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  1. Article ; Online: Evaluation of obstetricians' surgical decision making in the management of uterine rupture.

    Eze, Justus Ndulue / Anozie, Okechukwu Bonaventure / Lawani, Osaheni Lucky / Ndukwe, Emmanuel Okechukwu / Agwu, Uzoma Maryrose / Obuna, Johnson Akuma

    BMC pregnancy and childbirth

    2017  Volume 17, Issue 1, Page(s) 179

    Abstract: Background: Uterine rupture is an obstetric calamity with surgery as its management mainstay. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub) ... ...

    Abstract Background: Uterine rupture is an obstetric calamity with surgery as its management mainstay. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub)total hysterectomy predispose survivors to psychosocial problems like marital disharmony. This study aims to evaluate obstetricians' perspectives on surgical decision making in managing uterine rupture.
    Methods: A questionnaire-based cross-sectional study of obstetricians at the 46th annual scientific conference of Society of Gynaecology and Obstetrics of Nigeria in 2012. Data was analysed by descriptive and inferential statistics.
    Results: Seventy-nine out of 110 obstetricians (71.8%) responded to the survey, of which 42 (53.2%) were consultants, 60 (75.9%) practised in government hospitals and 67 (84.8%) in urban hospitals, and all respondents managed women with uterine rupture. Previous cesarean scars and injudicious use of oxytocic are the commonest predisposing causes, and uterine rupture carries very high incidences of maternal and perinatal mortality and morbidity. Uterine repair only was commonly performed by 38 (48.1%) and uterine repair with BTL or (sub) total hysterectomy by 41 (51.9%) respondents. Surgical management is guided mainly by patients' conditions and obstetricians' surgical skills.
    Conclusion: Obstetricians' distribution in Nigeria leaves rural settings starved of specialist for obstetric emergencies. Caesarean scars are now a rising cause of ruptures. The surgical management of uterine rupture and obstetricians' surgical preferences vary and are case scenario-dependent. Equitable redistribution of obstetricians and deployment of medical doctors to secondary hospitals in rural settings will make obstetric care more readily available and may reduce the prevalence and improve the outcome of uterine rupture. Obstetrician's surgical decision-making should be guided by the prevailing case scenario and the ultimate aim should be to avert fatality and reduce morbidity.
    Language English
    Publishing date 2017-06-08
    Publishing country England
    Document type Journal Article
    ISSN 1471-2393
    ISSN (online) 1471-2393
    DOI 10.1186/s12884-017-1367-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Obstetric outcome and significance of labour induction in a health resource poor setting.

    Lawani, Osaheni Lucky / Onyebuchi, Azubuike Kanario / Iyoke, Chukwuemeka Anthony / Okafo, Chikezie Nwachukwu / Ajah, Leonard Ogbonna

    Obstetrics and gynecology international

    2014  Volume 2014, Page(s) 419621

    Abstract: Objectives. The aim of this study was to evaluate the methods, indications, outcome of induced labor and its significance in obstetric practice in the study area. Methods. This was a retrospective study of cases of induced labor at the Catholic Maternity ...

    Abstract Objectives. The aim of this study was to evaluate the methods, indications, outcome of induced labor and its significance in obstetric practice in the study area. Methods. This was a retrospective study of cases of induced labor at the Catholic Maternity Hospital in Ogoja, Cross-River State, Nigeria, between January 1, 2002, and December 31, 2011. Data on the sociodemographic characteristics of the parturient, induction methods, indications for induction, outcomes and reasons for failed induction were abstracted from personal case files and the hospital's maternity/delivery register. The data were analyzed with SPSS15.0 window version. Result. The induction rate in this study was 11.5%. Induction was successful in 75.9% of cases but failed in 24.1%. Misoprostol was the commonest induction method (78.2%). The commonest indication for induction was postdate pregnancy (45.8%). Failed induction was due to fetal distress, prolonged labor, cephalopelvic disproportion and cord prolapse. The induction-delivery interval was 12 ± 3.6 hours. Conclusion. Induction of labor is a common obstetric procedure which is safe and beneficial in well-selected and properly monitored high risk pregnancies where the benefits of early delivery outweigh the risk of continuing the pregnancy.
    Language English
    Publishing date 2014-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2495157-2
    ISSN 1687-9597 ; 1687-9589
    ISSN (online) 1687-9597
    ISSN 1687-9589
    DOI 10.1155/2014/419621
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Prevalence and perinatal mortality associated with preterm births in a tertiary medical center in South East Nigeria.

    Iyoke, Chukwuemeka Anthony / Lawani, Osaheni Lucky / Ezugwu, Euzebus Chinonye / Ilechukwu, Gideon / Nkwo, Peter Onubiwe / Mba, Sunday Gabriel / Asinobi, Isaac Nwabueze

    International journal of women's health

    2014  Volume 6, Page(s) 881–888

    Abstract: Background: Preterm birth is a high risk condition associated with significant mortality and morbidity in the perinatal, neonatal, and childhood periods, and even in adulthood. Knowledge of the epidemiology of preterm births is necessary for planning ... ...

    Abstract Background: Preterm birth is a high risk condition associated with significant mortality and morbidity in the perinatal, neonatal, and childhood periods, and even in adulthood. Knowledge of the epidemiology of preterm births is necessary for planning appropriate maternal and fetal care.
    Objective: The objective of this study was to determine the prevalence, pattern, and perinatal mortality associated with preterm births at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria.
    Methods: This was a review of prospectively collected routine delivery data involving preterm deliveries that occurred between 1 January 2009 and 31 December 2013. Data analysis involved descriptive and inferential statistics at 95% level of confidence using SPSS version 17.0 for Windows.
    Results: There were 3,760 live births over the 5-year study period out of which 636 were preterm births, giving a prevalence rate of 16.9%. Spontaneous preterm births occurred in approximately 57% of preterm births while provider-initiated births occurred in 43%. The mean gestational age at preterm deliveries was 32.6±3.2 weeks while the mean birth weight was 2.0±0.8 kilograms. Approximately 89% of preterm births involved singleton pregnancies. Sixty-eight percent of preterm births were moderate to late preterm. The male:female ratio of preterm babies born during the period was 1.2:1. The adjusted perinatal mortality rate for preterm babies in the study center was 46.1% (236/512). The stillbirth rate for preterm babies was 22.0% (149/678) and the adjusted early neonatal death rate was 24.0% (87/363).
    Conclusion: The prevalence of preterm births and associated perinatal mortality were high which may be a reflection of suboptimal prenatal and newborn care. An urgent improvement in prenatal and newborn care is therefore needed in the study center in order to improve the capacity to prevent or abate preterm labor, and preterm premature rupture of membranes; and to reduce avoidable stillbirths. Further upgrading of personnel and facilities in the newborn special care unit is also required to minimize early neonatal deaths.
    Language English
    Publishing date 2014-10-17
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2508161-5
    ISSN 1179-1411
    ISSN 1179-1411
    DOI 10.2147/IJWH.S72229
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria.

    Iyoke, Chukwuemeka Anthony / Ugwu, George Onyemaechi / Ezugwu, Euzebus Chinonye / Ezugwu, Frank Okechukwu / Lawani, Osaheni Lucky / Onyebuchi, Azubuike Kanayo

    International journal of women's health

    2014  Volume 6, Page(s) 123–130

    Abstract: Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries.: Objective: The purpose of this study was to ... ...

    Abstract Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries.
    Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria.
    Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software.
    Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the prescribed courses of chemotherapy. Most patients with endometrial and vulval cancers had only surgical treatment, as compliance with follow-up for adjuvant chemotherapy or radiotherapy was poor. Functional radiotherapy facilities were not available at the center during the study period, thereby necessitating external referrals to centers hundreds of kilometers away.
    Conclusion: Late presentation of cases, noncompliance with treatment regimens, lack of use of cutting edge cytotoxic drugs, the poor outcome of radical surgeries, and lack of a functional radiotherapy facility combined to create a very difficult gynecological cancer care environment at the study center.
    Language English
    Publishing date 2014-01-24
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2508161-5
    ISSN 1179-1411
    ISSN 1179-1411
    DOI 10.2147/IJWH.S55797
    Database MEDical Literature Analysis and Retrieval System OnLINE

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