Browsing by Author "Woods, David"

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    Comparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospital
    (2013) Chinula, Lameck; Fawcus, Susan R; Woods, David
    Almost four million babies die in the first four weeks of life per year worldwide, most from preventable causes. In addition a million babies die during labour and delivery (Lawn J et al., 2005). In South Africa, ‘intrapartum hypoxia and birth trauma’ are among the top three causes of perinatal deaths. Severe intrapartum hypoxia is often preventable with appropriate maternal and fetal monitoring in labour. However, this remains a challenge in under-resourced settings, due to difficulties that accompany the use of a Pinard Fetal Stethoscope (PFS) which include user-dependence and lack of evidence based standardisation in taking measurements with it. Although intermittent fetal heart monitoring is as effective as continuous electronic monitoring in low risk labours (Banta DH and Thacker, 2001), the search is for reliable, robust and cheaper fetal monitoring devices. The innovative crank powered Doppler Ultrasound Fetal Heart Rate Monitor (DUFHRM) developed by Power-free Education and Technology is robust, cheaper and designed for use even in settings with no or erratic access to mains electricity and replaceable batteries, and overcomes some of the challenges that come with the use of PFS (Banta DH and Thacker, 2001). The aim of the study was to assess the accuracy of Fetal Heart Rates (FHRs)taken with the DUFHRM compared to FHRs taken with a PFS using a Cardiotocography (CTG) as a standard fetal heart rate monitoring device. This was a comparative diagnostic study conducted at Mowbray Maternity Hospital, a public sector maternity hospital in Cape Town during 2012. Women with singleton pregnancies in the active phase of the first stage of labour, who had consented to participation, were enrolled in the study. Paired readings of FHRs were taken with a DUFHRM and a PFS, by two midwives and also with a CTG during the active phase of the first stage of labour before and after two preferably consecutive uterine contractions. The midwives were blinded to the CTG measurements by silencing the CTG and turning it away from their view. The FHRs taken with a PFS were done over a 60 second period in accordance with the guidelines from professional bodies (ACOG, 1995, RANZCOG, 2002, RCOG, 2001a, Liston R et al., 2002) The DUFHRM and CTG readings were made at the start and end of each 60 second period of PFS monitoring. The proportion agreement of FHRs taken with a DUFHRM to FHRs recorded with a CTG, and the proportion agreement of FHRs taken with a PFS to FHRs recorded with a CTG were determined and compared using McNemar Exact Significance Probability test (mcc).
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    Open Access
    Genetic studies on Clostridium acetobutylicum
    (1982) Allcock, Errol Ralph; Woods, David; Reid, Sharon J
    The aim of this study involved the characterisation of the cellulolytic properties of Clostridium acetobutylicum and the development of a genetic transfer system for this organism. The production of a carboxymethyl cellulose and a cellobiase by C acetobutylicum was demonstrated. In liquid medium the carboxymethyl cellulase was induced by molasses, and it was not repressed by glucose. Optimum carboxymethyl cellulase activity occurred at pH 4.6 and 37°C. Optimum conditions for autolysis and autoplast formation in C. acetobutylicum were defined. Autolysis-deficient mutants which produced less autolysin than the parent strain were isolated. Growth of the P262 strain and the lyt-1 mutant was inhibited by the same concentrations of wall-inhibiting antibiotics.
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    Improving survival rates of newborn infants in South Africa
    (BioMed Central Ltd, 2005) Pattinson, Robert; Woods, David; Greenfield, David; Velaphi, Sithembiso
    BACKGROUND:The number, rates and causes of early neonatal deaths in South Africa were not known. Neither had modifiable factors associated with these deaths been previously documented. An audit of live born infants who died in the first week of life in the public service could help in planning strategies to reduce the early neonatal mortality rate. METHODS: The number of live born infants weighing 1000 g or more, the number of these infants who die in the first week of life, the primary and final causes of these deaths, and the modifiable factors associated with them were collected over four years from 102 sites in South Africa as part of the Perinatal Problem Identification Programme. RESULTS: The rate of death in the first week of life for infants weighing 1000 g or more was unacceptably high (8.7/1000), especially in rural areas (10.42/1000). Intrapartum hypoxia and preterm delivery are the main causes of death. Common modifiable factors included inadequate staffing and facilities, poor care in labour, poor neonatal resuscitation and basic care, and difficulties for patients in accessing health care. CONCLUSION: Practical, affordable and effective steps can be taken to reduce the number of infants who die in the first week of life in South Africa. These could also be implemented in other under resourced countries.