Browsing by Author "Fawcus, S."

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    Management of incomplete abortions at South African public hospitals
    (Health & Medical Publishing Group, 1997) Fawcus, S.; McIntyre, J.; Jewkes, R. K.; Rees, H.; Katzenellenbogen, J. M.; Shabodien, R.; Lombard, C. J.; Truter, H.; Cronje, H.; Duminy, P.; Marivate, M.; Moodley, J.; Pattinson, B.
    Objective. The objective of this report was to review and describe the management of incomplete abortion by public sector hospitals. Design. A descriptive study in which data were collected prospectively from routine hospital records on all women admitted with incomplete abortion to a stratified random sample of hospitals between 14 and 28 September 1994. Setting. Public sector hospitals in South Africa. Patients. Women with incomplete abortions. Main outcome measures. Length of hospital stay, details of medical management, details of surgical management, determinants of the above. Main results. Data were collected on 803 patients from the 56 participating hospitals. Of these, 767 (95.9%) were in hospital for 1 day or more, and 753 (95.3%) women underwent evacuation of the uterus. Sharp curettage was the method employed in 726 (96.9%) and general anaesthesia was used for 601 (88%) of the women requiring uterine evacuation. Antibiotics were prescribed for 396 (49.5%) and blood transfusions were administered to 125 (17%) women. Statistical analysis showed length of stay to be longer in small hospitals (under 500 beds) and when the medical condition was more severe. Antibiotic usage and blood transfusion were more common with increasing severity and a low haemoglobin level on admission. However, some inappropriate management was identified with regard to both. Main conclusions. It is suggested that uncomplicated incomplete abortion can be more effectively and safely managed using the manual vacuum aspiration technique with sedation/analgesia as an outpatient procedure. Attention should be directed at the introduction of this management routine at all types of hospital and to the ensuring of appropriate management of women with complicated abortion.
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    Maternal deaths from bleeding associated with caesarean delivery : a national emergency
    (Health & Medical Publishing Group, 2016) Fawcus, S.; Pattinson, R. C.; Moodley, J.; Moran, N. F.; Schoon, M. G.; Mhlanga, R. E.; Baloyi, S.; Bekker, E.; Gebhardt, G. S.
    ENGLISH ABSTRACT: Maternal deaths associated with caesarean deliveries (CDs) have been increasing in South Africa over the past decade. The objective of this report is to bring national attention to this increasing epidemic of maternal deaths due to bleeding associated with CD in the majority of provinces of the country. Individual chart reviews of women who died from bleeding at or after CD show that 71% had avoidable factors. Among the steps we can take are to improve surgical skills and experience, especially in rural hospitals, to improve clinical observations in the immediate postoperative period and in the postnatal wards, and to ensure that appropriate oxytocic agents are given to prevent postpartum haemorrhage. CEOs and medical managers of health facilities, district clinical specialists, heads of obstetrics and gynaecology, and midwifery training institutions must show leadership and accountability in providing an appropriate environment to ensure that women who require CD receive the procedure for the correct indications and in a safe manner to minimise risks.