Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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The study was done to determine obstetricians' attitude to and factors predicting obstetricians' acceptance of caesarean delivery on maternal request in Nigeria. Nigerian obstetricians were asked to respond to case scenarios depicting caesarean delivery on maternal request without medical indications and the reasons for their responses. The case scenarios were designed from previously published reasons for caesarean delivery on maternal request from Nigeria. ⋯ A good proportion (48.8%) of Nigerian obstetricians had performed at least one caesarean on maternal request. Obstetricians' bio-professional characteristics do not influence their attitude to request caesarean delivery on maternal request. Some obstetricians expressed fear of legal consequences from caesarean delivery on maternal request.
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The aim of maternal calcium homeostasis is to provide adequate calcium flux across the placenta during pregnancy and into breast milk during lactation, to ensure normal fetal and neonatal skeletal mineralisation. The objective of this study was to document the characteristics and outcome of patients who had postpartum hypocalcaemia. Cases of symptomatic postpartum hypocalcaemia managed over a 10-year period (1 January 1998 to 31 December 2007) at the University of Maiduguri Teaching Hospital, were retrospectively reviewed. ⋯ Multiparous women were significantly more affected than primiparae (χ² = 15.08; p = 0.0005). Half of the patients presented within 1 week of onset of symptoms. In conclusion, the association between anaemia and postpartum hypocalcaemia needs further study to determine the cause and effect relationship.
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Randomized Controlled Trial
Does saline irrigation reduce the wound infection in caesarean delivery?
The aim of this prospective randomised study was to estimate the effect of saline wound irrigation before wound closure in the prevention of infection following caesarean delivery. Participants with indications for elective or emergency caesarean section were randomly allocated to two groups. A total of 260 women who underwent wound irrigation before wound closure and 260 did not. ⋯ There were also no significant differences between the groups in terms of factors known to influence wound infection. The incidence of wound infection was 7.3% for the control group and 6.5% for the saline group; however, the difference was not significant (relative risk: 0.88; 95% confidence interval: 0.45-1.74; p=0.86). In conclusion, saline wound irrigation before wound closure did not reduce the infection rate in patients undergoing caesarean delivery.
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Comparative Study
Anaesthesia preference, neuraxial vs general, and outcome after caesarean section.
We investigated parturients' preference for neuraxial vs general anaesthesia, while they have experienced both techniques in the past. A total of 102 parturients who underwent elective caesarean section under general or neuraxial anaesthesia at different times completed a questionnaire comparing the two techniques. ⋯ Neuraxial anaesthesia was associated with less pain assessed by the Verbal Analogue Scale (VAS) (54 ± 21 vs 72 ± 20 p < 0.001), fewer days of hospital stay (4 ± 0.5 vs 5 ± 1.5, p = 0.001) and higher satisfaction scores (77 ± 18 vs 52 ± 24, p = 0.001) vs general anaesthesia. Finally, 80% of the women would choose neuraxial anaesthesia for a future caesarean section.
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Randomized Controlled Trial
Randomised clinical trial of the influence of pulmonary recruitment manoeuvre on reducing shoulder pain after laparoscopy.
Shoulder pain after laparoscopy is common and its probable mechanism is residual CO(2) gas after surgery. The aim of this study was to examine the effect of pulmonary recruitment manoeuvre which means pulmonary inflation with positive pressure of 40 cm H(2)O to remove gas and reduction of shoulder pain after gynaecological laparoscopic surgery. A double-blind clinical trial on 146 patients for minor gynaecological laparoscopy was performed from May 2008 to February 2009. ⋯ Pain scores in the control and intervention group were 3.6 +/- 3.5 vs 1.28 +/- 1.7; 3.4 +/- 2.9 vs 1.19 +/- 1.7; 2.6 +/- 2.4 vs 0.89 +/- 1.3; 1.5 +/- 1.6 vs 0.46 +/- 0.7, at 4, 12, 24 and 48 h after operation, respectively (p < 0.001). The controls had greater usage of analgesics 1.12 +/- 5.67 compared with 0.95 + 0.31 in the cases. It was concluded that pulmonary recruitment manoeuvre seems to be a simple and safe way to reduce shoulder pain and analgesic use after laparoscopy.