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Biomedical subjects

A O Agbai

Publications and source records attributed to A O Agbai.

12 recordsLinked to original sources

Headache following parturition.

The incidence of headache following childbirth in 226 Nigerian women is 24.3% (n=55) or one in four births. Headache was more prevalent among women aged between 21 and 30 years (n=44); those of social class 3-5 (n=50); and also increased incidence with increasing parity, although these relationships did not reach significance. There is a highly significant association between the incidence of postparturition headache and evidence of stress (P=0.004), but not with a history of migraine (p=0.102). A highly significant association also exists between the incidence of postparturition headache and anaemia (Hb value less than 10 g/dl (68%), (p=0.004). Headache started on the day of delivery in the majority of cases (36.4%; n=20) although the median number of days of onset after delivery was 2 days. Post-natal headache may be associated with some underlying sociomedical factors which may be influenced by the fall in pregnancy hormones following parturition.

Journal Article↗

Contraception in teenage Nigerian school girls.

Contraception is reviewed in 314 teenage Nigerian school girls comprising 128 students at secondary and 186 at tertiary levels of institution. Out of all the teenagers, 26.8% were sexually exposed, among whom there was a total pregnancy rate of 19.05%. The rate of sexual exposure was higher in teenagers from tertiary institutions, 38.7% compared with 9.4% from secondary institutions. However, the pregnancy rate was higher among the sexually exposed secondary school girls, 33% vs. 16.7% for tertiary school girls. The mean level of contraceptive awareness for the various methods of contraception was 38.2% for the entire survey group: 22.6% for the secondary school girls and 54.4% for the tertiary school girls. Mean true contraceptive usage (TCU) among sexually active students, on the other hand, was 17.7%: 5% and 16.5% for the secondary school girls and tertiary school girls, respectively. The source of information on contraception for the study group was highest from 'a friend' (37.3%) and from the 'newsprint' (36.9%) and was lowest from routine 'lectures and sex instructions' (9.2%). Twenty-five point five per cent of the entire study group, 43% of the secondary school girls and 13.4% of the tertiary school girls, had never had any information on contraception. Instruction on contraception, as part of the academic curricula at the primary, secondary and tertiary levels of education, would improve contraceptive knowledge and forestall the emotional and social problems resulting from unwanted teenage pregnancies.

Adolescent↗

Practice and perceptions of female genital mutilation among Nigerian Igbo women.

Genital mutilation occurred in 296 (48.5%) of 610 pregnant Nigerian Igbo women attending antenatal clinics. The incidence was especially high in association with high maternal age, high parity and low social class. Female genital mutilation (FGM) class 1 occurred in 75 (25.3%) cases while FGM class 2 occurred in 221 (74.7%). There was no cases of FGM class 3 (infibulation). The majority, 322 (52.8%) of the women were positively aware of their true genital mutilation status, but 288 (47.2%) showed negative response being either unaware of their true genital mutilation status or had become confused. Female genital mutilation was no longer practised in the locality of 337 (55.3%) of the women, was occasionally practised in that of 55 (9.0%) and was still fully practised in that of 88 (14.4%) of the respondents. Most of the women, 324 (53.1%) had no knowledge of any advantages of female genital mutilation. However, 157 (25.7%) believed that it discourages infidelity while 56 (9.2%) believed that it facilitated delivery. Similarly, 336 (55.1%) of the women were not aware of any risks of female genital mutilation, although 164 (26.9%) believed that it would cause difficult labour. Eighty (13.1%) of the respondents would advocate FGM for their daughters, out of which 34 (42.5%) cited cultural reasons. Four hundred and sixty-six women (76.4%) would not wish their daughters to be circumcised. The eradication of female genital mutilation must involve the identification of issues sustaining the practice in different localities and subsequent action supported either by logical persuasion following aggressive health education and by legislation.

Journal Article↗

Contraceptive choices among Nigerian women attending an antenatal clinic.

The factors determining the choice of contraception were studied among 230 pregnant women attending the antenatal clinic at Nnewi, Nigeria. There were 174 (52.1%) choices for the natural methods of contraception, 86 (25.7%) for the traditional methods, and 74 (22.2%) for the artificial methods. The most commonly chosen contraceptive methods were rhythm, 95 (28.4%) and Billings, 79 (23.5%), while the least was surgical contraception, 4 (1.2%). The barrier method was not chosen at all. The most common reason given for choice of contraception was safety, 28.7%, followed by dislike of artificial methods, 25.2%; the no-response rate was 29.1%. Other reasons given were ease of use, 10%; husband's decision, 1.3%; fear of the complications of the artificial methods, 13%; dislike of foreign body, 2.6%; the method most understood, 24.8%; need for further counselling, 7%; and long-lasting, 2.6%. The most common reason given against the use of the artificial methods of contraception was fear of its complications, 31.9%, followed by preference for the natural methods, 22.3%. Condom use decreased with increasing age, being highest at 16-20 years, 37.5%, and lowest at 31-35 years, 5.9%. When compared with other parity groups, the grandmultipara group (> or = 5) used the IUD, 14.3%; injectable contraception, 4.8%; and other traditional methods (breastfeeding and abstinence), 28.5%, and did not use the rhythm method. Women of the lowest social class most commonly chose other traditional methods, 57.1%, and never chose the Billings method. Women who desired 1 to 3 children most commonly chose the pill, 23.5%, or withdrawal method, 23.5%, while women who desired 4 to 10 children most commonly chose the rhythm and Billings methods. There was no difference in choice of method of contraception for the various religious denominations, although the artificial methods were less commonly chosen by Catholics, 14.1%, compared with Anglicans, 33%, and other Christian denominations, 33.3%. The physician was the most common source of information for the choosers of the condom, 18.9%; surgical contraception, 2.7%; and the pill, 8.1%; the nurse for injectable contraception, 4.9%, while the commonest source of information among choosers of the rhythm method was the electronic media, 40.5%; print media, 34.9%; and peer group, 34.4%. Lecture/sex instruction was the commonest source of information among choosers of the Billings, 35.5%, and withdrawal, 22.6%, methods, while the no-response rate on source of information on contraception was highest among choosers of the Billings method. There is a need to bridge the gap in contraceptive information by redirecting counselling strategies and restructuring family planning programs to dispel negative perceptions and encourage informed choice of effective family planning methods.

Adolescent↗

Multiple births in Nigerian Igbo women: incidence and outcomes.

The rate of multiple births varies amongst races and ethnic groups. This study shows that the incidence of multiple births among the Nigerian Igbo women is one in 35.5 or 28.2 per 1000 births. A significant difference in Apgar scores at 1 minute between the first and second twins suggests a greater risk for the second twin following the delivery of the first twin. Significantly lower Apgar scores and higher perinatal mortality rate in the twins compared with the singleton controls also indicate greater hazard for the multiple births in general. Successful management of multiple pregnancy can occur following early diagnosis and confirmation of fetal presentations, adequate antepartum fetal surveillance and prompt management of pregnancy complications; appropriate referrals to specialised centres when indicated; and prompt decisions as to timing and mode of delivery.

Journal Article↗

Umbilical cord encirclement in twins.

The incidence of umbilical cord encirclement in twins in this study was 10.1%. Twins with tight cord entanglement (TCE) had a 1-minute Apgar score predominantly at the range of 0-6, (3 of 4), unlike those with loose cord entanglement (LCE) whose Apgar scores at 1 minute occurred evenly in the 0-6 (15 of 29) and 7-10 (14 of 29) score range. The perinatal mortality rate was significantly higher for tight cord-entangled twins (750 per 1,000) compared to noncord-entangled (NCE) (58 per 1,000) and all twins (61 per 1,000). All the perinatal deaths occurred in the tight cord-entangled (TCE) twins, 2 of the 3 being in second twins with gestational age less than 30 weeks. The umbilical cord was significantly longer in cord-entangled twins compared to all twins (p < 0.0005) by 11.7 cm for twin 1 and 10.4 cm for twin 2. No difference occurred in birth-weight between cord-entangled twins 1 and 2 and between them and non-cord entangled twins. There was no difference in the overall mode of delivery for the cord entangled, nonentangled and all twins, although cord entanglement was more prevalent in spontaneous vertex vaginal deliveries compared to other modes of delivery for the first twin only.

Birth Weight↗

Influence of mode of delivery on twin births.

The mode of delivery and outcome in 158 twin births in a Nigerian sub-urban hospital are reviewed. Apgar scores at one minute were significantly higher for twin 1 compared to twin 2 in vertex deliveries only. There was no significant difference in Apgar scores at 5 minutes between the twins for the various modes of delivery. Apgar scores were generally higher for the controls (a set of singleton births) compared to twin births for all the modes of delivery except breech births. Birth weights were also significantly higher for controls compared to twin births although no significant difference occurred between the twins. Perinatal mortality rates were generally higher for twin 2 compared to twin 1, and for the twins compared to controls irrespective of mode of delivery. Better outcome could not be ascribed to any particular mode of delivery in twin births and would depend on the judgement and expertise of the labour attendant.

Apgar Score↗

The second twin: retained and unretained.

In this comparative review of retained and unretained second twins, the commonest causes of retention of the second twins, were found to be uterine inertia (48.4%) and obstruction from malpresentation and malposition (32.3%). The pair-presentation most likely to be retained was vertex/transverse. Apgar scores were lower for retained than unretained second twins. The perinatal mortality rate was significantly higher for the retained second twins (258/1000) compared to the unretained second twins (60.2/1000) (P < 0.002). Early recognition of twin pregnancies in which the 2nd twin is more likely to be retained, and prompt application of appropriate remedial measures would reduce the incidence of retention of the second twin.

Delivery, Obstetric↗

Sexual behavior and pregnancy among Nigerian students.

The sexual behavior of 539 Nigerian female students comprising 387 adults and 152 teenagers was studied. The overall incidence of sexual activity among the students was 51.2%. The incidence of sexual intercourse was significantly higher among adult students (61.0%) compared with teenagers (26.3%) (p < 0.0005). There was no significant difference in the mean age at sexual debut for the adult students (18.7 +/- 3.2) compared with the teenage population (16.1 +/- 1.7). The frequency of sexual exposure was also not significantly different in the two groups (4.1 +/- 6.1 times per month for the adult students and 3.6 +/- 5.9 times per month for the teenage students). However, pregnancy occurred more often among the adult students (38.1%) than among the teenagers (15.0%) (p < 0.005). This article looks at the psychosocial implications of adolescent sexuality and the overall relevance of adequate reproductive health education in encouraging responsible attitudes regarding sexuality among teenagers.

Adolescent↗

Pattern of twin births in Nigerian Igbo women.

The incidence of twin birth among the Nigerian Igbos from this study is 1 in 36.2 or 27.6 per 1000. The commonest pair presentation was vertex/vertex and the incidence of pre-term delivery was 27.8%, six times higher than in single controls 4.5%. The commonest mode of delivery was spontaneous vertex. Breech delivery was most prevalent in the second twin while assisted delivery (forceps and ventouse) showed no difference between the twins themselves and between them and the controls. However, caesarean section rate was much higher for the twins, particularly the second twin compared to the singleton controls. Twin pregnancies and delivery being high risk, are best managed in specialist obstetrics and gynaecological centres.

Case-Control Studies↗

Relevance of clinical pelvimetry to obstetric practice in developing countries.

The outcome of labour in 177 Nigerian primigravidae in whom clinical pelvic assessment was performed before delivery, is studied. No significant difference occurred in the mode of delivery for the rank of the pelvic assessors (consultants or resident doctors) at x = 0.05. No significant difference also occurred in the incidence of caesarean section between the pelvic assessed and the unassessed patients, and between those whose pelves were assessed adequate and those assessed inadequate. One-minute Apgar scores were significantly higher for fetuses delivered of women with adequate pelves compared to those with (i) borderline pelves (Z = 3.46, p < 0.001), (ii) unassessed pelves (Z = 2.84, p < 0.005) and (iii) the not adequate pelves-borderline and inadequate (Z = 3.04, p < 0.005), thereby conferring a predictive role on Apgar scores to clinical pelvimetry. The procedure is cost-free and requires minimal guidance to perfect. Its continued practice in routine ante-natal care in developing countries is therefore advocated.

Apgar Score↗

Influence of discipline of study on the sexual behaviour of Nigerian female students.

In this comparative study of the sexual behaviour of 476 Nigerian female students in tertiary institutions comprising of 243 students of the medical discipline of study (MD group) and 233 students of the non-medical discipline of study (NMD group), the overall incidence of sexual intercourse was 56.7 percent. The mean age at first sexual experience was not significantly different at & = 0.05 among the two groups. However, sexual exposure was significantly more prevalent among students of the non-medical discipline of study (NMD group)--69.1 percents compared to those of the medical discipline of study (MD group)--44.9 percent (p < 0.01). In addition, the frequency of sexual exposure was significantly higher among the former group, 5.5 +/- 6.8 times per month, than in the later, 1.7 +/- 3.8 times per month (t = 5.25 with 274 d.f.; p < 0.005). The incidence of pregnancy among the two groups of students 37.1 percent and 31.2 percent respectively for the NMD and MD groups showed no significant difference at & = 0.05. The reasons for the observed difference in the sexual behaviour between the students for the two groups are adduced. The overall implications of sexuality and the relevance of its management among the youth are also discussed.

Adolescent↗