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Biomedical subjects

J D Seffah

Publications and source records attributed to J D Seffah.

11 recordsLinked to original sources
PubMed2006

Secular trends in menarcheal age among Ghanaian women in Accra.

The Women's Health Study of Accra is a population-based cross-sectional survey that was conducted between March and September 2003 to assess the burden of disease in women in Accra. In addition to data relating to general health and living conditions, data on age at first menstruation was collected during the survey. A retrospective cohort analysis of the reported age at menarche was conducted using data from 2,644 women aged between 18 and 100 years. The median age of first menstruation of the entire cohort was 15.5 years and the median age of first menstruation among those aged <20 was 14.5 years. There was a statistically significant difference in median age at menstruation among the different age and socioeconomic groups. Multiple linear regression showed a significant decline of 0.2 years per decade in the mean age at menarche among Ghanaian women.

Adolescent↗
PubMed2005

Re-laparotomy after Cesarean section.

OBJECTIVE: The objective of the study was to find out the indications for management and the outcomes of reopening the abdomen during the puerperium after Cesarean section. PATIENTS AND METHODS: This was a retrospective descriptive survey at the Korle Bu Teaching Hospital in Accra, Ghana. RESULTS: There were 6120 Cesarean sections (17%) out of a total of 36,010 deliveries. Re-laparotomy was done in 44 patients (0.7%) of the Cesarean sections. The indications were: hemorrhage from uterine atony, hemorrhage from placental bed after operation for placenta previa, uterine sepsis with hemorrhage, hemorrhage after Cesarean section, myomectomy and hemorrhage from anterior abdominal wound dehiscence. The main surgeries performed were: hysterectomy, ligation of ascending branches of uterine arteries, ligation of hypogastric arteries, debridement and re-suturing of the uterine incision and secondary suturing of anterior abdominal wall. There were 6 near missed fatalities. There were 4 mortalities caused by excessive hemorrhage and severe sepsis. CONCLUSION: The case fatality rate for re-laparotomy after Cesarean section is high (9%). Near missed-fatalities are common. To reduce the unfavorable outcomes, instituting more intensive education on the use of the partograph should prevent prolonged labor. Centers carrying out Cesarean section should have efficient blood transfusion service in place.

Cesarean Section↗
PubMed2000

Antenatal ultrasonography for breech delivery.

OBJECTIVE: We studied the role of sonography in the management of 370 breech presentations > or = 34 weeks maturity. METHOD: 185 cases had sonographic confirmation of breech presentation prior to the delivery at the Korle Bu Teaching Hospital. A control group of 185 cases did not have prior scanning. RESULTS: Significantly more elective cesarean sections were done in the study group, while the control group had more emergency sections (P = 0.008), and had more traumatic delivery. Birth asphyxia and perinatal mortality were significantly more common in the control group (P < 0.05). CONCLUSION: Sonography done before delivery improved neonatal outcome in breech presentation > or = 34 weeks maturity.

Asphyxia Neonatorum↗
PubMed1999

Maternal and perinatal mortality and morbidity associated with transverse lie.

OBJECTIVE: The aim of this study of transverse lie in labor of patients admitted to Korle Bu Hospital between 1 January 1996 and 30 June 1998, was to identify the methods of delivery, the perinatal and maternal morbidities and mortalities, and to provide recommendations to improve the outcome. METHODS: This was a retrospective study of 152 patients who presented at the labor wards with transverse lie. The data sources of this study were the antenatal records, the labor wards delivery record books, the postnatal records and the admission books at the Neonatal Intensive Care Unit. RESULTS: One hundred and forty-two cases (92.1%) had an emergency cesarean section. The rest had the external version followed by vaginal delivery. There were two maternal deaths resulting from hemorrhage, infections and difficult surgery. There were 25 stillbirths, and 37 of the neonates required hospital admission. CONCLUSION: Transverse lie carries a high rate of complications in labor. Delivery should be carried out without delay in a hospital well-equipped for cesarean delivery and assisted vaginal delivery. The complications could be further reduced by early diagnosis during the antenatal period when associated risk factors, such as placenta previa could be diagnosed with the aid of the ultrasound scan. Elective deliveries could then be undertaken.

Adult↗
PubMed1999

Amniotic fluid index for screening late pregnancies.

OBJECTIVE: To find out whether amniotic fluid index (AFI) could be used to screen late pregnancies which presented at the clinic for the first time for any adverse perinatal outcome. DESIGN: Retrospective study that compared patients with AFI > or = 5 with those with AFI > or = 5. SETTING: Korle Bu Teaching Hospital, Accra, Ghana. PATIENTS: One thousand one hundred and eleven consecutive cases referred to the ultrasound unit for the first time after 36 weeks of pregnancy between 1st January 1997 and 31st December 1997. MAIN OUTCOME MEASURES: AFI and rate of induction, Caesarean Section; and incidence of foetal distress. RESULTS: Out of the 1111 patients, 350 had AFI < 5 and 761 had AFI > or = 5. The relative risk for induction and Caesarean section were 6.08 and 3.38 respectively. The relative risk for developing foetal distress was 8.48. The sensitivity was 79.6% and the specificity 89.5% in using AFI < 5 for predicting foetal distress. CONCLUSION: The results indicate that AFI < 5 could be used to screen late pregnancies for foetal distress.

Amniotic Fluid↗
PubMedDate not supplied

Caesarean section and birth weight at Korle Bu Teaching Hospital--preliminary report.

OBJECTIVE: This preliminary retrospective survey was done to find out whether the indications for Caesarean Section had any bearing on the birth weight. METHOD: The foetal outcome for 673 parturients who delivered at the Korle Bu Teaching Hospital between September 1, 1998 and December 31, 1998 was analysed. RESULT: Caesarean section done for cephalopelvic disproportion and for 2 or more previous sections yielded the highest mean birth weight (3.43 kg +/- 0.02 kg) and the best foetal outcome. Hypertensive disorders yielded the lowest mean birth weight (1.8 kg +/- 0.3 kg) and poorest foetal outcome. The mean parity and age of the parturients were similarly distributed. CONCLUSION: The birth weights appeared to vary with the indications for Caesarean section. Confounding factors such as the gestational age, parity and age of the parturients need to be controlled in a prospective study in future. Good antenatal supervision could improve on the birth weights.

Abruptio Placentae↗