Browsing by Author "Moodley, J."

Now showing 1 - 7 of 7
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    Failure to perform assisted deliveries is resulting in an increased neonatal and maternal morbidity and mortality : an expert opinion
    (Health & Medical Publishing Group, 2018) Pattinson, R. C.; Vannevel, V.; Barnard, D.; Baloyi, S.; Gebhardt, G. S.; Le Roux, K.; Moran, N.; Moodley, J.
    The need to perform assisted vaginal delivery (AVD) has been regarded as self-evident. In high-income countries, rates of AVD range between 5% and 20% of all births. In South Africa, the rate of AVD is only 1%. This has resulted in increased neonatal morbidity and mortality due to intrapartum asphyxia, and increased maternal morbidity and mortality due to a rise in second-stage caesarean deliveries. In this article, we address the possible causes leading to a decrease in AVD and propose measures to be taken to increase the rates of AVD and subsequently reduce morbidity and mortality.
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    The Magpie study - clinical implications for poor countries
    (Health & Medical Publishing Group, 2003) Steyn, D. W.; Hofmeyr, G. J.; Jackson, K. C.; Kambaran, A.; MacDonald, P.; Matsela, L.; Moodley, J.; Pattinson, R. C.; Pirani, N. E.; Schoon, M. G.
    [No abstract available]
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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.
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    Prophylactic human papillomavirus vaccination against cervical cancer : a summarised resource for clinicians
    (South African Society of Gynaecologic Oncology, 2011) Lindeque, B. G.; Dreyer, G.; Botha, M. H.; Moodley, T.; Soeters, R.; Smith, T.; Cooreman, B.; Guidozzi, F.; Hoosen, A.; Mouton, A.; Turner, A.; Koller, T.; Moodley, J.; Whittaker, R. J.; Williamson, A.; Rogers, L.; South African Human Papillomavirus Advisory Board
    Carcinoma of the cervix remains the most frequent cancer affecting women in South Africa. Twenty-three per cent of all reported cancers in women are of the uterine cervix. Cancer of the cervix resulted in an estimated 3 700 deaths in South Africa during 2002. The human papillomavirus (HPV) has been proven a potent carcinogen. The aetiological role of HPV infection in the development of preinvasive and invasive lesions of the cervix, vagina and the anogenital region has been conclusively established. Vaccination against infection with specific high-risk HPV is commercially available, and is likely to change the future of the disease.
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    The Magpie Trial: A randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for children at 18 months
    (2007) Duley, L.; Farrell, B.; Armstrong, N.; Spark, P.; Roberts, B.; Smyth, R.; Tivnan, M.; Laws, A.; Corfield, N.; Salte, A.; Thorn, L.; Altman, D.; Yu, L. M.; Abalos, E.; Carroli, B.; Dellepiane, L.; Duarte, M.; Fernandez, H.; Giordano, D.; Clarke, M.; Gray, A.; Hey, E.; Neilson, J.; Simon, J.; Doyle, L.; Kelly, T.; Squires, J.; Collins, R.; Karaoglou, A.; Lilford, R.; Moodley, J.; Robson, S.; Roberts, I.; Rubin, P.; Thornton J.; Twaddle, S.; Villar, J.; Walker, I.; Watkins, C.; Bimbashi, A.; Demalia, E.; Gliozheni ,O.; Shpata, A.; Karolinski, A.; Lamas, M.; Pesaresi, M.; Wainer, V.; Barbato, W.; Paciocco, M.; Bertin, M.; Boiza, E.; Castaldi, J.; Partida, Y.; Arias, C.; Farri, M.; Kerz, G.; Aguirre, J.; De Sagastizabal, M.; Falcone, R.; Morales, E.; Carroli, G.; Krupitzky, S.; Lopez, S.; Palermo, M.; Montes, Varela D.; Delprato, H.; Camusso, H.; Curioni, M.; Ludmer, E.; Brandi, R.; Martin, R.; Mesas, W.; Taralli, R.; Lezaola, M.; Morosini, M.; Andina, E.; Bernal, L.; Estiu, M.; Ulens, E.; Ortiz De Speranza, B.; Peyrano, A.; Damiano, M.; Saumench, C.; Horn, J.; Pritchard, M.; Smith-Orr, V.; Wilson, M.; Lawrence, A.; Watson, D.; Crowther, C.; Paynter, J.; Ashrafunnessa,; Mannan, M.; Shahidullah, M.; Shamsuddin, L.; Barros, Santos C.; Freire, S.; Melo, E.; Cobo, E.; Jaramillo, E.; Cardozo, C.; Fandino, N.; Gaitan, H.; Montano, L.; Lozano, J.; Rojas, M.; Breto, Garcia A.; Fuentes, Ramirez A.; Garcia, Miras R.; Sampera, S.; Farnot, U.; Gomez, E.; Rojas, G.; Valdes, R.; Abd El-Kreem, H.; Al-Hussaini, T.; Hammad, E.; Danso, K.; Kwapong, E.; Ofosu-Barko, E.; Padmini, Jasper M.; Peedicayil, A.; Regi, A.; Sharma, R.; Chauhan, A.; Raut, V.; Udani, R.; Batra, S.; Muthal-Rathore, A.; Ramji, S.; Zutshi, V.; Balakrishnan, S.; Eapen, E.; Koshy, G.; Ambardar, N.; Vadakkepat, P.; Vaidya, D.; Lema, V.; Rijken, Y.; Tadesse, E.; Dada, O.; Sofekun, A.; Ohiaeri, C.; Runsewe-Abiodun, T.; Adewole, I.; Adeyemo, A.; Brown, B.; Oladokun, R.; Adewale, O.; Inimgba, N.; John, C.; Ogu, R.; Ekele, B.; Isah, A.; Onankpa, B.; Jamelle, R.; Junejo, D.; Ruby, Faiz N.; Gul, F.; Sherin, A.; Bangash, K.; Mahmud, G.; Masud, K.; Tasneem, N.; Gassama, S.; Soyei, A.; Agarwal, P.; Rajadurai, V.; Pirani, N.; Delport, S.; Macdonald, P.; Mokhondo, R.; Pattinson, R.; Zondo, M.; Adhikari, M.; Mnguni, N.; Moodley, J.; Carstens, M.; Kirsten, G.; Steyn, W.; Van Zyl, J.; Helwig, A.; Jacobson, S. L.; Panosche, R.; Hammond, E.; Masanganise, L.
    Objective: To assess the long-term effects of in utero exposure to magnesium sulphate for children whose mothers had pre-eclampsia. Design: Assessment at 18 months of age for children whose mothers were recruited to the Magpie Trial (recruitment 1998-2001 ISRCTN 86938761), which compared magnesium sulphate with placebo. Setting: Follow-up of children born at 125 centres in 19 countries across five continents. Population: A total of 6922 children were born to women randomised before delivery at follow-up centres. Of these, 2271 were not included for logistic reasons and 168 were excluded (101 at a centre where <20% were contacted, 40 whose death or disability was due to a problem at conception or embryogenesis and 27 whose parent/s opted out). Therefore, 4483 children were included in follow-up, of whom 3283 (73%) were contacted. Methods: Assessment by questionnaire, with interview and neurodevelopmental testing of selected children. Main outcome measures: Death or neurosensory disability at age of 18 months. Results: Of those allocated magnesium sulphate, 245/1635 (15.0%) were dead or had neurosensory disability at 18 months compared with 233/1648 (14.1%) allocated placebo (relative risk [RR] 1.06, 95% CI 0.90-1.25), and of survivors, 19/1409 (1.3%) had neurosensory disability at 18 months compared with 27/1442 (1.9%) (RR 0.72, 95% CI 0.40-1.29). There were no substantial differences in causes of death or in the risk of individual impairments or disabilities. Conclusions: The lower risk of eclampsia following prophylaxis with magnesium sulphate was not associated with a clear difference in the risk of death or disability for children at 18 months. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.
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    The Magpie Trial: A randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years
    (2007) Duley, L.; Farrell, B.; Armstrong, N.; Spark, P.; Roberts, B.; Smyth, R.; Tivnan, M.; Laws, A.; Corfield, N.; Salter, A.; Thorn, L.; Altman, D.; Yu, L.-M.; Abalos, E.; Carroli, B.; Dellepiane, L.; Duarte, M.; Fernandez, H.; Giordano, D.; Clarke, M.; Gray, A.; Hey, E.; Neilson, J.; Simon, J.; Collins, R.; Karaoglou, A.; Lilford, R.; Moodley, J.; Robson, S.; Roberts, I.; Rubin, P.; Thornton, J.; Twaddle, S.; Villar, J.; Walker, I.; Watkins, C.; Doyle, L.; Bimbashi, A.; Demalia, E.; Gliozheni, O.; Shpata, A.; Karolinski, A.; Lamas, M.; Pesaresi, M.; Wainer, V.; Barbato, W.; Paciocco, M.; Bertin, M.; Boiza, E.; Castaldi, J.; Partida, Y.; Arias, C.; Farri, M.; Kerz, G.; Aguirre, J.; De Sagastizabal, M.; Falcone, R.; Morales, E.; Carroli, G.; Krupitzky, S.; Lopez, S.; Palermo, M.; Montes, Varela D.; Delprato, H.; Camusso, H.; Curioni, M.; Ludmer, E.; Brandi, R.; Martin, R.; Mesas, W.; Taralli, R.; Lezaola, M.; Morosini, M.; Andina, E.; Bernal, L.; Estiu, M.; Ulens, E.; Ortiz De Speranza, B.; Peyrano, A.; Damiano, M.; Saumench, C.; Horn, J.; Pritchard, M.; Smith-Orr, V.; Wilson, M.; Lawrence, A.; Watson, D.; Crowther, C.; Paynter, J.; Ashrafunnessa,; Mannan, M.; Shahidullah, M.; Shamsuddin, L.; Barros Santos, C.; Freire, S.; Melo, E.; Cobo, E.; Jaramillo, E.; Cardozo, C.; Fandino, N.; Gaitan, H.; Montano, L.; Lozano, J.; Rojas, M.; Breto Garcia, A.; Fuentes, Ramirez A.; Garcia, Miras R.; Sampera, S.; Farnot, U.; Gomez, E.; Rojas, G.; Valdes, R.; Abd El-Kreem, H.; Al-Hussaini, T.; Hammad, E.; Danso, K.; Kwapong, E.; Ofosu-Barko, E.; Padmini Jasper, M.; Peedicayil, A.; Regi, A.; Sharma, R.; Chauhan, A.; Raut, V.; Udani, R.; Batra, S.; Muthal-Rathore, A.; Ramji, S.; Zutshi, V.; Balakrishnan, S.; Eapen, E.; Koshy, G.; Ambardar, N.; Vadakkepat, P.; Vaidya, D.; Lema, V.; Rijken, Y.; Tadesse, E.; Dada, O.; Sofekun, A.; Ohiaeri, C.; Runsewe-Abiodun, T.; Adewole, I.; Adeyemo, A.; Brown, B.; Oladokun, R.; Adewale, O.; Inimgba, N.; John, C.; Ogu, R.; Ekele, B.; Isah, A.; Onankpa, B.; Jamelle, R.; Junejo, D.; Ruby, Faiz N.; Gul, F.; Sherin, A.; Bangash, K.; Mahmud, G.; Masud, K.; Tasneem, N.; Gassama, S.; Soyei, A.; Agarwal, P.; Rajadurai, V.; Pirani, N.; Delport, S.; Macdonald, P.; Mokhondo, R.; Pattinson, R.; Zondo, M.; Adhikari, M.; Mnguni, N.; Moodley, J.; Carstens, M.; Kirsten, G.; Steyn, W.; Van Zyl, J.; Helwig, A.; Jacobson, S.-L.; Panosche, R.; Hammond, E.; Masanganise, L.
    Objective: The aim of this study was to assess long-term effects for women following the use of magnesium sulphate for pre-eclampsia. Design: Assessment at 2-3 years after delivery for women recruited to the Magpie Trial (recruitment in 1998-2001, ISRCTN 86938761), which compared magnesium sulphate with placebo for pre-eclampsia. Setting: Follow up after discharge from hospital at 125 centres in 19 countries across five continents. Population: A total of 7927 women were randomised at the follow-up centres. Of these women, 2544 were not included for logistic reasons and 601 excluded (109 at a centre where <20% of women were contacted, 466 discharged without a surviving child and 26 opted out). Therefore, 4782 women were selected for follow-up, of whom 3375 (71%) were traced. Methods: Questionnaire assessment was administered largely by post or in a dedicated clinic. Interview assessment of selected women was performed. Main outcome measures: Death or serious morbidity potentially related to pre-eclampsia at follow up, other morbidity and use of health service resources. Results: Median time from delivery to follow up was 26 months (interquartile range 19-36). Fifty-eight of 1650 (3.5%) women allocated magnesium sulphate died or had serious morbidity potentially related to pre-eclampsia compared with 72 of 1725 (4.2%) women allocated placebo (relative risk 0.84, 95% CI 0.60-1.18). Conclusions: The reduction in the risk of eclampsia following prophylaxis with magnesium sulphate was not associated with an excess of death or disability for the women after 2 years. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.