Browsing by Author "De Villiers, V. P."
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- ItemBarton's forceps deliveries at Paarl Hospital(Health & Medical Publishing Group, 1988-02) De Villiers, V. P.ENGLISH ABSTRACT: Experience in using Barton's forceps for mid-pelvic arrest of the fetal head in 348 cases has proved that this instrument is both easy to apply and safe for the baby, provided rigid adherence to safety criteria are observed. As modern obstetric practice is favourably disposed towards mid-pelvic forceps vaginal delivery, the particular advantages of Barton's forceps should be more widely extolled. Their use is an invaluable addition to the obstetrician's armamentarium. Training in their use should, however, be thorough and extensive and under the guidance of a skilled senior obstetrician.
- ItemPostpartum sterilisation and demographic progress at Paarl Hospital(Health & Medical Publishing Group, 1988) De Villiers, V. P.The success of the postpartum sterilisation campaign at Paarl Hospital, CP, irrefutably supports the claim that a quality family planning programme can in itself reduce fertility. In 1971 only 10% of women undergoing sterilisation had 4 or fewer children - this incidence increased to 71% in 1986. Women with more than 10 children are now very rarely found - in 1970 they still accounted for 20% of all patients sterilised. Parity at time of sterilisation has levelled to about 4 in contrast with 7.52 in 1971. It is probable that as many as 15000 unwanted and unplanned pregnancies have been prevented in Paarl as a result of this sustained effort. The ideal of the 2-child family is increasingly possible.
- ItemPostpartum sterilisation by the Irving technique : a report of 200 cases at Paarl Hospital, CP(Health & Medical Publishing Group, 1987) De Villiers, V. P.; Morkel, D. J.Sterilisation by the Irving procedure accompanying caesarean section was the favoured form of sterilisation at Paarl Hospital from 1971 to 1985. No subsequent pregnancies have been reported from the 200 cases and this success is compared with sterilisation failure rates of 1,35% with the Pomeroy method, 1,27% with the total fimbriectomy method, 0,41% with the Vienna or modified Pritchard method, and 0,89% with the Filshie-clip method: Irving sterilisation is accordingly advised as the method of choice at the time of caesarean section.
- ItemPostpartum sterilisation with the Filshie titanium silicone-rubber clip and subsequent pregnancy(Health & Medical Publishing Group, 1987) De Villiers, V. P.Pregnancy subsequent to postpartum Filshie clip sterilisation has occurred in 8 out of 789 patients operated on at Paarl Hospital since early 1983. As most pregnancies after sterilisation occur within 2 years, more failures can be expected. The use of this method has thus been discontinued.
- ItemPostpartum sterilization and maternal mortality in the Paarl Hospital(Health & Medical Publishing Group, 1984) De Villiers, V. P.A single maternal death associated with postpartum sterilization has been encountered at Paarl Hospital among the 3,742 such procedures performed between January 1972 and December 1982 (19,75% of all the mothers delivered were sterilized). The safety of postpartum sterilization is confirmed. A strong plea is voiced for the expansion of this procedure on a massive national scale because of its simplicity and effectiveness.
- ItemPostpartum sterilization by mini-incision at Paarl, CP. A multicentre international comparison(Health & Medical Publishing Group, 1986) De Villiers, V. P.Postpartum sterilization at Paarl Hospital, CP, is compared with the situation obtaining in Thailand, India, Cuba, Chile, the Philippines, Australia and Singapore. This international study depoliticizes the issue and emphasizes that voluntary sterilization is a basic service which should be available everywhere. A transumbilical minilaparotomy is a fast and safe procedure, which should be carried out within hours of delivery - even on Saturdays and Sundays. Caesarean section when sterilization is the only indication is completely unjustified.
- ItemSeksonderrig onder tieners in die Paarl(Health & Medical Publishing Group, 1991) De Villiers, V. P.Over a 24-month period, 209 pregnant girls 16 years and younger were interviewed at the Paarl East Teenage Pregnancy Clinic. Only 60 (28,71%) had received some sex education at home and 108 (51,67%) had received some information at school. Firty-seven girls (27,2%) had received no instruction at all. This lack of sex education partly explains the high incidence of teenage pregnancy at Paarl - once reported as the highest in the world. Eradication of this teenage catastrophy afflicting South Africa must involve improved school education and the total community, including the business sector. Teenage instruction should start at junior school and should be repeated at frequent intervals from as early as Standard 2.
- ItemTienderjarige swangerskappe in die Paarl-hospitaal(Health & Medical Publishing Group, 1985) De Villiers, V. P.Of the 20,590 mothers delivered at the Paarl Hospital from the beginning of 1973 to the end of 1983, teenagers number 6,284 (30,51%). About 5% of all mothers were 16 years old or younger. No other country has such an alarming incidence of young teenage mothers, and no country can afford the vicious circle of socio-economic demands that will be generated by this catastrophe. Worst of all, the babies born are often defective at birth, with little chance of holding their own in life because of their subsequent inferior intellectual and somatic development. The demographic consequences are formidable.
- ItemTienerswangerskap en roetine-kolposkopie(Health & Medical Publishing Group, 1989) De Villiers, V. P.The superiority of colposcopy over cytology is clearly demonstrated by the finding of an atypical transformation zone in 42,7% of routine consecutive colposcopies performed on 206 pregnant teenagers 16 years and younger at Paarl Hospital; in only 1,46% of these girls did cervical cytology show atypia or dysplasia. Complete colposcopy was possible in 97,6% of cases whereas cytology was incomplete in 28,2%, with no endocervical cells shown. The colposcopical findings are very similar to those of a concurrent West German study very similar to those of a concurrent West German study which links these findings to the human papillomavirus notoriously missed by cytology. Colposcopy should be part of the routine evaluation of every teenage pregnancy as cytological examination alone is not only incomplete but also much less sensitive in detecting abnormal change of the cervix.