Obstetrics and Gynaecology Forum - Volume 14, Issue 3, 2004
Volume 14, Issue 3, 2004
Author J. MoodleySource: Obstetrics and Gynaecology Forum 14 (2004)More Less
Extracted from text ... EDITORIAL Obstetrics & Gynaecology Forum - August 2004 1 Preventing mother to child transmission of HIV Some key messages In this edition, the impact of HIV on women in one of the articles is highlighted. The HIV epidemic affects women disproportionately and is therefore devastating for women, particularly in sub-Saharan Africa. Among young women this discrepancy is particularly high; women aged 15- 24 years are up to 2.5 times more likely to be infected than young men in the same age group. It is not surprising therefore, that of the 600 000 children HIV-infected annually world-wide, most are due ..
Source: Obstetrics and Gynaecology Forum 14, pp 4 –5 (2004)More Less
KwaZulu-Natal is continuing to experience the increasing rates in the seroprevalence rates of HIV infection amongst antenatal attendees, despite reports of the epidemic levelling off in the country. With the nevirapine programme now being accessible at almost all maternity facilities in the province, the impact of HIV on the mothers is evident, as local audit shows increased mortality and morbidity rates. It is known that the survival of the mother greatly influences that of the infant in the first few years of life, whether the child is HIV infected or not.
Source: Obstetrics and Gynaecology Forum 14, pp 7 –11 (2004)More Less
The recent discovery that umbilical cord blood has a high concentration of haematopoeitic stem cells has led to cord blood being used to treat a variety of disorders. <br>Collection of cord blood is easy, non-invasive and generally does not interfere with the delivery process. However, there are various ethical and logistical issues surrounding both collection and storage of cord blood that require further discussion and clarification. <br>The vast discrepancy in cost between public and private cord blood banking has sparked debate surrounding commercial cord blood banks. This has led to various international bodies issuing policy statements and guidelines regarding collection protocols and banking. <br>Although banking of umbilical cord blood complies with the ethical principles of autonomy, beneficence and non-munificence, whether distributive justice is respected or not is debatable at present. The following article reviews all the issues and controversies surrounding umbilical cord blood banking.
Source: Obstetrics and Gynaecology Forum 14, pp 13 –19 (2004)More Less
Although twin pregnancies are usually welcome, the excitement of a twin pregnancy can often be overshadowed by unforeseen complications. These pregnancies are associated with an increased perinatal morbidity and mortality when compared to singleton pregnancies. In addition there may be significant maternal complications such as early onset pre-eclampsia and preterm labour. These factors certainly contribute to the psychological impact on the parents. <br>The incidence of twins is variable but the increased use of assisted reproductive technology has increased the frequency of multiple pregnancies in developed societies. Approximately two-thirds of twins are dizygotic (non-identical) and one-third monozygotic (identical). Early ultrasound can confirm the diagnosis and accurately establish chorionicity, amnionicity and gestational age. Later, structural anomalies can be excluded and growth monitored, while Doppler velocimetry of the umbilical artery can detect placental insufficiency. Monochorionic pregnancies are at highest risk of adverse outcome due to specific complications, such as twin-to-twin transfusion syndrome.
Complications following caesarean delivery at King Edward VIII hospital, Durban, South Africa : original articleSource: Obstetrics and Gynaecology Forum 14, pp 21 –26 (2004)More Less
<I>Aim:</I> This study was designed to determine the prevalence of complications associated with caesarean section in a setting of high caesarean section and HIV rates. <br><I>Setting:</I> A tertiary teaching hospital in Durban, South Africa. <br><I>Design: </I> A retrospective analysis. <br><I>Methods: </I> A detailed review of the records of 737 caesarean sections performed over a three month period. <br><I> Results: </I> The overall complication rate was 14.2%. Major complications included bladder injury, endometritis, wound sepsis and post-partum haemorrhage. HIV infection may have a negative impact on morbidity rates. Disimpacting the fetal head vaginally had a significant association with endometritis (p=0.021). The use of a corrugated drain did not prevent wound sepsis (p < 0.001). <br><I>Conclusion: </I>Complications associated with caesarean section are common is a setting of high caesarean section rates and HIV infection.
Source: Obstetrics and Gynaecology Forum 14, pp 29 –33 (2004)More Less
Advanced extrauterine pregnancy is a rare event and presents a challenge to the diagnostic and clinical management skills of every obstetrician. It is associated with significant maternal and fetal morbidity and mortality therefore early diagnosis is important. Prognosis appears good with appropriate pre-operative management and involvement of multi-disciplinary team.
Source: Obstetrics and Gynaecology Forum 14 (2004)More Less
Extracted from text ... O&G CPD ANSWER FORM - AUGUST 2004 Subscribe to the O&G Forum CPD programme and earn 16 CPD points per year CPD reference number A008/086/03/2004 Continuing Professional Development Point Questionnaire Accredited by the Wits CPD Office Instructions 1. Read the journal to find all the answers 2. Answer the questions and mark the answer form by putting an "X" in the appropriate square. 3. Make a photocopy for your records in case the form is lost in the mail. 4. Tear out page and place the answer form in a envelope, seal it and send to:- In House Publications, O&G ..