Obstetrics and Gynaecology Forum - Volume 15, Issue 3, 2005
Volume 15, Issue 3, 2005
Author J. MoodleySource: Obstetrics and Gynaecology Forum 15 (2005)More Less
Extracted from text ... EDITORIAL Obstetrics & Gynaecology Forum - August 2005 1 Women's health concerns This edition is devoted to issues surrounding women's health. It is obviously a tragedy that maternal mortality rates are probably not decreasing world wide. In fact in South Africa, maternal mortality rates may have remained the same over the last five years and the HIV pandemic may be the cause for a change in the pattern of the common causes of maternal deaths. In contrast to the initial Saving Mothers Report, which demonstrated that hypertensive disorders of pregnancy were the commonest cause of maternal mortality, the latest ..
Occupational exposure to HIV amongst health care workers in the maternity unit at King Edward VIII hospital, Durban, South Africa : original articleSource: Obstetrics and Gynaecology Forum 15, pp 5 –7 (2005)More Less
The increasing HIV sero-prevalence amongst pregnant women places health care workers in busy labour wards at high risk of occupational exposure to HIV.<br><I>Aim:</I> The aim of this study was to determine whether there has been a change in the prevalence of needle-stick and sharps injuries at King Edward VIII Hospital, Durban, South Africa, since the first study done on the issue in 1999, and if so - the reasons. <br><I>Design:</I> A cross-sectional retrospective survey assessing the prevalence of needle-stick and sharps injuries which occurred from January 2003 to December 2003. <br><I>Setting:</I> The study was conducted at the Department of Obstetrics and Gynaecology, King Edward VIII Hospital, Durban, South Africa. <br><I>Method:</I> Staff members in the labour ward, including doctors, nurses, student nurses, and supportive staff, i.e. cleaners, porters, and messengers were interviewed and asked to fill in a structured questionnaire. <br><I>Results:</I> Healthcare workers (114) were interviewed over a period of 1 year, from January to December 2003. 49 of the 90 (54%) who agreed to participate reported an incident of exposure to patients' body fluids, 19 of who were through sharp injuries (21%); forty percent of exposures occurred with known HIV infected patients, whereas at least 28% of patients sero-status was unknown at the time of the exposure. Only 61% of the sharps injuries were reported, and of these, only a third of the health workers completed the prescribed 4 week course of prophylactic antiretroviral treatment. <br><I>Conclusion:</I> This study showed an increase in the number of HIV exposures amongst health workers, and most of these are as a result of lack of adherence with preventative measures. Improved reporting mechanisms which ensure confidentiality may assist health workers to deal with this.
Cost implications of the use of magnesium sulphate for the prevention of convulsions in severe pre-eclampsia : original articleSource: Obstetrics and Gynaecology Forum 15, pp 9 –12 (2005)More Less
<I>Objective:</I> To assess the direct financial costs of using MgS0<sub>4</sub> for the prevention of convulsions in the management of severe pre-eclampsia. <br><I>Method:</I> A prospective costing study using resource data obtained from hospital records. Unit costs per patient were calculated. The costs to health provider only, of using or not using MgS0<sub>4</sub> are reported. <br><I>Setting:</I> Department of Obstetrics and Gynaecology of King Edward VIII Hospital, Durban, South Africa. 196 patients records were analysed and reviewed between 1 July and 31 December 2003. <br><I>Results:</I> The average unit cost per day for patients on MgS0<sub>4</sub> was R1575.12 while that of those not on MgS0<sub>4</sub> was R1085.15. <br><I>Conclusion:</I> Use of MgS0<sub>4</sub> to treat the severe pre-eclamptic patient has cost implications but, a case for its use in patients with severe pre-eclampsia can be made.
Author S.P. MoodleySource: Obstetrics and Gynaecology Forum 15, pp 15 –17 (2005)More Less
Extracted from text ... REVIEW Obstetrics & Gynaecology Forum - August 2005 15 Sexuality in the climacteric Introduction The climacteric is a complex transition in a woman's life. It is characterised by hormonal changes which can worsen pre-existing emotional lability or induce a new change in personality and mood. The doctor must be aware of co-morbid illnesses and their respective treatments which influences sexuality at every level. Therefore, it is not unexpected that issues of sexuality will form a major part of the consultation with the climacteric patient and her partner. The hallmark of any good consultation is dependent on the physician's ability to ..
Author S.R. RamphalSource: Obstetrics and Gynaecology Forum 15, pp 19 –24 (2005)More Less
Extracted from text ... REVIEW Obstetrics & Gynaecology Forum - August 2005 19 Use of prosthetic material in gynaecological surgery Introduction Urinary incontinence and uterovaginal prolapse are common problems with increasing prevalence rates worldwide. Ten to 20% of women experience urinary incontinence with this figure rising to 35% in those over the age of 65.1 Stress incontinence is the commonest cause of urinary incontinence and it is well known that the first operative procedure to rectify this problem has the best chance of a successful outcome. It is therefore imperative that the first attempt at surgery is successful and is associated with the ..
Source: Obstetrics and Gynaecology Forum 15, pp 27 –30 (2005)More Less
Rhesus D alloimmunisation remains a major problem despite the use of anti-D prophylaxis. Immunisation during pregnancy commonly occurs in the absence of any overt sensitizing event. Appropriate and timely intervention can significantly reduce the rate of immunisation (17% - 1%). In this respect, a simple algorhythm for the management of RhD negative women in pregnancy is presented. <br>Traditionally, identifying and monitoring fetuses at risk of anaemia in RhD alloimmunised pregnancies required invasive testing such as serial amniocentesis. This procedure is associated with significant complications. Recent evidence favours a non-invasive approach by measuring the peak systolic velocity in the fetal middle cerebral artery. This Doppler method has the same accuracy in predicting fetuses at risk of anaemia when compared with amniocentesis, but without its complications. We therefore present new guidelines for the monitoring of RhD alloimmunised pregnancies.
Source: Obstetrics and Gynaecology Forum 15 (2005)More Less
Extracted from text ... O&G CPD ANSWER FORM - AUGUST 2005 Subscribe to the O&G Forum CPD programme and earn 16 CPD points per year CPD reference number A008/024/02/2005 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 ..