Browsing by Author "Fakier, Ahminah"

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    An audit of peripartum hysterectomies at Groote Schuur hospital, 2014 -2019
    (2024) Adjei, Alfred; Fakier, Ahminah; Fawcus, Susan
    BACKGROUND Peripartum hysterectomy is a major surgical procedure performed in the se ng of life-threatening haemorrhage and uterine sepsis unresponsive to conserva ve measures. The opera on is considered one of the major interven ons in obstetrics and carries high maternal morbidity and mortality, mostly due to the reasons for which it is done. An audit of peripartum hysterectomies was performed at Groote Schuur Hospital during 1999-2003, which showed the main indica ons were uterine sepsis and obstetric haemorrhage. The problem of uterine sepsis was at a me when there was a high rate of HIV infec on with no treatment available for mothers.The introduc on of an retrovirals for pregnant women was commenced in the Western Cape in 2001 with the use of single dose Nevirapine during labour or prior to caesarean sec on. Currently, all pregnant women living with HIV are immediately provided with lifelong treatment regardless of CD4 count and adherence reinforced during the antenatal visits. It is thus of interest to repeat this audit twenty years later to evaluate if there is any difference in indica ons and outcomes. OBJECTIVES 1.To determine the incidence, indica ons, and complica ons associated with peripartum hysterectomy at Groote Schuur Hospital (GSH), New Somerset Hospital (NSH) and Mowbray Maternity Hospital (MMH) 2. To compare study results with a similar study conducted between 1999 to 2003 at Groote Schuur Hospital METHODOLOGY A retrospec ve descrip ve audit of peripartum hysterectomies was performed at GSH, NSH AND MMH for the years 2015-2019. Peripartum hysterectomy was defined as hysterectomy performed within 24 hours of delivery or within the same hospital admission or within 6 weeks of delivery. Pa ents who had peripartum hysterectomies during this period were iden fied from the labour ward and gynaecology theatre register, and data retrieved from their files. All sta s cal analysis was performed by using SPSS version 27.0.0.0 (IBM, Armonk, NY, USA).
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    Maternal Haemoglobin and outcome of pregnancy
    (2022) Amponsah, Kwaku Poku; Petro, Gregory; Fakier, Ahminah
    Background: The association between maternal haemoglobin concentration and the outcome of pregnancy has been a source of continual controversy. Preterm delivery and low birth weight are major causes of stillbirths and early neonatal deaths. Pre-eclampsia is a major complication which occurs during pregnancy and leads to significant maternal and fetal morbidity and mortality. This study aims to assess the association between maternal haemoglobin concentration and pregnancy outcome. Objectives: To assess the association between maternal haemoglobin concentration and pre-eclampsia, preterm birth and low birth weight. Methods: Retrospective analysis of 191 patients who delivered an infant of 28 weeks gestation or more from 1st to 22nd May 2017 at New Somerset Hospital with documented maternal haemoglobin concentration at 22 – 33 weeks gestation. The maternal haemoglobin concentration used was the lowest documented during 22 – 33 weeks gestation. Main outcome measures: Development of pre-eclampsia, low birth weight and preterm birth. Results: The distribution of pre-eclampsia, low birth weight and preterm birth were skewed towards the higher side of the maternal haemoglobin concentration spectrum. There were statistically significant differences in the development of pre-eclampsia, low birth weight and preterm birth between maternal haemoglobin concentrations =>13g/dl and that of < 13g/dl. Pre-eclampsia was associated with relatively lower birth weight, preterm birth and low placental weight independently of the haemoglobin status. Conclusion: High maternal haemoglobin concentration at 22 – 33 weeks gestation is associated with an increased prevalence of pre-eclampsia, low birth weight and preterm birth.
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    Mid-upper arm circumference: a surrogate for body mass index in pregnant women?
    (2015) Fakier, Ahminah; Fawcus, Susan; Petro, Gregory
    Background: Nutrition in pregnancy has important implications for both the mother and the fetus, hence the importance of an accurate assessment at the booking visit. Body mass index is currently the gold standard for measuring body fatness. However, pregnancy associated weight gain and oedema, as well as late booking in our population setting, questions the reliability of using the BMI to assess body fat or nutritional state in pregnancy. Mid upper arm circumference has been used for many decades in children under the age of five, to assess malnutrition. Many studies have shown a strong correlation between MUAC and BMI in the adult population. MUAC is a much simpler anthropometric measure to take as it eliminates the need for height charts, scales and calculations. One of the other main advantages of using MUAC is that there is minimal change in the MUAC during pregnancy, which may be a better indicator of pre-pregnancy body fat and nutrition. Objectives: To assess if there is a correlation between the mid upper arm circumference and body mass index in pregnant woman booking in the Metro West area. Methods: This was a cross sectional study of women booking at four MOUs in the Metro West area. Anthropometric measurements namely height, weight and MUAC were carried out on pregnant women booking for the first time in four midwives obstetrics units in Metro West area, Cape Town, South Africa. The participants were divided into two groups, early gestational age group for patients who booked less than twenty weeks, and a late gestational age group for those who booked more than twenty but less than thirty week Results: The results showed that there is a strong correlation between MUAC and BMI in pregnant women up to thirty weeks gestation. The correlation was calculated at 0.92 for the entire group. A regression analysis showed that there is a statistical difference in the mathematical relationship between BMI and MUAC, between the two groups (EGG and LGG). MUAC of 27cm and 31cm had sensitivities and specificities of more than 80% for identifying pregnant women as overweight and obese respectively. Conclusion: The MUAC correlates strongly with BMI in pregnancy up to a gestation of thirty weeks in women in Metro West maternity services. In a low resource settings, the simpler MUAC measurement to assess nutritional status and screen women who are at risk for potential adverse pregnancy outcomes could reliably be substituted for BMI estimation.