Browsing by Author "Stewart, Chantel"

Now showing 1 - 3 of 3
  • No Thumbnail Available
    Item
    Open Access
    Assessment of face mask use among peripartum women at mowbray maternity hospital during the covid-19 pandemic
    (2023) Adusei, Samuel; Stewart, Chantel
    Background: The current global COVID-19 pandemic has resulted in loss of life worldwide. According to the John Hopkins dashboard on COVID-19, 6 446 935 out of 595 645 271 infected patients lost their lives. There were 12 562 636 cases in Africa and 257 083 lost their lives as of 11th August 2022. South Africa recorded 4 007 080 cases with 101 982 mortalities and the Western Cape was one of the highest hit provinces in the same period (662 113 cases). Primary prevention for COVID-19 includes social distancing, hand washing, using alcohol- based hand sanitisers, and, mostly importantly, face mask use. Of these, face mask use is the least adhered to. Effective face mask use and reasons for use or non-use among a vulnerable population such as peripartum women are still unknown. Objective: To assess face mask use and associated factors among peripartum women at Mowbray Maternity Hospital during the COVID-19 pandemic. Method: An analytical cross-sectional study was used to assess the proportion of peripartum women who effectively wore face masks. Effective face mask use was measured with the WHO tool on mask usage in the context of COVID-19. A total of 500 women who visited the facility from the 1st of October 2020 to 31st October 2020 were first observed for effective face mask use before selection into the study to curb response bias. A structured interviewer-administered questionnaire was used to assess knowledge and perceived reasons for face mask use among 250 selected peripartum women. Data were analysed in STATA version 15.0. Frequencies and percentages were reported for categorical variables. Graphs and percentages were used to report the proportion of women who effectively used face masks in each of the stages of labour. The chi-square or Fisher's exact test (where necessary) were used to determine the association between effective face mask use and each independent variable. A multiple logistic regression model with a significance level set at p<0.05, was employed to determine the factors associated with effective face mask use. Results: Eighty-two percent of all women who visited the hospital wore their face mask effectively. Out of the 250 respondents, the proportion of effective face mask use was 78% (proportion = 78.0%; 95% CI = 72.3% - 83.0%); 90.0% had adequate knowledge of face mask use. More than half of the respondents, 133 (53.2%), agreed that they used face masks because they “felt susceptible to getting COVID-19 in the hospital”. One major reason for using face masks among most respondents ;227 (90.8%) was that “having COVID-19 will be troublesome as it may spread to loved ones”. Second/third stage of labour (aOR = 0.38; 95% CI = 0.17 - 0.83; p = 0.016), and secondary education (aOR = 0.25; 95% CI = 0.08 - 0.77; p = 0.016) were associated with ineffective mask usage, whereas disagreement with perception that pressure from mass media and government reminded them of the need to put on a face mask (aOR = 3.58; 95% CI = 1.44 - 8.93; p = 0.006), and adequate knowledge (aOR = 4.10; 95% CI = 1.49 - 11.28; p = 0.006) were factors associated with effective face mask use. Conclusion: Generally, effective face mask use was high amongst respondents but was lowest in the second/third stage of labour. Knowledge of effective face mask use was also high. Even though the use of face mask is of historic value now, it is worth noting these important factors associated with mask use, to ensure compliance during future respiratory pandemics like COVID-19. There is a need for health professionals at the hospitals to educate peripartum women with secondary education about the dangers of COVID-19 and the risk of spread, especially in the hospital
  • No Thumbnail Available
    Item
    Open Access
    Causes, management, and outcomes of polyhydramnios, at a level 2 hospital in Cape Town
    (2023) Siveregi, Amon; Stewart, Chantel
    Introduction: Polyhydramnios is defined as excessive accumulation of amniotic fluid and has an estimated incidence of 0.2% – 3.9%. It is associated with both maternal and fetal adverse outcomes. Mild polyhydramnios is often idiopathic and pregnancy outcomes in this group are usually no worse than in the general population of pregnant women. In contrast, conditions such as congenital anomalies, chromosomal abnormalities, or diabetes mellitus are often found in patients with moderate and severe polyhydramnios. Neonatal and maternal adverse outcomes, can be up to five times higher in this subgroup. Methodology: We conducted a retrospective cohort study at a Level 2 hospital in Cape Town. Folders of women diagnosed with polyhydramnios on ultrasound examination were reviewed. We recorded demographic data as well as information on underlying causes, management and outcomes. We summarised continuous variables using the mean (standard deviation) and categorical variables using count (percentage). We tested the association between categorical variables using the chi-square test. Statistical significance was set at p< 0.05. Results: A total of 136 patients with polyhydramnios (80 mild and 56 moderate + severe) were included from January 1, 2018 to December 31, 2020. Cases of idiopathic polyhydramnios accounted for 81.7% of the mild and 77.2% of the moderate + severe polyhydramnios group. Composite maternal and fetal adverse outcome occurred in 19/136 (14.0 %) polyhydramnios cases. Preterm labour occurrence was significantly higher in the moderate + severe polyhydramnios group (9/56; 16 %) compared to the mild polyhydramnios group (3/80; 3.8%, p = 0.01). There was a statistically significant difference in the occurrence of the composite adverse outcome in the moderate + severe group compared to the mild group [13/56(23.2 %) vs 6/80 (7.5 %) p = 0.001]. Elective delivery at 38 – 40 weeks for polyhydramnios was associated with an increased risk of composite perinatal adverse outcome (7.6% vs 3.4%) compared to those that awaited spontaneous labour or were delivered for other obstetric reasons. The difference was however not statistically significant (p = 0.14). Conclusions: Most cases of polyhydramnios are idiopathic, regardless of category. Adverse outcomes are, however, significantly lower in the mild group compared to the moderate + severe group. The rate of adverse outcome in the mild group is comparable to the background risk in the general population. Elective admission and delivery of patients for polyhydramnios between 38–40 weeks may be associated with adverse outcome compared to awaiting spontaneous labour or delivery indicated for other obstetric reasons.
  • Thumbnail Image
    Item
    Open Access
    The perinatal and obstetric outcomes of triplet conceptions at Groote Schuur Hospital in the five-year period: 1 January 2012 to 31 December 2016
    (2022) Turner, Jane; Stewart, Chantel; Osman, Ayesha
    Background: Triplet pregnancy rates have increased over the past few decades due to the advancing maternal age at conception and assisted reproductive technology. It is well known that the risk to both the mother and fetus are greater in multiple pregnancy when compared to singleton pregnancy. Groote Schuur Hospital (GSH), as a tertiary hospital, is the main referral unit for patients with high risk pregnancies in the Metro West region of the Western Cape and provides care to women with triplet pregnancies. There are no studies in South Africa reviewing the outcomes of triplet pregnancies; this study provided the opportunity to do so. Objectives: The outcomes of all triplet pregnancies at GSH were reviewed from 1 January 2012 to 31 December 2016. The primary objective of the study was to review the fetal and neonatal outcomes of triplet pregnancies at GSH. Fetal complications included the prevalence of fetal abnormalities, miscarriage, twin to twin transfusion syndrome, intrauterine growth restriction and discordant growth, stillbirths, preterm delivery, premature rupture of membranes and low birth weight. Neonatal complications included respiratory distress syndrome or hyaline membrane disease, intraventricular haemorrhage and necrotising enterocolitis. The secondary objective was to review maternal complications and outcomes, including anaemia, hyperemesis gravidarum, hypertensive disorders, gestational diabetes, preterm labour, antepartum and postpartum haemorrhage and operative complications. The demographic information, mode of conception and mode of delivery were also included.