Obstetrics and Gynaecology Forum - Volume 22, Issue 1, 2012
Volume 22, Issue 1, 2012
Author G.B. TheronSource: Obstetrics and Gynaecology Forum 22, pp 1 –3 (2012)More Less
The global effort towards reaching the Millennium Development Goals (MDG) has increased in intensity. During recent years, the global MDG focus has increasingly highlighted the fact that poor or no progress is being made towards reaching Goal 5 (improved maternal health) in sub-Saharan Africa (SSA). Target 6 of Goal 5 requires the reduction of maternal mortality by three-quarters between 1990 and 2015. Indicators 16 (maternal mortality ratio) and 17 (proportion of births attended by skilled health personnel) are used to measure the progress of countries towards achieving Goal.
Methamphetamine use by pregnant women : impact on the neonate and challenges for the perinatal team : reviewSource: Obstetrics and Gynaecology Forum 22, pp 8 –11 (2012)More Less
According to the United Nations Office on Drugs and Crime (UNODC)'s 2011 World Drug Report, amphetamine-type stimulants (ATS) are the second most widely used illicit drug group. This drug group comprises methamphetamine, amphetamine and ecstasy. Methamphetamine is the most widely manufactured drug in this group globally, with an estimated annual prevalence of 0.3 to 1.3% two years ago. Africa, notably West Africa, has been identified as an emerging region of consumption and trafficking of methamphetamine in particular.
Source: Obstetrics and Gynaecology Forum 22, pp 13 –18 (2012)More Less
Adnexal masses in different age groups may need different management approaches. By elimination of the type of mass that is less likely in a specific age group one can identify the most prevalent group which can guide management. Most important of all, the probability of malignancy must either be identified or ruled out. In view of our ethical responsibility to our patients, do no harm (primum non nocere) and non-maleficience, we must attempt to preserve fertility in a patient of reproductive age, and prioritise the future reproductive needs of the very young or adolescent patient presenting with an adnexal mass.
Source: Obstetrics and Gynaecology Forum 22, pp 20 –23 (2012)More Less
The management of a breech presentation has and will always be a controversial topic. In this review article we discuss the classification of breech presentations and the associated risks. We review the recent literature regarding the management options which include awaiting a spontaneous version, performing an external cephalic version (ECV) and the options to facilitate a successful version. We discuss the role of elective caesarean section (CS) versus vaginal delivery with regard to recent literature.
We conclude that ECV should be offered to all women with a breech presentation who do not have contraindications as it is effective and safe and that an ECV should be performed using a betamimetic for tocolysis. If an ECV is unsuccessful then the route of delivery for a persistent breech presentation should be individualised. Women with a breech presentation should be extensively counselled about the different delivery options and they should be provided with all the evidence, including the limitations of the evidence. The risks associated with caesarean section including the risk to future pregnancies must be emphasised as this enables a women to make an informed decision about their delivery. Vaginal delivery for certain selected breech presentations is still a good option. For women with a baby with flexed thighs who progress appropriately in labour with descent and spontaneous birth of the breech, the likelihood of difficulty with the delivery is very small. If progress is not good, even at full cervical dilation, recourse to CS is a safer option than attempts at breech extraction. Training videos are available in the World Health Organization Reproductive Health Library on the delivery of a breech presentation and on the technique of ECV (http://apps.who.int/rhl/videos/en/index.html).
Source: Obstetrics and Gynaecology Forum 22, pp 26 –30 (2012)More Less
This case report highlights the fact that in dealing with fetal ascites or possible early hydrops that the exact aetiology may not always be evident sonographically prenatally and that although the signs may point to a particular probable aetiology, other possibilities should also always be considered.
Author Z. AbdoolSource: Obstetrics and Gynaecology Forum 22, pp 32 –34 (2012)More Less
Urodynamic studies still remains a controversial investigation in the assessment of patients with urinary incontinence. A systematic review on the correlation between clinical and urodynamic diagnosis in classifying the type of urinary incontinence by van Leijsen et al in 2011 makes interesting reading. The review concluded that there is a significant reclassification of patients with clinically diagnosed stress urinary incontinence (SUI), mixed urinary incontinence (MUI) and urge urinary incontinence (UUI) after performing urodynamic studies.