Browsing by Author "Anthony, John"

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    Perinatal outcome in mothers with heart disease attending the combined Obstetric and Cardiology Clinic at Groote Schuur Hospital
    (2014) Elliott, Catherine; Anthony, John
    ith the advances made in the management of cardiac conditions, much importance has been placed on the maternal outcome in pregnancies complicated by heart disease. However, to enable attending clinicians to provide suitable counseling and manage the pregnancy appropriately, the potential complications arising in the fetus and neonate also require attention. Adverse neonatal and perinatal outcome is more common in pregnant women with cardiac disease. Analysis of the available data pertaining to the South African population is important, as this population’s profile, like that of Africa, differs from that of industrialized countries. The relevance of maternal heart disease is highlighted by the National Committee for the Confidential Enquiries into Maternal Deaths (NCCEMD) in South Africa ( http://www.doh.gov.za/docs/reports/2012/Report_on_Confidential_Enquiries_into_ Maternal_Deaths_in_South_Africa ). Objectives To describe the perinatal outcome in women with heart disease and to determine whether there is an associated adverse outcome related to babies born to mothers with heart disease. Methods 82 patients were collected serially over 18 months. Neonatal outcome was recorded. Adverse neonatal outcome was defined as perinatal mortality, admission to NICU and the need for delivery room resuscitation. Results Perinatal mortality rate in this cohort was good, and better than the rate in the general population from whence this cohort came, but was linked to a high rate of obstetric intervention. The rate of adverse neonatal outcome is better than the rate in industrialized countries. Conclusion Perinatal outcome is good when mothers with heart disease are managed in a multidisciplinary clinic.
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    The prevalence and effects of HIV infection among a population of pregnant women needing obstetric intensive care in Cape Town
    (2010) Mohlaba, Garish Masungi; Anthony, John
    Care of the critically ill pregnant woman poses exceptional challenges in the intensive care unit and requires the skills of health care providers who have knowledge of the physiological changes of pregnancy as well as specific pregnancy-related disorders in order to achieve optimal management.
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    Prevalence of known thrombophilia and incidence of venous thromboembolism in pregnant woment in the Western Cape Province of South Africa
    (2005) Boama, Vincent; Anthony, John
    Venous thromboembolism (VTE) is a major cause of maternal mortality worldwide. In many developed countries, all maternal deaths are investigated, and accurate statistics are available. In United Kingdom (UK) for example, VTE is the leading cause- and is increasing despite heightened awareness of risk factors, and wider use of thromboprophylaxis (1,2). The 1994-96 UK Confidential Enquiries reported an overall maternal mortality rate of 12.2 per 100, 000 deliveries, with specific mortality from VTE at 2.2 per 100, 000 deliveries, with approximately 15 deaths a year due to VTE.
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    The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings
    (BioMed Central, 2018-01-05) Nathan, Hannah L; Boene, Helena; Munguambe, Khatia; Sevene, Esperança; Akeju, David; Adetoro, Olalekan O; Charanthimath, Umesh; Bellad, Mrutyunjaya B; de Greeff, Annemarie; Anthony, John; Hall, David R; Steyn, Wilhelm; Vidler, Marianne; von Dadelszen, Peter; Chappell, Lucy C; Sandall, Jane; Shennan, Andrew H
    Background: Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device. Methods: Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach. Results: Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device’s accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period. Conclusion: The CRADLE device was well accepted by healthcare workers from a range of countries and levels of facility, including those with no previous vital signs measurement experience. The device motivated women to attend primary care and encouraged them to accept treatment and referral.
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    Urinary tract infection and pre-eclampsia in pregnancy : incidence of urinary tract infection in pre-eclamptic
    (2009) Chidakwa, Claitos; Anthony, John
    Some studies have found a positive association between UTI in pregnancy and the development of PET yet other studies have not found any such association. The objective is to determine the incidence of UTI in PET patients and thus determine if there is an assocition between UTI and PET.
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    The value of routine histological examination of curettings in all first and second trimester abortions
    (1992) Stewart, Chantal Juanita Michelle; Anthony, John
    A prospective study was carried out to assess whether, in first and second trimester abortions, the clinical diagnosis together with the macroscopic appearance of the curettings was an accurate guide to the correct diagnosis, and whether routine histological examination of all curettings was therefore necessary. The study included 1 464 consecutive patients presenting to the Gynaecology Department at Groote Schuur Hospital, Cape Town with clinically diagnosed abortions during the period 1st February 1988 to 31st December 1988. The correlation between the macroscopic appearance and histological examination compatible with the diagnosis of abortion was found to be 86%. Where the diagnosis was in doubt this correlation was lower. The sensitivity of using the macroscopic appearance as a screening test for the diagnosis of abortion was 96%, with a positive predictive value of 91%. The kappa statistic of agreement between macroscopic appearance and histology was 0,26. The incidence of gestational trophoblastic disease in this series was 0.06%. The diagnosis of ectopic pregnancy was not aided by the use of routine histology.