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Aims and Objectives: This study was to determine any significant difference between the incidence of infectious morbidity with the use of a 24 hour antibiotics regimen compared to a 7-day course of antibiotics following elective caesarean section using a cheap and easily available combination of Ampicillin/Cloxacillin and Metronidazole. Patients and Methods: Two hundred patients planned to have elective caesarean section for various indications and who satisfied the inclusion criteria were enrolled in the study in two groups of 100 patients each between the period of January to June 2010. Patients were randomized to receive either Ampiclox as 4 intravenous doses of 1g stat and 500mg each 6 hourly and Metronidazole as 3 intravenous doses of 500mg each 8 hourly both for 24 hours or same combination intravenously for 48 hours and subsequent oral use for 5 days. Results: The mean maternal age, parity, gestational age and indication for caesarean section were similar in the two groups of participants. There was no statistical difference in the incidence of febrile morbidity (17%/18%, p=0.852), urinary tract infection (6%/4%, p=0.196), wound infection (4%/3%, p=0.056) and endometritis (3%/2%, p=0.367). The mean cost of antibiotics per patient (N730/$4.65) in the short term prophylaxis group was half that of the long term prophylaxis group (N1, 540/$9.81). Conclusion: There was no difference in the incidence of infection related morbidity when short term prophylactic antibiotics was used at elective caesarean section compared to long term prophylactic antibiotics.

Aims and Objectives: This study aimed at predicting foetal birth weight using various clinical methods and to determine which of the methods is the most accurate in this population. Subjects and methods: Parturients of all parities admitted into the labour ward of OAUTHC, Ile-Ife at term for delivery were recruited for this study. They had their symphysiofundal height, abdominal circumference at the umbilical level, height and weight measured. The body mass index was then calculated. The birth weight was calculated from these measurements using four clinical formulae. The weights of the babies were measured after delivery and compared with the individual estimated birth weights. Results: There were 400 women who met the inclusion criteria during the time of this study. Three of the methods [Johnson′s Rule, Ojwang′s Rule and 5% maternal weight] overestimated the birth weight while 10% BMI underestimated the birth weight significantly. Conclusion: There is a strong correlation between the birth weights predicted by the various clinical methods and the actual birth weight. The accuracy of the methods can be improved by using the derived modified formulae.

Objectives: Malaria in pregnancy (MiP) increases maternal and perinatal complications including maternal anaemia and foetal growth restriction (FGR). Middle cerebral artery (MCA) indices obtained using Doppler ultrasound are an important tool in predicting the onset of FGR and perinatal mortality in MiP since ultrasound is cheap, readily available, noninvasive and radiation free. We aimed at comparing foetal MCA Doppler indices in pregnant women with and without malaria. The effect of parasitaemia level on these indices was also evaluated. Methods: Fifty-eight foetuses of women with MiP and 100 foetuses of age and gestational age matched apparently healthy controls between 24 and 40 weeks were consecutively recruited from the antenatal clinic of our hospital between January and December 2018. Venous blood was taken for peripheral blood film to diagnose and quantify malaria parasitaemia. Foetal MCA Doppler indices of both MiP subjects and controls were determined using real time 2.5-5.5 MHz diagnostic ultrasound machine with Doppler facility. Results: Mean foetal MCA resistive index, pulsatility index, peak systolic velocity (PSV), end-diastolic velocity, and systolic-diastolic ratio for MiP subjects were 0.81 ± 0.05, 1.65 ± 0.24, 48.31 ± 14.16, 9.72 ± 4.18 and 5.53 ± 1.34 while those for controls were 0.84 ± 0.04, 1.88 ± 0.19, 51.43 ± 11.41, 8.24 ± 2.51 and 6.51 ± 1.02, respectively. Apart from PSV (P = 0.132), other indices evaluated showed statistically significant difference between the two groups (P > 0.01). None of the parameters showed significance association with the level of parasitaemia. Conclusion: MiP causes detectable changes in the foetal MCA Doppler indices which may indicate foetal distress and also suggest FGR. [ABSTRACT FROM AUTHOR]

Background: Magnesium sulphate use in the prevention of seizures resulting from preeclampsia and eclampsia is widely accepted. However, several protocols exist worldwide. Aim: To determine serum magnesium levels and associated clinical outcomes in severe pre-eclamptic and eclamptic women treated with magnesium sulphate. Methods: Women, 28-41weeks pregnant or in the puerperium with severe pre-eclampsia or eclampsia, participated in this cross sectional study and their serum magnesium levels were measured using the Atomic Absorption Spectrophotometer (AAS) machine. All participants received the standard Pritchard regimen, including monitoring. Results: Seventy five patients participated in the study. They were mostly overweight (mean BMI 26.38 ± 3.40kg/m²). Mean pre-treatment serum magnesium level was 1.96 ± 0.29 mg/dL; eclamptics had significantly lower levels (p<0.001). Mean treatment serum magnesium level attained was 5.41 ± 0.58 mg/dL. No evidence of magnesium toxicity was observed. Therapeutic range of serum magnesium was required to prevent seizures, and was attained ≥4-hours after loading dose in most of the eclamptics (74%). All convulsions occurred in the interval between the loading dose and the first maintenance dose; eclamptics had greater risk of convulsing while on treatment (RR=11.56, 95%CI= 0.62-216.36, P=0.049). Conclusion: Low serum magnesium level before or during treatment with magnesium sulphate is a risk factor for convulsion in OAUTHC. The Pritchard regimen has a low risk for toxicity thus administration of magnesium sulphate at peripheral centres before referral may be beneficial in preventing repeat convulsions. Modifications involving additions to the loading dose in eclamptics and fewer number of maintenance doses may be beneficial. [ABSTRACT FROM AUTHOR]