South African Journal of Obstetrics and Gynaecology最新文献_第7页

An audit of the CaesAid vacuum-assisted delivery cup compared with forceps delivery of the fetal head in caesarean section 剖宫产中使用CaesAid真空助产杯与产钳娩出胎儿头的比较分析

South African Journal of Obstetrics and Gynaecology Pub Date : 2019-08-27 DOI: 10.7196/sajog.1377

N. Stolwijk, P. R. Jong

{"title":"An audit of the CaesAid vacuum-assisted delivery cup compared with forceps delivery of the fetal head in caesarean section","authors":"N. Stolwijk, P. R. Jong","doi":"10.7196/sajog.1377","DOIUrl":"https://doi.org/10.7196/sajog.1377","url":null,"abstract":"Background. Vacuum-assisted caesarean delivery may result in a quicker delivery of the fetal head than the use of forceps, and improve maternal and fetal outcomes. The new CaesAid vacuum-assisted delivery (VAD) cup was designed specifically for this use. Objectives. To assess whether the CaesAid VAD cup influences the duration of fetal head delivery at caesarean section when compared with forceps, and whether there are differences in perioperative complications in the mother and fetus. Methods. We carried out a retrospective clinical audit of 132 patients who underwent caesarean delivery at the Netcare Christiaan Barnard Memorial Hospital in Cape Town, South Africa, from April to November 2017, aided by either CaesAid VAD cup (C group, n =67) or forceps (F group, n =65). Results. The uterine incision-to-delivery interval was significantly shorter ( p =0.001) in the C group than the F group (median 38 (interquartile range (IQR) 20) v. 60 (IQR 50) seconds, respectively). The maternal blood loss was lower in the C group than the F group (250 mL v. 288 mL; p =0.025). There was no significant difference in Apgar scores or admissions to the neonatal intensive care unit. Neonatal skin injuries were less common in the C group (no cases v. 8 in the F group; p =0.004). Conclusion. The results of this audit suggest that the CaesAid VAD cup is a safe and efficient alternative to forceps for aiding the delivery of the fetal head at caesarean section. However, the routine use of vacuum cups is debatable. Further research could provide more insight into this procedure as a part of obstetric practice.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43551934","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}

引用次数: 0

Serum procalcitonin in pregnancy-associated sepsis: A case control study 妊娠相关性败血症患者血清降钙素原的病例对照研究

South African Journal of Obstetrics and Gynaecology Pub Date : 2019-08-27 DOI: 10.7196/sajog.1397

R. Agarwal, P. Priyadarshini, M. Mehndiratta

{"title":"Serum procalcitonin in pregnancy-associated sepsis: A case control study","authors":"R. Agarwal, P. Priyadarshini, M. Mehndiratta","doi":"10.7196/sajog.1397","DOIUrl":"https://doi.org/10.7196/sajog.1397","url":null,"abstract":"Background. Procalcitonin (PCT) is an established marker for sepsis, particularly bacterial, but its use in diagnosing pregnancy-associated sepsis (PAS) is relatively unexplored. Objective. To investigate whether PCT could be used for the diagnosis of PAS in our study population, and what the appropriate values might be for the diagnosis. Methods. The study included 40 pregnant, post-abortal and postpartum women with PAS, identified using systemic inflammatory response syndrome criteria. Patients with hypertensive disorders, premature rupture of membranes, severe trauma, liver cirrhosis and lung or thyroid malignancies were excluded. Forty healthy term pregnant women with sterile urine cultures were taken as controls. PCT levels were obtained at admission and statistically compared between the groups. Severity and culture positivity in PAS were also assessed. Results. Severe PAS was present in 30 patients. Overall culture positivity was seen in 55% ( n =22) of subjects. Culture-positive patients had higher PCT levels (3.03 μg/L) compared with the culture-negative (1.77 μ/L), though this did not reach statistical significance ( p =0.235). Mean (standard deviation) PCT in PAS patients was 2.46 (0.56) μ/L, while in healthy controls it was 0.091 (0.019) μg/L. This difference was statistically significant ( p 0.125 μg/L is suggested as the critical level for PAS diagnosis in appropriate clinical settings. Additionally, mean PCT levels differed significantly in severe v. non-severe PAS.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49101915","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}

引用次数: 5

Cover 封面

South African Journal of Obstetrics and Gynaecology Pub Date : 2019-08-27 DOI: 10.7196/sajog.1485

Gertrude Fani

引用次数: 0

Uterine leiomyosarcoma: A ten-year review in a referral hospital in Peru, 2005 – 2014 子宫平滑肌肉瘤:秘鲁一家转诊医院的十年回顾，2005 - 2014

South African Journal of Obstetrics and Gynaecology Pub Date : 2019-06-14 DOI: 10.7196/SAJOG.1355

Omar Fernando Yanque Robles

{"title":"Uterine leiomyosarcoma: A ten-year review in a referral hospital in Peru, 2005 – 2014","authors":"Omar Fernando Yanque Robles","doi":"10.7196/SAJOG.1355","DOIUrl":"https://doi.org/10.7196/SAJOG.1355","url":null,"abstract":"Objective: To describe general characteristics, clinical features, moment of diagnosis and treatment of patients with uterine leiomyosarcoma (LMS). Methods: From 2005 to 2014, clinical files of patients diagnosed with a uterine LMS at Hospital Nacional Edgardo Rebagliati Martins in Peru were reviewed. Results: Eleven cases with complete information were identified; mean age at diagnosis was 45.36 years (range, 27 - 61 years); most frequent symptom reported was pelvic pain in 6/11 (54%) patients. 8/11 (72%) patients were diagnosed after any surgical intervention. The most frequent clinical stage was IB in 10/11 (90%) cases. Initial treatment was total abdominal hysterectomy (TAH) + bilateral salpingo-oophorectomy (BSO) in 7/11 (62%) cases. Prevalence of undiagnosed uterine LMS in hysterectomies and myomectomies done for presumed leiomyomas was 0.24% and 0.22%, respectively. Conclusion: Clinical presentation of uterine LMS do not differ from usual leiomyoma. Most of the cases are diagnosed incidentally after surgical specimen analysis. Most accepted initial management to date is still en bloc TAH + BSO. Follow-up strategies should be implemented and be the goal of any long term program.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48777254","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}

引用次数: 2

Does perineal body thickness affect fecal incontinence in multiparous patients? 会阴体厚对多产患者大便失禁有影响吗?

South African Journal of Obstetrics and Gynaecology Pub Date : 2019-02-22 DOI: 10.7196/SAJOG.1305

A. Hurry, A. Hassan, S. Hosseini, H. Khazraei, Mohammed Abdzaid Akool, L. Moosavi, S. Pourahmad

{"title":"Does perineal body thickness affect fecal incontinence in multiparous patients?","authors":"A. Hurry, A. Hassan, S. Hosseini, H. Khazraei, Mohammed Abdzaid Akool, L. Moosavi, S. Pourahmad","doi":"10.7196/SAJOG.1305","DOIUrl":"https://doi.org/10.7196/SAJOG.1305","url":null,"abstract":"Background: Obstetric trauma is the mostcommon cause of fecal incontinence in multiparous women.The literature has shown that women with obstetric trauma to the anal sphincter have decreased perineal body thickness (PBT).We aimed to analyze the role of PBT by endoanalultrasonographyinassessment of this type of fecal incontinence in multiparous patients. Methods : Forty-fourfemales with anal incontinence and 36 asymptomatic ones that had two or more previous deliveries were investigated with endoanalultrasonographyfrom January2016 to December 2016. All patients were divided into three groups on thebasis of PBT: 10 mm or less, 10 to 12 mm, more than12 mm. The degree of FI was measured using the incontinence score of Wexner. Sphincter angle defect was separately measured for each patient. Results : The mean age of all our 80 patients was 46.9±1.3 years (26–77 years) and the mean PBT in incontinent patients was 8.78 ± 2.84 mm and 12.65± 16.76mm in asymptomatic subjects (P < 0.001). The mean Wexner score was 8.6 (2-20 in incontinent patients). External sphincter defect angles were negatively correlated with PBT (p = 0.045).For 89% of the patients there was a history of vaginal delivery and 62.5% had undergone one or more prior episiotomies during delivery. Conclusion : A PBT less than 10 mm is associated with sphincter defect in most incontinent patients. Perineal body thickness plays such a significantly important role in fecal incontinence that it should be one of the factors involved in anal incontinency evaluations.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/SAJOG.1305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47879789","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}

引用次数: 2

Gestational Outcomes of Patients with Multiple Sclerosis; A Tertiary Center Experience 多发性硬化症患者的妊娠结局；高等教育中心体验

South African Journal of Obstetrics and Gynaecology Pub Date : 2019-02-22 DOI: 10.7196/SAJOG.1368

Ö. Özyüncü, A. Tanaçan, Fatih Aktoz, Melek Büyükeren, R. Karabudak, M. Beksaç

{"title":"Gestational Outcomes of Patients with Multiple Sclerosis; A Tertiary Center Experience","authors":"Ö. Özyüncü, A. Tanaçan, Fatih Aktoz, Melek Büyükeren, R. Karabudak, M. Beksaç","doi":"10.7196/SAJOG.1368","DOIUrl":"https://doi.org/10.7196/SAJOG.1368","url":null,"abstract":"Background. Multiple sclerosis (MS) is a disease that predominantly affects the young female population. It is important for an obstetrician to know the effects of pregnancy on MS, and vice versa. Objective. To demonstrate the impact of MS on pregnancy outcomes. Methods. We retrospectively evaluated demographic features, clinical characteristics, and obstetric outcomes of 47 pregnancies in 24 patients with MS, between January 2007 and December 2016. Results. Patients were divided into three groups: (i) 35 pregnancies in patients with MS who were in remission at the beginning of pregnancy; (ii) 10 pregnancies in patients with MS whose disease was exacerbated at the beginning of pregnancy; and (iii) 2 pregnancies in patients with active MS whose symptoms were relieved after becoming pregnant. The overall early pregnancy loss rate was 36.2%, whereas it was 60% and 31.4% in the exacerbation and remission groups, respectively; and the overall preterm delivery rate was 30%, while it was 29.1% and 50% in the remission and exacerbation groups, respectively. Conclusion. Miscarriage and preterm delivery seem to be significant obstetric complications in pregnant women with MS.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/SAJOG.1368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45348218","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}

引用次数: 2

A rare case of ovarian Lymphangioma associated with chylous ascites and raised CA-125. 一例罕见的卵巢淋巴管瘤合并乳糜性腹水并升高CA-125。

South African Journal of Obstetrics and Gynaecology Pub Date : 2019-02-22 DOI: 10.7196/sajog.1347

M. Mangla

{"title":"A rare case of ovarian Lymphangioma associated with chylous ascites and raised CA-125.","authors":"M. Mangla","doi":"10.7196/sajog.1347","DOIUrl":"https://doi.org/10.7196/sajog.1347","url":null,"abstract":"Lymphangiomas are benign congenital malformations of lymphatic system, thought to happen due to obstruction of local lymph flow system. They can occur anywhere in the skin and the mucous membranes. Most common sites are the head and the neck but sometimes, they can be found in the intestines, the pancreas and the mesentery. Lymphangioma of the ovary is an extremely rare lesion. It was first described in 1908. Clinical manifestations can vary from asymptomatic ovarian mass to acute abdomen. They may be very frequently confused with malignant ovarian mass often leading to extensive surgery. A 34-year-old female presented with dull aching pain localized to lower abdomen from last 6 months. Ultrasound and CECT abdomen were suggestive of enlarged right ovary with massive ascites. Ca-125 was 685. Diagnostic laparoscopy revealed chylous ascites and further a frozen section revealed few atypical cells, further strengthening the diagnosis of malignant tumor. Staging laparotomy with total abdominal hysterectomy and salpingo-oophorectomy was finally done. Histopathology revealed lymphangioma, with no evidence of malignancy. CA-125 also showed a rapid decline following surgery. Lymphangiomas should be included in the differential diagnosis of ovarian cystic masses, especially in patients with chylous ascites. It is very important to discriminate such cases from other malignant tumors in order to avoid overtreatment. However, a careful follow up for at least 2 years is needed for patients with lymphangioma of the ovary in order to exclude recurrence.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46890814","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}

引用次数: 0

Maternal and Perinatal Outcomes in Women Undergoing Expectant Management of Early-Onset Preeclampsia: A Retrospective Cohort Study 接受早期发病先兆子痫预期治疗的妇女的孕产妇和围产期结局：一项回顾性队列研究

South African Journal of Obstetrics and Gynaecology Pub Date : 2019-02-22 DOI: 10.7196/SAJOG.1378

N. Vijayan, A. Keepanasseril, N. Plakkal, V. Udupa, Subrahmanian Soundara Raghavan

{"title":"Maternal and Perinatal Outcomes in Women Undergoing Expectant Management of Early-Onset Preeclampsia: A Retrospective Cohort Study","authors":"N. Vijayan, A. Keepanasseril, N. Plakkal, V. Udupa, Subrahmanian Soundara Raghavan","doi":"10.7196/SAJOG.1378","DOIUrl":"https://doi.org/10.7196/SAJOG.1378","url":null,"abstract":"Background. Expectant management of early-onset pre-eclampsia, with the aim of improving perinatal outcomes, may increase the risk of maternal morbidity. Objective. To study the maternal and perinatal outcomes and their association with various risk factors in women undergoing expectant management for early-onset pre-eclampsia. Methods. A retrospective cohort study was carried out in a tertiary centre in south India between April 2014 and June 2015. We studied 201 women with singleton pregnancies with pre-eclampsia diagnosed between 28 and 34 weeks’ gestation. Demographic data, medication and treatment details, and delivery data were extracted from maternal charts. The primary outcomes were: (i) composite maternal outcomes, defined as the development of any of eclampsia, abruptio placentae, pulmonary oedema or renal failure; and (ii) perinatal mortality. Logistic regression was used to assess the independent association risk factors with primary outcomes, after adjusting for other variables. Results. Sixty-nine women (34.3%) had one or more of the composite adverse maternal outcomes, and there were 74 (36.8%) cases of perinatal mortality. The presence of imminent symptoms (odds ratio (OR)=2.35) and multiparity (OR=2.31) were associated with composite adverse maternal outcomes, whereas low birth weight and breech vaginal delivery were associated with perinatal mortality. Perinatal mortality was higher in women with pre-eclampsia diagnosed between 28 and 30 weeks. Gestational age at diagnosis was not found to be associated with composite adverse maternal outcomes or perinatal morbidity. Conclusion. Expectant management in early-onset pre-eclampsia can be safely considered without increasing maternal risk, after thorough counselling about outcomes, based on the available neonatal facilities in low-resource settings.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/SAJOG.1378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46414532","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}

引用次数: 2

Thoracic Endometriosis Syndrome 胸部子宫内膜异位症

South African Journal of Obstetrics and Gynaecology Pub Date : 2018-12-14 DOI: 10.7196/SAJOG.1340

D. Guidozzi, Esther Rockson

引用次数: 55

Comparison of newborn and placental weights between adolescent and adult women 青春期和成年妇女新生儿和胎盘重量的比较

South African Journal of Obstetrics and Gynaecology Pub Date : 2018-12-03 DOI: 10.7196/SAJOG.1296

A. Cersosimo, E. A. Júnior, E. Santana, B. D. C. França, F. Vasques

{"title":"Comparison of newborn and placental weights between adolescent and adult women","authors":"A. Cersosimo, E. A. Júnior, E. Santana, B. D. C. França, F. Vasques","doi":"10.7196/SAJOG.1296","DOIUrl":"https://doi.org/10.7196/SAJOG.1296","url":null,"abstract":"Background. Low placental weight is associated with adverse perinatal outcomes. Adolescent pregnant women are associated with higher preterm labour, low birth weight and fetal growth restriction rates than adult pregnant women. Objective. To compare placental and newborn weights between groups of adolescent (≤19 years old) and adult mothers (20 - 28 years old). Methods. A prospective cross-sectional study was conducted with primiparous mothers who had their deliveries at ≥37 weeks’ gestation, and without maternal chronic disease or obstetrical intercurrence. Adolescents were divided into two groups (group A1, aged <15 years; group A2, 15 - 19 years), and the outcomes compared with a control group of adult mothers aged 20 - 28 years (group B). Group A1 included 23 newborns and 18 placentas, group A2 comprised 28 newborns and 28 placentas, and group B included 27 newborns and 27 placentas. The placental and newborn weights were compared between the groups using Student’s t -test for paired samples. Results. The mean (standard deviation (SD)) weights of the newborns and placentas in group A were significantly lower than those in group B: 3167.8 g (359.6) v. 3404.0 g (136.8) ( p =0.0016) and 573.7 g (98.7) v. 651.0 g (109.8) ( p =0.0028), respectively. The mean (SD) newborn and placental weights in group A1 were significantly lower than those in group A2: 2996.0 g (373.7) v. 3309.0 g (273.6) ( p =0.0012) and 513.0 g (94.9) v. 612.5 g (73.8) ( p =0.0026), respectively. Conclusion. The placental and newborn weights were significantly lower in the adolescent groups, and this difference was more pronounced in the younger of the adolescent groups.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/SAJOG.1296","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42542090","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}

引用次数: 3