Browsing by Author "Sefogah, P.E."

Now showing 1 - 5 of 5

Challenges In The Diagnosis And Management Of A Ruptured Heterotopic Gestation Following Ultrasound-Guided Embryo Transfer In Low Resource Settings: A Case Report
(Journal of Medical Case Reports, 2024) Oyeh, E.; Ofori, S.; Sefogah, P.E.; Hiadzi, E.K.
Background Heterotopic pregnancies are increasing in incidence with the rising prevalence of in vitro fertilization and embryo transfer (IVF-ET) globally. Although rare, this condition is serious and potentially life-threatening gynaecological complication. Case presentation We present the case of a 36-year-old Ghanaian woman who conceived following IVF and presented two weeks after confrmation of intrauterine gestation with sudden-onset lower abdominal pain. A diagnosis of ruptured heterotopic pregnancy was made, laparotomy and salpingectomy were done, followed by further management of the intrauterine gestation. Conclusion To the best of our knowledge, this is the first reported case of heterotopic pregnancy in Ghana. A high index of suspicion for heterotopic pregnancy is required even in the presence of a confirmed intrauterine gestation following IVF-ET.
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.
Modern contraceptive use among women living with HIV/AIDS at the Korle Bu Teaching Hospital in Ghana
(International Journal of Gynecology and Obstetrics, 2018-01) Samba, A.; Mumuni, K.; Adu, J.A.; Sefogah, P.E.; Kudzi, W.; Nartey, E.T.
OBJECTIVE: To examine factors influencing contraceptive use among women living with HIV/AIDS. METHODS: The present cross-sectional study included a randomly selected sample of sexually active females aged 15-60 years who were living with HIV/AIDS and receiving care at the HIV Clinic, Korle Bu Teaching Hospital, Accra, Ghana, between September 1 and November 31, 2016. Data were collected via a structured interviewer-administered questionnaire. RESULTS: Among 202 women who completed the survey, 50 (24.7%) were using contraceptives. Of the women using contraception, 39 (78%) were married and 6 (12%) were cohabiting. Twenty-eight (56%) reported that their primary sexual partners were HIV-positive, 14 (28%) had HIV-negative partners, and 8 (16%) did not know their partner's HIV status. Condoms were used by 42 (84%) women and the majority (41 [82%]) wanted to have more children; almost all (47 [94%]) had received counseling on contraceptive use. Overall, 133 (65.8%) and 45 (22.3%) women reported that they would prefer to share their family planning concerns with a doctor and nurse, respectively, at the HIV clinic. CONCLUSION: Women living with HIV/AIDS desired more children but preferred to share their family planning concerns with their clinician at the HIV clinic. Integrating HIV care and reproductive health services could help these women achieve childbearing goals safely. © 2018 International Federation of Gynecology and Obstetrics.
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.
Surgical site infections following caesarean sections in the largest teaching hospital in Ghana
(Infection Prevention in Practice, 2022) Onuzo, C.N.; Sefogah, P.E.; Nuamah, M.A.; Ntumy, M.; Osei, M-M.; Nkyekyer, K.
Background: Surgical site infections complicate up to 15% of all surgical procedures depending on surgery type and underlying patient status. They constitute 14e31% of all hospital-acquired infections, placing huge financial burdens on patients, healthcare institutions and the nation. Objective: To determine the incidence, risk factors, microbiological aetiology and antibiotic susceptibility patterns of surgical-site infections following caesarean sections (CSs) at Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Methods: This prospective study involved 500 women who underwent CS from April to July 2017 at KBTH. Overall, 474 women completed the study with 26 women lost to follow-up or opting out of the study. Women were recruited on the first postoperative day and followed-up postnatally. Sociodemographic and obstetric data were obtained using a structured questionnaire. Swabs of infected surgical wounds were taken for culture and sensitivity testing using the KirbyeBauer disk diffusion technique. Data was analysed using SPSS version 22. Results: Sixty-one (61/474) women (12.8%) had SSIs after CS. Of these, 41 (67.2%) were superficial, 18 (29.5%) were deep incisional and 2 (3.3%) were organ space SSIs. Significant risk factors for SSI were: emergency CS after 8 h of active labour, midline incisions, use of stored water for surgeon’s pre-operative scrubbing, maternal status being single and alcohol consumption during pregnancy. Staphylococcus aureus was the commonest pathogen isolated with 6 (9.8%) being meticillin resistant (MRSA). Antibiotic susceptibility was mostly to quinolones. Conclusion: SSI occurred in 12.8% of CS wounds at the KBTH, commonly caused by S. aureus