Unintended Pregnancy Determinants among Antenatal Clinic Attendees: A University of Port Harcourt Teaching Hospital Experience

An unintended pregnancy is a pregnancy that is either mistimed or unplanned. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among pregnant women attending antenatal clinics at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State, Nigeria. It was a descriptive, cross-sectional study of 215 women attending the antenatal clinic of UPTH from July to August 2022. Information on socio-demographic characteristics, reproductive history, desirability of the current pregnancy at the time of conception, knowledge and use of contraceptive methods were collected using a pretested questionnaire and analyzed using SPSS version 26.0. Chi-square test was used for test of associations with the level of significance set at P < 0.05. The prevalence rate of unintended pregnancy from the study was 16.28% (≈16%). The contraceptive awareness was very high (209, 97.21%), however, 101 (46.98%) participants had never used any form of contraceptives. Univariate analysis using Chi-square test showed a statistically significant association between age and unintended pregnancy (P = 0.042), level of education and unwanted pregnancy (P = 0.033) as well as parity and unintended pregnancy (P = 0.019). The prevalence of unintended pregnancy among women attending antenatal clinics was high, possibly due to low contraceptive usage. More efforts should be geared towards ensuring access to comprehensive contraceptive care and contraceptive methods, this will enhance uptake and reduce the rate of unintended pregnancy.

Diagnostic Accuracy of Hysterosalpingography in the Identification of Intrauterine Adhesions in Infertile Women in a Referral Centre, Southern Nigeria

Background: Examination of the endometrial cavity is crucial in the management of infertile women. This evaluation is done by Hysterosalpingography (HSG) in the University of Port Harcourt Teaching Hospital. The diagnostic value and accuracy of hysterosalpingography varies in various centres and has not been assessed in the University of Port Harcourt Teaching Hospital (UPTH), hence this study. Methodology: A prospective cross sectional study done among 101 infertile women at the gynaecology clinic of the UPTH from December 2018 to July 2019. Socio-demographic data of women who met the eligibility criteria were collected. Their hysterosalpingographic and outpatient hysteroscopic findings were statistically analyzed using IBM SPSS for windows version 20.0. The validity and reliability statistics of hysterosalpingography for the identification of endometrial adhesions were determined and significance was reported at p-value < 0.05. The analyzed data was presented in tables and figure. Result: The respondents were all married, 66.3% of them were nulliparous, while 54.5% were above 35 years of age. Most, 93.1% of the studied group had at least secondary education and had duration of infertility of more than 2 years. There was a moderate strength of agreement in the diagnostic accuracy of HSG with hysteroscopy in the diagnosis of intrauterine adhesions;showing sensitivity and specificity of 59.6% and 90.9% respectively. The accuracy of HSG in the identification of intrauterine adhesions in this study was 73.3%. The agreement in the diagnostic accuracy of HSG using Hysteroscopy as a gold standard for intrauterine adhesions was therefore moderately significant (k = 0.482). Conclusion: HSG had an overall fair strength of agreement with office hysteroscopy in the identification of intrauterine adhesions. It is a specific but not a sensitive predictor of intrauterine adhesion.

Assessment of Clients Satisfaction in Family Planning Service Delivery in Port Harcourt, Nigeria

Background: Client satisfaction is considered as one of the desired outcomes of health care service delivery and it is directly related to the utilization of any health services. The family planning clinic remains one of the important health care delivery outlets where client satisfaction guarantees continuation of usage, hence this study. Objective: The objective of this study is to assess the determinants of client satisfaction with the family planning (FP) services provided in Port Harcourt. Materials and methods: This was a descriptive prospective cross-sectional study conducted between 18th of June 2018 and 18th of July 2018. The target population is women of reproductive age group (15 - 49) who visited 11 randomly selected family planning health facilities in Port Harcourt during the study period. A set of exit interviewer-administered questionnaire (pretested for reliability and validity) was used for data collection from a sample size of 195 respondents;and analyzed using SPSS 22.0. Standard deviation was used for continuous variable while categorical variables were presented in simple percentages and frequencies. The P value was set at <0.05 and confidence interval was 95%. Results: Age range 30 - 39 years constituted the largest proportion of 51.3%. A large proportion of the women (87.2%) expressed satisfaction with FP services provided. All respondents said the facilities were easily accessible, clean and were treated respectfully. However, only about half of the clients (51.3%) received their chosen contraceptive product after 1 hour. Conclusion: A huge proportion of family planning clients expressed satisfaction with family planning service delivery in Port Harcourt;not minding the longer waiting time. Implication of this is continued use and by implication improved contraceptive prevalence.

Combined Oral Contraceptive Use at the University of Port Harcourt Teaching Hospital, Port Harcourt, Southern Nigeria: A-20 Year Review

Background: While the combined oral contraceptive pill (COCP) is one of the most commonly used methods of birth control especially in the developed countries, robust and current information on the pill use in developing countries including Nigeria is at best lacking. Objectives: The study was conducted to determine the prevalence rate, efficacy and side effects of COCP at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Southern Nigeria. Methods: It was a retrospective analysis of all clients who used the COCP between 1st January 1997 and 31st December, 2016, at the family planning clinic of UPTH Port Harcourt. Data on sociodemographic profile, side effects and source of information were extracted from the clients’ case notes coded and fed into Excel spread sheet and analysed. Results: Of the 8310 new acceptors of modern contraceptive methods in UPTH, 399 clients used the COCP, giving a prevalence rate of 4.8%. The mean age of the acceptors was 26.42 ± 4.27 years while the mean parity was 1.90 ± 0.36. Menstrual disruption was the most common complications with 78 episodes constituting 47.0% of all the complications. One unintended pregnancy occurred during the period of observation, giving a Pearl index of 0.01. Conclusion: The study showed that although COCP is very effective, readily available, safe and reliable method of fertility control, the acceptance rate is very low and the patronage rapidly declining and may therefore go into extinction as a family planning method in Port Harcourt, Southern, Nigeria.

Evaluation of Condom Use among University Undergraduates in Port Harcourt, Nigeria

Background: Barrier contraception has the beauty of dual protection—against pregnancy and sexually transmitted infections. Following the persisting burden of unsafe abortion and human immunodeficiency virus (HIV), much sensitization/campaign has been ongoing in the past few decades by government and non-governmental organisations (NGOs) in Nigeria against unprotected sexual intercourse. The youth are generally assumed to have high risk sexual behaviour, hence this study on Port Harcourt university undergraduates. Objectives: To determine the awareness and use of condom among University undergraduates in Port Harcourt. Methods: The study was a prospective descriptive cross-sectional study of 636 undergraduate students of the University of Port Harcourt and Rivers state University, South-south Nigeria. The multistage sampling technique was used to randomly select participants and data collected using a pretested structured self administered questionnaire. Data was analyzed using version 23.0 SPSS and reported in means, frequencies and percentages. Probability value was set at 5% (p χ2 = 200.602). Only 5.5% of the respondents in this study were willing to know their HIV status. Conclusion: There is a high level of condom awareness among Port Harcourt University undergraduates. Surprisingly, their practice of unprotected sexual intercourse is still high.