Obstetrics and Gynaecology Forum - Volume 21, Issue 3, 2011
Volume 21, Issue 3, 2011
Source: Obstetrics and Gynaecology Forum 21, pp 1 –3 (2011)More Less
Advances in ultrasound technology has enabled clinicians not only to visualize their second patient the 'fetus' clearly, but has also assisted the sub specialty of fetal medicine to expand and undertake ambitious and intricate interventions on the fetus in utero. Also the improvement in the quality of the ultrasound machines available at present, has assisted the specialist to perform a detailed and intricate assessment of the fetus at 11-13 weeks and beyond, which no doubt will alter the manner in which we manage the fetus and the pregnant mother, as demonstrated in our case presentation in this edition of the O&G forum.
Author M. MasenyaSource: Obstetrics and Gynaecology Forum 21, pp 9 –11 (2011)More Less
The human papilloma virus has been shown to play a significant aetiological role in invasive cervical cancer. The changes caused by human papilloma virus can be evaluated using Pap smear. The discovery of Pap smears has led to an unprecedented dramatic decline in the incidence of cervical cancer over the past five decades. This has been the case in high income countries due to effective cervical cancer screening programmes. The effectiveness of this simple cost-effective tool has led to attempts at improving the quality of the Pap smear sample as well as the processing technique in the laboratory. This has led to the introduction of Liquid based cytology, a technique slowly replacing conventional cytology in the world due to its advantages. Although initially thought to be more sensitive and specific than conventional cytology, recent studies suggest that there are no significant differences in this aspect. The main advantage is that Liquid based cytology is less likely to be unsatisfactory or limited. Liquid based cytology has also reduced the screening time leading to improved turn-around time. The specimen submitted for liquid based cytology can be used to perform further tests such as molecular and microbiological studies. The Pap smear still plays an integral part in cervical cancer screening, despite recent advances in detection of human Papilloma virus using molecular techniques. The implementation of cervical screening programmes in low and middle income countries will assist in reducing the mortality related to invasive cervical cancer.
Author S.P. MoodleySource: Obstetrics and Gynaecology Forum 21, pp 13 –14 (2011)More Less
Author M. BhanaSource: Obstetrics and Gynaecology Forum 21, pp 16 –19 (2011)More Less
The use of HAART (Highly Active Antiretroviral Therapy) has significantly decreased the morbidity and mortality in individuals infected with HIV. Many couples who are infected with HIV (sero-discordant and sero-concordant) seek assistance with conception. The objective of the paper is to address the options available to these couples using artificial reproductive techniques (ART), in order to decrease the risk of transmission of HIV to the uninfected partner and the unborn fetus.
Source: Obstetrics and Gynaecology Forum 21, pp 22 –23 (2011)More Less
Aim: To identify avoidable factors for birth asphyxia during the antenatal and intrapartum care.
Method: All asphyxiated babies born at Lower Umfolozi District War Memorial Hospital (LUDWMH) from November 2010-January 2011 were analysed. Babies with congenital anomalies, congenital infections and extreme prematurity were excluded. Substandard care and avoidable factors were identified and divided into patient-related, healthcare worker-related and administrative associated; and recorded with a coding system similar to that of the Perinatal Problem Identification Programme (PPIP).
Results: There were 20 intrapartum asphyxiated babies. Analysis of antenatal care showed healthcare worker-related avoidable factors in 20% and patient related avoidable factors in 20%. Analysis of intrapartum care showed healthcare worker related avoidable factors in 40%, administrative avoidable factors in 30% and patient related factors in 20%. The most common patient related factor was a delay in seeking help during labour (25%). The most common health worker related avoidable factor was fetal distress not detected during fetal monitoring. The main administrative problem was a delay in caesarean section due to an inadequate number of staffed theatres (84%).
Conclusion: This audit identifies resource deficiencies. Healthcare workers must have regular in-service training and education on fetal monitoring, interpretation and timeous action when an abnormal CTG occurs. The hospital management must be involved in delays in CS due to staff shortages and alternate arrangements made to ensure optimal service delivery at all times. There still exists in our community, a number of women who don't access healthcare to an appropriate level during pregnancy. Health education for the general public and pregnant women in this area should be emphasised.
Author M.S. BodlaniSource: Obstetrics and Gynaecology Forum 21, pp 27 –25 (2011)More Less
Rudimentary horn pregnancy is a rare complication that is thought to occur in 1:76000 pregnancies. Rupture of the horn in pregnancy is considered the most serious and common complication of rudimentary horns. The investigation of choice is considered to be magnetic resonance imaging (MRI). Evaluation of renal tract anomalies is mandatory in all patients with mullerian anomalies. Excision of all rudimentary horns with endometrial cavity is recommended to prevent complications. We present a case of ruptured rudimentary horn of a unicornuate uterus at 18 weeks gestation.
A case report of a complex corpus callosal abnormality using advanced sonographic techniques : case reportSource: Obstetrics and Gynaecology Forum 21, pp 29 –32 (2011)More Less
Mrs K P, a 29 year old P0G1 who presented at 12 weeks gestation for routine antenatal care. Aneuploidy screen revealed that her composite risk for Down's syndrome using a combination of nuchal translucency (measurement was 1.1mm), nasal bone assessment and biochemistry was low. Her blood group was O positive and screening tests for syphilis, rubella and HIV were negative. There was no family history of genetic or congenital anomalies. The rest of the antenatal care until 22 weeks was uneventful.