Background. Early diagnosis and appropriate management of congenital anomalies can help prevent neonatal morbidity and mortality. Termination of pregnancy for severe congenital anomalies is permitted under South African law. Objective . To determine factors causing delayed diagnosis of lethal congenital abnormalities requiring late termination of pregnancy at Steve Biko Academic Hospital in Pretoria, South Africa. Methods. Medical records of pregnant women who presented with lethal fetal anomalies over a period of 7.5 years were analysed. Patients’ demographic profile, the interval from referral to feticide, gestational age at first scan and diagnosis, type of anomaly and feticide methods were considered. The cohort was divided in two groups based on timing of termination (i.e. earlier than 28 weeks and later than 28 weeks’ gestation) for statistical comparison. Results. The majority of women ( n =45; 78.9%) were younger than 35 years and had no chronic medical conditions or risk factors ( n =40; 70%). Although 30 women (52.6%) had been booked for antenatal examination early in their pregnancy, only three (5.2%) had a first-trimester scan. Mean time to referral was not significantly different between the women whose pregnancies terminated earlier than 28 weeks and those with a termination after 28 weeks ( p =0.671). Conclusion. A basic ultrasound scan in the second trimester is recommended for all pregnant women. Task shifting can be a viable option to provide this facility at primary and secondary health centres. A national registry should be established to document all late terminations for fetal anomalies.
{"title":"Late termination of pregnancy for fetal anomalies: Experience at a tertiary-care hospital in South Africa","authors":"Fauziasham Shahid, P. Soma-Pillay","doi":"10.7196/SAJOG.1402","DOIUrl":"https://doi.org/10.7196/SAJOG.1402","url":null,"abstract":"Background. Early diagnosis and appropriate management of congenital anomalies can help prevent neonatal morbidity and mortality. Termination of pregnancy for severe congenital anomalies is permitted under South African law. Objective . To determine factors causing delayed diagnosis of lethal congenital abnormalities requiring late termination of pregnancy at Steve Biko Academic Hospital in Pretoria, South Africa. Methods. Medical records of pregnant women who presented with lethal fetal anomalies over a period of 7.5 years were analysed. Patients’ demographic profile, the interval from referral to feticide, gestational age at first scan and diagnosis, type of anomaly and feticide methods were considered. The cohort was divided in two groups based on timing of termination (i.e. earlier than 28 weeks and later than 28 weeks’ gestation) for statistical comparison. Results. The majority of women ( n =45; 78.9%) were younger than 35 years and had no chronic medical conditions or risk factors ( n =40; 70%). Although 30 women (52.6%) had been booked for antenatal examination early in their pregnancy, only three (5.2%) had a first-trimester scan. Mean time to referral was not significantly different between the women whose pregnancies terminated earlier than 28 weeks and those with a termination after 28 weeks ( p =0.671). Conclusion. A basic ultrasound scan in the second trimester is recommended for all pregnant women. Task shifting can be a viable option to provide this facility at primary and secondary health centres. A national registry should be established to document all late terminations for fetal anomalies.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/SAJOG.1402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49647455","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":"Procalcitonin: Blood tests are useful but must be interpreted with caution – inflammatory markers are no exception","authors":"W. Edridge","doi":"10.7196/sajog.1484","DOIUrl":"https://doi.org/10.7196/sajog.1484","url":null,"abstract":"","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46561703","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}
W. J. Steinberg, G. Joubert, A. Adu-Parko, M. Godloza, N. P. Lehasa, N. Manele, N. Moselakgomo, M. Motsoikha
Background. Infectious diseases are transmissible from mother to unborn child. Appropriate treatment during antenatal care is crucial. Objective. To determine whether routine antenatal tests (syphilis, HIV, Rhesus factor) were performed in women delivering at National District Hospital (NDH), Bloemfontein, South Africa, and whether treatment was initiated for women testing positive for these infections. Methods. This descriptive retrospective study consisted of 2 425 women who delivered between January and December 2016. Antenatal care history was obtained from the delivery register. Results. Nearly all women were tested for syphilis (99.1%), HIV (99.9%) and Rhesus factor (99.9%). A third (33.3%) of the patients who tested positive for syphilis were untreated. Of the 27.0% of patients who tested HIV-positive, 99.7% were recorded to have been on treatment. Just over half (54.3%) of the patients who tested Rhesus-negative received prophylaxis. Conclusion. A record of routine antenatal testing of women delivering at NDH was found. The reaction to positive results could improve.
{"title":"Audit of routine tests in the antenatal period in women delivering at National District Hospital, Bloemfontein, South Africa, in 2016","authors":"W. J. Steinberg, G. Joubert, A. Adu-Parko, M. Godloza, N. P. Lehasa, N. Manele, N. Moselakgomo, M. Motsoikha","doi":"10.7196/sajog.1438","DOIUrl":"https://doi.org/10.7196/sajog.1438","url":null,"abstract":"Background. Infectious diseases are transmissible from mother to unborn child. Appropriate treatment during antenatal care is crucial. Objective. To determine whether routine antenatal tests (syphilis, HIV, Rhesus factor) were performed in women delivering at National District Hospital (NDH), Bloemfontein, South Africa, and whether treatment was initiated for women testing positive for these infections. Methods. This descriptive retrospective study consisted of 2 425 women who delivered between January and December 2016. Antenatal care history was obtained from the delivery register. Results. Nearly all women were tested for syphilis (99.1%), HIV (99.9%) and Rhesus factor (99.9%). A third (33.3%) of the patients who tested positive for syphilis were untreated. Of the 27.0% of patients who tested HIV-positive, 99.7% were recorded to have been on treatment. Just over half (54.3%) of the patients who tested Rhesus-negative received prophylaxis. Conclusion. A record of routine antenatal testing of women delivering at NDH was found. The reaction to positive results could improve.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43356032","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}
Pregnancy is associated with complications ranging from minor ailments to major morbidity and mortality. To prevent such complications, some women, including some in South Africa, resort to the use of traditional medicines. These are meant to either supplement or replace conventional medicines that are offered by their healthcare facilities. Some of these medicines, however, have the potential to cause harm, can increase pregnancy-related complications and may adversely interact with other medicines prescribed during the pregnancy. We present a case of an 18-year-old primigravida who commenced prenatal ingestion of traditional medicine ( moruto wamfene , otherwise called baboon urine) at 28 weeks’ gestation, in an attempt to improve her pregnancy outcomes. However, she instead developed uterine hyperstimulation, fetal bradycardia and thick meconium-stained liquor during labour. This report is intended to raise awareness about prenatal ingestion of traditional medicine (particularly moruto wamfene ), highlights the safety concerns and suggests preventive measures.
{"title":"Adverse pregnancy outcomes associated with maternal prenatal ingestion of traditional medicine","authors":"N. Ngene, A. Siveregi","doi":"10.7196/sajog.1423","DOIUrl":"https://doi.org/10.7196/sajog.1423","url":null,"abstract":"Pregnancy is associated with complications ranging from minor ailments to major morbidity and mortality. To prevent such complications, some women, including some in South Africa, resort to the use of traditional medicines. These are meant to either supplement or replace conventional medicines that are offered by their healthcare facilities. Some of these medicines, however, have the potential to cause harm, can increase pregnancy-related complications and may adversely interact with other medicines prescribed during the pregnancy. We present a case of an 18-year-old primigravida who commenced prenatal ingestion of traditional medicine ( moruto wamfene , otherwise called baboon urine) at 28 weeks’ gestation, in an attempt to improve her pregnancy outcomes. However, she instead developed uterine hyperstimulation, fetal bradycardia and thick meconium-stained liquor during labour. This report is intended to raise awareness about prenatal ingestion of traditional medicine (particularly moruto wamfene ), highlights the safety concerns and suggests preventive measures.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49138939","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.1486","DOIUrl":"https://doi.org/10.7196/sajog.1486","url":null,"abstract":"","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41418377","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}
The combination of immune thrombocytopenic purpura and haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is rare, with only two previous case reports published. Management of the two conditions is vastly different, and the diagnosis of HELLP syndrome superimposed on immune thrombocytopenic purpura may be difficult, resulting in delayed management.
{"title":"A case of immune thrombocytopenic purpura complicated by HELLP syndrome","authors":"S. Prithipal","doi":"10.7196/sajog.1353","DOIUrl":"https://doi.org/10.7196/sajog.1353","url":null,"abstract":"The combination of immune thrombocytopenic purpura and haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is rare, with only two previous case reports published. Management of the two conditions is vastly different, and the diagnosis of HELLP syndrome superimposed on immune thrombocytopenic purpura may be difficult, resulting in delayed management.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44604589","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}
Swyer syndrome, or pure 46,XY gonadal dysgenesis, is a rare disorder of sex development, characterised by the failure of sex gland development (ovaries or testes) in a phenotypic female patient. A 24-year-old woman with this syndrome presented at a tertiary academic hospital in South Africa, complaining of primary amenorrhoea and infertility. After gonadectomy and fertility treatment, a rare successful pregnancy outcome was achieved. A patient with Swyer syndrome, in a specialist fertility programme, can maintain a normal pregnancy and delivery.
{"title":"Successful pregnancy in a patient with Swyer syndrome, or pure 46,XY gonadal dysgenesis","authors":"A. Chrysostomou, M. Tsuari","doi":"10.7196/sajog.1448","DOIUrl":"https://doi.org/10.7196/sajog.1448","url":null,"abstract":"Swyer syndrome, or pure 46,XY gonadal dysgenesis, is a rare disorder of sex development, characterised by the failure of sex gland development (ovaries or testes) in a phenotypic female patient. A 24-year-old woman with this syndrome presented at a tertiary academic hospital in South Africa, complaining of primary amenorrhoea and infertility. After gonadectomy and fertility treatment, a rare successful pregnancy outcome was achieved. A patient with Swyer syndrome, in a specialist fertility programme, can maintain a normal pregnancy and delivery.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47894457","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}
M. Hajiesmaello, E. Mohammadi, H. Farrokh-Eslamlou
Background. The intrauterine device (IUD) is among the most efficient contraceptive methods. However, IUD insertion is accompanied by pain and discomfort. Objectives. To evaluate the analgesic effects of 10% lidocaine spray in reducing pain during IUD insertion. Method. In a randomised clinical trial, 80 volunteers attending two clinics for IUD insertion were selected for study, and randomly allocated to two groups. The intervention group received four puffs of 10% lidocaine spray on their cervix prior to IUD insertion. The routine procedure (without an analgesic) was followed in the control group. The intensity of perceived pain in both groups was measured using a visual analogue scale from 0 to 10. Results. The two groups had significant differences in pain intensity at all stages of the procedure ( p <0.001). The most painful stage of the procedure was tenaculum placement (mean (standard deviation) pain intensity 2.2 (1.34) in the intervention group; 4.25 (1.92) in the control group). Conclusion. Based on our findings, 10% lidocaine spray can be applied as a non-invasive, inexpensive, easy-to-use and accessible method to decrease IUD insertion pain.
{"title":"Evaluation of the effect of 10% lidocaine spray on reducing the pain of intrauterine device insertion: A randomised controlled trial","authors":"M. Hajiesmaello, E. Mohammadi, H. Farrokh-Eslamlou","doi":"10.7196/sajog.1383","DOIUrl":"https://doi.org/10.7196/sajog.1383","url":null,"abstract":"Background. The intrauterine device (IUD) is among the most efficient contraceptive methods. However, IUD insertion is accompanied by pain and discomfort. Objectives. To evaluate the analgesic effects of 10% lidocaine spray in reducing pain during IUD insertion. Method. In a randomised clinical trial, 80 volunteers attending two clinics for IUD insertion were selected for study, and randomly allocated to two groups. The intervention group received four puffs of 10% lidocaine spray on their cervix prior to IUD insertion. The routine procedure (without an analgesic) was followed in the control group. The intensity of perceived pain in both groups was measured using a visual analogue scale from 0 to 10. Results. The two groups had significant differences in pain intensity at all stages of the procedure ( p <0.001). The most painful stage of the procedure was tenaculum placement (mean (standard deviation) pain intensity 2.2 (1.34) in the intervention group; 4.25 (1.92) in the control group). Conclusion. Based on our findings, 10% lidocaine spray can be applied as a non-invasive, inexpensive, easy-to-use and accessible method to decrease IUD insertion pain.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44685698","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. Procalcitonin (PCT) is an established marker for sepsis, particularly bacterial, but its use in diagnosing pregnancy-associated sepsis (PAS) is relatively unexplored. Objective. To investigate whether PCT could be used for the diagnosis of PAS in our study population, and what the appropriate values might be for the diagnosis. Methods. The study included 40 pregnant, post-abortal and postpartum women with PAS, identified using systemic inflammatory response syndrome criteria. Patients with hypertensive disorders, premature rupture of membranes, severe trauma, liver cirrhosis and lung or thyroid malignancies were excluded. Forty healthy term pregnant women with sterile urine cultures were taken as controls. PCT levels were obtained at admission and statistically compared between the groups. Severity and culture positivity in PAS were also assessed. Results. Severe PAS was present in 30 patients. Overall culture positivity was seen in 55% ( n =22) of subjects. Culture-positive patients had higher PCT levels (3.03 μg/L) compared with the culture-negative (1.77 μ/L), though this did not reach statistical significance ( p =0.235). Mean (standard deviation) PCT in PAS patients was 2.46 (0.56) μ/L, while in healthy controls it was 0.091 (0.019) μg/L. This difference was statistically significant ( p 0.125 μg/L is suggested as the critical level for PAS diagnosis in appropriate clinical settings. Additionally, mean PCT levels differed significantly in severe v. non-severe PAS.
{"title":"Serum procalcitonin in pregnancy-associated sepsis: A case control study","authors":"R. Agarwal, P. Priyadarshini, M. Mehndiratta","doi":"10.7196/sajog.1397","DOIUrl":"https://doi.org/10.7196/sajog.1397","url":null,"abstract":"Background. Procalcitonin (PCT) is an established marker for sepsis, particularly bacterial, but its use in diagnosing pregnancy-associated sepsis (PAS) is relatively unexplored. Objective. To investigate whether PCT could be used for the diagnosis of PAS in our study population, and what the appropriate values might be for the diagnosis. Methods. The study included 40 pregnant, post-abortal and postpartum women with PAS, identified using systemic inflammatory response syndrome criteria. Patients with hypertensive disorders, premature rupture of membranes, severe trauma, liver cirrhosis and lung or thyroid malignancies were excluded. Forty healthy term pregnant women with sterile urine cultures were taken as controls. PCT levels were obtained at admission and statistically compared between the groups. Severity and culture positivity in PAS were also assessed. Results. Severe PAS was present in 30 patients. Overall culture positivity was seen in 55% ( n =22) of subjects. Culture-positive patients had higher PCT levels (3.03 μg/L) compared with the culture-negative (1.77 μ/L), though this did not reach statistical significance ( p =0.235). Mean (standard deviation) PCT in PAS patients was 2.46 (0.56) μ/L, while in healthy controls it was 0.091 (0.019) μg/L. This difference was statistically significant ( p 0.125 μg/L is suggested as the critical level for PAS diagnosis in appropriate clinical settings. Additionally, mean PCT levels differed significantly in severe v. non-severe PAS.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49101915","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. Vacuum-assisted caesarean delivery may result in a quicker delivery of the fetal head than the use of forceps, and improve maternal and fetal outcomes. The new CaesAid vacuum-assisted delivery (VAD) cup was designed specifically for this use. Objectives. To assess whether the CaesAid VAD cup influences the duration of fetal head delivery at caesarean section when compared with forceps, and whether there are differences in perioperative complications in the mother and fetus. Methods. We carried out a retrospective clinical audit of 132 patients who underwent caesarean delivery at the Netcare Christiaan Barnard Memorial Hospital in Cape Town, South Africa, from April to November 2017, aided by either CaesAid VAD cup (C group, n =67) or forceps (F group, n =65). Results. The uterine incision-to-delivery interval was significantly shorter ( p =0.001) in the C group than the F group (median 38 (interquartile range (IQR) 20) v. 60 (IQR 50) seconds, respectively). The maternal blood loss was lower in the C group than the F group (250 mL v. 288 mL; p =0.025). There was no significant difference in Apgar scores or admissions to the neonatal intensive care unit. Neonatal skin injuries were less common in the C group (no cases v. 8 in the F group; p =0.004). Conclusion. The results of this audit suggest that the CaesAid VAD cup is a safe and efficient alternative to forceps for aiding the delivery of the fetal head at caesarean section. However, the routine use of vacuum cups is debatable. Further research could provide more insight into this procedure as a part of obstetric practice.
背景。与使用产钳相比，真空辅助剖宫产可以更快地娩出胎儿头，并改善产妇和胎儿的结局。新的凯撒真空辅助分娩(VAD)杯是专门为这种使用而设计的。目标。评估与产钳相比，CaesAid VAD杯是否影响剖宫产时胎头娩出时间，以及母婴围手术期并发症是否存在差异。方法。我们对2017年4月至11月在南非开普敦Netcare克里斯蒂安巴纳德纪念医院(Netcare Christiaan Barnard Memorial Hospital)剖腹产的132例患者进行了回顾性临床审计，这些患者使用CaesAid VAD杯(C组，n =67)或产钳(F组，n =65)辅助。结果。C组子宫切开至分娩间隔明显短于F组(中位数38(四分位间距(IQR) 20)和60 (IQR 50)秒)(p =0.001)。C组产妇失血量低于F组(250 mL vs 288 mL;p = 0.025)。在阿普加评分或新生儿重症监护病房入院方面没有显著差异。C组新生儿皮肤损伤发生率较低(0例vs . F组8例;p = 0.004)。结论。本审计结果表明，CaesAid VAD杯是一种安全、有效的替代产钳辅助剖宫产胎儿头娩出的方法。然而，常规使用真空杯是有争议的。进一步的研究可以提供更多的深入了解这一程序作为产科实践的一部分。
{"title":"An audit of the CaesAid vacuum-assisted delivery cup compared with forceps delivery of the fetal head in caesarean section","authors":"N. Stolwijk, P. R. Jong","doi":"10.7196/sajog.1377","DOIUrl":"https://doi.org/10.7196/sajog.1377","url":null,"abstract":"Background. Vacuum-assisted caesarean delivery may result in a quicker delivery of the fetal head than the use of forceps, and improve maternal and fetal outcomes. The new CaesAid vacuum-assisted delivery (VAD) cup was designed specifically for this use. Objectives. To assess whether the CaesAid VAD cup influences the duration of fetal head delivery at caesarean section when compared with forceps, and whether there are differences in perioperative complications in the mother and fetus. Methods. We carried out a retrospective clinical audit of 132 patients who underwent caesarean delivery at the Netcare Christiaan Barnard Memorial Hospital in Cape Town, South Africa, from April to November 2017, aided by either CaesAid VAD cup (C group, n =67) or forceps (F group, n =65). Results. The uterine incision-to-delivery interval was significantly shorter ( p =0.001) in the C group than the F group (median 38 (interquartile range (IQR) 20) v. 60 (IQR 50) seconds, respectively). The maternal blood loss was lower in the C group than the F group (250 mL v. 288 mL; p =0.025). There was no significant difference in Apgar scores or admissions to the neonatal intensive care unit. Neonatal skin injuries were less common in the C group (no cases v. 8 in the F group; p =0.004). Conclusion. The results of this audit suggest that the CaesAid VAD cup is a safe and efficient alternative to forceps for aiding the delivery of the fetal head at caesarean section. However, the routine use of vacuum cups is debatable. Further research could provide more insight into this procedure as a part of obstetric practice.","PeriodicalId":49579,"journal":{"name":"South African Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7196/sajog.1377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43551934","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：