We reviewed the records of antenatal clinic attendees over a period of 9 years to determine the prevalence of anaemia at booking. The laboratory records of 8751 out of a total of 37,506 pregnant women who booked for antenatal care between 2004 and 2013 at the BMSH were reviewed. The effects of maternal age, educational status, parity, gestational age, haemoglobin genotype and infections on the prevalence of anaemia were investigated. The prevalence of anaemia at booking was 69.6%, most of whom had moderate anaemia. Anaemia was significantly prevalent in the 10-19 year age group, and in women with secondary education, in their 2nd trimester and with SS genotype. Anaemia also increased with gestational age, this however was not statistically significant. There was no statistical difference between those who are human immunodeficiency virus (HIV) positive and had anaemia and those who are HIV negative who also had anaemia. This study shows that anaemia in pregnant women is still unacceptably high considering the consequences and despite interventions on the ground to reduce prevalence. There is a need to review the intervention measures with emphasis on programmes that would increase awareness among pregnant women and the general public.

The practice of abdominal massage dates to years ago and associated with foetal and maternal morbidity and mortality when undertaken by untrained traditional birth attendants in our setting. We present a 30-year old G3P2+0 with uterine rupture and intra-uterine foetal death following abdominal massage. She was resuscitated and had emergency exploratory laparotomy and repair of uterine rupture.

Background: Caesarean section (CS) is one of the most common surgical procedure in obstetrics. It involves a surgical incision made through the abdominal and uterine walls to deliver the foetus and placenta after the period of foetal viability.Methods: This was a cross-sectional study aimed at reviewing emergency caesarean section in Rivers State University Teaching Hospital (RSUTH) over a 5-year period, to determine the prevalence and sequelae. Data were analysed using IBM Statistical Product and Service Solution (SPSS) version 25.0 (Armonk, NY).Results: During the review period, there were 13516 deliveries and 3699 cases of emergency CS, giving the prevalence of emergency CS as 27.4% or 274 per 1000 deliveries. Majority (90%) of the parturient were unbooked. The most common complication in women that had emergency caesarean section was fever (56.4%), followed by endometritis (14.7%), absconding from hospital (8.8%), urinary tract infection (7.1%) and wound infection (6.1%). There was a statistically significant association between types of CS and their sequelae, χ2=1153.9, p<0.001, (95% CI: 0.000, 0.000). Women that had emergency CS were 101 times more likely to have a complication compared to those that had planned CS.Conclusions: The rate of emergency caesarean section is high in RSUTH and with more complications compared to planned caesarean section. Booking for antenatal care, early presentation for delivery, birth preparedness and complication readiness will enhance improved maternal and perinatal outcome.

Background: Caesarean section (CS) is a major obstetric surgery done for pregnant women and is lifesaving.  Aim: The study was aimed at reviewing CS at the Rivers State University Teaching Hospital (RSUTH), to determine the prevalence, trend and indications, for improved management outcomes. Methods: In this cross-sectional study, we reviewed five thousand, five hundred and ninety-eight (5598) cases of caesarean sections (3699 emergency, 1899 planned) managed at the RSUTH from 1st January, 2015 to 31st December, 2019.  Data collected were analysed using IBM, Statistical Product and Service Solutions (SPSS), version 25.0 Armonk, New York. Results: There were 13,516 deliveries and 5,598 cases of CS over the review period, giving the prevalence of CS as 41.4% or 414 per 1000 deliveries.  Emergency and planned CS cases accounted for 66.1% and 33.9% respectively. An increasing trend of CS was observed over the review period. The mean age ± SD of the participants was 32.30±1.04 years (95% CI:30.26,34.34). Modal age group was 35-39 years, accounting for 33.2% followed by those aged 30-34 years (26.2%). Majority of the patients were multipara [3396 (60.7%)], married [4890 (87.4%)], Christians [5540 (99%)] and had tertiary level education [2800 (50%)]. The commonest indication for CS in RSUTH was previous caesarean section [1925(34%)], followed by cephalopelvic disproportion [757(13.4%)], foetal distress [418(7.4%)], preeclampsia [390(6.9%)] and multiple gestation [252 (4.5%)]. Conclusion: The rate of caesarean section is high in RSUTH with an increasing trend.  Although CS is lifesaving, efforts should be made to reduce the rate to the level recommended by WHO, especially in Low-middle-income countries (LMICs), where there is high aversion to CS.