Urban-Rural Comparison of Group B Streptococcus Infection in Pregnancy among Antenatal Women in Cross River State (Published)
Group B streptococcus (GBS) infection is a common cause of infection among the newborn in developing countries. Neonatal mortality is high in Nigeria due to preventable causes which include vertical transmission of Group B streptococcus (GBS) infection. The objective was to determine GBS anogenital infection among pregnant women in rural and urban settings in Cross River State and to compare GBS infection among pregnant HIV positive and negative women. The study was conducted at the antenatal care clinics of University of Calabar Teaching Hospital (UCTH), Calabar as the urban study site and Akamkpa General Hospital (AGH), Akamkpa as the rural site. Study populations were HIV negative and positive pregnant women that were in their third trimester between 35 to 37 weeks of pregnancy in both rural and urban areas. A total of 84 pregnant women were recruitment in each study sites and data were collected on socio-demographic and obstetric history, as well as laboratory samples for assessment of GBS colonization. Each subject recruited in the rural study site was matched with pregnant woman in the urban study site on socio-demographic characteristic which includes age, marital status, and parity. The Prevalence of GBS infection was 13.1% among the rural subjects compared to 8.3% in urban subject and the difference was not statistically significant (p=0.32). Among urban subjects, the prevalence of GBS infection among HIV positive subjects compared to HIV negative subjects were 9.5% and 7.1% respectively and the difference was not statistically significant (p=0.69). Among rural subjects, the prevalence of GBS infection among HIV positive subjects compared to HIV negative subjects (21.4 vs. 4.8%) was statistically significant (p=0.02). Anogenital colonization with GBS is slightly high among pregnant women in rural than urban area, although, it was not statistically significant. Preventive approach is a worthy measure through screening especially among high risk pregnancies in rural areas and follow-up treatment to prevent feto-maternal adverse effects.
Changes in Blood C-Reactive Protein in Pregnancy and Labour Among Apparently Healthy Pregnant Women in Benin City (Published)
C-reactive protein (CRP), a very sensitive marker, has recently been associated with inflammatory conditions and their management. Pregnancy is a pro-inflammatory state associated with changes in CRP values. Proper interpretation of CRP levels in inflammatory conditions requires good knowledge of these changes. However, most studies and reference values obtained on serum CRP in pregnancy were done in developed western countries. Regional differences in the level of CRP have been reported. It was imperative, therefore, to determine local reference values for CRP in apparently healthy pregnant women in our setting to serve as nomograms. Methods: Longitudinal case-control study with 160 women who met the criteria recruited. These were divided into two arms comprising of study and control, each consisting of 80 women. Maternal serum CRP was measured with competitive immunoassay in the first and second half of pregnancy and labour as women were followed up. Specimens were also obtained for CRP from the control group. Data obtained were analysed using the SPSS version 17 and GraphPad instant 3 software. Categorical variables were expressed as absolute numbers, and percentages and the differences in proportion were analysed using the Chi-square test or Fisher exact test, while continuous variables were presented as means with standard deviations and the differences were analysed with the t-test where appropriate. The level of significance was set as p<0.05. Result: Revealed a progressive increase in the C reactive protein concentration as pregnancy advanced. The rise however attained maximum level during labour. Statistical significance noted for that of labour against non-pregnant as control (p<0.05). Conclusion: C-reactive protein levels may serve as a marker for disease severity, though non-specific. The study shows that serum concentration of C-reactive protein in normal pregnancy for women in our environment should be 82.62 ± 32.19 ng/ml. Also, levels of concentration are increased during labour compared to non-pregnant and pregnant women with a mean value of 93.46 ± 24.00 ng/ml. Therefore, it could be of prognostic value in some pregnancy-associated complications such as preterm labour, premature rupture of membrane, chorioamnionitis, pre-eclampsia and diabetes mellitus.
Thirst Perception and Fluid Intake in Pregnant Female Humans in the Three Trimesters of Pregnancy (Published)
This work was done to access the thirst perception and fluid intake of pregnant women in the three trimesters of pregnancy in pregnant women. The study was divided into two main groups Group 1 was made up of euhydrated pregnant women while group 2 was made up of dehydrated pregnant women. For the group 1, a total of thirty pregnant women were used, ten in each trimester of pregnancy. The subjects had water ad libitum. For the group 2, a total of seventy five pregnant women, twenty five in each trimester of pregnancy were dehydrated for eighteen hours. Thirst perceptions were taken 8am the following morning using the visual analogue scale of Thompson et al., (1986). Blood and urine samples were collected and analyzed for electrolyte concentrations. Plasma osmolality was estimated using the formula of Leonard (2003). Results for group 1, showed statistically significant increase (p<0.05) in the thirst perception in the first, second and third trimesters of pregnancy when compared with the non-pregnant women. The volume of water intake till satiety was significantly higher (P<0.05) in the third trimester of pregnancy when compared with non-pregnant women. The increases in volume of water intake in first and second trimesters were not statistically significant. Results for group 2, showed that thirst perception was significantly higher (P<0.05) in pregnant women when compared with non-pregnant women. The thirst perception was significantly increased in the three trimesters of pregnancy when compared with non- pregnant women. The volume of water intake was significantly increased (p<0.05) in the first, second and third trimesters in pregnant women when compared with the non-pregnant women. Our result reveals a significant drop (p<0.05) in plasma osmolality in the pregnant women when compared with the non- pregnant women.. Conclusively, this research has been able to establish that there is decrease in plasma osmolality, but increase in thirst perception, in the three trimesters of pregnancy.
Management Outcome of Uterine Fibroids in Pregnancy in a Secondary Health Facility in Calabar, South-South Nigeria (Published)
Uterine fibroid is the commonest benign tumors of the uterus and may lead to several complications in pregnancy. The objective was to determine the maternal and foetal outcome of fibroids in pregnancy. This prospective study was conducted in Nigerian Navy Hospital, Calabar over 2 year among women with fibroids in pregnancy. Result showed that a total of 889 women booked for antenatal care during the period, of which 72 had fibroids in pregnancy giving the incidence of 8.1%. Majority of the women were within the age group of 30-39 years 39(54.2%) and nulliparae 32(44.4%). A total of 3(4.2%) had 1st trimester miscarriages, 4(5.2%) had preterm delivery, 22(30.6%) had spontaneous normal vaginal delivery at term while 37(51:3%) had caesarean section. In conclusion, uterine fibroid is a common finding in pregnancy and the manifestation varies depending on their size and site. Pregnancies with uterine fibroid are high risks and are commonly associated with complications such as caesarean sections, primary post partum haemorrhage, miscarriage and preterm labour.