Papers by OSAMUDIA OKHIONKPAMWONYI
Context: Hysterectomy is a major surgical procedure that is performed worldwide for several indic... more Context: Hysterectomy is a major surgical procedure that is performed worldwide for several indications ranging from benign to malignant conditions. It may be life-saving especially in certain obstetric situations. Objective: The aim was to determine the incidence, indications and complications of hysterectomy in Delta State University Teaching Hospital (DELSUTH), Oghara. Materials and methods: This was a retrospective descriptive study of hysterectomy performed in st st DELSUTH, Oghara from January 1 , 2012 to December 31 2016. Every patient that had hysterectomy was included. Results: During the period, there were there 468 major gynaecological surgeries. Eighty-five patients had hysterectomy accounting for 18.2%. The mean age of the patients was 47.9±10.6 years. Majority (46.6%) of the patients were para 5 and above. The mean parity was 3.2±0.83. Uterine fibroid accounted for majority (30.0%) of the cases. Total abdominal hysterectomy accounted for 78.75% while 8.75% had sub-total abdominal hysterectomy and 12.5% had vaginal hysterectomy. Fifty-two percent of the patients had bilateral salpingo-oophorectomy while 6.25% had unilateral salpingo-oophorectomy. Anaemia and wound sepsis were the most common complications. One patient (1.25%) ended as a mortality during the period under review. The indications for, and surgical outcome following hysterectomy are comparable to that from other public hospitals across the country.
Background: Caesarean delivery is a commonly performed surgical intervention in pregnant women. H... more Background: Caesarean delivery is a commonly performed surgical intervention in pregnant women. Hemorrhage remains one of the most feared complications, despite the application of a number of preventive strategies. Misoprostol administered post-operatively has been demonstrated in several studies to be efficacious in reducing blood loss during caesarean delivery. However, it is uncertain if misoprostol administered pre-operatively would lead to a better reduction in blood loss during caesarean delivery. Aim: To compare the effectiveness of rectally administered misoprostol given pre-operatively versus those given post-operatively in minimizing blood loss during and 24 hours after caesarean delivery. Materials and Methods: This study was a randomized controlled trial that was conducted in two tertiary hospitals in Delta state, Nigeria. One hundred (100) consenting patients undergoing caesarean delivery were randomized equally to either pre-operative group or post-operative group. Primary outcome measure were intraoperative blood loss and 24 hours post-operative blood loss; secondary outcome measures were changes in haemoglobin concentration and packed cell volume, need for additional uterotonics, need for blood transfusion, need for further surgical intervention and maternal and fetal adverse effect. Results: Results showed that there was a significant reduction in the intraoperative blood loss in the pre-operative misoprostol group compared with post-operative misoprostol group (512.8 ± 89.4 vs 671.8 ± 90.2mls respectively). Also, there was a significant reduction in post-operative blood loss in pre-operative misoprostol group compared with post-operative misoprostol group (112 ± 31.8 vs 135 ±32.6mls respectively) with a p value of 0.001. Postpartum haematocrit and packed cell volume was significantly higher in pre-operative group compared to post-operative group. Conclusion: This study showed that preoperative administration of 600µg of rectal misoprostol (group 1) during caesarean section is associated with reduction in intra-operative blood loss, post-operative blood loss and lesser drop in haematocrit level compared with post-operative misoprostol administration.
Background: Long-acting reversible contraceptive (LARC) methods are cost-effective and offer very... more Background: Long-acting reversible contraceptive (LARC) methods are cost-effective and offer very effective contraception for lengthy durations without relying on daily adherence or compliance from clients. Despite these benefits, a huge gap exists between demand for and uptake of modern contraceptive methods such as LARC to prevent pregnancy. While majority of married women of reproductive age in Nigeria acknowledged the desire to delay child birth, only a few of them use modern contraceptive method to prevent pregnancy. Objectives: To assess the uptake of long-acting reversible contraceptive (LARC) use among women who accepted a modern method of contraception at the family planning clinic in DELSUTH. Methods: A retrospective record-based review of 628 women who accepted a modern contraceptive method in DELSUTH, Oghara between January 1, 2019 and December 31, 2021. Results: The uptake of LARC in this study was high (72.4%). The uptake of the progesterone only implant (jadelle-93 and implanon-225) was 50.6% while IUCD (133) was 21.2%. Uptake by adolescents and nulliparous women was low 0.9% and 1.5% respectively. Seventy-one percent had secondary level of education. Majority of acceptors were limiters (56.7%) and uptake of LARC increased with increasing parity, but declined after 45 years (1.3%). Conclusion: The prevalence of LARC was relatively high among our attendees of the family planning clinic. Counseling should target adolescent, and nulliparous women and the fa mily planning should made friendly to these groups to improve access.
Mullerian duct agenesis, also known as Mayer-Rokitansky-Kuster-Hauser syndrome(MRKH syndrome), si... more Mullerian duct agenesis, also known as Mayer-Rokitansky-Kuster-Hauser syndrome(MRKH syndrome), simply called Rokitansky syndrome or uterine aplasia, is a congenital malformation characterized by failure of the mullerian duct to develop, resulting in missing fallopian tubes, uterus and a variable degree of hypoplasia of the upper portion of the vagina with presence of normal development of secondary sexual characteristics and normal 46XX karyotype. Complete mullerian duct agenesis is rare and only a few cases of MRKH syndrome have been reported in Africa. Here, we present a case of a 35year old woman who presented with primary amenorrhoea and the challenges of making a diagnosis of complete agenesis of the mullerian duct in a low resource setting.
Background: Birth weight is a crucial indicator of pregnancy health and the likelihood of a newbo... more Background: Birth weight is a crucial indicator of pregnancy health and the likelihood of a newborn's survival. Objective: This study aimed to determine the prevalence of low birth weight (LBW), identify the major maternal conditions contributing to LBW, and analyze the determinants of LBW over the last 5 years at Delta State University Teaching Hospital. Materials and Methods: This study involved a review of secondary data obtained from the Obstetrics and Gynecology Department, following approval from the relevant authorities. Maternal and neonatal data were collected for the period from April 2019 to March 2024. The prevalence of LBW, maternal obstetric contributors, associated comorbidities, and determinants were assessed. A P value of <0.05 was considered statistically significant. Results: During the study period, there were 821 deliveries; however, 15 (1.8%) had incomplete data, and 53 (6.5%) were stillbirths, resulting in their exclusion from the study. Of the 753 live deliveries, 193 (25.6%) were unsupervised, 198 (26.4%) were preterm, and 383 (50.9%) were males. The prevalence of LBW was 29.0% (218/753), with 66 (30.3%) cases having intrauterine growth restriction and 107 (49.1%) requiring admission. The leading maternal contributor to LBW was hypertensive disorder of pregnancy (HDP), accounting for 73 (33.5%) of the LBW cases. Following logistic regression analysis, the observed predictors of LBW were unsupervised pregnancy and multiple gestation. (AOR = 2.21; 95% CI = 1.70-2.88: P < 0.001 and AOR = 0.08; 95% CI = 0.03-0.20: P < 0.001, respectively). Conclusion: The prevalence of LBW was notably high, with HDP identified as a major contributor. Unsupervised pregnancy and multiple gestation are the determinants of LBW in the study population.
Nitric oxide in infertile females in the niger-delta region of Nigeria
Nigerian Journal of Clinical Practice, 2021
Background: Infertility is a public health challenge and it is a distressing personal tragedy for... more Background: Infertility is a public health challenge and it is a distressing personal tragedy for couples, more so for the female partners. Risk factors and causes of infertility vary from region to region. Reactive species is of current interest in the pathogenesis and management of infertility, especially in the Niger-Delta Region of Nigeria where environmental hazards of oil exploration exists. Aim: The overall goal of this study was to determine and compare the serum reactive species levels (nitric oxide) in fertile and infertile women attending the infertility clinic at the Delta State University Teaching Hospital, Oghara, and Central Hospital, Warri. Methods: This was a prospective case-control study in which 70 women evaluated for infertility were recruited into the study. A fertile patient matched for age and body mass index (BMI) attending family planning clinic was selected as control. Serum nitric oxide estimation was done using the BioVision Nitric Oxide Colorimetric Ass...
Background: Infertility is a public health challenge and it is a distressing personal tragedy for... more Background: Infertility is a public health challenge and it is a distressing personal tragedy for couples, more so for the female partners. Risk factors and causes of infertility vary from region to region. Reactive species is of current interest in the pathogenesis and management of infertility, especially in the Niger-Delta Region of Nigeria where environmental hazards of oil exploration exists. Aim: The overall goal of this study was to determine and compare the serum reactive species levels (nitric oxide) in fertile and infertile women attending the infertility clinic at the
Understanding the sexual and reproductive health rights and experiences of very young adolescents... more Understanding the sexual and reproductive health rights and experiences of very young adolescents in rural Uganda from the perspectives of emerging adults
Introduction: postdate pregnant women with one previous caesarean section that are planned for va... more Introduction: postdate pregnant women with one previous caesarean section that are planned for vaginal birth after caesarean sections are faced with adverse pregnancy outcomes. This trial was conducted to determine the effect of serial membrane sweeping from 38 weeks gestation in pregnant women planned for vaginal birth after caesarean section. Methods: this randomized controlled trial (RCT) was conducted on 90 women at 38 weeks with one previous caesarean section. In the study group, membranes sweeping commenced at 38 weeks and repeated weekly till labour onset. If no labour onset at 41 weeks and 3 days, elective caesarean section was done. In the control group, patients awaited labour onset till 41 weeks and 3 days, after which elective caesarean section was done. Data collected were analyzed using the Statistical Package for Social Sciences (SPSS ver. 22). All analyses were done at p<0.05. Results: labour onset before 41 weeks and 3 days was statistically significantly higher in the study group compared to the control group (RR= 1.5; 95% CI: 1.1 -2.0; P=0.006). Likewise, successful vaginal birth after caesarean section was statistically significantly higher in the study group (RR=1.7; 95% CI: 1.2-2.5; P = 0.001). Conclusion: serial membrane sweeping from 38 weeks gestation has significant beneficial effect on labour onset and successful vaginal delivery in women with one previous caesarean section.
Hidradenitis suppurativa (HS) is a painful and chronic condition commonly occurring in women in t... more Hidradenitis suppurativa (HS) is a painful and chronic condition commonly occurring in women in the reproductive age group. A 53-year para 5 +0 , 3years postmenopausal retroviral positive lady on highly active antiretroviral therapy (HAART) presented to our clinic with a 3-month history of a discharging ulcer on the left labium majus with ipsilateral non-tender inguinal lymphadenopathy. Surgical excision biopsy of the lesion was done and histopathological examination of excised tissue showed features of HS. The patient was treated with oral antibiotics, oral steroids and anti-inflammatory medications. Following these treatment interventions, the lesion healed well and had no recurrence over 2years of follow-up.
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Papers by OSAMUDIA OKHIONKPAMWONYI