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- Volume 11, Issue 3, 2005
South African Journal of Obstetrics and Gynaecology - Volume 11, Issue 3, 2005
Volume 11, Issue 3, 2005
Author Elbie ViljoenSource: South African Journal of Obstetrics and Gynaecology 11, pp 51 –52 (2005)More Less
Extracted from text ... September 2005, Vol. 11, No. 3 51 SAJOG Exposure of the fetus to cigarette smoke is an important, dose-related and preventable risk factor in the quest for optimal pregnancy outcome. It is therefore essential that all health care workers and mothers are fully aware of these adverse effects. Nicotine, the dominant alkaloid in tobacco smoke, easily crosses the placenta, leading to fetal plasma concentrations on average 15% higher than those of the mother.1 Nicotine also concentrates in placental tissue, amniotic fluid and breast-milk. Amniotic nicotine levels in the mid-trimester are up to 54% higher than those in maternal serum. The ..
Source: South African Journal of Obstetrics and Gynaecology 11 (2005)More Less
Extracted from text ... PRODUCT NEWS ? PRODUCT NEWS Detrol LA/DetrustitolSR reduces urgency, the most bothersome symptom for patients with overactive bladder A Pfizer Inc study showed that Detrol LA (tolterodine tartrate extended release capsules)/Detrusitol SR (tolterodine tartrate sustained release capsules) significantly increases the urgency-free interval (UFI) of patients with overactive bladder (OAB) symptoms compared with patients taking placebo. Results from the multi-centered international study were presented at the International Continence Society meeting in Paris. Study author Vik Khullar, MD, Department of Obstetrics and Gynecology, St Mary's Hospital, London, explained: 'Detrol LA/Detrusitol SR seems to prolong the filling phase, delays sensation of urgency and ..
Source: South African Journal of Obstetrics and Gynaecology 11 (2005)More Less
Extracted from text ... SAJOG 54 September 2005, Vol. 11, No. 3 NEWS ? NEWS ? NEWS ? NEWS ? NEWS ? NEWS Towards '3 by 5' Since late 2003, and the launch of a strategy by the World Health Organization (WHO) and UNAIDS to ensure treatment for 3 million people living with HIV / AIDS in lowand middle-income countries worldwide by the end of 2005 (the '3 by 5' target), the coverage of antiretroviral (ARV) therapy in these countries has more than doubled, increasing from 400 000 to approximately 1 million people receiving treatment at the end of June 2005, according to the ..
Source: South African Journal of Obstetrics and Gynaecology 11, pp 56 –57 (2005)More Less
Extracted from text ... SAJOG 56 September 2005, Vol. 11, No. 3 A recent study by the Medical Research Council (MRC) Perinatal Mortality Research Unit at Tygerberg Hospital found that 39% of pregnant women smoked cigarettes.1 Smoking in pregnancy is clearly recognised in the literature as an important, dose-related, preventable risk factor for poor perinatal outcome.2 A previous MRC finding that 47% of South African coloured women smoke during pregnancy3 stands in sharp contrast to the prevalence in developed countries, for example 15.8% in the USA.4 In a developing country, where poverty in itself increases perinatal mortality and morbidity, this increase in cigarette smoking ..
Source: South African Journal of Obstetrics and Gynaecology 11, pp 59 –64 (2005)More Less
<I>Objective.</I> To investigate the current smoking cessation practices and attitudes of doctors working in the public antenatal services, as well as their perceived barriers to addressing the issue in the context of routine care. <br><I>Study design.</I> The study was qualitative, consisting of 14 semi-structured, one-to-one interviews with doctors purposefully sampled from 5 public sector hospitals in Cape Town, South Africa. <br><I>Results.</I> The doctors in this study regarded HIV, poor nutrition, alcohol abuse and psychosocial stress as equal or higher risks to pregnant women than smoking. They tended to underestimate the magnitude of the risk of smoking during pregnancy. Doctors were unaware of the guidelines offering clinicians brief, structured approaches to smoking cessation counselling and were generally pessimistic that they could influence the smoking behaviour of pregnant women, especially poor, disadvantaged women who face multiple barriers to achieving health-enhancing behaviour. However, most doctors were concerned about improving their communication with pregnant women about smoking and open to adopting new approaches or tools that could assist them. Perceived barriers to providing smoking cessation interventions included a lack of counselling skills and educational resources, other pressing priorities, too little time, and the levels of stress currently experienced by doctors and midwives working in public sector hospitals as a result of dramatic staff and budget cuts. <br><I>Conclusion.</I> The study suggests that doctors working in the public sector antenatal services are not routinely addressing the issue of smoking during pregnancy or using effective methods to assist women to give up smoking. Doctors need convincing that smoking cessation interventions can be effective. The promotion and provision of evidence-based guidelines such as the Clinical Practice Guideline for Treating Tobacco Use and Dependence (Fiore, 2000), with minimal training, is a possible strategy for integrating smoking cessation interventions into routine antenatal care in South Africa.
Source: South African Journal of Obstetrics and Gynaecology 11, pp 66 –69 (2005)More Less
Extracted from text ... SAJOG 66 September 2005, Vol. 11, No. 3 In a recent issue of the Journal, 1 views were expressed that our national private sector caesarean section (CS) rate is too high at over 60%, and government and/or funders are likely to intervene unless doctors begin to self-regulate by developing appropriate protocols and guidelines. This is not a new issue for South Africa or for medically insured populations around the world, and the sheer volume of literature on the subject of high CS rates indicates that it is unlikely one will reach consensus on a national target CS rate simply by ..
Source: South African Journal of Obstetrics and Gynaecology 11, pp 71 –73 (2005)More Less
Extracted from text ... September 2005, Vol. 11, No. 3 71 SAJOG The origin of antenatal fetal heart rate monitoring (AFM) appears lost in the mists of time. Odendaal, 1 in his signal thesis on cardiotocography, mentions that Legumeau de Kegadarek had first observed the occurrence of fetal heart rate decelerations in 1822, after which Von Winckel, in 1893, observed that bradycardia may be associated with poor fetal outcome. Electronic AFM has remained an integral part of obstetric practice since the early 1970s, when continuous monitoring became established and the true significance of decelerations was appreciated. Developing communities often have inordinately high perinatal mortality ..
Author P.R. De JongSource: South African Journal of Obstetrics and Gynaecology 11 (2005)More Less
Extracted from text ... SAJOG 76 September 2005, Vol. 11, No. 3 A 30-year-old gravida 3 para 2 woman presented to the casualty department in hypovolaemic shock. She had several hours' history of severe right illac fossa pain, of increasing intensity. The patient gave a history of 6 weeks of amenorrhoea, was sexually active and not on contraception. She had never had any previous assisted reproduction intervention, and had 2 children born vaginally in the past. On examination the patient was found to be haemodynamically unstable with a blood pressure of 90/60 mmHg, and a tachycardia of 120 beats per minute. She was ..
32nd National Congress of the South African Society of Obstetricians and Gynaecologists : 4 - 7 September 2005, Champagne Sports Resort, Drakensberg : abstractsSource: South African Journal of Obstetrics and Gynaecology 11, pp 78 –104 (2005)More Less
Extracted from text ... SAJOG 78 September 2005, Vol. 11, No. 3 International Speakers MANAGEMENT OF INTERSEX CONDITIONS Adam Balen, MD, FRCOG Department of Reproductive Medicine, Leeds General Infirmary, Leeds, UK Introduction. In the management of young women with gynaecological problems we have to be sensitive to the specific needs of the adolescent who is confronted with issues relating to sexual function and sexual identity, endocrinology and fertility. Whilst rare it is imperative that intersex conditions are managed in centres by a multi-disciplinary team that includes paediatric surgeons, urologists (often paediatric and adult), plastic surgeons, endocrinologists, specialist nurses, psychologists and also the gynaecologist - ..