Doctoral Degrees (Obstetrics and Gynaecology)

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Browsing Doctoral Degrees (Obstetrics and Gynaecology) by browse.metadata.advisor "Hall, David Raymond"

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    Comparing the diagnosis of gestational diabetes using the oral glucose tolerance test and a designed breakfast in a randomised, cross-over trial
    (Stellenbosch : Stellenbosch University, 2017-12) Marais, Colin; Hall, David Raymond; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.
    ENGLISH ABSTRACT: Objective This study compared a standardised, user-friendly designed breakfast (DB) to the 75g OGTT, comparing venous and capillary glucose values for the diagnosis of gestational diabetes. Methods 6 prospective, randomised, cross-over trial comparing the gold standard OGTT to a designed breakfast glucose profile (DBGP) in the diagnosis of gestational diabetes, was performed from March to December 2015. Fifty-one patients, attending the high-risk antenatal clinic at Tygerberg Hospital, were randomised to OGTT or DBGP at baseline. One week later, before intervention, the alternative test was performed. Fasting and 2-hour, venous and capillary values were measured. Patients qualified for screening on risk factors: previous gestational diabetes, previous unexplained intra-uterine death, previous macrosomic baby, booking BMI >40 kg/m2, age >40 years, affected first degree relative, susceptible family origin (Asiatic), acanthosis nigricans and polycystic ovarian syndrome. Results Fasting and 2-hour capillary glucose values measured during the OGTT correlated significantly with laboratory venous samples (Pearson's 0.74; p <0.001 at both time intervals). The 2-hour capillary glucose values obtained for the DB showed satisfactory correlation to the current gold standard OGTT (Pearson's 0.54; p <0.001). Conclusions The designed breakfast glucose profile provides a user-friendly, sufficiently accurate, promising alternative to diagnose GDM that deserves further investigation.
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    A critical analysis of preterm birth in a largely homogeneous community near Tygerberg Academic Hospital with a high prevalence of preterm birth
    (Stellenbosch : Stellenbosch University, 2022-11) Brink, Lucy Theresa; Odendaal, Hendrik Johannes; Hall, David Raymond; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology.
    ENGLISH ABSTRACT: There is a high priority to address the heavy burden of preterm birth (PTB) on a low- to middle- class community in the Western Cape Province of South Africa (SA), where the Safe Passage Study (SPS) by the PASS Network was conducted. The latter study was undertaken to determine the role of alcohol consumption in stillbirths and sudden infant deaths. We documented a high rate (13.8%) of PTB in that community. Preterm birth (birth before 37 weeks) is one of the most common causes of perinatally related deaths at Tygerberg Academic Hospital (TAH), the tertiary referral hospital for the community. Complications of PTB also account for 75% of perinatal mortalities and more than 50% of chronic infant morbidities and therefore remains one of the greatest challenges in obstetrics. Perinatal outcome is particularly susceptible to socioeconomic conditions that have profound effects on the health of individuals and communities. SA has one of the highest levels of alcohol consumption (including binge drinking i.e. drinking four or more standard drinks during one sitting) as well as concomitant smoking in certain communities. Individuals with low socioeconomic status experience greater exposure to stress and are more likely to engage in risk-taking behaviours such as smoking, drinking and drug use during pregnancy, which may contribute to adverse birth outcomes. Despite the attention given to PTB in medical research, the aetiology remains largely unexplained, and placental pathology may illuminate the clinical understanding thereof. Increasing evidence indicates that placental dysfunction is an important risk factor for PTB, but contexts differ and information from low-income-countries is lacking.