misoprostol and Shock

Nigeria has one of the highest maternal mortality ratios in the world. The nurses and midwives being the first point of contact play a central role in addressing these problems. This study was conducted to assess the knowledge and utilization of the technologies (misoprostol, anti-shock garment and magnesium sulphate) in the reduction of maternal mortality amongst the Primary Health Care (PHC) nurses and midwives in Lagos State, Nigeria. In addition, the availability of the technologies in the flagship Primary Health Centres (PHCs) was assessed.. This was a cross-sectional study among all the nurses and midwives at the flagship PHCs in Lagos state and a total of 230 were eventually studied. Data was collected using a self-administered, structured questionnaire and a checklist. Descriptive and inferential statistics were applied. Level of significance was set at 5% (p<0.05).. All the respondents were aware of the technologies but most (73.9%) had poor knowledge of them. Majority (74.8%) of the respondents had good knowledge of maternal mortality and its major causes. Most, 81.3% of the respondents have administered misoprostol, 37.0% magnesium sulphate while 52.2% have administered anti shock garment. Out of the 57 flagship PHCs, 27 (47.4%) had magnesium sulphate, 42 (73.7%) had misoprostol and 52 (91.2%) had anti-shock garments in their facilities. Respondents who were double qualified (nurse/midwife) had significantly better knowledge of maternal mortality and its major causes (p = 0.009) than the other cadres. Longer years of experience (p = 0.019), training in the use of misoprostol (p = 0.020) and training in the use of magnesium sulphate (p = 0.001) significantly improved knowledge of the technologies.. Respondents had good knowledge of maternal mortality and its major causes and poor knowledge of the technologies for maternal mortality reduction, despite the trainings attended. Of the three technologies considered, misoprostol was the most commonly used. Periodic refresher courses for the training and retraining of PHC nurses and midwives on the technologies for maternal mortality reduction is recommended.

Topics: Adult; Aged; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Magnesium Sulfate; Male; Maternal Mortality; Middle Aged; Midwifery; Misoprostol; Nigeria; Nurse Midwives; Pregnancy; Primary Health Care; Shock; Surveys and Questionnaires

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Administration, Sublingual; Adult; Anaphylaxis; Female; Humans; Misoprostol; Pregnancy; Shock

Maternal morbidity and mortality has been a major World Health Organization concern over the years, especially in sub-Saharan Africa. This paper reports uterine rupture with severe hypovolemic shock managed at the Douala General Hospital, Cameroon. Early clinical diagnosis is paramount to maternal survival.. Mrs. MM aged 25 years, G3P2012, of the Bamileke tribe in Cameroon was admitted to our Department in hypovolemic shock BP = 70/40 mmHg, pulse 120 beats per minute, with altered consciousness (Glasgow Coma Scale = 13). She has a history of missed abortion at 19 weeks gestation and an attempt to evacuate the uterus with misoprostol that led to uterine rupture. She underwent a total abdominal hysterectomy and blood transfusion. Her post-operative stay in hospital was uneventful.. Uterine rupture is a complication that can be eliminated under conditions of best obstetric practice. To attain this objective, use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. The survival of patients after uterine rupture depends on the time interval between rupture and intervention, and the availability of blood products for transfusion.

Topics: Abortifacient Agents, Nonsteroidal; Adult; Blood Transfusion; Cameroon; Disease Management; Early Diagnosis; Female; Humans; Hysterectomy; Misoprostol; Pregnancy; Pregnancy Trimester, Second; Shock; Uterine Rupture

Induced abortion on demand or for socio-economic indications is illegal in Papua New Guinea under the 1974 Criminal Code. Nevertheless, the procedure is known to be widely practised. This prospective study examines the demographic and medical features of women presenting with complications of induced abortion to Goroka Hospital in a 6-month period. It was noted that abortion was most commonly induced using the synthetic prostaglandin analogue misoprostol. Although illegal induced abortion cannot be condoned, it appears that misoprostol, much safer in this context than mechanical or traditional herbal methods, is now being widely used for the purpose of induced abortion in Papua New Guinea, as it is in other developing countries.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Criminal; Abortion, Induced; Abscess; Adolescent; Adult; Anemia; Employment; Female; Hemorrhage; Humans; Marital Status; Misoprostol; Papua New Guinea; Pregnancy; Prospective Studies; Shock; Surveys and Questionnaires; Young Adult