A Specialised Obstetrician and Gynaecologist, Dr Abosede Lewu, says some women with fibroids can experience painful sex, painful mensuration and other devastating symptoms.
Lewu, Team Lead at Girlsaide Initiative and Convener, Keep All Mothers Alive (KAMA) Project, told the News Agency of Nigeria on Friday that symptoms of fibroids could be huge, stressful and sometimes devastating.
She described fibroids as abnormal growths of the muscles of the womb of which the exact cause is unknown.
According to her, fibroids are not cancers; they are common in 50 to 70 per cent of women and less than half of women with fibroids have symptoms.
“These women experience heavy menses; some use adult diapers, some sit on bowls, just to bleed into it; some need to be transfused with blood after each period, painful menses so severe some can’t move or work
“They also experience tummy and back pains, painful sex, in some, sex is impossible, frequent urination, constipation, and big tummy that may look like pregnancy.
“Fibroids can contribute to infertility in some women and depending on
location of fibroids; it can also affect kidneys, disturbs pregnancy with risk of miscarriage or premature delivery of babies.
“It can cause repeated hospital admissions from degeneration of the fibroid in pregnancy.
“This can be painful too. Abnormal position of baby necessitating CS and risk of bleeding after delivery,” she said.
Lewu said that treatment might be unnecessary, if a woman with fibroids did not have symptoms or it was not affecting her in any way.
She advised that such woman should do an annual pelvic ultrasound to monitor the fibroids.
The gynaecologist said there were newer and more advanced method of fibroid treatment.
Lewu said that women with fibroids should discuss with a specialist on the best line of management or treatment.
She said that treatment could depend on the size of the fibroid, severity of symptoms, age, desire to have babies and available specialist or expertise.
“The treatment can be medical, that is, non hormonal or hormonal and it can be surgical with minimally invasive or open surgeries.
“Medications treat the symptoms and shrink fibroids, but it may grow back.
“It can also reduce bleeding, reduce pain, reduce size before surgery, stop the process of menstruation or build back blood level.
“Some have to do surgeries such as
Myomectomy, which is the removal of fibroids or Hysterectomy which is removal of the womb, to get better. These treatments are to alleviate symptoms and not a cure for fibroids.
“It is advisable to receive care from a gynaecologist than fall victim to scammers, who dupe women, promising them the impossible treatments,” Lewu said.
Edited By: Edith Bolokor/Olagoke Olatoye (NAN)
COVID-19: Group donates PPEs for management of pregnant women in public hospitals
GirlsÀide Initiative, a community-based organisation, on Tuesday, donated Personal Protective Equipment (PPEs)
The initiative, in collaboration with Aspire Coronation Trust (ACT) Foundation, Novartis and World Connect, provided gloves, sanitizers, face masks,
It also donated Maternal Essential Packs, which addresses four causes of maternal death and provides Personal Protective Equipment (PPE) to be
used by the pregnant woman and her care provider.
Dr Abosede Lewu, Team Lead of the initiative, presented the items to the Chief Medical Director of the Lagos Island Maternity Hospital, Dr Femi Omololu.
Lewu said that the initiative targeted pregnant women “because they are vulnerable at this critical period.”
She said that the pandemic was affecting pregnant women in the country as they were experiencing difficulties accessing maternity services at the hospitals.
She added that “the focus is majorly on COVID-19 patients and those with symptoms. Our pregnant women should not be neglected during this period and
maternal mortality is already high
that have risen.
“As community spread becomes rampant, everyone is at risk, especially the healthcare providers – doctors, midwives, nurses to pregnant women.
“Therefore, we designed Keep All Mothers Alive (KAMA) project for pregnant women and healthcare workers attending to them.”
She said there was another intervention where pregnant women were linked to antenatal services through telehealth and any other virtual channel accessible to the women.
“The Initiative is also donating PPE to healthcare workers in Iga Iduganran Health Care Centre, Lagos, Bola Tinubu Primary Healthcare Centre in Alimosho, Ita Elewa Primary Healthcare Centre
in Ikorodu and 10 health institutions across the country.
“It will help to flatten the curve of COVID-19 and protect our frontline health workers as they attend to citizens, especially pregnant women.
“The driving force of GirlsAide Initiative is to ensure that the gains they have made on maternal health before the pandemic will not be lost to COVID-19.”
Dr Femi Omololu, the Chief Medical Director of Lagos Island Maternity Hospital, who received the items, thanked the initiative for reaching out to
healthcare workers and pregnant women during the pandemic.
“We appreciate your support to the hospital’s COVID-19 efforts and we promise that more attention will be given to maternity care,” he said.
Edited By: Vivian Ihechu/Hadiza Mohammed-Aliyu (NAN)
Giving hope to pregnant COVID-19 patients: LUTH in giant strides
Giving hope to pregnant COVID-19 patients: LUTH in giant strides
Although, the World Health Organisation (WHO) maintains that, at present, there is no evidence that pregnant women are at higher risk of severe illness than the general population, pregnant women in Nigeria are bothered about bringing life during a pandemic, considering the associated risks, strained healthcare and fear of infection.
Before the outbreak of COVID-19, high-quality and timely maternal healthcare services were deficient, inaccessible or unaffordable for thousands of women in Nigeria, a factor that contributes to maternal mortality in the country.
To exacerbate trepidation, reports of pregnant COVID-19 patients who died in Ekiti, Jigawa and Ogun states went viral on social media and the mainstream media.
“We have made steady progress in reducing preventable child and maternal deaths in Nigeria over the last 20 years.
“It would be devastating – if that progress is lost or reversed – for Nigerian families, communities and the country as a whole,” Peter Hawkins, UNICEF Country Representative in Nigeria, says.
Nigeria’s maternal mortality ratio of 512 per 100,000 live births, as contained in the National Demographic and Health Survey 2018 Report, shows no major reduction from the 545 per 100,000 live births in the NDHS 2013 Report.
With this, it becomes important to provide lifesaving support to pregnant women, especially COVID-19 positive ones.
Among those who have taken up the challenge of giving hope to pregnant women, who tested positive for COVID-19, is a multidisciplinary team of obstetricians, anaesthetists, neonatologists, nurses, psychiatrists and infectious disease control experts at the Lagos University Teaching Hospital (LUTH), Idi-Araba.
The team of specialists has delivered five COVID-19 pregnant women of babies, including a set of twins.
Prof. Chinyere Ezeaka of the Neonatology Unit, Department of Paediatrics, College of Medicine, University of Lagos, believes that COVID-19 infection is not a death sentence even for pregnant women.
Ezeaka, a member of the team of LUTH specialists, however, regrets that many pregnant women, because of fear of stigmatisation, are avoiding antenatal care and child delivery in hospitals.
“I am using this opportunity to appeal to pregnant women to stop devising various means of avoiding hospitals.
“They should attend antenatal clinics and come to hospital to deliver babies with the help of skilled birth attendants,” Ezeaka urges.
Affirming that being pregnant and positive for COVID-19 is not the end of the world, or a reason to despair, she notes that medical practitioners have successfully delivered pregnant COVID-19 patients of their babies.
Highlighting measures that will assist Nigeria to achieve safe delivery for pregnant COVID-19 patients, Ezeaka advises that every state should have a designated centre for treating and delivering pregnant COVID-19 patients.
“COVID-19 will be a threat for a while. I would advise proper planning, coordination and communication at the national, state and local levels to ensure effective response.
“There must be the full protocol for antenatal, pre-delivery care; centres for birth should be well equipped with full monitoring, theatre and diagnostic equipment for mothers and babies.
“There should be plans for where the stable babies with symptomatic mothers will be, and also plans for babies that might test positive; designated and isolated areas should be created,” she urges.
On whether all pregnant COVID-19 patients should be restricted to Caesarean Section (CS) for delivery, Makwe says the delivery option should be individualised.
“One of the patients had done two Caesarean Sections; automatically she doesn’t qualify for vaginal delivery. Another patient had done a fibroid surgery.
“For the multiple birth, the first baby was breech, and was blocking the birth canal, definitely such a delivery has to be CS,” he says.
According to the obstetrician, one of the patients requested for CS, saying she didn’t want to go through the stress of vaginal delivery.
“For the fifth patient, her symptoms were worsening and we felt it might compromise the baby’s status; we had to conduct the delivery preterm – 37th week – to save her and the baby.”
Makwe says vaginal delivery will be done for COVID-19 patients who request for it, and whose medical conditions are deemed clinically satisfactory.
“All the babies delivered tested negative and their clinical status stable,” Makwe adds.
According to him, LUTH Obstetrics and Gynaecology Department is committed to eliminating maternal morbidity and mortality.
He, however, says, that the department needs better facilities to function more effectively.
He urges governments to invest more in maternal and child care, noting that maternal health, neonatal morbidity and mortality are indices used to measure a country’s health status.
“The healthcare team is willing and has demonstrated the capacity; we just need the support.
According to one of the five pregnant COVID-19 positive women, each patient’s experience differs.
“I was not sick throughout and I tested negative to the virus in less than two weeks. The medical personnel were very kind, understanding and supportive.
“However, facilities in the hospital are very poor. Imagine being in a room without air conditioners, and the doctors performing surgery dripping with sweat in their PPE.
“It is not a good experience, the hospital management and government should improve facilities in LUTH,” she urges.
The survivor also calls for improvement in the way patients’ COVID-19 status is being relayed to them.
According to her, she was traumatised at the news until medical personnel at an isolation centre counselled and encouraged her.
Dr Olutola Olatosi, Consultant Anaesthetist, is, however, confident that the medical team establishes rapport with patients and allays their fears.
He adds that patients are monitored through telemedicine to provide psychosocial support and ensure their wellbeing.
On the anaesthetic techniques deployed for surgery for pregnant COVID-19 patients, Olatosi reveals that regional -based techniques are used.
According to him, the techniques have better post operation outcomes and rapid recovery among patients.
He calls for an urgent increase in the number of anaesthetists in the country,
as a strategy to reduce maternal mortality.
He notes that there are about 200 specialist anaesthetists serving Nigeria and about 600 undergoing training.
“It is important that we grow the number if we are to reduce the rate of maternal mortality, because most patients with complications will require surgical interventions and safe anaesthesia.
“We have to address that with emphasis on manpower development because some patients will present with COVID-19 and other co-existing medical problems.
“It is an existential challenge for us to provide critical care,” he adds.
He appeals to the Federal Government to support LUTH with more critical care equipment options that will enable it to function efficiently toward saving more lives.
Adeyemo emphasises that oxygen saves lives, adding that its provision is a critical component for emergency respiratory resuscitation globally.
Mr Rotimi Dada, Head of Theatre Nurses, is of the opinion that implementation of Infection Prevention and Control (IPC) and other safety measures for healthcare workers and patients is of great importance to the team.
Dada urges that the hospital’s IPC Committee should map out the dedicated theatre and delivery area, and decide on work flows for a unidirectional area.
Corroborating, Makwe says proper training of every member of the team on IPC, wearing and removal of PPE, and emphasis on hygiene are done constantly to reduce exposure of health workers and patients to infections.
“We have a dedicated operating space and we streamline the number of operational staffs in the operating room to reduce the number of people that might be exposed to infection.
“We place a priority on IPC because it is key. We know that if we have a member of the team infected, it will demoralise other members and affect our capacity to function effectively,” he argues.
On the role of the pharmacy department in supporting delivery of pregnant COVID-19 patients, Mrs Olabisi Opanuga,
Head of Pharmacy Department, LUTH, says the department must always be on ground to ensure the medical team gets all the required supplies for a successful operation.
“We give the patients medications depending on their comorbidities.”
She notes that PPEs are scarce and expensive.
“The procedure itself for normal Cesarean Section is N65,000, but the PPE to be worn by health workers is over N300, 000,” she says.
Opanuga appeals to the Federal Government to intervene through adequate funding.
“Local production of PPE should be explored and encouraged, with the government providing financial support.
“Nigerians are ingenious, we should be able to produce standard PPE which will help to reduce cost,” she urges.
Dr Tunji Akintade, Chairman, Association of General and Private Medical Practitioners of Nigeria, is optimistic that concerted efforts will save more pregnant COVID-19 patients and their babies.
Akintade advises that advocacy and awareness should be sustained to enlighten pregnant women and the general public on the preventive measures against the virus pending discovery of a vaccine.
Analysts hail Nigeria’s giant steps in the fight against COVID-19 particularly in giving hope to pregnant patients.
They urge more support for health workers and institutions to achieve a stronger response. (END)
**If used, please credit the writer and the agency***
Undetected diabetes can cause delay in pregnancy, says Gynaecologist
An Obstetrician and Gynaecologist, Dr Abosede Lewu, on Sunday called for preconception care to prevent and manage diabetes which could lead to reproductive challenges, delay in getting pregnant and abnormalities in babies.
Lewu, Team lead at Girlsaide Initiative and Convener, Keep All Mothers Alive (KAMA) Project, made the call in an interview with the News Agency of Nigeria to commemorate, “Diabetes Awareness Week 2020”.
NAN reports that Diabetes Awareness Week is marked from June 8 to June 14 every year to raise awareness about the disease.
According to Lewu, Diabetes is associated with many reproductive challenges, but with prevention, early detection and interventions, the outcome improves.
“Women that have poorly controlled diabetes may experience delay in getting pregnant.
“This is because hyperglycaemia, excess level of sugar in the blood can prevent fertilisation and implantation process needed to get pregnant.
“This hyperglycaemia causes oxidative stress, damage to and premature death of cells leading to congenital abnormalities in babies and miscarriages.
“The excess level of insulin also leads to accelerated growth causing big or macrosomic babies and delayed lung maturation of babies.
“It can cause late stillbirths as well as injury to mother and baby at delivery.
“After birth, the babies can experience asphyxia, low sugar, low micronutrients and are at risk of heart diseases.
“Through a process called foetal programming, the child is now at risk of obesity and developing diabetes in future,” she said.
Lewu said that preconception care should be a must as it could prevent, identify and treat medical conditions like diabetes mellitus before pregnancy, thereby improving the reproductive outcomes.
According to her, Diabetes is preventable and the first step to preventing type 2 Diabetes is knowing your risk level.
“Women should endeavour to go for blood sugar test and consult your healthcare practitioner to know your numbers.
“What is your Body Mass Index (BMI)? Are you overweight or obese? Does any of your parents or siblings have diabetes?, ” she said.
Edited By: Bola Akingbehin/Olagoke Olatoye (NAN)
Kaduna :Women groups stage stand-still-peaceful rally against rape
Some women groups in Kaduna on Thursday staged stand still peaceful rally to end rape in the country.
The rally was organised by the International Federation of Women Lawyers (FIDA) in collaboration Jammiyyar Matan Arewa and other women organisations in the state.
Mrs Zainab Atoba, President, Federation of women Lawyers (FIDA), Kaduna branch said the rally was aimed at saying “enough is enough of all forms of girl-child abuses and abuses of other children that are facing rape cases on daily basis across the country”.
Atoba said that the rate of violence against women and children in the society was getting out of hand, hence the need to quickly address it to save lives of women and children in communities.
She said that the rally was to raise more awareness on the dangers of rape in the society that is affecting lives of innocent children and women, including elderly women and widows.
She pointed out that most of the rape victims faced psychological trauma and other health challenges.
According to her, the gathering was to say No to rape in the society, as almost every minute, there is report of rape of a child in the country.
“This is not really good for women and children in the country, ” she said.
The president said the women were calling on Government to consider castrating rapists or sentence them to death as deterrent.
She called on religious leaders, traditional title holders and other stakeholders to support the battle against rape and other abuses against children.
Similarly, the National President of Jamiyyar Matan Arewa, Rabi Saulawa emphasised the need to educate parents and guardians to always monitor the movement of their children.
Saulawa noted that there was need to engage traditional rulers and clerics in sensitizing the public on the dangers of rape in the society.
Also in her remark, the National President of Interfaith Dialogue, Kaduna Women Wing, Hajiya Aisha Kazaure, expressed worries over increased abuse of children and women in the society due to lack of commitment in punishing offenders.
Kazaure called for the review of Nigeria’s laws dealing with issues of child abuses and rape in the society.
She applauded the organisers of the peaceful rally saying, it should be a continuous process.
Meanwhile, Hajiya Ramatu Tijjani, an interfaith specialist, has called on Civil Society Organisations to embark on advocacy visit to necessary stakeholders in the state to push for review of laws on rape and sexual abuse
She urged women across the country to join the campaign against all forms of child abuses and domestic violence in their communities.
Tijjani who spoke in an interview with newsmen, stressed the need to co-opt all necessary stakeholders such as UNICEF, WHO, federal and state ministry’s of women affairs, security forces and para-military in the fight.
She said daily report of violence which included sexual assault, battery, rape, defilement, trafficking, forced marriage, abuse and host of other vices against women and children must be tamed.
“There is need for Government to start castrating rapists so as to make life better for children in both rural and urban centers,” she said.(NAN)
Edited By: Emmanuel Nwoye/Maharazu Ahmed (NAN)