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- South African Journal of Obstetrics and Gynaecology
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- Volume 11, Issue 1, 2005
South African Journal of Obstetrics and Gynaecology - Volume 11, Issue 1, 2005
Volume 11, Issue 1, 2005
Source: South African Journal of Obstetrics and Gynaecology 11, pp 6 –8 (2005)More Less
<I>Objective.</I> To investigate the impact of oestrogen supplementation from the early luteal to the late proliferative phase on biochemical and ongoing pregnancy rates in gamete intrafallopian transfer (GIFT). <br><I>Methods.</I> Ninety-five patients were assigned to clomiphene citrate-human menopausal gonadotrophin (hMG)-induced GIFT cycles, with or without the use of oestrogen support (oral administration of estradiol valerate). The main outcome measures were biochemical pregnancy rate and clinical pregnancy rate. <br><I>Results.</I> The biochemical pregnancy rate was 38.09% in the oestrogen group v. 22.9% in the controlgroup (p = 0.096, 95% CI: 5.7 - 37.3%). The clinical pregnancy rate in the oestrogen supplementation group was 23.8% v. 14.58% in the control group (p= 0.1988, 95% CI: 10.3 - 31.7%). <br><I>Conclusion.</I> Although the results of this study show no significant statistical difference, there is a clinical trend in favour of giving oestrogen support.
Source: South African Journal of Obstetrics and Gynaecology 11, pp 9 –10 (2005)More Less
Misoprostol is currently being used for induction of labour at or near term and also for termination of pregnancy. Its use without proven dosage regimens is possibly associated with an increase in the incidence of uterine hyperstimulation, preterm labour, induced abortion above 20 weeks' gestation, meconium-stained liquor in the latent phase of labour, fetal distress and cases of uterine rupture as demonstrated by these case reports and literature review. Its use for these purposes must be under controlled circumstances, using minimum doses.
Antepartum and intrapartum complications in grandmultiparous patients compared with multiparous patients at Tygerberg HospitalSource: South African Journal of Obstetrics and Gynaecology 11, pp 14 –16 (2005)More Less
<I>Objective.</I> To examine whether grandmultiparous women in a modern setting with adequate health care are at greater risk of complications in the antepartum and intrapartum period than multiparous women. <br><I>Patients and methods.</I> The labour registry and hospital files were used and all grandmultiparas were identified from 31 December 2002 retrospectively for a period of 18 months, with each grandmultiparous patient matched with a control patient selected by identifying the first multiparous patient to deliver within the same week. <br><I>Results.</I> No statistical difference was noted in antenatal maternal medical disorders such as chronic hypertensive disease in multiparas versus grandmultiparas (7/97 v. 6/101, 7.2% v. 5.9%) and diabetes mellitus. The development of pre-eclampsia was also not significantly different. Although the difference in pregnancy-induced hypertension (PIH) was not significant, with PIH in the multiparous group 22/97 (22.7%) and in the grandmultiparous group 12/101 (11.9%) (p-value = 0.04398, odds ratio 2.18, confidence interval: 0.95 - 5.03), a trend was observed for more multiparas to develop PIH. <br><I>Conclusion.</I> In the modern setting with adequate health care, properly trained nursing staff and doctors and well-designed protocols grandmultiparity is not associated with a significantly increased risk of the classic complications traditionally associated with it. We conclude that provided adequate health care exists, there should be no difference in the complications experienced by grandmultiparous and multiparous patients.