Background: Antenatal care is a core component of safe motherhood initiative and it helps indirectly in reducing maternal and perinatal morbidity and mortality. Despite the obvious benefits of antenatal care, utilization of this service is very poor in our environment. Therefore, this study sought to assess the gestational age at booking, the reason for booking and determine the factors responsible for late booking among antenatal attendees at the Alex Ekwueme Federal University Teaching Hospital Abakaliki.Methods: This was a cross-sectional descriptive study conducted 5th May 2016 and 10th June 2016 among 258 consecutive pregnant women who presented for booking at the antenatal clinic of the hospital, using self-administered, pre-tested questionnaires. Statistical analysis was done using Epi Info 7.2.1.Results: The mean gestational age at booking was 21.5±4.8 weeks. The mean age of the respondents was 28.2±3.8 years while the mean parity was 1.5±1.6 years. Most of the women booked after the first trimester of pregnancy, only 61(24.8%) of the respondents booked in the first trimester of pregnancy. Majority of the women had no problem at booking 36.7%. Women aged 20-34 years booked late compared to women aged less than 20 years and those above 34 years and the difference was statistically significant. There was no statistically significant difference in maternal parity, education, marital status and religion with regards timing of booking. However, women who were sick during the first trimester were more likely to book early as well as women who booked early in their previous pregnancy.Conclusions: Late booking was common in our environment. There is an urgent need for increase awareness of the benefits of early booking to pregnancy outcome.

Objective: To compare the analgesic efficacy and safety of paracervical block and conscious sedation in the surgical evacuation of the uterus following a first-trimester miscarriage. Methods: This is an open-label, randomised control trial comparing pain relief by paracervical block versus conscious sedation during manual vacuum aspiration of first-trimester incomplete miscarriages. One-hundred and sixty-two women were equally randomised into two groups. Group A (paracervical group) received a paracervical block of 4 ml of lidocaine each at the 4 and 8 o’clock positions. Group B (conscious sedation group) received intravenous 30 mg pentazocine and 10 mg diazepam. Data obtained were presented using a frequency table, student t-test, chi-square and Mann–Whitney test and bar chart. A P-value of ⩽0.05 was taken to be statistically significant. Results: The mean pain score was lower in the paracervical block group compared to the conscious sedation group (P < 0.05); however, there was no significant difference in women’s satisfaction between the groups (P ⩾ 0.05). Conscious sedation had more negative side effects compared to paracervical block which was significant (P < 0.05). Conclusion: Paracervical block has better pain control compared with conscious sedation and has a good side effect profile. Trial registration: Pan African Clinical Trial Registry (registered trial no. PACTR202108841661192). Synopsis Paracervical block for manual vacuum aspiration (MVA) during first-trimester miscarriage is associated with less pain among women compared with conscious sedation.

Background: Obstetric ultrasound forms an essential part of antenatal care around the world. The ultrasound is now widely available and accessible in most government and private health facilities in developing countries. Aim of this study was to determine the reasons for pregnant women’s self-referral and perspectives on the use of obstetric ultrasound.Methods: This was a questionnaire-based cross-sectional study conducted among 198 consenting pregnant women attending prenatal care at Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.Results: Of 198 participants, 182 (91.9%) reported performing obstetric ultrasound examination without doctor’s request. Determination of fetal viability (40.7%) was the commonest reason for self-referral to ultrasound examination. Other common reasons include vaginal bleeding (15.3%), estimation of gestational age (9.3%), fetal sex determination (7.7%) and estimation of date of delivery (7.6%). Over half (57.7%) of the participants reported that the prenatal ultrasonography was costly whereas 76.9% believed that ultrasound use was unsafe in pregnancy.Conclusions: The study participants were highly aware of the import of ultrasonography in pregnancy confirmation, dating and fetal wellbeing. As a result, are always willing to carryout prenatal ultrasound even without doctors’ request.