Obstetrics and Gynaecology Forum - Volume 20, Issue 4, 2010
Volume 20, Issue 4, 2010
Author E.J. CoetzeeSource: Obstetrics and Gynaecology Forum 20, pp 109 –111 (2010)More Less
Why are we as obstetricians the most frequent target of litigants and why do we carry the brunt of the financial load in litigation? Obstetricians in private practice in South Africa now pay R139 000.00 annually to the Medical Protection Society [MPS] for their medico-legal indemnity and this is likely to increase even further. While this appears excessive in our medical community, insurance payments in developed countries far exceed this.
Author D.W. SteynSource: Obstetrics and Gynaecology Forum 20, pp 117 –121 (2010)More Less
Cervical cerclage includes a variety of surgical procedures involving suturing the cervix with a purse type stitch to keep it closed during pregnancy. More than fifty years have passed since Shirodkar introduced this as a procedure to manage women who had at least four miscarriages between "the fourth and seventh month" due to "a weak cervical sphincter".
Source: Obstetrics and Gynaecology Forum 20, pp 123 –126 (2010)More Less
Adenomyosis is a common gynaecological condition. In the past, it was believed that the diagnosis could be made clinically and confirmed histologically following hysterectomy, which was the treatment of choice. Presently, it has been accepted that adenomyosis cannot be diagnosed clinically. There are newer insights into the pathogenesis of the disease, as well as advanced diagnostic tools that allow reliable diagnosis. This has resulted in different management options which are available to the clinician. The aim of this review is to present an update of the current knowledge and outline alternate management options.
Author L.K. SchoemanSource: Obstetrics and Gynaecology Forum 20, pp 129 –132 (2010)More Less
Blood transfusions are governed by the Human Tissue Act. Blood users and providers should be aware of their legal and clinical responsibility when using blood and blood products.
The safety of blood products cannot be guaranteed and an inherent risk remains when using these products. All efforts should be made to optimize safety, and the use of these products should be considered only where valid indications exist. The risk of HIV transmission remains a concern and patients should be aware of these risks. All clinicians and institutions should incorporate good blood use into the standard of practice.
Red blood cell transfusions are indicated to restore oxygen carrying capacity of blood. The importance of perfusion in maintaining oxygenation should not be forgotten and the decision to transfuse should take into consideration not only the haemoglobin level, but also physiological signs of inadequate perfusion.
Preoperative correctable chronic anaemia should be treated pharmacologically. When intra- or postoperative transfusionseems likely clinicians should consider alternatives to allogenic blood transfusion and discuss these options with patients.
Source: Obstetrics and Gynaecology Forum 20, pp 133 –137 (2010)More Less
The World Health Organization (WHO) defines miscarriage as ''the expulsion or extraction from its mother of an embryo or fetus weighing 500g or less.'' Recurrent pregnancy loss (RPL) is defined as ''the loss of three or more consecutive pregnancies before 20 weeks gestation.''