Obstetric analgesia for vaginal birth in contemporary obstetrics: a survey of the practice of obstetricians in Nigeria

BMC Pregnancy and Childbirth

Nduka N Ekem¹  Chukwuemeka A Iyoke³  Okechukwu B Anozie¹  Justus N Eze¹  Lucky O Lawani² 

[1] Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Abalkaliki, Ebonyi State, Nigeria;School of Post Graduate Studies, Department of Community Medicine, University of Nigeria, Enugu, Enugu State, Nigeria;Department of Obstetrics & Gynecology, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria

关键词: Pain;    Contemporary;    Practice;    Obstetrics;    Analgesia;   

Others  :  1127417
DOI  :  10.1186/1471-2393-14-140

 received in 2013-06-17, accepted in 2014-04-09,  发布年份 2014

【 摘 要 】

Background

Contemporary obstetrics in sub-Saharan Africa is yet to meet the analgesic needs of most women during child birth for a satisfactory birth experience and expectedly, obstetricians have a major role to play in achieving this.

Methods

This was a questionnaire-based, cross-sectional study of 151 obstetricians and gynecologists that attended the 46th Annual General Meeting and Scientific Conference of the Society of Gynaecology and Obstetrics of Nigeria (SOGON) held in Abakaliki, southeast Nigeria in November, 2012. SOGON is the umbrella body that oversees the obstetric and gynecological practice in Nigeria. Data was collated and analyzed with Epi-info statistical software, and conclusions were drawn by means of simple percentages and inferential statistics using Odds Ratio, with P-value < 0.05 at 95% Confidence Interval (CI) taken to be statistically significant.

Results

Of the 151 participants, males predominated; 110 (72.9%) practiced in government-owned tertiary hospitals in urban locations. Only 74 (49%) offered obstetric analgesia. Among users, only 20 (13.3%) offered obstetric analgesia routinely to parturients, 44 (29.1%) sometimes and 10 (6.6%) on patients’ requests. The commonest analgesia was opioids (41.1%). Among non-users, the commonest reasons adduced were fear of respiratory distress (31.1%), cost (24.7%) and late presentation in labour (15.6%).

Conclusion

The routine prescription and utilization of obstetric analgesia by obstetricians in Nigeria is still low. Obstetricians are encouraged to step up its use to make childbirth a more fulfilling experience for parturients.

【 授权许可】

   
2014 Lawani et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Takrouri MSM: Basis of obstetric analgesia and anesthesia during child birth. The internet Journal of Health 2009, 9:2.
• [2]Lally JE, Murtagh MJ, Macphail S, Thomson R: More in hope than expectation: a systematic review of women’s expectations and experience of pain relief in labor. BMC Med 2008, 6:7. BioMed Central Full Text
• [3]Cynthia AW: Advances in labor analgesia. Int J Womens Health 2009, 1:139-154.
• [4]ACOG Committee Opinion #295: pain relief during labor Obstet Gynecol 2004, 104:213.
• [5]Nice clinical Guideline 55. : Intrapartum care. Care of healthy women and their babies during child birth (Coping with pain in labor: non-epidural and pain relief in labor: regional analgesia): Guidance 1.4-1.5; 2009. http://publications.nice.org.uk/intrapartum-care-cg55/guidance webcite
• [6]Lliyasu Z, Galadanci HS, Abubakar IS, Isah H, Aliyu MH: Desire for obstetric analgesia among women in Northern Nigeria. Trop J Obstet Gynaecol 2012, 29(2):53-61. ISSN:0189–5178 http://www.ajol.info/index.php/tjog/article/view/8 webcite
• [7]Fyneface-Ogan S, Mato CN, Anya SE: Epidural Analgesia: Views and outcomes of women in labor in a Nigerian Hospital. Ann Afr Med 2009, 8(4):250-256.
• [8]Imarengiaye CO, Ande ABA: Demand and utilisation of labour analgesia service by Nigerian women. J Obstet Gynaecol 2006, 26(2):130-132.
• [9]Faponle AF, Kuti O: Perception of labor pain by pregnant women in Southwestern Nigeria. Trop J Obstet Gynaecol 2004, 21:153-155.
• [10]Olayemi O, Morhason-Bello IO, Adedokun BO, Ojengbede OA: The role of ethnicity on pain perception in labor among parturients at the University College Hospital Ibadan. J Obstet Gynaecol Res 2009, 35(2):277-281.
• [11]Weber SE: Cultural aspects of pain in childbearing women. J Obstet Gynecol Neonatal Nurs 1996, 25(1):67-72.
• [12]Ogboli-Nwasor E, Adaji S, Bature S, Shittu O: Pain relief in labor: a survey of awareness, attitude and practice of health care providers in Zaria, Nigeria. J pain Res 2011, 4:227-232.
• [13]Chigbu CO, Onyeka TC: Denial of pain relief during labor to parturients in Southeast Nigeria. Int J Gynecol Obstet 2011, 114(3):226-228.
• [14]William WK: Epidural analgesia in labor. Hong Kong Med J 2007, 13:208-215.
• [15]Ebirim LN, Buowari OY, Ghosh S: Physical and psychological aspects of pain in obstetrics. In: Pain in Perspective; 2012:219-236.
• [16]Size M, Soyanwo OA, Justins DM: Pain management in developing countries. Anesthesia 2007, 62(Suppl. 1):38-43.
• [17]Oladokun A, Eyelade O, Morhason-Bello I, Fadare O, Akinyemi J, Adedokun B: Awareness and desirability of labor epidural analgesia: a survey of Nigerian women. Int J Obstet Anesth 2009, 18(1):38-42.
• [18]Mung’ayi V, Nekyon D, Karuga R: Knowledge, attitude and use of labour pain relief methods among women attending antenatal clinic in Nairobi. East Afr Med J 2008, 85:438-441.
• [19]Rocke DA, Rout CC, Russell HD, Singh S: The labour ward analgesic service at King Edward VIII Hospital, Durban. S Afr Med J 1993, 83:32-33.
• [20]Imarengiaye CO: Trends in pain relief in labor: Implications for obstetric analgesia services in Nigeria. Niger Postgrad Med J 2005, 12(3):193-202.
• [21]Onah HE, Obi SN, Oguanuo TC, Ezike HA, Ogbuokiri CM, Ezeugwuorie JO: Pain perception among parturient in Enugu South-Eastern Nigeria. J Obstet Gynaecol 2007, 27(6):585-588.
• [22]Audu B, Yahaya U, Bukar M, El-Nafaty A, Abdullahi H, Kyari O: Desire for pain relief in labor in Northeastern Nigeria. J Public Health and Epidemiol 2009, 1(2):53-57.
• [23]Ann L, Cynthia S: Use of oxytocin and misoprsotol for induction or augmentation of labor in low-resource settings. 2004. Cited on 25th January, 2014. Available from http://www.pphpreventio.org/files/induction-augmentation webcite working paper.pdf
• [24]Kuti O, Faponle AF: Perception of labor pain among the Yoruba ethnic group in Nigeria. J Obstet Gynaecol 2006, 26:332-334.
• [25]Ballard CG, Stanley AK, Brockington IF: Post-traumatic stress disorder (PTSD) after childbirth. Br J Psychiatry 1995, 166(4):525-528.