Browsing by Author "Nuamah, H.G."

Now showing 1 - 5 of 5

Assessing Preterm Birth with Gross Examination of the Placenta of Patients Attending Korle Bu Teaching Hospital
(University of Ghana, 2019-07) Nuamah, H.G.
Background: Preterm births are the single greatest direct cause of neonatal deaths, responsible for 35% of the world's 3.1 million deaths a year. Preterm deliveries in Ghana is unacceptably higher than that of global estimates. An understanding of the placental morphological characteristics is essential for advancing our knowledge of the cause and mechanisms through which placental characteristics influence preterm births as well as identifying pregnancies at risk of these adverse perinatal outcomes. General Objective: The objective of this study was to assess preterm births with gross examination of the postpartum placenta of pregnant women who deliver preterm at Korle Bu Teaching Hospital. Methods: This was a cross sectional study which involved the consecutive sampling of pregnant women with preterm labor attending Korle Bu Teaching Hospital. After obtaining the patient’s consent, demographic characteristics were collected from the patient’s folder. Once the baby was delivered and the placenta was removed from the womb, various morphological characteristics of the placenta and its associated structure were recorded. Information on the pregnancy (preterm or term deliveries) was also recorded. The associations between dependent variable and each selected independent variable were analyzed using a multiple logistic regression. Results: The prevalence of preterm deliveries among the study population during June 2019 was 12.6% (99 of the 785 singleton deliveries). The results revealed that umbilical cord pseudoknots are strong predictors of preterm delivery. The odds of preterm birth are 2.17 times greater when a pseudoknot is present on the umbilical cord as compared to when it is absent [Adjusted Odds Ratio (AOR) = 3.17 (95% CI = 1.19 – 8.48), p=0.02]. Conclusion: Proportion of preterm deliveries in the study population is high. Umbilical cord pseudoknots are strong predictors of preterm deliveries. Early detection of umbilical cord pseudoknots through ultrasonography and close monitoring may assist in management. Keywords: Preterm, Placenta morphology, Pseudoknots, Determinants, Gross Examination
Clinical presentation and persistent symptoms in patients at a post-COVID-19 clinic in Ghana
(African Field Epidemiology Network, 2023) Nuamah, H.G.; Oduro-Mensah, E.; Oliver-Commey, J.
Introduction: on March 11th, 2020, the World Health Organization recognized COVID-19 as a pandemic. By March 31st, 2021, the Ghana Health Service had recorded a cumulative 90,782 positive cases and 748 deaths in the country. Despite the significant resources and efforts being put into containing and treating individuals with COVID-19, there is a lack of information within sub-Saharan Africa on clinical presentations and factors associated with experiencing persistent symptoms of COVID-19. Methods: in this retrospective study, we collected data obtained from patients with COVID-19 who were discharged from the post COVID-19 clinic at the Ga East Municipal Hospital, Ghana, between April 1st, 2020, and March 31st, 2021, to assess clinical presentations and identify predictors of COVID-19 symptoms that persist beyond 14 days from the onset of the symptom.Results: of the 253 patients who experienced symptoms of COVID-19, 81 (32.0%) experienced symptoms that persisted beyond 14 days. Cough (64.0%), headache (38.7%), and chest pain (28.1%) were the most common symptoms. After adjusting for covariates, the odds of patients presenting with COVID-19 symptoms that persist beyond 14 days are 98% higher among patients who experienced chest pain compared to those who did not and 2% increased for each additional year of their age. Conclusion: patient´s age and experiencing chest pain were significant predictors of symptoms that persist beyond 14 days. The findings of our study highlight the need to continue to monitor and care for individuals with identified predictors of experiencing persistent symptoms of COVID-19.
Factors Associated with Ruptured Ectopic Pregnancy: A 10-Year Review at a District Hospital in Ghana
(Hindawi, 2022) Sefogah, P.E.; Oduro, N.E.; Swarray-Deen, A.; Nuamah, H.G.; Takyi, R.B.; Nuamah, M.A.; Oppong, S.A.
Background. Approximately 1–2% of all pregnancies are ectopic. Despite a decline in ectopic pregnancy-related mortality, there is still a paucity of information on the factors associated with clinical presentation and outcomes in Sub-Saharan Africa which is essential in determining the most appropriate treatment modalities. Methods. We performed a ten-year retrospective chart review of cases of ectopic pregnancies managed at the Lekma hospital and assessed them for peculiar risk factors, clinical presentation, and outcomes. Associations between patients’ sociodemographic characteristics, clinical presentation, and treatment outcome were evaluated using multiple logistic regression and reported as adjusted odds ratios (AOR). ,e confidence interval (CI) was set at 95%, and a p value <0.05 were considered significant. Results. Over the ten-year period, there were 115 ectopic pregnancies and 14,450 deliveries (7.9/1,000).,e mean age ± standard deviation of the 115 patients was 27.61 ± 5.56. More than half of the patients were single (59/115, 51.3%). ,e majority (71.3%) of the patients presented with a ruptured ectopic pregnancy. After adjusting for covariates, the odds of an ectopic pregnancy presenting as ruptured among single patients was 2.63 times higher than that of married patients (AOR =3.63, 95% CI: 1.33–9.93, p = 0.01). Ectopic pregnancies located in the isthmic region of the tube had a 77% lower odds of presenting as ruptured than those located in the ampullary region (AOR = 0.23, 95% CI: 0.07–0.74, p = 0.01). ,e odds of rupturing were 1.69 times increased for every additional week after the missed period (AOR = 2.69, 95% CI: 1.56–4.64, p < 0.01). No mortalities were reported as a result of an ectopic pregnancy. Conclusion. Most of the cases of ectopic pregnancy presented ruptured. Marital status and period of amenorrhoea were significantly associated with rupture.
The Impact of Plasmodium Infection on Placental Histomorphology: A Stereological Preliminary Study
(Infectious Diseases in Obstetrics and Gynecology, 2019-03) Ahenkorah, J.; Tetteh-Quarcoo, P.B.; Nuamah, M.A.; Kwansa-Bentum, B.; Nuamah, H.G.; Hottor, B.; Korankye, E.; Torto, M.; Ntumy, M.; Addai, F.K.
Background: Malaria during pregnancy may threaten the mother's health and cause serious structural damage to the internal architecture of the placenta, which subsequently affects the pregnancy outcome. A better understanding of the impact of malaria parasites on the placenta morphology is crucial for better management of pregnant women and their babies. Aim: To assess by stereology the histomorphology of selected placental structures in placenta malaria compared with normal placentae at term. Method: A total of 10 placentae comprising 5 controls and 5 cases were selected from 50 placentae that were collected at term (38 weeks ± 2 weeks) from the maternal delivery suit of Korle-Bu Teaching Hospital in Accra, Ghana. Blood from the placentae was collected for both rapid diagnostic test and microscopic examinations. Samples collected were examined for Plasmodium parasites, after which they were classified as study group (Plasmodium positive) or control (Plasmodium negative). Stereological quantification using systematic uniform random sampling technique with test point and intersection counting of photomicrographs were employed to estimate the mean volume densities of syncytial knots, syncytial necrosis, foetal capillaries, and intervillous spaces of the placentae on a total of 1,600 photomicrographs. Results: Out of the fifty placental samples from the maternal side tested for Plasmodium, six representing 12% were found to be infected with the parasite by both rapid diagnostic test and microscopy. On stereological assessment, the mean volume density of syncytial knots was significantly higher in the placental malaria group compared with the control placentae at term (P = 0.0080), but foetal capillaries (P = 0.7813), intervillous spaces (P = 0.8078), and syncytial necrosis (P = 0.8249) were not significantly different. Conclusion: This preliminary result indicates that placental malaria may cause significant increase in the syncytial knots but not foetal capillaries, intervillous spaces, or syncytial necrosis. This finding signifies early maturation of the placenta and may be crucial in understanding perinatal outcomes.
Perinatal autopsy in Ghana: Healthcare workers knowledge and attitude
(Frontiers in Global Women’s Health, 2023) Swarray-Deen, A.; Attah, D.A.; Sefogah, P.E.; Oduro, N.E.; Nuamah, H.G.; Nuamah, M.A.; Adzadi, C.; Oppong, S.A.
Background: Perinatal mortality refers to stillbirths and early neonatal deaths. Stillbirth, the death of a foetus from 28 weeks or with a birth weight 1,000 g or above, and early neonatal deaths, the death of a newborn within 24 h of delivery, are among the most distressing global health problems, with approximately 2 million stillbirths occurring annually. Although a post-mortem examination of the stillborn baby is essential for understanding and learning the cause of stillbirth, many couples decline the procedure. Sub-Saharan Africa has one of the highest stillbirth rates in the world, yet there is a dearth of studies on post-mortem uptake from the region. Aim: To explore healthcare professionals’ views and perceptions of perinatal autopsy in Ghana. Methods: Mixed-method approach consisted of semi-structured interviews and an electronic cross-sectional survey to evaluate the views and perceptions of healthcare professionals at Korle-Bu Teaching Hospital on autopsy for stillbirths and early neonatal deaths. Descriptive quantitative data were summarised in frequencies and percentages, and statistical results and descriptions were tabulated and coded in terms of types of barriers. For the qualitative aspect, the audio-taped interviews were transcribed, themes generated, and direct quotes and descriptions were coded for all knowledge, beliefs, attitudes and practices concerning the barriers and facilitators for post-mortem. Results: Ninety-nine healthcare professionals participated. No participant had formal training regarding counselling for perinatal autopsy and 40% had “no idea” who is responsible for counselling and obtaining consent for a perinatal autopsy. Forty-four percent (44%) of the participants knew of only the “Conventional/ Full” autopsy and <4% were aware of less invasive methods of performing an autopsy. Qualitative data showed healthcare worker influence, religious and financial considerations impede the implementation of perinatal autopsies. Despite the low uptake of perinatal autopsies, interviews from healthcare workers suggest acceptance rates would improve if parents knew about different options, especially less invasive procedures. Conclusion: At Ghana’s largest referral centre, perinatal autopsy counselling and uptake are at extremely low levels. Most healthcare professionals have little knowledge, skills, and capacity to advise parents regarding perinatal autopsies. Training is needed to update the workforce on recommended perinatal autopsy practices.