South African Journal of Obstetrics and Gynaecology最新文献

{"title":"Ingestion of herbal medication during pregnancy and adverse perinatal outcomes","authors":"L. Kekana, M. Sebitloane","doi":"10.7196/SAJOG.1615","DOIUrl":"https://doi.org/10.7196/SAJOG.1615","url":null,"abstract":"Background. Pregnant women in South Africa (SA) traditionally use herbal medicines even though the potential risk or benefit is not fully elucidated.  Objectives. To determine the prevalence of the use of herbal medicines in pregnant women in our setting, as well as explore the reasons for use.  Methods. This cross-sectional study was conducted at King Edward VIII Hospital, from 1 September 2014 to 31 December 2014. Women were interviewed using a structured questionnaire during the post-delivery period, irrespective of outcome. The questionnaires enquired about women’s demographic data, social and previous obstetric history and herbal medication use during current pregnancy.  Results. Two hundred and ninety-nine women were interviewed. The prevalence of herbal medication use was 33.7% ( n =101), mainly via the oral route. Fifty-eight (57.4%) of these women used herbal medication throughout their pregnancy. Reasons given for herbal ingestion included general well-being, or to make labour easier or come sooner. There was a high rate of caesarean delivery among pregnant women who used herbal medication compared with those who did not (79.2% v. 52.8%; p =0.001). One hundred and eighteen women had meconium-stained liquor; 59% of the herbal medication users compared with 29.6% of the non-users ( p <0.001) comprised this group.The perinatal mortality rate was also higher among users ( p <0.04). There were no maternal deaths.  Conclusion. Herbal medicine was used by a third of black South African pregnant women in this study and was associated with significant adverse obstetric and perinatal outcomes.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43345317","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":"Making the case for an obstetric medicine subspecialty in South Africa","authors":"J. Zamparini, L. Wium","doi":"10.7196/SAJOG.1589","DOIUrl":"https://doi.org/10.7196/SAJOG.1589","url":null,"abstract":"Obstetric medicine is a subspecialty of internal medicine that involves the management of medical conditions that may affect the course of pregnancy. It is an established subspecialty in many parts of the world, with recognised training programmes and an active international society; however, no formal training programme has been developed in South Africa (SA) as yet. Medical problems are responsible for the majority (60%) of maternal deaths in SA and women of childbearing potential are disproportionately affected by medical conditions such as HIV and obesity. Obstetric physicians would play a complementary role in the care of pregnant patients and could contribute to improving maternal health and lowering the maternal mortality rate in SA.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45198337","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":"Ruptured renal artery aneurysm in pregnancy","authors":"N. Mdlalose, T. L. Khumalo","doi":"10.7196/SAJOG.1552","DOIUrl":"https://doi.org/10.7196/SAJOG.1552","url":null,"abstract":"Renal artery aneurysm is a rare condition, the incidence being ~0.01 - 1%. In pregnancy this condition is rare but carries a significant mortality. Predisposing factors in pregnancy are thought to be physiological, hormonal and haemodynamic. Clinical diagnosis requires a high level of suspicion, as patients are usually asymptomatic prior to rupture. The clinical presentation often mimics other common obstetric conditions such as labour, uterine rupture or placental abruption. It is essential at laparotomy in cases of intra-abdominal bleeding that a thorough search is made for the source of blood loss when no obvious obstetric cause is found. We report a case of a maternal death that was due to rupture of a renal artery aneurysm in the immediate peripartum period in a patient with chronic hypertension.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48674439","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":"The use of the cerebroplacental ratio in the latent phase of labour to predict adverse outcomes in a resource-limited setting","authors":"A. Wise, E. Nicolaou, H. Lombaard","doi":"10.7196/SAJOG.1590","DOIUrl":"https://doi.org/10.7196/SAJOG.1590","url":null,"abstract":"Background. Risk stratification of pregnant women may decrease the perinatal mortality rate in South Africa. This relies on the assessment of the referring health facility and timeous presentation of the patient. Inaccurate dating affects the ability to detect growth restriction. Patients requiring referral may go undetected and deliver with the inappropriate level of care. Doppler studies can assist in detecting at-risk fetuses.  Objectives. To describe the short-term outcomes of fetuses with a normal or abnormal cerebroplacental ratio (CPR) according to the various definitions in the literature.  Methods. A cohort of 200 pregnant women were prospectively recruited while in early labour. Patient history including previous ultrasound scans were obtained. Ultrasound was done for biometry, umbilical artery (UA), middle cerebral artery (MCA) and uterine Dopplers, and the CPR was calculated. Labour and delivery details were recorded. An association between an abnormal CPR, adverse outcomes and composite score was determined.  Results. Less than a tenth (7.7%; n =15) of the participants had a CPR <1.08. Furthermore, 16.5% ( n =31) of the participants were <5th centile and 24.2% ( n =47) were <10th centile. The composite score of adverse outcomes in those with and without a CPR <5 th centile was not significant ( p =0.737). There was no association between adverse outcomes ( p =0.179) or a composite score ( p =0.237) and the CPR cut-off of the 10th centile. Moreover, there was no association between an abnormal CPR and adverse outcomes after adjusting for confounders. There were no cases of perinatal death or neonatal encephalopathy.  Conclusion. An abnormal CPR was not clinically useful in detecting fetuses at risk of adverse outcomes in early labour regardless of the CPR cut-off. However, this is reassuring when normal and may if combined with other parameters still prove useful.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42160700","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":"Beckwith-Wiedemann syndrome associated with congenital cytomegalovirus in an HIV-exposed neonate","authors":"K. Sprong, C. Wright, M. Mabenge, S. Govender","doi":"10.7196/SAJOG.1595","DOIUrl":"https://doi.org/10.7196/SAJOG.1595","url":null,"abstract":"Congenital cytomegalovirus (CMV) infection is associated with preterm birth and congenital abnormalities, which could be exacerbated by maternal co-infection with HIV. This case report describes an HIV-exposed neonate with Beckwith-Wiedemann syndrome (BWS), born by a mother who had a CMV infection of the placenta, who demised following laparoscopic repair of an omphalocele.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45306408","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":"Medication adherence in HIV-positive pregnant women on antiretroviral therapy attending antenatal clinics in Ado metropolis, south-west Nigeria: A multicentre study","authors":"O. P. Aduloju, T. Aduloju, I. Ade-Ojo, A. Akintayo","doi":"10.7196/SAJOG.1611","DOIUrl":"https://doi.org/10.7196/SAJOG.1611","url":null,"abstract":"Background. Adherence to antiretroviral therapy (ART) and optimal viral suppression are crucial to the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS.  Objective. To determine adherence to ART and associated factors in Ado-Ekiti, Nigeria.  Methods. A cross-sectional multicentre study was conducted among 170 HIV-positive pregnant women attending antenatal clinics of Ekiti State University Teaching Hospital and the Comprehensive Health Centre in Ado-Ekiti. Data collected using a semi-structured questionnaire were analysed with SPSS. Descriptive statistics, univariate and logistic regression were performed to determine factors associated with good adherence.  Results. Using the pill count method and the Morisky Medication Adherence Scale-8 (MMAS-8), the prevalence of good adherence was 73.5% and 75.3%, respectively. Women with higher education were three times more likely to practise good adherence than those with little or no formal education (adjusted odds ratio (aOR)=3.03; 95% confidence interval (CI) 1.23 - 5.79; p =0.043) and those employed were four times more likely to practise good adherence (aOR=4.13; 95% CI 1.83 - 8.15; p =0.02). Also, partner disclosure, treatment support and use of ARVs for prevention of mother-to-child transmission (PMTCT) were indications of women three times more likely to practise good adherence ((aOR=2.53; 95% CI 0.99 - 5.80; p =0.035); (aOR=2.15; 95% CI 0.77 - 4.15; p =0.014) and (aOR=3.15; 95% CI 0.93 - 6.21; p =0.035)). Forgetfulness, busy schedule and stigmatisation were reasons given for non-adherence.  Conclusions. The majority of the women had good adherence. However, counselling on adherence and partner disclosure should be sustained to ensure full benefits of PMTCT.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44489003","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":"The spectrum of placental pathology in a public v. private laboratory practice in Gauteng Province, South Africa","authors":"M. Savage-Reid, C. Wright, R. Wadee","doi":"10.7196/SAJOG.1599","DOIUrl":"https://doi.org/10.7196/SAJOG.1599","url":null,"abstract":"Background. Laboratory information systems have a wealth of patient and health data that can be made available for research. These data can serve to better inform healthcare delivery and formulation of policies. The placenta is just one histopathology laboratory specimen that can provide such insight, particularly with regard to maternal and neonatal healthcare.  Objectives. To describe the spectrum of placental pathology in a private and public laboratory and to ascertain implications for improved maternal and neonatal healthcare and policies.  Methods. We conducted a retrospective descriptive study of placental histopathology reports from Lancet Laboratories and the National Health Laboratory Service (NHLS) in Johannesburg over a 1-year period (August 2017 - July 2018). The reports were categorised according to the 2014 Amsterdam Placental Workshop Group Consensus Statement and the percentages of each diagnostic entity compared between the two laboratories. These diagnostic categories included ascending infection, maternal vascular malperfusion (MVM), fetal vascular malperfusion, haematogenous infection, chronic villitis of unknown aetiology, retroplacental haemorrhage, no specific pathological changes and ‘other’. Differences in maternal age and gestational age were also compared.  Results. There were 1 172 and 946 placentas that were entered into the study at Lancet and NHLS, respectively. MVM was the most prevalent pathology seen in both laboratories (40.6% and 47.7%; p =0.3193). Mean maternal and gestational age were both higher in the private system (both p <0.0000).  Conclusion. Differences in placental pathology were multifactorial and reasons may include differences in socioeconomic status and resources, clinical and laboratory policies and practices, as well as pathologist training and expertise. Clear clinical guidelines for the submission and histopathological examination of the placenta are required to better inform neonatal and maternal healthcare and policies. In our divided healthcare system, collaborative medical research is not only possible between the public and private sectors but also necessary to achieve better healthcare and equity for patients in South Africa.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43057172","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":"The impact of COVID-19 on obstetrics and gynaecology care","authors":"Z. Abdool, S. Maswime, W. Edridge","doi":"10.7196/SAJOG.2020.V26I2.02028","DOIUrl":"https://doi.org/10.7196/SAJOG.2020.V26I2.02028","url":null,"abstract":"","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46926359","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":"Mitigating the judicious use of PPE to keep maternity units functional","authors":"S. Adam, S. Maswime, P. Soma-Pillay, M. Matjila, L. Chauke, M. Botha, R. Pattinson","doi":"10.7196/SAJOG.1605","DOIUrl":"https://doi.org/10.7196/SAJOG.1605","url":null,"abstract":"","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43358700","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":"Contents","authors":"Gertrude Fani","doi":"10.7196/sajog.1626","DOIUrl":"https://doi.org/10.7196/sajog.1626","url":null,"abstract":"","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48582855","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}