RESUMEN
BACKGROUND: Changes in lipid metabolism have been shown to occur during pregnancy, to ensure a continuous supply of nutrients to the growing fetus, despite intermittent maternal food intake. Abnormal lipid metabolism has also been linked to atherosclerosis. OBJECTIVE: To investigate the effect of pregnancy on the lipid profile and possible predisposition of pregnant Nigerian women to atherosclerosis. SETTINGS AND DESIGN: Serum lipid and lipoprotein levels of 60 apparently healthy pregnant women aged between 25 and 45 years, attending the antenatal clinic of the U.N.T.H, Enugu and 60 apparently healthy non-pregnant, age-matched females (controls) were estimated. The test samples were collected from each subject at each of the trimesters. MATERIALS AND METHODS: Total cholesterol (TC), high-density lipoprotein (HDL) and triglyceride (TG) were analyzed using enzymatic/spectrophotometric methods while low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL) were calculated using Friedewald's formula. STATISTICAL ANALYSIS USED: The data obtained were analyzed with Students' t-test and Pearson's Product Moment Correlation, using graph pad prism software program and results expressed as mean ± SD. The level of significance was determined at 95% confidence level. RESULTS AND CONCLUSION: The serum lipid levels were significantly higher (P<0.05) in all the trimesters of the pregnant women than in the controls. There was a steady increase in the serum lipid levels with increasing gestational age. A significant positive correlation (P<0.05) was observed between the lipid fractions and the different trimesters of pregnancy. TC/HDL was decreased significantly (P<0.05) in pregnant women, with increasing gestational age. Cardiac risk factor, however, decreased with gestational age, signifying possible protection from atherosclerosis. A comparison of two age groups of pregnant women (25-34 years and 35-45 years) showed no significant differences (P>0.05) in all the lipid fractions studied, suggesting no possible age-related effect on lipid metabolism in the women in their first trimester. Even with significant increase in plasma lipid during pregnancy, normal pregnancy in Nigerian women does not appear to increase the risk.
RESUMEN
OBJECTIVE: To determine the rate of acceptance/refusal of colposcopy and the reasons for refusal by women referred for the procedure in southeast Nigeria. METHODS: An audit was performed of the computerized database for all women referred for colposcopy at the University of Nigeria Teaching Hospital, Enugu, from August 1, 2009, to July 31, 2010. The characteristics of those who accepted colposcopy were compared with those who refused the procedure. An interviewer-administered questionnaire was used to assess reasons for refusal and the subsequent treatment chosen. RESULTS: During the study period, 154 women were referred for colposcopy: 103 (66.9%) accepted and 51 (33.1%) refused. Those who refused were younger and tended to be nulliparous (P=0.029 and P=0.004, respectively). The most common reasons for refusal were fears of possible diagnosis of cervical cancer and compromise of future fertility. Most women who refused resorted to spiritual healing. CONCLUSION: The rate of refusal of colposcopy in southeast Nigeria was high, indicating an urgent need for appropriate remedial measures instituted through intensive education of women regarding cervical cancer and its prevention. Targeted counseling should be initiated early as part of prescreening counseling.