Adegboyega Adisa FAWOLE
@unilorin.edu.ng
Professor, Faculty of Basic Clinical Sciences
University of Ilorin
RESEARCH, TEACHING, or OTHER INTERESTS
Obstetrics and Gynecology
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
OA Ogunlaja, TY Bakare, T Bobo, IP Ogunlaja, AA Fawole, and Y Olasinde
Medical and Dental Consultants Association of Nigeria, OOUTH Chapter
Background: Birth weight is a commonly used indicator of newborn maturity and health and a reliable predictor of postnatal survival. There is a need to determine the birth weight pattern and maternal factors that influence the birth weight in babies delivered at term. Objective: To determine the birth weight pattern and maternal factors influencing the birth weight of babies delivered at term. Methods: In this retrospective, descriptive study, the hospital records of all pregnant women who had childbirth at term in Bowen University Teaching Hospital (BUTH), Ogbomoso, Nigeria, from 01 January 2018 to 31 December 2020, were retrieved. Data on birth weight and maternal obstetric factors were retrieved for analysis. Results: The mean age of the mothers was 30.52 ± 5.23 years. A total of 1072 deliveries were recorded during the study period. These consisted of 580 (54.1%) males and 492 (45.9%) females, with a male-to-female ratio of 1.18:1. The caesarean section rate was 37.7%. The mean birth weight was 3.15±0.56 kg, and male babies had a higher mean weight (3.186±0.535kg vs 3.14±0.493kg). Normal birth weight (NBW) was recorded among 90.3%, while low birth weight (LBW) and high birth weight (HBW) were 6.7% and 3.0%, respectively. Only maternal comorbidities (p = 0.0001) and number of gestation (p = 0.0001) were significantly associated with birth weight. Conclusion: Maternal and foetal factors influenced the birth weights of the babies. Implementing measures to minimise the risk of delivering babies with abnormal birth weights is essential to improve newborn survival.
Abiodun S. Adeniran, Adegboyega A. Fawole, Stella T. Filani, Kikelomo T. Adesina, Bilqis W. Alatishe-Muhammad, and Abiodun P. Aboyeji
Elsevier BV
Adebayo Adewole, Adegboyega Fawole, Munirdeen Ijaiya, Abiodun Adeniran, Adeshina Kikelomo, and Abiodun Aboyeji
Babcock Medical Society
Objectives: This study aimed to determine the rate and predictive factors for successful vaginal birth after cesarean delivery, and measure maternal and neonatal outcomes of VBAC following one previous cesarean delivery. Methods: In this hospital-based prospective study, sixty women with one previous CD (subjects) who attempted VBAC and another sixty without previous CD (controls) carrying singleton cephalic fetuses matched for maternal age, parity, and gestational age were compared. The primary outcome measures were successful vaginal delivery and its predictors. Data were analyzed using SPSS (version 22.0), and p<0.05 was significant. Results: Out of 1768 deliveries, 105 (5.9%) had one previous CD; 57.1% (60/105) attempted while 61.7% (37/60) had successful VBAC; 23 (38.3%) had failed VBAC and repeat CD, while 14 (23.3%) of the control group had CD. The significant predictors of successful VBAC were cervical dilatation ≥4cm on admission (p=0.003), maternal age >35 years (p=0.019); and augmentation of labor (p=0.020); while previous vaginal delivery (p=0.108), parity (p=0.706), BMI (0.240), and inter-delivery interval (p=0.265) were not statistically significant. The maternal and neonatal outcomes were not statistically different among women who had successful VBAC after one CD compared to women without previous CD. Important morbidities following VBAC included uterine rupture (3.3%) and primary postpartum hemorrhage (6.7%). There was no peripartum hysterectomy or maternal death; the perinatal mortality rate was 16.7/1,000 live births for women who attempted VBAC while no perinatal death was recorded among the controls. Conclusion: VBAC is safe, and its outcome is comparable to women without previous CD.
Sophia H. L. George, Ayodele Omotoso, Andre Pinto, Aisha Mustapha, Alex P. Sanchez-Covarrubias, Usman Aliyu Umar, Ali Bala Umar, Timothy Abiola Oluwasola, Clement Abu Okolo, Umeh Uchenna Anthony,et al.
Frontiers Media SA
ObjectiveOvarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora.MethodsPatients diagnosed with ovarian cancer (all histologies) between June 2016-December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student’s t-test with significance set at p&lt;0.05.ResultsNigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sex-cord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p&lt;0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7± 12.8 years) relative to USB (58.9 ± 15.0) and CBB (59.0± 13.0,p&lt;0.001). Black women [CBB (25.2 ± 15.0), Nigerians (29.5 ± 15.1), and USB (33.9 ± 17.9)] were diagnosed with GCT younger than White women (35.4 ± 20.5, p=0.011). Black women [Nigerians (47.5 ± 15.9), USB (50.9 ± 18.3) and CBB (50.9 ± 18.3)] were also diagnosed with SCST younger than White women (55.6 ± 16.5, p&lt;0.01).ConclusionThere is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation.
Abiodun S. Adeniran, Olumuyiwa O. Ogunlaja, Idowu P. Ogunlaja, Shukurat B. Okesina, Adegboyega A. Fawole, Kikelomo T. Adesina, and Abiodun P. Aboyeji
African Journals Online (AJOL)
Objectives: The study evaluated pre and post-operative perception and aversion to caesarean delivery (CD) among men whose partners underwent the procedure.Design: A multicentre cross-sectional study.Setting: Two tertiary and two secondary health facilities.Participants: Men whose partners underwent CD at the study sites.Methods: Participants were recruited by purposive sampling, data collection was through interaction via an interviewer-administered questionnaire first immediately the decision for CD was made and thereafter on the third postoperative day. Men whose partners had vaginal delivery were excluded from the study and data management was with SPSS version 21.0 while p<0.05 was significant.Results: Awareness about CD was 84.0% mainly through the healthcare workers (42.1%) and the female partner (34.1%); 88.0% of participants recommended CD for medically-indicated reasons. The greatest influence on consent was the male partner (48.8%). The major pre-operative concerns were limitation of family size (34.7%) and fear of repeat CD (34.0%). Pre-operative perceptions of CD included being expensive (60.7%), fear of the procedure (48.0%), fear of complications (45.3%) and longer hospital stay (44.0%). Aversion to CD was 30.0% pre and 5.3% post-operation; predictors of aversion were history of previous surgery among male or female partner and awareness about CD. However, there were reductions in negative perception and aversion post-operation.Conclusion: The high negative perception and aversion to CD among male partners were reduced post-operation. Healthcare workers should address the concerns and negative perceptions about CD and prioritize patient-friendly experiences during surgical operations.
Grace G Ezeoke, Abiodun S Adeniran, Kikelomo T Adesina, Adegboyega A Fawole, Munirdeen A Ijaiya, and Adebunmi O Olarinoye
African Journals Online (AJOL)
Background: Despite collaborative efforts aimed at its eradication, Female Genital Mutilation/Cutting (FGM/C) continuesin endemic areas.
 Objective: To evaluate the experience and preparedness of female adolescents to protect their future daughters from FGM/C.
 Methods: A cross-sectional survey involving adolescent secondary school girls in North Central Nigeria. Participants were secondary school students who completed the study’s self-administered questionnaire after informed parental or participant’s consent. Data management was with SPSS 20.0 (IBM, USA), P-value <0.05 was significant.
 Results: There were 2000 participants aged 13-19 years (mean 15.56±1.75), prevalence of FGM/C was 35.0%, awareness was 86.1%, mutilation was performed between infancy and eight years of age (mean 3.85±3.24 years), 644(32.2%) desire to mutilatetheir future daughters, 722(36.1%) expressed support for FGM/C and 63.1% of victims of FM/C reported adverse post-mutilation experiences. Support for FGM/C was associated with low social class (P0.0010), opinion that FGM/C has benefit (P0.001) and desire to mutilate future daughters (P0.001) while awareness of efforts to eradicate FMG/C was 813(40.7%).
 Conclusion: FGM/C remains prevalent with potential support for its continuation among female adolescents despite reported adverse post-mutilation experiences. The multi-pronged approach to eradicate FGM/C should prioritize re-orientation for adolescent girls, rehabilitation of mutilated girls and girl child formal education.
 Keywords: Female genital mutilation/cutting; female circumcision, harmful traditional practices, adverse childhood experiences.
O. Ayeni, A. Aboyeji, M. Ijaiya, K. Adesina, A. Fawole and A. Adeniran
Background Preventing prolongation of the decision-to-delivery interval (DDI) for emergency caesarean delivery (CD) remains central to improving perinatal health. This study evaluated the effects of the DDI on perinatal outcome following emergency CD. Methods A prospective cross-sectional study involving 205 consenting women who had emergency CD at a tertiary hospital in Nigeria was conducted. The time-motion documentation of events from decision to delivery was documented; the outcome measures were perinatal morbidity (neonatal resuscitation, 5-minute Apgar score, neonatal intensive admission) and mortality. Data analysis was performed with IBM SPSS Statistics version 20.0, and P<0.05 was considered significant. Results The overall mean DDI was 233.99±132.61 minutes (range 44–725 minutes); the mean DDI was shortest for cord prolapse (86.25±86.25 minutes) and was shorter for booked participants compared with unbooked participants (207.19±13.88 minutes vs 249.25±12.05 minutes; P=0.030) and for general anaesthesia compared with spinal anaesthesia (219.48±128.60 minutes vs 236.19±133.42 minutes; P=0.543). All neonatal parameters were significantly worse for unbooked women compared with booked women, including perinatal mortality (10.8% vs 1.3%; P=0.012). Neonatal morbidity increased with DDI for clinical indications, UK National Institute of Health and Care Excellence (NICE) and Robson classification for CDs; perinatal mortality was 73.2 per 1000 live births, all were category 1 CDs and all except one occurred with DDI greater than 90 minutes. Severe preeclampsia/eclampsia, obstructed labour and placenta praevia tolerated DDI greater than 90 minutes compared with abruptio placentae and umbilical cord prolapse. However, logistic regression showed no statistical correlation between the DDI and neonatal outcomes. Conclusion Perinatal morbidity and mortality increased with DDI relative to the clinical urgency but perinatal deaths were increased with DDI greater than 90 minutes. For no category of emergency CD should the DDI exceed 90 minutes, while patient and institutional factors should be addressed to reduce the DDI.
AbiodunS Adeniran, IsaacI Aun, AdegboyegaA Fawole, and AbiodunP Aboyeji
Medknow
Background: Although out-of-pocket (OOP) payment for health services is common, information on the experience in maternal health services especially caesarean delivery (CD) is limited. Aim: To compare the pregnancy events and financial transactions for CD among OOP and health-insured clients. Materials and Methods: A comparative (retrospective) study of 200 women who had CD as OOP (100 participants) or health-insured clients (100 participants) over 30 months at Anchormed Hospital, Ilorin, using multistage sampling was conducted. The data were analysed using Chi-square, t-test and regression analysis; P < 0.05 was considered statistically significant. Results: Of 1246 deliveries, 410 (32.9%) had CD; of these, 186 (45.4%) were health-insured and 224 (54.6%) were OOP payers. The health-insured were mostly civil servants (60.0% vs. 40.0%; P = 0.009) of high social class (48.0% vs. 29.0%; P = 0.001). The payment for CD was higher among OOP (P = 0.001), whereas duration from hospital discharge to payment of hospital bill was higher for the health-insured (P = 0.001). On regression, social class (odds ratio [OR]: 0.23, 95% confidence interval [CI]: −0.0891252–0.112799; P = 0.048), amount paid (OR: 48.52, 95% CI: −7.14–6.68; P = 0.001) and duration from discharge to payment (OR: 28.68, 95% CI: 51.7816–70.788; P = 0.001) were statistically significant among participants. The amount paid was lower (P = 0.001), whereas time interval before payment was longer (P = 0.001) for the public-insured compared to private-insured clients. Conclusion: OOP payers are prone to catastrophic spending on health. The waiting time before reimbursement to health-care providers was significantly prolonged; private insurers offered earlier and higher reimbursement compared to public insurers. The referral and transportation of health-insured clients during emergencies is suboptimal and deserve attention.
Kikelomo T. Adesina, Olumuyiwa A. Ogunlaja, Adebunmi O. Olarinoye, Abiodun P. Aboyeji, Halimat J. Akande, Adegboyega A. Fawole, and Abiodun S. Adeniran
Walter de Gruyter GmbH
Abstract Objectives: The umbilical coiling index (UCI) is one of cord parameters for foetal assessment with limited studies in our environment. With recent advances in its evaluation, its significance, pattern, abnormalities and correlates need to be defined in our parturients. Methods: The umbilical cords of 436 neonates were examined. Gross examination was done within 5 min of delivery. The UCI was defined as the number of complete coils per centimetre of cord. Normal UCI was defined as values between the 10th and 90th percentiles of the study population. Results: The mean umbilical cord length was 52.7±11.5 cm, mean number of coils was 10.8±5.1 and mean UCI was 0.21±0.099. The range was between 0.0 and 1.0. UCI values of 0.13 and 0.30 were 10th and 90th percentiles, respectively. Normal UCI was observed in 351 (80.5%) neonates, 44 (10.4%) and 41 (9.1%) had hypo- and hypercoiled cords, respectively. Congenital abnormalities occurred in the normocoiled and hypercoiled groups but was not demonstrated in the hypocoiled group. The mean value of UCI in neonates with congenital abnormalities was 0.29±0.12 (P=0.011). There was no significant statistical relationship between foetal outcome and degree of UCI. Conclusion: The UCI was not associated with adverse perinatal outcome in this study.
Abiodun Adeniran, Kikelomo Adesina, Abiodun Aboyeji, Olayinka Balogun, Peace Adeniran, and Adegboyega Fawole
African Journals Online (AJOL)
Background Despite increasing request for the male partners' presence at delivery in developing countries, the view and practice of birth attendants remained poorly understood.This study aimed to evaluate the perception, attitude and practice of birth attendants concerning the requests in Nigeria. Methods A prospective, cross-sectional survey involving consenting birth attendants was conducted in six public and six private health facilities in North Central Nigeria. Statistical analysis was done with SPSS-version 20.0; p-value <0.05 was considered statistically significant. Results Among 564 participants (24.8% male, 75.2% female), 465(82.4%) support the presence of male partners at delivery, 409(72.5%) desire to be with their partner at delivery, 434(77.0%) had previous request for male partner's presence at delivery while 225(51.8%) declined it due to perception that men will disturb. Among the male partners allowed at delivery, 92(44.0%) did not disturb the birth attendant while 5(2.4%) ended in litigation. Among birth attendants who allowed men at delivery in the past, 160(76.6%) will allow men in the future. There was no statistical significance regarding the age, gender, cadre or year of service of birth attendants and attitude to a protocol change to allow men at delivery. Birth attendants who support the presence of men at delivery showed positive attitude (OR33.178, 95%CI6.996–157.358; p<0.001) while those who opined that men would disturb at delivery had a negative attitude (OR0.306, 95%CI0.124–0.755); p0.010) to possible protocol change. Conclusion Despite perceived negative effects of allowing male partners at delivery, many birth attendants are willing to allow them if necessary structural modifications are instituted.
Kabir Adekunle Durowade, Oluwole Adeyemi Babatunde, Lukman Omotayo Omokanye, Olusegun Elijah Elegbede, Lawrence Majekodunmi Ayodele, Kayode Razaq Adewoye, Stella Adetokunbo, Charles O. Olomofe, Adegboyega A. Fawole, Oyebola Eyitayo Adebola,et al.
African Journals Online (AJOL)
Background Early adolescent sexual activity remains a recurring problem with negative psychosocial and health outcomes. The age at sexual debut varies from place to place and among different individuals and is associated with varying factors. The aim was to determine the prevalence and risk factors of early sexual debut among secondary school students in Ido-Ekiti, South-West Nigeria. Methodology This was a cross-sectional study. The respondents were selected using multi-stage sampling technique. Pre-tested, semi-structured, self-administered questionnaire was used to collect data. Data was analyzed using SPSS version 15. Results More than two-thirds, 40(67.8%), had early sexual debut. The prevalence of early sexual debut was about 11%. The mean age of sexual debut was 13.10±2.82; the mean age for early sexual debutants was 11.68±1.98. The mean number of sexual partners was 2.44±1.99. Male gender, having friends who engaged in sexual activities had association with early sexual exposure (p<0.05). Alcohol intake had the strongest strength of association for early sexual debut among the students. Conclusion The high prevalence of early sexual exposure among the students calls for urgent interventions to stem the trend. This will help to reduce the devastating negative psycho-social and health sequels.
Olayinka Balogun, Abiodun Adeniran, Adegboyega Fawole, Kikelomo Adesina, Abiodun Aboyeji, and Peace Adeniran
African Journals Online (AJOL)
Background As efforts continue to increase contraceptive uptake, male partner support remains important in spousal modern contraceptive use. Methods A prospective cross-sectional survey involving women on modern contraception was conducted at the family planning clinic of the University of Ilorin Teaching Hospital, Nigeria, between December 2013 and April 2014. All consenting participants completed a self-administered questionnaire designed for the study, and statistical analysis was done with SPSS version 20.0 using with chi square test and logistic regression; p value <0.05 was significant. Results There were 305 participants: 208(68.2%) were multipara, the commonest current and previous contraceptives used were IUD and injectables while male partner was responsible for discontinuation in 30(23.3%) of previous users. Covert contraceptive use was 22(7.2%), male partner support was 209(68.5%) as payment for the contraceptives (203; 66.6%) or transportation to the clinic (198; 64.9%). Also, 55(18.0%) women failed to comply with contraception recently due to male partner hindrance (25; 45.5%) or inability to pay for contraceptive (11; 20%) or transportation to the clinic (8; 14.5%). Male partners hindered contraception by reporting the woman to relatives/friends (8; 32%) or denying her money for feeding allowance (6; 24%); 277(90.8%) women want contraception to be couple decision while 261(85.6%) want contraception administered only if both partners consented. The significant predictors of male partner support were awareness about the contraceptive use (p<0.001, OR0.114; CI0.041–0.319), level of education (p0.007, OR1.488; CI1.114–1.9870) and social class (p0.029, OR0.690; CI0.495–0.963). Conclusion Male partner hindrances and costs of contraceptive or transportation to clinic are important in noncompliance. Male partner education, subsidized/free contraceptives and mobile/community services will improve compliance.
Abiodun S Adeniran, Munirdeen A Ijaiya, Adegboyega A Fawole, Olayinka R Balogun, Kikelomo T Adesina, Abdul Waheed O Olatinwo, Adebunmi O Olarinoye, and Peace I Adeniran
South African Medical Association NPC
BACKGROUND
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).
OBJECTIVE
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.
Kola M. Owonikoko, Hajarah T. Bello-Ajao, Adegboyega A. Fawole, and Adetunji O. Adeniji
Walter de Gruyter GmbH
Abstract Background: Abortion complications constitute 13% of maternal deaths worldwide and 40% of maternal deaths in Nigeria, while 80% of patients with abortion complications are adolescents. Aims: Assessing the adolescents’ knowledge and attitude and the determinants of their sexual activities and contraceptive usage. Methods: This was a cross-sectional study conducted among high school students of Ogbomoso – a semi-urban settlement. Stratified multistage randomization was used to select one high school from each of five local government areas of the study site. Students were interviewed with pretested questionnaire to sought information on demographic status, family type, knowledge of sexuality, and contraceptive usages. Results: The age range of the respondents was 10–19 years with mean±SD age 13.7±1.9 years. Among them, 6.5% were sexually active. Of the respondents, 56.8% scored good knowledge about sexuality and contraception and 57.5% respondents had good attitude to contraception. Age (p=0.004) and father’s education (p=0.001) were factors associated with knowledge about sexuality and contraception, while mothers’ occupation (p=0.02) and fathers’ occupation (p=0.001) and education (p=0.04) were significantly associated with positive attitude toward contraception. Conclusion: This study revealed that a significant percentage of the studied adolescents had poor knowledge and attitude toward contraception, and many of the sexually active respondents had inaccurate knowledge on the use of contraceptives and where it could be obtained.
Abiodun S. Adeniran, Abiodun P. Aboyeji, Adegboyega A. Fawole, Olayinka R. Balogun, Kikelomo T. Adesina, and Salamat Isiaka-Lawal
Wiley
A S Adeniran, A A Fawole, O R Balogun, M A Ijaiya, K T Adesina, and I P Adeniran
South African Medical Association NPC
Background . 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 in schools, 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 initiators among the women; 44 (17.0%) women and 23 (20.4%) men held the opinion that females should be circumcised, while the majority considered 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.
AS Adeniran, BO Bolaji, AA Fawole, and OO Oyedepo
African Journals Online (AJOL)
AIM
Evaluation of the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU).
METHODS
A case control study to evaluate the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU) of the University of Ilorin Teaching Hospital, Ilorin, Nigeria from 1st January 2010 to 30th June 2013. Participants were critically ill obstetric patients who were admitted and managed at the ICU during the study period. Subjects were those who died while controls were age and parity matched survivors. Statistical analysis was with SPSS-20 to determine chi square, Cox-regression and odds ratio; p value < 0.05 was significant.
RESULTS
The mean age of subjects and controls were 28.92 ± 5.09 versus 29.44 ± 5.74 (p = 0.736), the level of education was higher among controls (p = 0.048) while more subjects were of low social class (p = 0.321), did not have antenatal care (p = 0.131) and had partners with lower level of education (p = 0.156) compared to controls. The two leading indications for admission among subjects and controls were massive postpartum haemorrhage and severe preeclampsia or eclampsia. The mean duration of admission was higher among controls (3.32 ± 2.46 versus 3.00 ± 2.58; p = 0.656) while the mean cost of ICU care was higher among the subjects (p = 0.472). The statistical significant predictors of maternal deaths were the patient's level of education, Glasgow Coma Scale (GCS) score, oxygen saturation, multiple organ failure at ICU admission and the need for mechanical ventilation or inotrophic drugs after admission.
CONCLUSION
The clinical state at ICU admission of the critically ill obstetric patients is the major outcome determinant. Therefore, early recognition of the need for ICU care, adequate pre-ICU admission supportive care and prompt transfer will improve the outcome.
O.I. Oyinloye, O. A. M. Adesiyun, M.O. Atobatele, and A.A. Fawole
Medknow
Posterior reversible encephalopathy syndrome is a clinico-neuroradiologic diagnosis, with rapidly evolving neurologic condition, characterized by headache, confusion, altered mental status, seizures, cortical blindness, lethargy, stupor, and occasionally, focal neurological signs accompanied by a typical computed tomography or magnetic resonance imaging pattern. With early recognition and treatment, complete resolution of symptoms occurs. Typical imaging findings characteristically involve the white matter bilaterally in the parieto-occipital regions. Atypical imaging finding of contrast enhancement of lesion can occur, but is less common. A 20-year-old primiparous lady presented with posterior reversible encephalopathy syndrome. To the best of our knowledge, this is the first documented case in Nigeria. This case-report highlights the importance of recognizing the salient imaging features in this lethal but reversible entity with prompt management.
Enang E. Eno, Adegboyega A. Fawole, Abiodun P. Aboyeji, Kikelomo T. Adesina, and Abiodun S. Adeniran
Wiley