Papers by fatimat akinlusi
BMJ Open, 2020
IntroductionInvoluntary leakage of urine and or stool per vaginam (vaginal fistula) after childbi... more IntroductionInvoluntary leakage of urine and or stool per vaginam (vaginal fistula) after childbirth remains a public health challenge in Africa and South East Asia. To the best of our knowledge, there is no previous national data that examined the awareness of vaginal fistula among women in Nigeria.AimTo determine the prevalence of awareness of urinary/faecal incontinence due to vaginal fistula, and the associated risk factors among women with no previous experience of incontinence.MethodsWe used a cross-sectional study, the 2018 Nigerian Demographic Health Survey, to analyse awareness of vaginal fistula among women with no previous leakage of urine or stool. The primary outcome was childbirth experience, and other variables were demographics, access to information and reproductive or sexual history. The descriptive, univariate and multivariable models were presented.ResultsOf 26 585 women interviewed, 50 (0.2%) who had experienced fistula were excluded from the risk factor analysi...
Nepal Journal of Obstetrics and Gynaecology, 2018
Aims: To review the classification systems of obstetric fistula (OF). Methods: A two-day stakeho... more Aims: To review the classification systems of obstetric fistula (OF). Methods: A two-day stakeholders’ meeting in Nigeria involving fistula surgeons, nurses, anesthetists, trainee, fistula desk officers at the federal and state government levels and other stakeholders was facilitated by Engender health. The meeting involved presentation of common classifications of obstetric fistula, critical analysis of each classification, group and plenary discussions. Presentation involved a critical analysis of classification parameters, strength and weakness. Three working groups designed classification criteria, prognostic scoring and suggested level of surgical skills needed to manage the patient. Outcome of each group work was presented and discussed in plenary. Each of the classification scenarios were modified by consensus and ratified at subsequent follow up meeting. Results: Three new classification systems of the OF were developed, and from these, a consensus classification was also d...
Physicians with gynaecological training often have correct information about contraceptive techno... more Physicians with gynaecological training often have correct information about contraceptive technologies, their effects and benefits. Their personal choices may affect their practice. The objectives of this study are to find out what contraceptives Nigerian trainee gynaecologists use, and if this affects the way they counsel their clients. This was a cross-sectional survey. Participation was voluntary and 150 trainees were to fill out a pretested, self-administered questionnaire eliciting general demographic information, academic post and years of training, information on personal contraceptive use and choices, and how it may influence their practices. Analysis was done using the statistical package for social science (SPSS) computer software, version 20. Descriptive analysis was performed, using frequency tables. Chi-square test was used to compare variables and assess significance. P value of <0.05 was considered significant. There was a response rate of 62%. About 25.8% of respondents were not currently using any form of contraception and 53% were currently using modern methods of contraception, most commonly barrier methods and intrauterine devices. There was poor uptake of male sterilization. Twenty four respondents (25.8%) had several objections to contraceptive use. The choice of contraception used was significantly associated with gender. Sixteen respondents (17.2%) felt their personal choices may affect how they counsel patients and prescribe contraceptive agents. The level of respondents and number of children significantly affected counseling practices. In conclusion, trainees prefer to use natural forms of contraception. However, larger studies will be required to verify that personal objections to contraceptives introduce bias to contraceptive counseling practices.
The Journal of Sexual Medicine, May 1, 2023
Introduction The novel SARS corona virus (SARS COV 2) causing the Corona Virus Disease (COVID--19... more Introduction The novel SARS corona virus (SARS COV 2) causing the Corona Virus Disease (COVID--19) was first reported in Wuhan, China in 2019 and became a global pandemic in 2020 with severe health and economic consequences forcing nations to declare nationwide lockdown to limit the ragging pandemic. Different patterns of signs and symptoms as well as complications were reported to have followed COVID-19. Objective The objectives of the study were to describe the prevalence of female sexual dysfunction and pattern of dysfunction and to determine the effect of COVID--19 infection pandemic and lockdown on sexual function and activities among women reproductive age. Methods This was a cross sectional study of women in the reproductive age-group evaluating the sexual health function before, during and after the COVID--19 infection pandemic and lockdown. This was assessed using a structured questionnaire and a modified Female Sexual Function Index (FSFI). A pre-tested interviewer administered questionnaire was administered to 203 women participants and the information collected included socio-demographic and gynaecologic characteristics, COVID--19 experiences, sexual history and function before, during and after the COVID--19 pandemic lockdown. Results Most of the respondents were aged between 20 and 50 years (95%), married (77.7%) and were sexually active at the time of the study (92.6%) and 16.3% of the respondents had COVID-19 infection at least once. Only 43.6% of the sexually active respondents currently have normal overall female sexual function score with the mean FSFI score of 24.5. 71.4% had at least mild hyposexual desire, 54.2% with arousal disorder, 32.1% disorders of lubrication, 43.3% have orgasm related dysfunction, 37.8% have sexual satisfaction related dysfunction and 41.1% have disorders of sexual pain. COVID-19 lockdown may have had effect on sexual activities as 11.3% of respondents were not sexually active before the lockdown, 13.3% during the lockdown whereas only 7.4% after the lockdown suggesting abstinence as a result of the lockdown. Among the sexually active respondents during COVID-19 lockdown mean FSFI score of 23.76 and only 36.9% had normal overall FSFI score. Conclusions Female sexual dysfunction is still prevalent with the most common form being disorders of desire and arousal. COVID-19 lockdown resulted in abstinence from sexual intercourse in some women and sexual function also noted to be reduced among the sexually active women with higher incidence of female sexual dysfunction during the lockdown. Disclosure No
Objective The aim of this study is to determine the effectiveness of antenatal corticosteroid in ... more Objective The aim of this study is to determine the effectiveness of antenatal corticosteroid in reducing respiratory morbidity in babies born in the late preterm period. Materials and methods Two hundred and eighty-six pregnant women at risk of having a late preterm delivery were studied. One hundred and forty-three (143) served as the cases and were given 2 doses of 12mg intramuscular dexamethasone 12 hours apart, while 143 served as the controls and were given a similar quantity of placebo. The women were followed up prospectively and data were collected on the pregnant women and their newborns on a standardized form. The neonates were assessed for acute respiratory distress syndrome and transient tachypnea of the newborn based on clinical signs, symptoms, and chest x-ray results (when indicated). The primary outcome was the occurrence of neonatal respiratory morbidity. Results The primary outcome occurred in 5 out of 130 infants (3.8%) in the dexamethasone group and 31 out of 12...
Zenodo (CERN European Organization for Nuclear Research), Mar 30, 2023
Background: Term prelabour rupture of membranescomplicates about 5% to 10% of term pregnancies an... more Background: Term prelabour rupture of membranescomplicates about 5% to 10% of term pregnancies and imposes therapeutic challenges upon the managing obstetrician. While spontaneous labour followed by ruptured membranes is the accepted default pathway towards delivery at term, comparative studies on term PROM and spontaneous onset of labour preceding ruptured membranes are scarce globally. Objective: To compare maternal socio-demography and neonatal outcomes of term PROM versus spontaneous onset of labour before membrane rupturein our tertiary facility. Methods: A prospective comparative study of 300 subjects allocated intothe study group comprising 150 subjects with prelabour rupture of membranes and the other 150 subjects with spontaneous labour before membrane rupture as the control group. Data were obtained on maternal sociodemographic characteristics and neonatal outcomes in both groups.Epi-info statistical softwarewas deployed for data analysis. Results: The incidence of premature rupture of membranes was 9.23%. Term PROM was highest in the age group 20-29 years while subjects with low socioeconomic status accounted for 58.7% in the study group. The study group had higher caesarian delivery than the control (22.6% versus 8.0%; P < 0.001). One hundred and thirty-nine (139) babies of subjects in the study group had APGAR scores> 7 compared to 149 babies of subjects in the control group (P < 0.001). More neonates in the study group were admitted into the Neonatal Intensive Care Unit (NICU) compared to the control (6.7% versus 0.7%; P = 0.025). Seven neonates in the study group had Neonatal sepsis compared to none in the control group(P < 0.01). Similarly, three perinatal death were recorded in the study group compared to none in the control group (P = 0.06). Conclusion: Actively managed term PROM was significantly associated with unbooked maternal status, poorer Apgar scores, higher rate of caesarian delivery, and increased perinatal morbidity and mortality compared to spontaneous labour before membrane rupture.
BMC Pregnancy and Childbirth, Jan 30, 2023
Background Prior caesarean delivery (CD) impacts CD rates in many parts of the world. In low and ... more Background Prior caesarean delivery (CD) impacts CD rates in many parts of the world. In low and middle-income countries, few women attempt a trial of labour after caesarean delivery (TOLAC) due to inadequate resources for safe vaginal birth after caesarean delivery (VBAC). The CD rates continue to rise as more women undergo repeat CD. In Nigeria, VBAC rate is low and the contribution of women's prior childbirth experiences and delivery wishes to this situation deserves further investigation. This study examined the parturient factor in the low VBAC rate to recommend strategies for change. Objective To describe prior caesarean-related childbirth experiences and attitudes towards subsequent vaginal birth in pregnant women with one previous CD. Method This cross-sectional study of antenatal clinic attendees in a tertiary hospital employed the convenience sampling method to recruit 216 consenting women with one previous CD. Structured questionnaires were used to collect information on participants' prior caesarean-related birth experiences, attitudes to vaginal birth in the index pregnancy, future delivery intentions and eventual delivery route. Univariate and bivariate analyses compared delivery wishes based on CD type. SPSS version 22.0 was used for data analysis. Results The modal maternal and gestational age groups were 30-39 years (68.1%) and 29-34 weeks (49.1%) respectively; majorities (60.6%) were secundigravida; 61.6% experienced labour before their CDs while 76.9% had emergency CDs. Complications were documented in 1.4% and 11.1% of mothers and babies respectively. Ninety percent reported a satisfactory overall childbirth experience. A majority (83.3%) preferred TOLAC in the index pregnancy because they desired natural childbirth while 16.7% wanted a repeat CD due to the fear of fetal-maternal complications. The previous CD type and desire for more babies were significantly associated with respondents' preferred mode of delivery (p = 0.001 and 0.023 respectively). Women with previous emergency CD were more likely to prefer vaginal delivery.
GSC Advanced Research and Reviews
Background: During the postpartum period, family planning (FP) can prevent about 30% of maternal ... more Background: During the postpartum period, family planning (FP) can prevent about 30% of maternal mortality and 10% of child mortality if couples space their pregnancies more than 2 years apart. Conversely, closely spaced pregnancies within the first year postpartum increase the risks of preterm birth, low birth weight, and small-for-gestational-age babies. Objective: To determine the perception and practice of family planning in the extended postpartum period. Methodology: A cross-sectional descriptive study was conducted among women in the extended postpartum period, attending the Gynaecology clinic, family planning clinic, and infant welfare clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos. Information obtained includes socio-demographic data, spouse education, and income, knowledge of, attitude towards, and utilization of family planning methods along with the partner’s involvement in decision-making towards arrival at choice methods. The data obtained were pr...
Journal of Patient Experience, 2022
To facilitate improvements in health service delivery, patients’ satisfaction with gynecological ... more To facilitate improvements in health service delivery, patients’ satisfaction with gynecological services was assessed at a tertiary hospital. Five hundred gynecological care-seekers who presented for outpatient consultation, inpatient care, or theatre procedures had face-to-face interviews using close-ended questionnaires. The assessment encompassed hospital ambience, healthcare providers’ attitude, waiting time, duration of consultation among others. Univariate and bivariate analyses were performed with SPSS 22.0 software. Mean age was 37.8 ± 10.9 years; 319(63.8%) had tertiary education; 81(16.2%) and 82(16.4%) had inpatient and theatre care, respectively; 233(46.6%) were managed for infertility. One in five respondents reported delayed retrieval of medical records (20.8%), dissatisfaction with hospital meals (22.2%) and 31.6% were displeased with waiting time. Overall, 92.7%, 74.2%, and 66.7% of participants reported high levels of satisfaction with theatre, outpatient, and inpa...
Pan African Medical Journal, 2021
Introduction the burden of overweight and obesity is rapidly increasing worldwide with significan... more Introduction the burden of overweight and obesity is rapidly increasing worldwide with significant health and social consequences. We determined the prevalence of overweight and obesity, pattern of gestational weight gain (GWG) and the associations of these with perinatal outcome among pregnant women in Lagos, Nigeria. Methods this was a retrospective review of case records of all deliveries in Lagos State University Teaching Hospital (LASUTH) over a period of two years. Case records of women with singleton pregnancies who registered for antenatal care at or below 20 weeks gestation were retrieved and reviewed to extract information on demography, anthropometrics, composites of pregnancy and perinatal outcomes. World Health Organization classification of BMI and the United States Institute of Medicine categorization of GWG were used to stratify subjects. Results out of 4,512 deliveries, 365 (8.1%) met our criteria. The prevalence of overweight and obesity in early pregnancy was 34.6% and 25.6% respectively while 2.9% were underweight. Thirty-seven (11.1%) pregnant women gained more than the recommended weight while 77.8% of underweight pregnant women gained less than the recommended weight. Following multiple logistic regression analysis, obesity in early pregnancy was significantly related to hypertensive pregnancy disorder (AOR 2.2; 95% CI, 1.08-4.32, p = 0.030), gestational diabetes mellitus (AOR 14.4; 95% CI, 4.85-42.6, p = < 0.001), caesarean section (AOR 2.7; 95% CI, 1.51-4.87, p = 0.001) and infections (AOR 4.9; 95% CI, 1.93-12.62, p = 0.001) while excessive GWG was significantly associated with gestational diabetes mellitus (AOR 4.8; 95% CI, 1.63-14.12, p = 0.004). Conclusion prevalence of early pregnancy overweight, obesity and excessive GWG were high among pregnant women in Nigeria and were associated with significant adverse consequences.
Background: Contraception has been identified as an effective means of combating the problem of u... more Background: Contraception has been identified as an effective means of combating the problem of unwanted pregnancy and unsafe abortion. It is equally an effective means of family planning and fertility control and therefore an important tool in promoting maternal and child health. Methodology: It was a retrospective study. Records of clients attending the family planning clinic at LASUTH from January 2011 to December 2013 were reviewed. Information extracted included age, parity, type of contraception, source of information, complications and action taken to address the complication. Data obtained were represented using frequency tables, means, percentages, bar charts.Results: A total of 1,843 clients accepted various forms of contraceptive methods during the period of study. There was a steady increase in the number of acceptors of contraceptives over the period of study from 585 (31.7%) in 2011 to 645 (35.0%) in 2013. The mean age and parity were 34.08±5.37 years and 2.9±1.22, res...
Journal of Advances in Medicine and Medical Research, 2021
Background: Polycystic ovarian syndrome (PCOS) is a very common endocrine cause of infertility af... more Background: Polycystic ovarian syndrome (PCOS) is a very common endocrine cause of infertility affecting about 10% of women of reproductive age. We evaluated the pattern of reproductive hormones in infertile Nigerian women with PCOS. Methods: This was a prospective cross-sectional study at the Lagos State University Teaching Hospital over a 6-month period in which One hundred and fifty infertile women, with diagnosis of PCOS using the Rotterdam’s criteria, had quantitative assessment of their reproductive hormones like Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Progesterone, Testosterone, Prolactin and Thyroid Stimulating Hormone (TSH), with relevant socio-demographic and clinical data noted in the study proforma. Z test, chi-square and correlation tests were used as appropriate to analyse the data with p<0.05 significance level. Results: The mean age of infertile women with PCOS was 26.50±4.4years; all the women had either oligomenorrhea (62%) or secondary ame...
Nigerian Medical Journal, 2020
Background: There has been a global increase in cesarean section rates. While this has improved p... more Background: There has been a global increase in cesarean section rates. While this has improved perinatal outcome, it is associated with complications such as wound infection. We determined risk factors for cesarean section wound infection in a tertiary hospital in Lagos, Nigeria. Materials and Methods: We prospectively studied a cohort of 906 women who had cesarean section at the Obstetrics Unit of the Lagos State University Teaching Hospital between January 1, 2011, and December 31, 2011. A comparison was made between 176 women who had wound infection and 730 women who did not using logistic regression. Results: Of the 2134 deliveries during the study, 906 (42.5%) had cesarean section and of which 176 (19.4%) had wound infection. Independent risk factors for wound infection were: preoperative anemia (adjusted odds ratio [aOR] = 1.88; 95% confidence intervals [CI] = 1.03–3.41; P = 0.0396), presence of diabetes mellitus (aOR = 7.94; 95% CI = 1.60–39.27; P = 0.0111), HIV infection (aOR = 6.34; 95% CI = 1.74–23.06; P = 0.0051), prolonged operation time (aOR = 2.30; 95% CI = 1.19–4.42; P = 0.0127), excessive blood loss at surgery (aOR = 5.05; 95% CI = 2.18–11.66; P = 0.0002), and chorioamnionitis (aOR = 9.00; 95% CI = 1.37–59.32; P = 0.0224). Conclusions: Patients with HIV infection, diabetes mellitus, preoperative anemia and chorioamnionitis have an increased risk of postcesarean wound infection as is when surgical time exceeds 1 h or when associated with blood loss >11.
Open Journal of Obstetrics and Gynecology, 2020
Background: Young people, especially those in tertiary institutions are vulnerable to unplanned a... more Background: Young people, especially those in tertiary institutions are vulnerable to unplanned and unprotected sexual intercourse which predisposes them to unintended pregnancies and subsequently unsafe abortions. One of the key interventions for reduction of unwanted pregnancies and unsafe abortions is effective use of emergency contraceptives. Objectives: To assess the sexuality, perception, attitude towards and determinants of usage of emergency contraception among female undergraduates in Lagos, Nigeria. Methods: Cross-sectional survey conducted in June 2016 among 805 female students of the Lagos State University. Data were collected through structured self-administered questionnaire by obtaining information on demography, sexual and contraceptive history, perception, attitude towards and use of emergency contraceptives. Data obtained were analyzed using SPSS version 16. Chi-square and logistic regression models were applied to variables to test for significance that predicts the use of emergency contraceptives. Results: Of the 725 (90%) completed questionnaires, 334 (46%) of the respondents were sexually active with 115 (34%) having previous history of pregnancy. Eighty-two percent of those pregnancies were unintended. Eighty-eight percent of those with unintended pregnancy had them terminated by induced abortions, 54% of which was carried out by untrained persons. Only 29% of those who had unprotected sexual intercourse used emergency contraceptives. Lack of knowledge and promotion of sexual promiscuity were identified as the main reasons for not using emergency contraceptives. Previous use of contraceptives, married status, increasing age and year of study were positive predictors for the use of emergency contraceptives while poor knowledge was a significant predictor of non-use. Conclusion: There was poor knowledge and low utilization of emergency contraceptives among respondents.
Nepal Journal of Obstetrics and Gynaecology, 2020
Aims: To determine the prevalence of urinary incontinence, risk factors and impact on the quality... more Aims: To determine the prevalence of urinary incontinence, risk factors and impact on the quality of life in gynecological clinic attendees of a University Hospital. Methods: A cross sectional descriptive study was conducted amongst gynecological clinic attendees in a Teaching Hospital in Nigeria from 1st February to 31st July 2017. Structured questionnaires were used to ascertain the presence of urinary incontinence. Socio-demographic and medical factors; impact on daily activities and treatment history were assessed. Women with and without urinary incontinence were compared. Univariate, bivariate and multivariable analyses were performed. Results: There were 395 women of 25 - 67 years (mean age = 38.81±10.1). About 33% had experienced urinary incontinence in the previous 6 months with Urgency, Mixed and Stress urinary incontinence occurring in 18.0%, 7.6% and 7.3% respectively. Independent risk factors for urinary incontinence were age (odds ratio=0.49, 95% confidence interval [CI...
World Journal of Innovative Research, 2020
Extrapelvic endometriosis a is rare condition and most cases occur after gynecological or obstetr... more Extrapelvic endometriosis a is rare condition and most cases occur after gynecological or obstetrics procedure involving the uterus. Uterocutaneous fistula is a rarely reported clinical condition after uterine procedures. In this case report, endometriotic uterocutaneous fistula with lower uterine synechiae following complicated caesarean section was diagnosed simply with fistulogram in a 21year old Nigeria woman. She was managed by fistula tract excision, uterine wall repair, adhesiolysis with rail-roading, combined with medical treatment using gonadotropin-releasing hormone agonist to prevent recurrent fistula and preserve fertility.
Nigerian Medical Journal, 2019
Background: The Papanicolaou (Pap) smear is a standard test for cervical cancer screening; howeve... more Background: The Papanicolaou (Pap) smear is a standard test for cervical cancer screening; however, the most important challenge is high false-negative results due to inadequate sampling using the Ayres spatula. The cytobrush has been used in combination with the Ayres spatula (cytobrush– spatula) in an attempt to improve the quality of smears with additional costs. The aim of this study was to compare the Pap smear quality with the anatomical spatula (with extended tip) and the cytobrush–spatula. Materials and Methods: This was a prospective single-bind clinical trial. One hundred and ten sexually active women aged between 22 and 65 years were randomized into groups, each having two smears at the same time: one with a cytobrush–spatula and another with an anatomical spatula. Fifty-five patients were randomized to have the anatomical spatula first to obtain their smears and 55 were randomized to have the cytobrush–spatula first to obtain their smears. Slides were assessed by a pathologist. Results: There was no significant difference in the quality of the smears using the two devices with respect to cellular adequacy (P = 0.3532), absent blood staining (P = 0.7766), presence of endocervical cells (P = 0.3502), and evidence of transformation zone sampling using the Bethesda criteria (0.4028). Kappa analysis shows moderate inter-rater agreement between the two devices by ability to show evidence of transformation zone using British Society for Clinical Cytology and Bethesda criteria. Conclusions: There was no significant difference in the quality of smears obtained using the two different methods. The anatomical spatula can be used as a single device in conventional cytology in place of the cytobrush–spatula with the aim of improving the quality of smears without necessarily increasing the cost.
Nepal Journal of Obstetrics and Gynaecology, 2018
Aims: To determine the prevalence of urinary incontinence (UI); risk factors; impact on quality o... more Aims: To determine the prevalence of urinary incontinence (UI); risk factors; impact on quality of life and symptom specific health seeking behaviour. Methods: A cross-sectional study of 395 women attending gynaecological clinic of the Lagos State University Teaching Hospital. UI was defined as the complaint of any involuntary leakage of urine in the previous six months. Socio-demographic characteristics, obstetrics, gynaecological, medical and surgical risk factors, impact on daily activities and treatment history were assessed. Univariate, bivariate and multivariable analyses were performed. Results: Participants age ranged from 25-67 years with a mean of 38.81 ± 10.1. Prevalence of UI was 32.9%. Urge UI occurred in 18.0% of all respondents while the prevalence of stress and mixed incontinence was 7.3% and 7.6% respectively. Independent risk factors for urinary incontinence were age (OR= 0.49, 95%;CI = 0.26-0.92), higher body mass index (OR = 1.92; 95% CI =1.53-3.00) and history ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Background: Progesterone only injectable contraceptive provides long acting contraception against... more Background: Progesterone only injectable contraceptive provides long acting contraception against unwanted pregnancy. Alterations in menstrual pattern are a well known side effect of this effective contraceptive method. Objective of this study was to compare the weight gain and pattern of menstrual abnormalities in users of Depot Medroxyprogesterone Acetate (DMPA) and Norethisterone Enanthate (Noristerat) in LASUTH.Methods: Retrospective comparative study conducted over a 3year period (January 2013 to December 2015) and involving 237 subjects who used injectable hormonal contraceptive (either DMPA or Noristerat). Case records of all the subjects were retrieved and information obtained on socio-demographic data, parity, previous contraceptive method and reason for discontinuation within one year of usage. Other information including subjects’ weight, menstrual cycle length and pattern, and side effects were collected at 3, 6 and 12 months for DMPA group and 2, 4 and 12 months interva...
BMC Pregnancy and Childbirth, 2018
Background: Caesarean delivery carries a risk of major intra-operative blood loss and its perform... more Background: Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. Methods: A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011. A comparison was made between 188 women who underwent blood transfusion and 718 who did not. Data were obtained on a daily basis by investigators from patients, clinical notes and referral letters using structured pre-tested data collecting form. Socio-demographic characteristics; antenatal, perioperative and intraoperative details; blood loss; transfusion; and puerperal observations were recorded. EPI-Info statistical software version 3.5.3 was used for multivariable analysis to determine independent risk factors for blood transfusion. Results: Of the 2134 deliveries during the study period, 906 (42.5%) had caesarean deliveries and of which 188 (20. 8%) were transfused. The modal unit of blood transfused was 3 pints (41.3%). The most common indication for caesarean section was cephalo-pelvic disproportion (25.7%).The independent risk factors for blood transfusion at caesarean section were second stage Caesarean Section (aOR = 76.14, 95% CI = 1.25-4622.06, p = 0.04), placenta previa (aOR = 32.57, 95% CI = 2.22-476.26, p = 0.01), placental abruption (aOR = 25.35, 95% CI = 3.06-211.02, p < 0. 001), pre-operative anaemia (aOR = 12.15, 95% = CI 4.02-36.71, p < 0.001), prolonged operation time (aOR = 10.72 95% CI = 1.37-36.02, p < 0.001), co-morbidities like previous uterine scar (aOR = 7.02, 95% CI = 1.37-36.02, p = 0.02) and hypertensive disorders in pregnancy (aOR = 5.19, 95% CI = 1.84-14.68, p < 0.001). Obesity reduced the risk for blood transfusion (aOR = 0.24, 95% CI = 0.09-0.61, p = 0.0024). Conclusion: The overall risk of blood transfusion in cesarean delivery is high. Paturients with the second stage Caesarean section, placenta previa, abruptio placentae and preoperative maternal anaemia have an increased risk of blood transfusion. Hence, adequate peri-operative preparations for blood transfusion are essential in these situations. Optimizing maternal hemoglobin concentration during antenatal period may reduce the incidence of caesarean-associated blood transfusion.
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Papers by fatimat akinlusi