South African Journal of Obstetrics and Gynaecology最新文献

{"title":"Does adding coenzyme Q10 to dehydroepiandrosterone sulphate positively impact fertility outcomes in young, poor responder infertile women undergoing antagonist protocol for IVF/ICSI cycles?","authors":"M. Dawoud, A. Abd Al Waheed, S. H. Gad Allah, F. Abd Al Kader Hemila, A. Eid Abd El Mohsen, A. Ibrahim Ogila","doi":"10.7196/sajog.2024.v30i1.1595","DOIUrl":"https://doi.org/10.7196/sajog.2024.v30i1.1595","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. One of the biggest issues in reproductive medicine is treating women with low ovarian reserves or a poor ovarian response (POR) to stimulation. Oxidative stress was suggested as one of the major contributors to POR. However, the pathophysiology remains unknown. Focusing on certain subpopulations within the diverse group of poor responders may help determine the best therapy for these patients.\u0000Objective. To investigate the effect of adding coenzyme A Q10 to dehydroepiandrosterone (DHEA) in young, poor responder infertile females undergoing in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycles.\u0000Methods. One hundred and sixty-eight females with poor ovarian response (Poseidon Group 3) from multiple centres were randomly divided into two groups. The first group received DHEA orally along with coenzyme 10, while the second group received only DHEA. Both groups underwent controlled ovarian stimulation.\u0000Results. There was a significant improvement in the quality of oocytes and the number and quality of embryos transferred in the coenzyme A Q10 group. However, no significant differences were observed in other parameters between the groups.\u0000Conclusion. In young, poor-responder women with decreased ovarian reserve, pretreatment with CoQ10 enhances oocyte and embryo quality and boosts ovarian response to stimulation. An improvement in clinical pregnancy and live birth rates may be possible.\u0000\u0000\u0000\u0000","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and severity of depression and anxiety in infertile female patients attending an academic hospital in central South Africa","authors":"T. Mulondo, S. Baloyi, J. Sempa","doi":"10.7196/sajog.2024.v30i1.1452","DOIUrl":"https://doi.org/10.7196/sajog.2024.v30i1.1452","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. Infertility has an incidence of 15 - 20% in South Africa (SA). It may lead to the development of psychological disorders such as anxiety and depression.\u0000Objective. To determine the prevalence of depression and anxiety among infertile women attending the Infertility Clinic at a tertiary hospital in central SA.\u0000Methods. In this prospective analytic cross-sectional study, information captured included sociodemographic variables such as age, employment status, type and duration of infertility, marital status, type of marriage and education level. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) test were used to screen for depression and anxiety, respectively.Results. In total, 100 of 108 infertile women completed all the questionnaires correctly. Forty-two (42.0%) of the patients were >35 years and 58.0% were married, with five (8.6%) being in a polygamous marriage. Fifty-three (53.0%) women had never been pregnant before. The prevalence of depression was 53.0%, with 45.0% of these patients showing moderate to moderately severe levels of depression. The level of education was significantly associated with depression (p<0.025). Half of the participants (50.0%) screened positive for anxiety, with 12 (24.0%) having severe anxiety. In total, 40.0% of the participants screened positive for both anxiety and depression. No statistically significant association was observed between depression or anxiety and age, duration of infertility, marital status and employment status.\u0000Conclusions. Depression and anxiety disorders are common and often underdiagnosed in women undergoing infertility treatment. Practitioners should screen for these conditions at the initial patient presentation and refer patients for psychological support.\u0000\u0000\u0000\u0000","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is medicine a process of scientific rigour?","authors":"W. Edridge","doi":"10.7196/sajog.2022.v28i2.2200","DOIUrl":"https://doi.org/10.7196/sajog.2022.v28i2.2200","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48629015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to care for fetuses with prenatally diagnosed severe abnormalities","authors":"C. Stewart","doi":"10.7196/sajog.2022.v28i2.2013","DOIUrl":"https://doi.org/10.7196/sajog.2022.v28i2.2013","url":null,"abstract":"Ultrasound in pregnancy has become standard of care, resulting in an increased number of antenatally diagnosed fetal anomalies. It isimportant to have a consistent approach to the management of these abnormalities. This may include offering termination of pregnancy,standard care or non-aggressive/palliative care. A categorisation of anomalies and management options is proposed to assist with thesedecisions, underpinned by an ethical framework.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45796822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related changes in serum anti-Müllerian hormone in women of reproductive age in Kenya","authors":"M. Andhavarapu, D. Maina, A. Murage, C. Muteshi","doi":"10.7196/sajog.2022.v28i2.2067","DOIUrl":"https://doi.org/10.7196/sajog.2022.v28i2.2067","url":null,"abstract":"Background. Anti-Müllerian hormone (AMH) is produced by the granulosa cells of ovarian antral follicles and plays a role in therecruitment of dominant follicles during folliculogenesis. The serum level of AMH is proportional to the number of developing folliclesin the ovaries and reflects ovarian reserve. Nomograms of AMH variation with age exist from Caucasian populations, but there are none drawn from local African data.Objectives. To establish age-specific median serum AMH levels in an unselected East African population of women of reproductive age.Methods. We retrospectively analysed data on 1 718 women who underwent AMH testing using the Beckman Coulter AMH Gen IIenzyme-linked immunosorbent assay during the period 2015 - 2019 at Aga Khan University Hospital, Nairobi, Kenya. Age-specific median AMH levels were derived and presented in 5-year age bands. AMH levels were then log-transformed and, using linear regression in a natural spline function, presented on a scatter plot to demonstrate variation across reproductive age.Results. The median (interquartile range (IQR)) age of women who were tested for AMH was 38 (19 - 49) years. For the study population, the median (IQR) serum AMH level was 0.87 (0.01 - 17.10) ng/mL. The AMH concentration was inversely related to age, with a progressive decline whereby an increase of 1 year resulted in a corresponding decrease in AMH of 0.18 ng/mL. The proportion of women with decreased ovarian reserve increased exponentially with age from 14.9% in those aged 20 - 24 years to 48.7% at 35 - 39 years.Conclusion. From a large dataset of mainly black African women, this study confirms that serum AMH declines with advancing age,as reported elsewhere in Caucasian populations. There was, however, a higher than expected number of women with diminished ovarian reserve for age. Future studies prospectively exploring ovarian reserve in the general population could unravel underlying biological, reproductive and environmental factors that may influence AMH levels and reproductive capacity in this indigenous population.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49112544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of and sociodemographic factors associated with antenatal depression among women in Limpopo Province, South Africa","authors":"M. C. Ramohlola, Mph E BCur, Maimela, PhD T S Ntuli MSc, T. Ntuli","doi":"10.7196/sajog.2022.v28i2.2097","DOIUrl":"https://doi.org/10.7196/sajog.2022.v28i2.2097","url":null,"abstract":"Background. Pregnancy-related depression is a common psychiatric disorder and a major public health concern in both developed and developing countries, but the disorder receives little attention and few resources, particularly in developing countries.Objectives. To assess the prevalence of antenatal depression and its sociodemographic risk factors among pregnant women in Limpopo Province, South Africa.Methods. This was a cross-sectional descriptive study conducted in a district hospital from 8 March to 12 April 2021. Consecutive women attending antenatal care services during the data collection period were included in the study. The Edinburgh Postnatal Depression Scale was used to assess depression symptoms.Results. The prevalence of antenatal depression was 31% (95% confidence interval 26.1 - 36.3). Being unmarried, being a smoker, being without financial support from a partner, having a violent partner and having a less-educated partner were significant predictors of antenatal depression in these women.Conclusion. Nearly one-third of the pregnant women in our study had depressive symptoms. The important predictors of antenataldepression included being unmarried, smoking, lack of financial support from a partner, intimate partner violence and having a lesseducated partner. These findings may help healthcare workers to identify women at risk early, so that support can be offered during pregnancy and childbirth.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48612566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An assessment of mismatch repair deficiency in ovarian tumours at a public hospital in Johannesburg, South Africa","authors":"S. de Klerk, R. Wadee","doi":"10.7196/sajog.2022.v28i2.2075","DOIUrl":"https://doi.org/10.7196/sajog.2022.v28i2.2075","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000Background. Epithelial ovarian carcinomas (EOCs) are lethal female genital tract malignancies with high-grade serous, low-grade serous, endometrioid, clear cell, mucinous and malignant Brenner subtypes. The lifetime risk for developing ovarian carcinoma (OC) is 15% in females who have mismatch repair deficiency (MMR-d). MMR-d is associated with Lynch syndrome, a cancer predisposition condition. Patients who have MMR-d may benefit from immunotherapy. To the best of the authors’ knowledge, MMR-d testing of OCs in South Africa (SA) has not been undertaken to date. \u0000Objectives. To assess the clinicopathological characteristics and mismatch repair (MMR) status of non-serous EOCs at a single institution in SA.Methods. Following ethical clearance and application of exclusion criteria, 19 cases of non-serous EOC from the Department of Anatomical Pathology at Charlotte Maxeke Johannesburg Academic Hospital were retrieved and assessed. Four immunohistochemical markers (MLH1, MSH2, MSH6 and PMS2) were used to evaluate MMR status. \u0000Results. Most tumours were early-stage, unilateral, mucinous EOCs, without capsular breach or lymphovascular invasion (LVI). A single case of grade 1, stage I, unilateral, endometrioid EOC showed MMR-d for MLH1 and PMS2 MMR proteins. This patient had been diagnosed with endometrioid endometrial carcinoma 2 years prior to the diagnosis of OC.Conclusion. Our study documented a lower proportion of MMR-d OCs compared with international studies. However, our results are concordant with global studies regarding tumour subtype, laterality, grade, stage, LVI and capsular breach. Larger studies are required to estimate the true incidence of MMR-d OCs in SA and to direct effective treatment options globally. \u0000 \u0000 \u0000 \u0000","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48562042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for maternal and congenital syphilis with a chemiluminescence immunoassay in a South African private specialist healthcare sector setting","authors":"O. Onyangunga, K. Moodley, J. Moodley","doi":"10.7196/sajog.2022.v28i2.2017","DOIUrl":"https://doi.org/10.7196/sajog.2022.v28i2.2017","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000Background. Syphilis is a sexually transmitted infection that is most frequently found in lower socio-economic groups globally and is associated with significant maternal and fetal complications. In South Africa (SA), the last two to three decades have seen a rise in the number of people in the low and middle economic social groups seeking private specialist healthcare services.Objective. To evaluate the prevalence rates of maternal and congenital syphilis in a private specialist healthcare setting. \u0000Methods. The laboratory case records of women who had antenatal maternal syphilis (MS) screening using the automated chemiluminescence immunoassay (Architect Syphilis TP) in a private laboratory facility in Durban were reviewed.Results. A total of 9 740 individual maternal serum samples were analysed and 256 were Architect Syphilis TP positive, resulting in a MS prevalence rate of 2.7%. Of the less than three-quarters of exposed neonates tested (71.1%; n=182/256), 38.5% (n=70/182) were Architect syphilis TP positive. Less than a tenth of exposed neonates (2.43%; n=6) had only rapid plasma reagin (RPR) titers test whereas 26.6% (n=68/256) did not have a syphilis screen test. Based on the 182 exposed neonates tested, the congenital syphilis (CS) prevalence from the laboratory records was 7.7%. The highest rate of MS was in the ≥35 years age group. \u0000Conclusion. The prevalence of MS in the private specialist healthcare sector in SA is relatively high and warrants continued maternal antenatal screening during early pregnancy across all socio-economic groups. The high rate of MS in the age group over 35 years warrants further investigations and explanation. \u0000 \u0000 \u0000 \u0000","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46742213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An audit of complications of complex operative gynaecological laparoscopy at a tertiary healthcare facility in South Africa","authors":"C. N. Omile, S. Ramphal, J. Moodley","doi":"10.7196/sajog.1640","DOIUrl":"https://doi.org/10.7196/sajog.1640","url":null,"abstract":"Background. Operative laparoscopic surgery has many advantages over traditional/open laparotomy. However, it is also associated with complications particularly when performed for complex gynaecological procedures. There are very few reports on operative laparoscopic surgery from developing countries. Objective. To evaluate the intraand postoperative complications associated with laparoscopic surgery performed for complex gynaecological conditions by a single surgeon at a tertiary institution. Method. This was a retrospective chart review of patients who underwent complex laparoscopic surgery between 2004 and 2016. Results. We retrieved 446 patient records. Surgery for extensive endometriosis (29.8%) and laparoscopic-assisted vaginal hysterectomy (29.8%) were the most common procedures. Less than a tenth of patients (4.3%; n=19) had complications, 9 had minor injuries (4 inferior epigastric vessel injury, 1 peritoneal vessel injury, 1 omental vessel injury, 1 surface tissue bleeding and 2 cases of postoperative ileus) and 10 had major injuries (6 intestinal, 2 ureteric and 3 bladder). More than a quarter of complications (26.3%; n=5) occurred at the time of abdominal entry, 63.2% (n=12) occured intraoperatively and 10.5% (n=2) occurred postoperatively. All entry injuries were vascular. Intestinal injury was the most common intraoperative complication. Conclusion. Despite the many advantages of laparoscopic surgery, complications occur particularly in patients with complex gynaecological pathology.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48906993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced extra-uterine pregnancy: A review of the literature","authors":"S. Ramphal, Fcog SA MB ChB, PhD P Khaliq, J. Moodley","doi":"10.7196/sajog.1641","DOIUrl":"https://doi.org/10.7196/sajog.1641","url":null,"abstract":"Advanced extra-uterine pregnancies, although uncommon, are associated with significant morbidity and mortality. Early diagnosis is essential. A high index of suspicion is necessary and ultrasound examination is probably the most suitable investigative tool to date. Conservative management with the aim of fetal viability in pregnancies >24 weeks’ gestation is an appropriate form of management and does not adversely affect maternal morbidity and mortality.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44102796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}