to eradicate it. We present a cases series of two clitoral cysts and one each of post-mutilation haemorrhage, labial adhesion and excess crural flap. One of the victims intended to circumcise her daughters for cultural reasons but rescinded the decision after counseling and education. FGM is a continuing abuse, individual perception does not depend on the degree of complication experienced and there is need for increased education and enlightenment on its dangers.Item Exploringthe practice and attutide of circumcisers in the eradication of female genital mutilation/ cutting(Kenya Medical Association, 2016) Adeniran, Abiodun; Ijaiya, Munirdeen; Adesina, Kikelomo; Balogun, Olayinka; Uthman, Mohammed; Salaudeen, Ganiyu; Adeniran, Peace; Fawole, AdegboyegaBackground: Female Genital Mutilation/Cutting (FGM/C) remains a form of violence against women despite efforts aimed at its eradication. Objectives: To explore the practice and attitude of circumcisers towards eradication of FGM/C. Methods: A descriptive (pilot) study involving local circumcisers in Kwara State, Nigeria using interviewer-administered questionnaire; analysis was done using SPSS version 21.0 and p <0.05 was significant. Results: There are 57 circumcisers including 36(63.2%) males, 49(86%) acquire the skill for circumcision as a family tradition, 3(5.3%) practice circumcision as sole occupation and 49(79%) derive higher average monthly income from other sources. Forty-two (73.7%) have a dedicated knife used for multiple clients, 44(77.2%) clean the instrument before use, 17(29.8%) wear protective gloves, 55(96.5%) apply substances to the wound mostly iodine 15(26.3%) and shea butter 11(19.3%) while 27(47.4%) have encountered complications previously. Among circumcisers, 44(77.2%) believe FGM/C prevent sexual promiscuity while 26(45.6%) think it is for culture/tradition. Thirty (52.6%) are aware of government activities to stop FGM/C, 53(93.0%) are willing to stop the act if support is provided in form of money to establish a trade 33(57.9%) or new employment 12(21.1%). Conclusions: Circumcisers are willing to discontinue FGM/C if necessary support including vocational skill acquisition, credit facilities to start a trade or new employments are provided. Efforts should be expedited to support their rehabilitation to achieve the eradication.Item Female genital mutilation/cutting: Knowledge, practice and experiences of secondary school teachers in North Central Nigeria(South Africa Medical Association, 2015-12) Adeniran, Abiodun; Fawole, Adegboyega; Balogun, Olayinka; Ijaiya, Munirdeen; Adesina, Kikelomo; Adeniran, PeaceBackground. Despite global efforts at eradicating female genital mutilation/cutting (FGM/C), the act continues to be performed globally. Objective. To determine the experience of schoolteachers about FGM/C and their possible role in contributing to its eradication. Methods. A prospective cross-sectional survey involving secondary schoolteachers from 18 secondary schools in Ilorin, North Central Nigeria, was undertaken during October and November 2014. All consenting participants completed a self-administered questionnaire on FGM/C. Statistical analysis was with SPSS version 20.0 with χ2 and logistic regression; a p-value of <0.05 was considered significant. Results. There were 371 participants (113 males (30.5%) and 258 females (69.5%)). More females than males were aware of FGM/C (205 v. 94; χ2 41.2; p=0.001); 180 women (69.8%) and 81 men (71.7%) wanted awareness and the implications of FGM/C to be taught inschools, while 46 women (17.8%) and 23 men (20.4%) had previously educated students about FGM/C. Also, 109 (42.3%) of the female teachers had been mutilated (mean (standard deviation) age 4.76 (4.86) years), and 49 mutilations (45.0%) had been performed by traditional circumcisers. Of the teachers, 44.0% of men and 24.5% of women had subjected their daughters to FGM/C (p=0.029), mostly for religious reasons. The men initiated the majority of their daughters’ mutilations, while the mothers-in-law were the main initiatorsamong the women; 44 (17.0%) women and 23 (20.4%) men held the opinion that females should be circumcised, while the majorityconsidered education and legislation to be the most important interventions to encourage its eradication. Predictors of the likelihood to support discontinuation of FGM/C include awareness of government policy about FGM/C and having a mutilated daughter. Conclusion. Education, reorientation and motivation of teachers will position them as agents for eradicating FGM/C.Item Fibrinolytic proteins of normal pregnancy and pre-eclamptic patients in North West Nigeria(2018) Oladosu-Olayiwola, Rashidat Oluwatosin; Olawumi, Hannah; Babatunde, Abiola; Ijaiya, Munirdeen; Durotoye, Idayat; Biliaminu, Sikiru A; Ibraheem, Rasheedat MBackground: The hypercoagulability of pregnancy is exaggerated in pre-eclamptic state because of endothelial activation with resultant production of some endothelial derived proteins that are said to be inhibitors of fibrinolysis. This study compares these proteins like tPA, PAI-1 and D-dimers in normal pregnant women and the pre-eclamptic women. Methodology: This was a comparative cross-sectional study. Eighty-five pre-eclamptic women were recruited as subjects and eighty five age, trimester and parity matched normotensive pregnant women as controls. Levels of PT, aPTT, tPA, PAI-1, D-dimer protein were determined in blood samples of subjects and controls. Urinalysis was performed with dipstick method on their urine samples. Data generated was analysed using the IBM®SPSS 20.0 (2011) soft ware packages and the level of significance was a p-value <0.05. Results: The mean age of the respondents was 29.9±5.2 years. The median(25th-75th percentile) values of D-dimer, tPA, and PAI-1 of subjects were 730 (305.000-1560.000ng/ml), 0.11 (0.065-0,300ng/ml) and 3.65 (2.970-4,400ng/ml) respectively which were significantly higher than the corresponding values in the controls of 520 (24.000-1030.000ng/ml), 0.05 (0.040-0.090ng/ml and 2.650 (2.125-3.400ng/ml) respectively, p<0.05 each. Conclusion: The abnormal levels of PAI-1,D-dimer and tPA imply that they contribute to the exaggerated hypercoagulabilty state in pre-eclampsia thus, measuring their levels can help in the management of the condition.Item Grandmultiparity: Evaluating obstetric and neonatal outcomes after eliminating confounders(National Postgraduate Medical College of Nigeria, 2014-03) Adeniran, Abiodun; Fawole, Adegboyega; Fakeye, Olurotimi; Ijaiya, Munirdeen; Adesina, KikelomoAims and Objectives: The objective was to evaluate obstetric and neonatal outcomes in booked grandmultiparas (para e”5) and compare with outcome in age and social status matched booked multiparas (para 2-4) after eliminating confounders. Patients and Methods: A cohort study with grandmultiparas (subjects) and age and social status matched multiparas as controls. All participants were counseled and an informed consent obtained at the antenatal clinic. Maternal demography and history were taken; they were subsequently monitored during pregnancy, labour and immediate puerperium. The main outcome measures were obstetric and neonatal outcomes among subjects and controls. Results: The incidence of grandmultiparity was 4.1%. During antenatal period, grandmultiparas had statistically significantly higher occurrence of late antenatal booking (P=0.0202), anaemia (P=0.0024) and past history of poor perinatal outcome (P=0.0124). Grandmultiparas had statistically significant occurrence of preterm delivery (P=0.0389) and higher but not statistically significant mean duration of labour (P=0.3532), intrapartum complications (P=0.2014) and postpartum haemorrhage (P=0.2126). Neonates of grandmultiparas had statistically significant low first minute Apgar scores (P=0.0011) with higher but not statistically significant occurrence of low birth weight (P=0.1613) and neonatal intensive care admission (P=0.7202). The perinatal mortality rates were 136 and 75 per 1 000 deliveries for grandmultiparas and multiparas. There were no maternal deaths during the study period. Conclusion: After controlling for age and social class, booked grandmultiparas had poorer obstetric and neonatal outcome compared to booked multiparas but these were majorly statistically insignificant due to effect of modern antenatal care.Item Intermittent preventive therapy in pregnancy with sulfadoxine/pyrimethamine for malaria prophylaxis among parturients in Ilorin, Nigeria(Faculty of Medical Sciences, University of Jos, 2018-01) Adeniran, Abiodun; Mobolaji-Ojibara, Moji; Adesina, Kikelomo; Aboyeji, Peter; Ijaiya, Munirdeen; Balogun, OlayinkaBackground:The use of intermittent preventive treatment in pregnancy with sulfadoxine/pyrimethamine (IPTp-SP) for malaria remains an important tool for improving pregnancy outcome in malaria endemic areas. Objective: To assess the knowledge, attitude, and factors associated with the use of IPTp-SP among antenatal clinic attendees in Ilorin. Materials and Methods: A prospective, multicentre, cross-sectional study among consenting parturients receiving antenatal care at three public health facilities in Ilorin Ilorin, Nigeria. Statistical analysis was conducted with the Statistical Package for the Social Sciences version 20.0 software (SPSS Inc., Chicago, IL, United States) with the calculation of percentages, chi square, odds ratios (ORs), and confidence intervals (CIs); P < 0.05 was considered significant. Results: There were 422 participants with mean age of 28.8±4.7 years and 368 (87.2%) were aware of the use of IPTp-SP for malaria prevention, while 388 (91.9%) were willing to use IPTp-SP.Only 154 (36.5%)had prescription for IPTp-SPamong whom 139 (90.3%) were compliant; IPTp-SP uptake in preceding pregnancy was 148 (59.7%). The most common reason for the non use of IPTp-SP prescribed was the fear of harm to the fetus (53.3%). Significant determinants of willingness to use IPTp-SP were maternal age (P=0.007) and monthly income (P=0.013), IPTp-SP use in preceding pregnancy (P=0.001), and the treatment for malaria in index pregnancy (P=0.014). On logistic regression, maternal age <20 years (OR=36.457, 95% CI=2.260–588.011; P=0.011) and the use of IPTp-SP in preceding pregnancy (OR=0.051, 95% CI=0.010–0.252; P=0.001) were significant predictors of willingness to use IPTp-SP. Conclusion: Parturients desire IPTp-SP, but the prescription rate by healthcare providers was low. Health care providers should increase the prescription and address the concerns about its teratogenicity. Governments and other agencies should prioritize free provision and the availability of SP at health facilities.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.Item PAI-1 and tPA as markers of severity among pre-eclamptics in a tertiary institution in north central Nigeria(2016) Oladosu-Olayiwola, Rashidat Oluwatosin; Olawumi, Hannah; Babatunde, Abiola S; Ijaiya, Munirdeen; Durotoye, Idayat; Biliaminu, Sikiru A; Ibraheem, Rasheedat M; Ogunfemi, Mutiat KObjectives: Endothelial dysfunction contributes to the pathogenesis of pre-eclampsia as well as increased production of some factors such as tissue plasminogen activator (tPA) and plasminogen activator inhibitor type-1 (PAI-1). These factors are said to be biomarkers of pre-eclampsia but their role in assessing the severity of pre-eclampsia is underreported. Methodology: A cross-sectional study involving 85 subjects with pre-eclampsia. They were classified clinically as having mild or severe pre-eclampsia using ACOG classification. Blood and urine samples were collected for determining tPA, PAI-1, D-dimer and proteinuria in the two groups. Clinical and laboratory values were compared using the IBM®SPSS 20.0 (2011) soft ware packages. Results: The mean age of the respondents was 29.9±5.2 years. Forty-five (52.9%) of the subjects had severe pre-eclampsia while 40(47.1%) had mild pre-eclampsia. The median values of tPA and PAI-1 of subjects with severe pre-eclampsia were significantly higher than the corresponding values in subjects with mild pre-eclampsia (each p=0.001). There was a positive correlation between each of the tPA and PAI-1 levels with the degree of severity of pre-eclampsia (p=0.001 each). Conclusion: Fibrinolytic proteins like tPA and PAI- 1 are useful in assessing the severity of preeclampsia.Item Primary Postpartum Haemorrhage (PPH) in Ilorin: Current Trends(College of Health Sciences, University of Ilorin, 2014-07) Adeniran, Abiodun; Ijaiya, Munirdeen; Aboyeji, Peter; Balogun, Olayinka; Fawole, Adegboyega; Adesina, KikelomoPostpartum Haemorrhage [PPH] remains a major cause of maternal mortality all over the world. In line with the attainment of the Millennium Development Goal improve availability of blood and blood products for [MDG-5] which aims to reduce maternal death by three quarters, there is the need for a regular review. This study was carried out to determine the incidence of Primary Postpartum Haemorrhage following vaginal delivery and evaluate the trend at the University of Ilorin Teaching Hospital [UITH], Ilorin, Nigeria. This study was a hospital based retrospective study of all cases of Primary Postpartum Haemorrhage [PPH] following vaginal delivery at the centre between 1st January 2004 and 31 December 2008. The case notes of all women who had primary PPH over the study period were retrieved from the records department of the hospital and necessary information was extracted. The results were compared with previous studies on primary PPH at the centre from 1987-2003. There were 14,700 vaginal deliveries, primary PPH occurred in 614 giving the incidence of PPH as 4.2%. Unbooked patients had a three times higher risk of developing primary PPH than their booked counterparts; the commonest risk factor was grandmultiparity [27.0%], uterine atony was the commonest aetiology [54.1%] and 64.8% had blood transfusion. Uterine massage and uterotonics were effective in 44.3% and two maternal mortalities were recorded during the period. The trend in primary PPH over a 22 year period showed an improvement in survival and a reduction in mortality.Item Spectrum of Uropathogens and its antibiotic susceptibility in pregnant women with symptomatic urinary tract infection in a Nigerian Teaching Hospital(Society of Obstetrics and Gynaecology of Nigeria, 2014-04) Idris, Haruna; Ijaiya, Munirdeen; Adeniran, Abiodun; Akanbi II, AibolaBackground: Urinary tract infections (UTI) are the most common bacterial infections in pregnancy and associated with maternal and perinatal morbidity and mortality. Objectives: To determine the current uropathogens and their antibiotic susceptibility pattern and to compare the pregnancy outcome among clinical UTI and non clinical UTI cohorts. Patients and methods: This was a prospective matched cohort study carried out between 1st January, 2012 and 30th June, 2012 at the department of Obstetrics and Gynaecology of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The study population was made up of 200 pregnant women with clinical signs and symptoms of urinary tract infections and 200 pregnant women without clinical signs and symptoms of urinary tract infection as control matched with maternal age group, parity and gestational age. Results: Of 3442 obstetric patients seen 200 had clinically diagnosed UTI in pregnancy giving a rate of 5.8%. Age bracket 21- 30years and multipara had highest frequency of significant bacteriuria. Low social status and third trimester of pregnancy were identified risk factors for UTI in pregnancy. Frequency of maternal anaemia (p=0.02) and hypertension (p=0.03) were significantly higher among subjects than control. The common bacterial uropathogen isolated were Escherichia coli (46.7%), Staphylococcus aureus (17.9%), Proteus spp.(13.3%) and Klebsiella spp. (11.1%). The antibiotics with highest coverage included Co-amoxyclave (81%), Gentamicin (68.8%) and Cefuroxime (54.4%). Conclusion: Maternal anaemia and hypertension were significantly higher among subjects than control. Gram negative isolates were predominant and E. coli was the most common isolated bacteria. Co-amoxyclave had highest coverage against the bacteria. Therefore, co-amoxyclave is recommended for empirical use for urinary tract infection in pregnancy in this locality.Item Unilateral post-tuberculosis lung destruction and massive haemoptysis in pregnancy with successful outcome(Faculty of Medicine, Alexandria University, Egypt, 2016) Adeniran, Abiodun; Ijaiya, Munirdeen; Fawibe, Ademola; Adeoye, Oladapo; Abdulkadri, ZainabPost-tuberculosis destroyed lung is a fatal complication of pulmonary tuberculosis which can manifest with severe life-threatening haemoptysis. Its occurrence during pregnancy is rare and challenging because of the significant risk to both the mother and the foetus. We present an unbooked 36 year old G6P4 +1 (4 alive) woman who presented with chronic cough, massive haemoptysis and multiple pregnancy (twin) at 35 week gestation. She had completed anti-tuberculosis treatment twice at and over nine years prior to presentation. On evaluation, there were clinical and radiological evidences of unilateral (right) destroyed lung but no evidence of active tuberculosis; resuscitation was with antibiotics, blood transfusion and oxygen therapy followed by an emergency caesarean delivery due to significant maternal compromise. The symptoms resolved following antibiotic therapy and she was subsequently discharged home. Post-tuberculosis destroyed lung is a fatal uncommon condition that may present during pregnancy and requires a multi-disciplinary specialist care to ensure good maternal and foetal outcomeItem Vesicovaginal fistula: A review of Nigerian experience(West African College of Physicians and Surgeons, 2010-09) Ijaiya, Munirdeen; Rahman, A; Aboyeji, Peter; Olatinwo, Abdulwaheed; Esuga, S; Ogah, O; Raji, Hadijat; Adebara, Idowu; Akintobi, Abdulhakeem; Adeniran, Abiodun; Adewole, AdebayoBACKGROUND: Vesicovaginal fistula is a preventable calamity, which has been an age-long menace in developing countries. OBJECTIVE: To review the causes, complications, and outcome of vesicovaginal fistula in Nigeria. METHODS: Studies on vesicovaginal fistula were searched on the internet. Information was obtained on Pubmed (medline), WHO website, Bioline Innternational, African Journal on Line, Google scholar, Yahoo, Medscape and e Medicine. RESULTS: Many Nigerian women are living with vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria than southern Nigeria. Obstetric fistula accounts for 84.1%–100% of the vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9%–96.5%) in all the series. Other common causes include caesarean section, advanced cervical cancer, uterine rupture, and Gishiri cut. The identified predisposing factors were early marriage and pregnancy, which were rampant in northern Nigeria, while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance were poverty, illiteracy, ignorance, restriction of women’s movement, non-permission from husband, and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87%–91.7%. Stigmatization, divorce and social exclusion were common complications. Overall fistula repair success rate was between 75% and 92% in a few centres that offer such services. CONCLUSION: Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern.