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R Seeras

Publications and source records attributed to R Seeras.

5 recordsLinked to original sources

External cephalic version at term. A randomized controlled trial using tocolysis.

OBJECTIVE: To assess the role of external cephalic version (ECV) at term, using tocolysis. DESIGN: A randomized controlled trial over a 12 month period. SETTING: Harare Maternity Hospital, Harare, Zimbabwe. SUBJECTS: 208 women with breech presentation at term were recruited after satisfying eligibility criteria. There were 103 women in the study group and 105 in the control group. At the end of the study a further 104 women were recruited for ECV. INTERVENTION: ECV attempted after intravenous injection of 10 micrograms of hexaprenaline, using either forward or backward somersault over a maximum period of 5 min. MAIN OUTCOME MEASURES: Success rate in terms of presentation during labour, need for caesarean section, and various variables related to fetal outcome. RESULTS: ECV reduced the frequency of breech presentation during labour from 83% to 17% and that of caesarean section from 33% to 13%. There were no troublesome complications from the procedure. CONCLUSION: In carefully selected women with breech presentation, ECV at term using tocolysis, safely reduced the rate of breech presentation in labour and also the caesarean section rate. Further research is needed to determine the role of ECV in early labour.

Adolescent

Breech delivery of infants weighing more than 2000 grams: a case controlled retrospective analysis of 751 patients.

This is a case controlled study of 385 women with breech presentation and 357 with cephalic presentation. Unlike many recent studies, vaginal breech delivery was associated with a significantly worse outcome for the infant. The reasons for these are discussed particularly in relation to developing countries and a protocol for management of these women is suggested to attempt to reduce the unacceptably poor outcome. Selective external cephalic version is advocated.

Adolescent

Outcome of term breech presentation.

Three hundred and ninety five cases of breech presentation at Harare Maternity Hospital, Harare revealed that caesarean section either electively or in labour resulted in good fetal outcome. Vaginal breech delivery was associated with a perinatal mortality of 74 per 1,000. Fifty four (25%) out of 216 infants delivered vaginally required admission to the Neonatal Unit and thirteen of these had a five minute Apgar Score of 5 or less. Various reasons for this unacceptably high morbidity and mortality are discussed in order to develop a protocol for management of breech presentation in a developing country. The protocol includes the advocation of external cephalic version.

Breech Presentation

Evaluation of prophylactic use of tetracycline after evacuation in abortion in Harare Central Hospital.

A randomised controlled trial involving 140 non-septic incomplete abortions was performed to determine the efficacy of prophylactic tetracycline as practiced in these cases in Harare Central Hospital. The treatment group (62) received tetracycline (500 mg four times daily) for a week. The remainder acted as controls. No significant difference in sepsis rate between treatment and control groups was noted. The high sepsis recorded in the treatment group was thought to be due to poor compliance. A new prophylaxis regimen has been suggested.

Abortion, Incomplete