Pub Date : 2020-09-15DOI: 10.7196/SAJOG.2020.V26I1.1605
S. Adam, S. Maswime, P. Soma-Pillay, M. Matjila, L. Chauke, M. Botha, R. Pattinson
{"title":"Judicious use of personal protective equipment to prevent the spread of COVID-19 in maternity units","authors":"S. Adam, S. Maswime, P. Soma-Pillay, M. Matjila, L. Chauke, M. Botha, R. Pattinson","doi":"10.7196/SAJOG.2020.V26I1.1605","DOIUrl":"https://doi.org/10.7196/SAJOG.2020.V26I1.1605","url":null,"abstract":"","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46623551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 16-year-old primigravida at term developed fetal compromise in the second stage of labour and had a delayed caesarean delivery (CD) because she declined the procedure after the medical manager had consented on her behalf following the unavailability of her parents. The baby that was delivered suffered neonatal encephalopathy. This report provides a recommendation on how to improve the process of obtaining consent for CD in minors in South Africa.
{"title":"Challenges in obtaining consent for caesarean delivery in minors in South Africa","authors":"N. Ngene, T. Bodiba","doi":"10.7196/SAJOG.1628","DOIUrl":"https://doi.org/10.7196/SAJOG.1628","url":null,"abstract":"A 16-year-old primigravida at term developed fetal compromise in the second stage of labour and had a delayed caesarean delivery (CD) because she declined the procedure after the medical manager had consented on her behalf following the unavailability of her parents. The baby that was delivered suffered neonatal encephalopathy. This report provides a recommendation on how to improve the process of obtaining consent for CD in minors in South Africa.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47051092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-15DOI: 10.7196/SAJOG.2020.V26I1.1518
B. Unnikrishnan, P. Rathi, S. Bhat, PH Nayak, N. Ravishankar, A. Singh, O. Praveen
Background. In the light of the rise in prevalence of gestational diabetes mellitus (GDM) and the importance of early suspicion and prompt diagnosis, different regions have reported different risk factors. This warrants multiple regional studies in sub-populations and diverse geographic areas to quantify determinants of GDM. Objective. To determine risk factors of GDM. Methods. A case-control study was conducted in a tertiary care maternity hospital in coastal South India based on pregnancy records of all those women diagnosed with GDM who received in-patient care between January 2018 and December 2018. There were 131 cases pairmatched for age in the ratio of 1:1 with 131 controls. Results. Women from rural areas and those with a monthly income ≤INR20 000, body mass index (BMI) >23 kg/m2 , polyhydramnios (a trend), pregnancy-induced hypertension (a trend), oligohydramnios (a trend) and a gap between pregnancies of 23 kg/m2 and a spacing gap of <2 years between pregnancies were significant risk factors, whereas those having had a vaginal birth in previous pregnancies in this population had a diminished risk of developing GDM. A larger study is required to demonstrate significance in other factors.
{"title":"Risk factors of gestational diabetes mellitus: A hospital-based pairmatched case-control study in coastal South India","authors":"B. Unnikrishnan, P. Rathi, S. Bhat, PH Nayak, N. Ravishankar, A. Singh, O. Praveen","doi":"10.7196/SAJOG.2020.V26I1.1518","DOIUrl":"https://doi.org/10.7196/SAJOG.2020.V26I1.1518","url":null,"abstract":"Background. In the light of the rise in prevalence of gestational diabetes mellitus (GDM) and the importance of early suspicion and prompt diagnosis, different regions have reported different risk factors. This warrants multiple regional studies in sub-populations and diverse geographic areas to quantify determinants of GDM. Objective. To determine risk factors of GDM. Methods. A case-control study was conducted in a tertiary care maternity hospital in coastal South India based on pregnancy records of all those women diagnosed with GDM who received in-patient care between January 2018 and December 2018. There were 131 cases pairmatched for age in the ratio of 1:1 with 131 controls. Results. Women from rural areas and those with a monthly income ≤INR20 000, body mass index (BMI) >23 kg/m2 , polyhydramnios (a trend), pregnancy-induced hypertension (a trend), oligohydramnios (a trend) and a gap between pregnancies of 23 kg/m2 and a spacing gap of <2 years between pregnancies were significant risk factors, whereas those having had a vaginal birth in previous pregnancies in this population had a diminished risk of developing GDM. A larger study is required to demonstrate significance in other factors.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48617466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Contents","authors":"Gertrude Fani","doi":"10.7196/sajog.1621","DOIUrl":"https://doi.org/10.7196/sajog.1621","url":null,"abstract":"","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45340869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Maternal intravenous immunoglobulin (IVIG) may delay the onset and severity of fetal anaemia in Rhesus D (RhD)- sensitised pregnancies, thereby minimising the need for intrauterine transfusion and its associated complications. Objective. To compare the pregnancy outcomes of RhD-sensitised women who received antenatal IVIG with those who did not receive antenatal IVIG. Methods. This was a retrospective cross-sectional analysis of RhD-sensitised women who attended the Wits Fetal Medicine Centre (Johannesburg) from 1 January 2008 to 31 May 2018. Criteria for maternal IVIG administration were: (i) previous adverse pregnancy outcome (early neonatal death, intrauterine fetal death or miscarriage related to RhD sensitisation), ( ii ) women with high antibody titre levels (≥1:64) in the absence of fetal anaemia; and ( iii ) rising antibody titre levels. Maternal antibody titre levels, pregnancy and neonatal outcomes were compared in women who received IVIG v. those who did not receive IVIG. Results. Of the 42 RhD-sensitised women, 14 received IVIG. A greater proportion of women experienced a decrease in antibody titres in the IVIG v. no-IVIG group (43% v. 11%, respectively; p =0.04). Nine of the 10 women in the IVIG group with a previous adverse pregnancy outcome had a successful pregnancy outcome following IVIG treatment. Conclusion. Maternal IVIG may provide a successful pregnancy outcome in RhD-sensitised women with previous adverse pregnancy outcomes related to Rh disease, or women with raised or increasing maternal antibody titre levels who present in the first or early second trimester.
{"title":"Maternal intravenous immunoglobulin: A non-invasive treatment option for Rhesus D-sensitised women with previous adverse pregnancy outcomes","authors":"N. Frank, Poovangela Naidoo, E. Nicolaou","doi":"10.7196/SAJOG.1629","DOIUrl":"https://doi.org/10.7196/SAJOG.1629","url":null,"abstract":"Background. Maternal intravenous immunoglobulin (IVIG) may delay the onset and severity of fetal anaemia in Rhesus D (RhD)- sensitised pregnancies, thereby minimising the need for intrauterine transfusion and its associated complications. Objective. To compare the pregnancy outcomes of RhD-sensitised women who received antenatal IVIG with those who did not receive antenatal IVIG. Methods. This was a retrospective cross-sectional analysis of RhD-sensitised women who attended the Wits Fetal Medicine Centre (Johannesburg) from 1 January 2008 to 31 May 2018. Criteria for maternal IVIG administration were: (i) previous adverse pregnancy outcome (early neonatal death, intrauterine fetal death or miscarriage related to RhD sensitisation), ( ii ) women with high antibody titre levels (≥1:64) in the absence of fetal anaemia; and ( iii ) rising antibody titre levels. Maternal antibody titre levels, pregnancy and neonatal outcomes were compared in women who received IVIG v. those who did not receive IVIG. Results. Of the 42 RhD-sensitised women, 14 received IVIG. A greater proportion of women experienced a decrease in antibody titres in the IVIG v. no-IVIG group (43% v. 11%, respectively; p =0.04). Nine of the 10 women in the IVIG group with a previous adverse pregnancy outcome had a successful pregnancy outcome following IVIG treatment. Conclusion. Maternal IVIG may provide a successful pregnancy outcome in RhD-sensitised women with previous adverse pregnancy outcomes related to Rh disease, or women with raised or increasing maternal antibody titre levels who present in the first or early second trimester.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45582432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Considering the perspectives of African women affected by gestational diabetes mellitus (GDM) may facilitate the development of culturally sensitive interventions to address this public health concern. Objective. To identify the personal experiences, challenges, coping strategies and health decisions made by urban indigenous South African women affected by GDM. Methods. The experiences of urban African women ( n =10) previously affected by GDM were documented during focus group discussions. The Diabetes Conversation Map educational instrument was used to facilitate discussions. Sessions were audio-recorded, transcribed and thematically analysed. Results. Participants experienced shock and fear on diagnosis of GDM, but family support and sharing their experiences with their peers provided relief from anxiety. They were aware of the inconsistent implementation of GDM diagnostic procedures at tertiary hospitals and community health clinics, which exacerbated their confusion. Despite their initial difficulty in adjusting to a diet perceived as unpalatable, adopting a healthier lifestyle was considered a positive consequence of a GDM diagnosis. Healthy lifestyle changes were partially retained post partum and were reported to have a positive effect on other family members. The participants had little awareness of their long-term risk of developing diabetes mellitus and the need for regular follow-up screening. Unexpectedly, the majority of participants concurred that being HIV-positive would be less stressful than living with diabetes. Conclusion. Participants viewed being HIV-positive as preferable to having GDM, which may reflect the distress caused by inadequate pretest counselling, inconsistent health information, inconsistent screening practices and suboptimal support from healthcare professionals.
{"title":"Women’s accounts of the gestational diabetes experience – a South African perspective","authors":"L. Dickson, E. Buchmann, A. Norris","doi":"10.7196/SAJOG.1534","DOIUrl":"https://doi.org/10.7196/SAJOG.1534","url":null,"abstract":"Background. Considering the perspectives of African women affected by gestational diabetes mellitus (GDM) may facilitate the development of culturally sensitive interventions to address this public health concern. Objective. To identify the personal experiences, challenges, coping strategies and health decisions made by urban indigenous South African women affected by GDM. Methods. The experiences of urban African women ( n =10) previously affected by GDM were documented during focus group discussions. The Diabetes Conversation Map educational instrument was used to facilitate discussions. Sessions were audio-recorded, transcribed and thematically analysed. Results. Participants experienced shock and fear on diagnosis of GDM, but family support and sharing their experiences with their peers provided relief from anxiety. They were aware of the inconsistent implementation of GDM diagnostic procedures at tertiary hospitals and community health clinics, which exacerbated their confusion. Despite their initial difficulty in adjusting to a diet perceived as unpalatable, adopting a healthier lifestyle was considered a positive consequence of a GDM diagnosis. Healthy lifestyle changes were partially retained post partum and were reported to have a positive effect on other family members. The participants had little awareness of their long-term risk of developing diabetes mellitus and the need for regular follow-up screening. Unexpectedly, the majority of participants concurred that being HIV-positive would be less stressful than living with diabetes. Conclusion. Participants viewed being HIV-positive as preferable to having GDM, which may reflect the distress caused by inadequate pretest counselling, inconsistent health information, inconsistent screening practices and suboptimal support from healthcare professionals.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47680131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Caesarean scar ectopic pregnancy (CSEP) is a rare condition in which the implantation of the gestational sac takes place within the uterine scar of a previous caesarean section (CS). If the pregnancy continues within the uterus, the risk of placenta accrete or uterine rupture is increased. Objective. To investigate four treatment methods, based on each patient’s clinical presentation, gestational age of the pregnancy and haemodynamic stability, for the management of CSEP. Methods. CSEP cases ( N =30) were diagnosed by ultrasound at the Shatby Maternity University Hospital, Egypt. Various treatment modalities, based on gestational age, were employed to treat the patients. Treatments included suction curettage ( n =12), embryo reduction with local methotrexate injection ( n =12), laparoscopic excision ( n =3) and excision through laparotomy ( n =3). Serum levels of beta-human chorionic gonadotrophin (β-hCG) were measured at diagnosis and weekly following treatment until the levels returned to non-pregnant values. Results. There was a significant positive correlation between gestational age in weeks and the CSEP management strategy employed. β-hCG levels decreased from before treatment to the end of the follow-up period 3 weeks later. No cases required a hysterectomy, and no maternal complications were reported in this study. Conclusion. The appropriate CSEP management strategy varies according to gestational age. Suction and embryo reduction with local methotrexate injection offers an effective, safe and minimally invasive surgical treatment to remove ectopic pregnancy tissue. Closely monitored follow-up of patients, including serial measurement of β-hCG levels and ultrasonographic examinations, is recommended after CSEP management.
{"title":"Incidence and outcomes of cases of caesarean scar ectopic pregnancy in a tertiary referral centre","authors":"T. Abdeldayem, E. Awad, E. Fattah, S. El-Kamary","doi":"10.7196/SAJOG.1520","DOIUrl":"https://doi.org/10.7196/SAJOG.1520","url":null,"abstract":"Background. Caesarean scar ectopic pregnancy (CSEP) is a rare condition in which the implantation of the gestational sac takes place within the uterine scar of a previous caesarean section (CS). If the pregnancy continues within the uterus, the risk of placenta accrete or uterine rupture is increased. Objective. To investigate four treatment methods, based on each patient’s clinical presentation, gestational age of the pregnancy and haemodynamic stability, for the management of CSEP. Methods. CSEP cases ( N =30) were diagnosed by ultrasound at the Shatby Maternity University Hospital, Egypt. Various treatment modalities, based on gestational age, were employed to treat the patients. Treatments included suction curettage ( n =12), embryo reduction with local methotrexate injection ( n =12), laparoscopic excision ( n =3) and excision through laparotomy ( n =3). Serum levels of beta-human chorionic gonadotrophin (β-hCG) were measured at diagnosis and weekly following treatment until the levels returned to non-pregnant values. Results. There was a significant positive correlation between gestational age in weeks and the CSEP management strategy employed. β-hCG levels decreased from before treatment to the end of the follow-up period 3 weeks later. No cases required a hysterectomy, and no maternal complications were reported in this study. Conclusion. The appropriate CSEP management strategy varies according to gestational age. Suction and embryo reduction with local methotrexate injection offers an effective, safe and minimally invasive surgical treatment to remove ectopic pregnancy tissue. Closely monitored follow-up of patients, including serial measurement of β-hCG levels and ultrasonographic examinations, is recommended after CSEP management.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45854748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Hysterectomy remains one of the most common operative procedures for benign uterine diseases. Total abdominal hysterectomy (TAH) constitutes the most common approach despite the advantages of minimally invasive hysterectomy (MIH). Objectives. To explore the current opinion on hysterectomy choices amongst members of the South African Society of Obstetricians and Gynaecologists (SASOG), as well as the perceptions and potential barriers that may inhibit gynaecologists from offering MIH to their patients. Methodology. An anonymous survey designed to explore the preferences of practising obstetrician gynaecologists regarding the optimal hysterectomy procedure, and perceived barriers towards MIH. Results. The average age of the respondents ( N =152) was 45.7 years, with 88.2% having >5 years’ experience in private practice. When asked about the preferred route of hysterectomy for themselves or their relatives, 46.2% chose vaginal hysterectomy (VH), 25.4% chose total laparoscopic hysterectomy (TLH), 15% chose laparoscopic assisted vaginal hysterectomy (LAVH) and 8.5% chose TAH. However, the most commonly performed hysterectomy procedure undertaken by the respondents in the last year was TAH. Only half of the respondents wished to increase their rate of VH and a lesser number to extend their laparoscopic hysterectomy rates. Conclusion. Although the majority of the respondents preferred the minimally-invasive VH or TLH for themselves or their relatives, TAH remains the most common hysterectomy method among SA gynaecologists. This difference could present an ethical dilemma for the gynaecologist. The desire of a minority to change their approach to VH indicates the difficulty in changing attitudes and the need to promote VH as a technique within SASOG.
{"title":"Preferred and actual methods of hysterectomy: A survey of current practices among members of the South African Society of Obstetricians and Gynaecologists","authors":"Andreas K. Chrysostomou, D. Djokovic","doi":"10.7196/SAJOG.1558","DOIUrl":"https://doi.org/10.7196/SAJOG.1558","url":null,"abstract":"Background. Hysterectomy remains one of the most common operative procedures for benign uterine diseases. Total abdominal hysterectomy (TAH) constitutes the most common approach despite the advantages of minimally invasive hysterectomy (MIH). Objectives. To explore the current opinion on hysterectomy choices amongst members of the South African Society of Obstetricians and Gynaecologists (SASOG), as well as the perceptions and potential barriers that may inhibit gynaecologists from offering MIH to their patients. Methodology. An anonymous survey designed to explore the preferences of practising obstetrician gynaecologists regarding the optimal hysterectomy procedure, and perceived barriers towards MIH. Results. The average age of the respondents ( N =152) was 45.7 years, with 88.2% having >5 years’ experience in private practice. When asked about the preferred route of hysterectomy for themselves or their relatives, 46.2% chose vaginal hysterectomy (VH), 25.4% chose total laparoscopic hysterectomy (TLH), 15% chose laparoscopic assisted vaginal hysterectomy (LAVH) and 8.5% chose TAH. However, the most commonly performed hysterectomy procedure undertaken by the respondents in the last year was TAH. Only half of the respondents wished to increase their rate of VH and a lesser number to extend their laparoscopic hysterectomy rates. Conclusion. Although the majority of the respondents preferred the minimally-invasive VH or TLH for themselves or their relatives, TAH remains the most common hysterectomy method among SA gynaecologists. This difference could present an ethical dilemma for the gynaecologist. The desire of a minority to change their approach to VH indicates the difficulty in changing attitudes and the need to promote VH as a technique within SASOG.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46012472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Pregnant patients with Factor V Leiden (FVL) mutation are at an increased risk of venous thromboembolic disease (VTED) and placental-mediated complications. Thromboprophylaxis with low-molecular-weight heparin (LMWH) can potentiallymitigate these risks. Objective. To describe the clinical course of a cohort of patients with FVL mutation with different underlying genotypes. Methods. The pregnancy outcomes, occurrence of VTED events and laboratory test results of pregnant women with FVL mutation managed at a quaternary medical centre over a period of 18 years in Johannesburg, South Africa, were analysed. Results. Over the period of analysis, 25 pregnant women with FVL mutation were referred to the haematology department for management. Ten patients (40%) had a family history, and 15 patients (60%) a personal history of VTED. The majority of provoked VTED events (90%) were secondary to combined oral contraceptive exposure. Previous pregnancy loss occurred in 4 (16%) patients, of whom 3 (75%) suffered recurrent losses. All women received prophylactic anti-Factor Xa (anti-FXa) dose-adjusted LMWH during anteand postnatal periods. All pregnancies resulted in live births with 1 VTED event recorded. Conclusion. Patients with FVL mutation show phenotypical heterogeneity in terms of pregnancy outcomes, VTED events and placentalmediated complications. Confounders contributing to the heterogeneity are not completely defined and deciding on appropriate treatment is not fully standardised but the live birth rate is encouraging.
{"title":"A case series of Factor V Leiden mutation in pregnancy","authors":"J. Bailly, B. Jacobson, S. Louw","doi":"10.7196/SAJOG.1517","DOIUrl":"https://doi.org/10.7196/SAJOG.1517","url":null,"abstract":"Background. Pregnant patients with Factor V Leiden (FVL) mutation are at an increased risk of venous thromboembolic disease (VTED) and placental-mediated complications. Thromboprophylaxis with low-molecular-weight heparin (LMWH) can potentiallymitigate these risks. Objective. To describe the clinical course of a cohort of patients with FVL mutation with different underlying genotypes. Methods. The pregnancy outcomes, occurrence of VTED events and laboratory test results of pregnant women with FVL mutation managed at a quaternary medical centre over a period of 18 years in Johannesburg, South Africa, were analysed. Results. Over the period of analysis, 25 pregnant women with FVL mutation were referred to the haematology department for management. Ten patients (40%) had a family history, and 15 patients (60%) a personal history of VTED. The majority of provoked VTED events (90%) were secondary to combined oral contraceptive exposure. Previous pregnancy loss occurred in 4 (16%) patients, of whom 3 (75%) suffered recurrent losses. All women received prophylactic anti-Factor Xa (anti-FXa) dose-adjusted LMWH during anteand postnatal periods. All pregnancies resulted in live births with 1 VTED event recorded. Conclusion. Patients with FVL mutation show phenotypical heterogeneity in terms of pregnancy outcomes, VTED events and placentalmediated complications. Confounders contributing to the heterogeneity are not completely defined and deciding on appropriate treatment is not fully standardised but the live birth rate is encouraging.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46166525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Contents","authors":"Claudia Naidu","doi":"10.7196/sajog.1574","DOIUrl":"https://doi.org/10.7196/sajog.1574","url":null,"abstract":"","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44455595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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