Omdurman Maternity Hospital Research Articles

A perspective of the epidemiology of malaria and anaemia and their impact on maternal and perinatal outcomes in Sudan

Both malaria and anaemia have adverse effects on maternal and perinatal outcomes. Thus there is an urgent need to investigate the co-epidemiology of malaria and anaemia and their combined impact on maternal and perinatal outcomes in the different regions of Sudan. Various cross-sectional and case control studies conducted during the years 2003-2010 to investigate the epidemiology of malaria and anaemia and their impact on maternal and perinatal outcomes in different regions of Sudan were compared. While 13.7% of antenatal attendants in New Halfa had peripheral microscopically detected Plasmodium falciparum malaria, placental malaria (using histological examinations) was prevalent in 32.0-40% and 19.5% of parturient women in New Halfa and Gadarif Hospitals, respectively. Malaria was a risk factor for anaemia in New Halfa and for stillbirths in Omdurman Maternity Hospital. Anaemia was present in 52.5%, 62.6% and 80.2% of pregnant women in Medani, New Halfa, and Gadarif Hospitals, respectively. In Gadarif, 57.3% of pregnant women had a folate deficiency, while 1% had a vitamin B12, deficiency. In Medani, zinc and copper deficiencies were detected in 45.0% and 4% of pregnant women, respectively. Anaemia was a risk factor for low birth weight in Al-Fashir, for fetal anaemia in New Halfa, and for stillbirth in Kassala Hospital. More care should be taken to ensure proper nutrition and malaria prevention such as bed nets and intermittent preventive treatments to avoid these diseases and their effects on maternal and perinatal outcomes.

Seroprevalence of Cytomegalovirus among blood donors and antenatal women attending two hospitals in Khartoum State

Back ground: Cytomeglovirus(CMV) is a common viral infection globally. Although most infections are subclinical; infection during pregnancy may be associated with serious outcome such as abortion, stillbirth and congenitally malformed child. Methods and results: During the period from June to July2003, 250 subjects (150 blood donors and 100 women presenting to Khartoum Teaching Hospital's and Omdurman Maternity Hospital respectively)had their blood tested for IgG antibodies against Cytomegalovirus using ELISA test. Of these 84% were found to harbor Cytomegalovirus antibodies. The seroprevalence of the virus was higher in the antenatal women (95%) compared to the blood donors (77%). Conclusion: The study revealed insignificant association between infection with the virus and both history of previous surgical operation and blood transfusion (p> 0.05).CMV infection was found to be associated with increased risk of abortion in women under study.Keywords: herpesviruses, abortion, blood transfusion.

Malaria and stillbirth in Omdurman Maternity Hospital, Sudan

Objective The study was conducted in the labor ward of Omdurman Maternity Hospital, Sudan, from November 2007 to February 2008 to investigate the prevalence and risks factors for stillbirth. Methods A case-control study. Cases were women who delivered stillbirths; 2 consecutive women who delivered a live-born singleton neonate at term (37–42 weeks) per case were used as controls. Sociodemographic, clinical (including malaria infections), and obstetric histories were gathered using standard questionnaires. Maternal body mass index and hemoglobin levels were measured. Maternal, placental, and cord blood smears were investigated for malaria parasites. Results Among 4760 singleton deliveries, there were 103 stillbirths, yielding a stillbirth rate of 22 per 1000 deliveries. Over half (52.4%) of these stillbirths were macerated stillbirths. Maternal sociodemographic characteristics were not associated with stillbirth, while a history of maternal malaria in the index pregnancy was the main risk factor for stillbirth (odds ratio, 3.0; 95% confidence interval, 1.0–8.9; P = 0.04). Conclusion Measures to prevent malaria infection should help to prevent stillbirth in this part of Sudan.

Epidemiology of preterm birth in Omdurman maternity hospital, Sudan

Objective. To investigate the prevalence and to identify risk factors for live singleton preterm birth in Omdurman Maternity hospital, Sudan.Methods. Case–control study. Odds ratios were adjusted for the confounding factors using multiple logistic regression models.Results. Among 3240 live birth at maternity hospital during the 3 months period of the study, 126 (3.8%) were a live preterm birth. About 99 live preterm births at a mean (SD) of 32.7 (2.2) gestational weeks were included in the final analyses. About 80 (81.0%) of these 99 preterm births were spontaneous preterm births and the rest 19 (19.0%) were medically indicated preterm births. Univariate and Multivariate analyses showed that those women who had history of miscarriage, preterm birth, cesarean delivery, dental maneuver, and vaginal bleeding in the index pregnancy, both low body mass index (BMI) (<25) and high BMI (>30) and those women who had short interpregancy interval were at higher risk for preterm birth.Conclusions. The study showed that spontaneous preterm birth predominates in this setting. Preterm birth has a tendency to recur. Infections (periodontal) and nutrition were the risk factors for preterm birth. More research is needed especially in the area of nutrition and oral hygiene.

O717 Establishment of a gynecological laparoscopy unit in Omdurman Maternity Hospital, Sudan – challenges and outcome

International Journal of Gynecology & ObstetricsVolume 107, Issue S2 p. S298-S299 Free communication (oral) presentations O717 Establishment of a gynecological laparoscopy unit in Omdurman Maternity Hospital, Sudan – challenges and outcome M. Omer, M. OmerSearch for more papers by this author M. Omer, M. OmerSearch for more papers by this author First published: 06 October 2011 https://doi.org/10.1016/S0020-7292(09)61090-0AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume107, IssueS2Abstracts of XIX FIGO World Congress of Gynecology and ObstetricsOctober 2009Pages S298-S299 RelatedInformation

Serum calcium level as a marker of pregnancy-induced hypertension

Background: Regulation of intracellular calcium plays a key role in hypertension. Hypertension has been estimated to complicate 5% of all pregnancies and 11% of first pregnancies. Half of the pregnant women with hypertension have pre-eclampsia. Hypertensive disorders account for up to 40 000 maternal deaths annually. Objective: To compare total serum calcium levels in pregnant women complicated with pre-eclampsia with those in normotensive control. Patients and Methods: This is a case-control hospital based study carried out at Omdurman Maternity Hospital, Khartoum Teaching Hospital, and Khartoum North Teaching Hospital in Khartoum State, Sudan in the period from October 2006 to June 2007. One hundred thirty-five women were enrolled in this study. 90 women with pregnancy - induced hypertension (PIH) admitted after 20th week of pregnancy represented the study group. Forty five women with normal pregnancy, at same age; same gestational age were selected as control group. Results: The mean (±SD) serum calcium of the study group was 8.38±1.04 mg/dl, while that of the control group was 9.04±1.13mg/dl (P= 0.001). Conclusion: Low level of maternal total calcium may have a role in the development PIH. Therefore calcium consumption in pregnancy should be encouraged. Calcium supplement is recommended for women who live in places of low socioeconomic status as well as for women who prefer to skip milk and milk products due to personal preference. Keywords: calcium, pre-eclampsia, calcium supplementation, pregnancy Sudan Journal of Medical Sciences Vol. 2 (4) 2007: pp. 245-248

Classification of perinatal death in a developing country

Objectives: To evaluate and compare the three most commonly used perinatal death classification systems: (1) the Nordic–Baltic; (2) the Aberdeen; and (3) the Wigglesworth, and assess their applicability in a developing country (Sudan) with a high perinatal mortality rate, and their justification for practical use in quality assurance and audit activities. Methods: At Omdurman Maternity Hospital (OMH), Khartoum, Sudan, 166 perinatal deaths were prospectively assessed during a 3-month period (May–August 2000) with a total of 2260 births. Narratives of 166 perinatal deaths were prepared for the purpose of audit. A panel of two Danish and one Sudanese obstetrician categorized the cases according to: (1) the Nordic–Baltic; (2) the Aberdeen; and (3) the Wigglesworth classification. Results: By all three classifications a similar fraction of cases (approx. 85%) were allocated to one category only, and in 15% of cases the assessors were in doubt into which of two categories the cases should be allocated. The necessary information is often not available, giving at least 40% classified as ‘unknown’ in the Aberdeen classification, whereas the Wigglesworth classification results in an even larger group of unspecified asphyxia. Conclusion: Classification of perinatal deaths in developing countries is associated with problems regarding application, validity and usefulness. The Nordic–Baltic classification seems to be most suitable for appropriate stratification using routinely recorded variables and providing categories associated with specific levels of care.

Introducing qualitative perinatal audit in a tertiary hospital in Sudan

In a 3-month period, May to August 2000, the perinatal mortality rate at Omdurman Maternity Hospital (OMH), Sudan, was 8.2%. Two groups of perinatal deaths, intrapartum deaths of non-malformed infants and neonatal deaths of mature infants above 34 weeks, both considered to be potentially avoidable by improved care, were in excess when compared with other regions. It was therefore decided to perform in-depth assessment of cases in these two groups. An interdisciplinary internal audit was designed in collaboration with two external obstetricians. The audit activity was preceded by a 2-day workshop at the hospital. Individual assessments based on 43 detailed narratives were followed by regular consensus meetings. This structure seemed useful for interdisciplinary discussions, and the audit process resulted in several specific suggestions for quality improvement in data collection, interdisciplinary collaboration, and obstetric and neonatal care. The present audit activity is not very resource demanding and therefore a good starting point for quality assurance in a developing country. However, since adverse outcome audit only focuses on selected cases and may encourage interventions without considering the full impact on the population, it should not stand alone. Audit of perinatal deaths should be combined with other quantitative and qualitative quality assessment activities for improvement of perinatal care.

Antenatal blood group serology in Sudanese women.

2,140 pregnant Sudanese women attending the antenatal clinic in Omdurman Maternity Hospital during the period November 1975 to December 1976 had ABO and Rh typing performed. Their sera were also screened by a modified papain enzyme technique for the presence of atypical antibodies. The rate of Rhesus immunization, the frequency distribution of blood groups, the atypical antibodies encountered, and the advantages of the method used for screening the sera in a developing country are discussed.