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Biomedical subjects

G B Theron

Publications and source records attributed to G B Theron.

12 recordsLinked to original sources
PubMed1995

The impact of the Perinatal Education Programme on cognitive knowledge in midwives.

OBJECTIVE: To determine whether the Maternal Care and Newborn Care manuals from the Perinatal Education Programme significantly improves the cognitive knowledge of midwives. DESIGN: Assessment of cognitive knowledge by means of multiple-choice testing. These tests were conducted before and after each of the 30 units of the Programme. In addition, a multiple-choice examination was arranged on completion of each of the two manuals. SETTING: Level I, II and III hospitals and level I clinics in urban and rural areas of South Africa. PARTICIPANTS: One hundred and fourteen midwives from hospitals and clinics. INTERVENTION: Maternal and Newborn Care manuals of the Perinatal Education Programme, studied at home and later discussed by the participants in groups every few weeks. MAIN OUTCOMES MEASURED: Number of participants who completed a manual, mean results of the pretests and post-tests, mean results of the final examination, and percentage of participants achieving 80% or more in the pretests, post-tests and final examination. RESULTS: Mean pretest and post-test results for the Maternal Care manual were 65% and 85% respectively. Mean pretest and post-test results for the Newborn Care manual were 72% and 93% respectively. The mean result for the final examination for the Maternal Care manual was 90%, while the mean result for the Newborn Care manual was 95%. There was a significant improvement in cognitive knowledge when either manual was used. CONCLUSION: The cognitive knowledge of both maternal and newborn care can be significantly improved when midwives use the Perinatal Education Programme in an outreach, co-operative learning course.

Female↗
PubMed1994

Does a nonreactive fetal heart rate pattern really mean fetal distress?

The aim of the study was to compare three different fetal heart rate (FHR) patterns, namely, a nonreactive pattern with good long-term variability (fluctuation of 5 or more beats/min), a reactive pattern, and a nonreactive pattern with poor long-term variability (less than 5 beats/min). For this purpose, nonstress tests done less than 24 hours before delivery and FHR patterns recorded during labor were separately assessed. Endpoints for comparison were 5-minute Apgar scores, intrauterine growth retardation, and umbilical blood gas values at birth. Regarding the nonstress test, the prevalence of low 5-minute Apgar scores in reactive, good variability, and in poor variability patterns were 7.2%, 5.3%, and 24%, respectively. The prevalences of small for gestational age newborns were 8%, 17.6%, and 60.6%, respectively. Blood gas values did not differ significantly. Regarding the FHR patterns during labor, using the same sequence, the prevalences of low 5-minute Apgar scores were 3.5%, 6%, and 23%, respectively. Small for gestational age babies occurred in 8.8%, 15.6%, and 80% of the different FHR patterns, respectively. Regarding umbilical artery blood gas values, the only significant difference was a lower pH in the poor variability group. No difference was found between the blood gas values of babies with a reactive pattern and a nonreactive pattern with good variability.

Apgar Score↗
PubMed1993

The usefulness of weight gain in predicting pregnancy complications.

The usefulness of recently constructed centile charts for weight gain during pregnancy was studied. The association of weight gain in pregnancy with pregnancy complications was investigated. The incidence of pre-eclampsia and small for gestational age babies both had a significant relationship with weight gain. Use of the charts to screen for pregnancy complications on a selected population had both a sensitivity and specificity of about 50 per cent. The positive and negative predictive values of the charts ranged from 49 to 53 per cent. The question arises as to whether the routine recording of maternal weight at each antenatal visit is necessary.

Birth Weight↗
PubMed1992

Management of patients with poor symphysis pubis-fundus growth by Doppler flow velocimetry of the umbilical artery--an effective method to detect the fetus at risk.

This study evaluated Doppler flow velocimetry of the umbilical artery in patients with suspected intrauterine growth retardation as detected by poor symphysis-fundus growth (SFG). The sensitivity of Doppler in detecting light for gestational age babies and intrauterine growth retardation was poor. Antenatal complications, neonatal morbidity and perinatal mortality occurred significantly more frequently in patients with abnormal flow. Doppler flow velocimetry is an excellent test to identify babies at high risk for perinatal morbidity and mortality, when poor SFG is present.

Adult↗
PubMed1990

Maximum likelihood estimation of reference centiles.

We propose the use of centile estimates which are based on the fitting of appropriate densities by maximum likelihood. In the case of cross-sectional centile estimation, we show that this approach will generally lead to more precise estimates than would result from the use of non-parametric centile estimates. When longitudinal data are available or a series of cross-sectional data at different time points, the maximum likelihood approach can be used to simultaneously fit densities to each cross-section, subject to constraints (for example, smoothness constraints) on the parameters. The variances of these centile estimates are readily obtained and missing values and unequally spaced records are easily accommodated. We illustrate the procedure by means of an application using the Johnson family of densities to a study of weight gain in pregnancy.

Adult↗
PubMed1990

A centile chart for weight gain in pregnancy for the urban population of the Western Cape, South Africa.

Weight gain during pregnancy was studied. Women with low body mass index (BMI) gained significantly more weight than women with high BMI. Older women gained significantly less weight than younger women. Centile charts were constructed using a maximum likelihood procedure. The centile charts for patients who are less than or equal to 25 years or with a BMI = less than or equal to 24 kg/m2 cannot be regarded as differing significantly, however the chart for patients greater than 25 years with a BMI greater than 24 kg/m2 does lie significantly below the others. For practical purposes the process of weight gain can be regarded as independent of gestational age. These charts can thus be used without knowledge of gestational age.

Adolescent↗
PubMed1989

Inter-observer variation in symphysis-fundus measurements. A plea for individualised antenatal care.

Two groups of midwives were compared with regard to ability to detect small-for-gestational-age (SGA) babies using symphysis-fundus (S-F) measurements. The patients were all low-risk obstetric patients. In group A 2 midwives provided antenatal care to 97 patients; 14 delivered SGA babies, of which 12 were identified by S-F measurements (sensitivity 85.7%). In group B 15 midwives provided antenatal care to 126 patients, 12 delivered SGA babies, and 5 of these were identified (sensitivity 41.2%). It is considered that this difference was due to inter-observer variability. A plea is made for individualised antenatal care.

Adult↗
PubMed1989

Doppler ultrasonography of the fetoplacental circulation--normal reference values.

Normal reference values for the resistance index, A/B ratio and pulsatility index of the umbilical artery obtained by Doppler ultrasonography are presented. The resistance index and A/B ratio values are very similar to those previously published, indicating no need to formulate normal values for different populations. The pulsatility index differed from other published values, probably reflecting different calculation methods built into the spectrum analysers rather than differences in waveforms. The resistance index had the lowest coefficient of variation and showed least inter-observer variation. For routine use the resistance index is preferable to other indices.

Adult↗
PubMed1989

Primary causes of total perinatally related wastage at Tygerberg Hospital.

The primary obstetric cause of total perinatally related wastage (TPRW) (i.e. all antepartum or postpartum deaths of infants greater than or equal to 500 g and who died before hospital discharge) was studied in a clearly defined population in the western Cape over a 1-year period. There were 302 deaths from 7,923 singletons and 31 deaths from 65 pairs of twins delivered from patients cared for by Tygerberg Hospital maternity services. Thirty per cent of the deaths were late abortions, 42% stillbirths, 18% early neonatal deaths, 7% late neonatal deaths and 4% perinatally related infant deaths. The major primary obstetric events leading to TPRW in singletons were antepartum haemorrhage (27.8%), spontaneous preterm labour (24.8%), unexplained intra-uterine deaths (11.9%), infections (9.3%) and fetal abnormalities (7.9%). Multiple pregnancies accounted for 9.3% of the TPRW of all deliveries. The cause, risk factors associated and methods of prevention of abruptio placentae, spontaneous preterm labour and infections should receive priority in perinatal research in the western Cape.

Black or African American↗
PubMed1988

[Perinatal deaths in the rural areas of the Cape Province, January--December 1985].

In this study 18 rural hospitals in the Cape Province were prospectively surveyed in respect of the number of deliveries, perinatal deaths, low-birth-weight babies, and the hospital facilities available for routine antenatal, intrapartum and neonatal care. During the study period (1 January - 31 December 1985) there were a total of 19,274 deliveries (birth weight greater than or equal to 1,000 g). The mean perinatal mortality rate was 27,3/1,000 deliveries (range 15.3-45.3). The prevalence of low-birth-weight babies ranged from 13.3% to 34.4% with a mean of 17.7%. By plotting the perinatal mortality rate against the prevalence of low-birth-weight babies a perinatal care index was established. A low perinatal mortality coupled with a high prevalence of low-birth-weight infants, for example, signifies proper care. The perinatal index was then used to compare the neonatal outcome of different hospitals. Outcome varied considerably, as did facilities and care. Serological tests for syphilis and blood groups were not known in the majority of patients at 4 hospitals involving 2,387 deliveries. No cervical cytology was done at 6 hospitals involving 5,462 deliveries. One hospital had no neonatal resuscitation equipment. There were no facilities for serum bilirubin measurements at 10 hospitals involving 8,867 deliveries. However, most problems identified are easily and cheaply rectifiable.

Cause of Death↗
PubMed1986

C-reactive protein levels in ectopic pregnancy, pelvic infection and carcinoma of the cervix.

The value of C-reactive protein (CRP) levels in the differential diagnosis of pelvic infection and ectopic pregnancy, in the staging of carcinoma of the cervix, and after necrotizing irradiation for tumour was assessed. CRP was measured using a sensitive magnetizable solid-phase immunoradiometric assay. There was an obvious difference in CRP levels between patients with ectopic pregnancies and acute pelvic infections, but CRP levels failed to differentiate between stages IIB and IIIB carcinoma of the cervix, the majority of patients not having a significant acute-phase response. During radiotherapy there was wide variation and substantial individual differences in CRP levels which could have been caused by undiagnosed infective complications.

C-Reactive Protein↗