SUNScholar - Browsing by Author "Theron, G. B."

Browsing by Author "Theron, G. B."

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C-reactive protein levels in ectopic pregnancy, pelvic infection and carcinoma of the cervix
(Health & Medical Publishing Group, 1986-05) Theron, G. B.; Shepherd, E. G. S.; Strachan, A. F.
ENGLISH ABSTRACT: The value of C-reactive protein (CRP) levels in the differential diagnosis of pelvic infection and ectopic pregnancy, in the staging of carcinoma of the cervix, and after necrotizing irradiation for tumour was assessed. CRP was measured using a sensitive magnetizable solid-phase immunoradiometric assay. There was an obvious difference in CRP levels between patients with ectopic pregnancies and acute pelvic infections, but CRP levels failed to differentiate between stages IIB and IIIB carcinoma of the cervix, the majority of patients not having a significant acute-phase response. During radiotherapy there was wide variation and substantial individual differences in CRP levels which could have been caused by undiagnosed infective complications.
A centile chart for birth weight for an urban population of the Western Cape
(Health and Medical Publishing Group (HMPG), 1995-12) Theron, G. B.; Thompson, M. L.
Evidence from large epidemiological studies has supported concern that being born light for gestational age (LiGA) may be detrimental. The incidence of LiGA babies is an important indicator of the health of women of reproductive age in deprived communities. In the assessment of LiGA in the Western Cape, centile charts constructed for populations in other parts of the world are generally used. These charts, however, may not be appropriate. Patients residing in the area served by the Tygerberg Hospital obstetric service, who booked early with singleton pregnancies, had their gestational age confirmed by early ultrasound and delivered between 1 March 1989 and 28 February 1990 were included in the study. The sample consisted of 3 643 patients. The mean birth weight was 2 995 g (SD 573 g) and the range 760-5 080 g. The distribution of birth weight at each week of gestation from 28 to 42 weeks was not normal. The 4-parameter Johnson family of densities was used to model the distribution of birth weight at each gestational age. A comparison of the distribution of birth weight in the study relative to the perinatal growth chart for international reference constructed by Dunn was also made. In addition to considering an overall chart, the sample was subdivided according to a number of characteristics (e.g. gender, firstborn and latter-born babies, smoking habit, hypertensive disorders and induction of labour) in order to explore their impact on the distribution of birth weight. Having explored the potential impact of all these factors, it was concluded that a single chart including all patients could be constructed.
A centile chart for fetal weight for gestational ages 24 - 27 weeks
(Health and Medical Publishing Group (HMPG), 2008) Theron, G. B.; Geerts, L.; Thompson, M. L.; Theron, A. M.
The centile chart currently in use for Western Cape birth weight for gestational age covers a gestational age range from 28 to 42 weeks. Advances in maternal, fetal and neonatal medicine allow interventions prior to 28 weeks; a growing need therefore exists to extend the chart down to at least 24 weeks.
Comparison between a newly developed PC-based Doppler umbilical artery waveform analyser and a commercial unit
(Health and Medical Publishing Group (HMPG), 2005-01) Theron, G. B.; Theron, A. M.; Odendaal, H. J.; Bunn, A. E.
Objectives. To determine the accuracy of the resistance index (RI) of flow velocity waveforms of the umbilical artery measured using a newly developed PC-based continuous wave Doppler device (Umbiflow) with regard to systematic and random variations when compared with a commercial standard (Vasoflow). Design. A cohort study. Setting. The fetal evaluation clinic (FEC) at Tygerberg Hospital. Subjects. Patients referred to the FEC at Tygerberg Hospital with suspected chronic placental insufficiency. Outcome measures. The correlation coefficients indicating the strength of the relationship between the two devices and their agreement using the method of Bland and Altman. Results. A total of 248 patients were studied. The mean RIs of the first Doppler assessment were 0.69 (standard deviation (SD) 0.11) and 0.67 (SD 0.11) using the Vasoflow and Umbiflow respectively. The Pearson's correlation coefficient comparing the RI of the first test was 0.85. The degree of agreement between the two methods was excellent, the mean differences being very small (< 0.024) with tight confidence intervals. One hundred and ninety-four patients (78.2%) of patients remained in the same percentile category with both the Vasoflow and Umbiflow. Conclusions. The accuracy of the Umbiflow has been proved. A non-significant trend towards slightly lower values needs to be considered. This could be addressed by changing the percentile cut-off to slightly lower values.
Doppler ultrasonography of the fetoplacental circulation : normal reference values
(Health & Medical Publishing Group, 1989) Pattinson, R. C.; Theron, G. B.; Thompson, M. L.; Lai Tung, M.
Normal reference values for the resistance index, A/B ratio and pulsatility index of the umbilical artery obtained by Doppler ultrasonography are presented. The resistance index and A/B ratio values are very similar to those previously published, indicating no need for formulate normal values for different populations. The pulsatility index differed from other published values, probably reflecting different calculation methods built into the spectrum analysers rather than differences in waveforms. The resistance index had the lowest coefficient of variation and showed least inter-observer variation. For routine use the resistance index is preferable to other indices.
Effect of the Maternal Care Manual from the Perinatal Education Programme on the quality of antenatal and intrapartum care rendered by midwives
(Health & Medical Publishing Group, 1999) Theron, G. B.
Objectives. To assess changes in the quality of antenatal and intrapartum care rendered by midwives following intervention with the Maternal Care Manual from the Perinatal Education Programme (PEP). Design. A prospective controlled study. Setting. A study town and two control towns in the Eastern Cape. Subjects. Before the study a sample of files was drawn to provide baseline information. Subsequently all the midwives in the study town studied the manual, following which a second sample of files was drawn. Outcome measures. A check-list was used to assess antenatal cards and partograms. Results. The mean score allocated to the four subunits evaluating the front page of the antenatal card in the study town improved significantly (P = 0.000) from 58.5% (standard deviation (SD) 20.6) to 74.5% (SD 19.2). No changes occurred in the control towns (47.5% and 52.9%). The score obtained for the completion of the back page also improved significantly (P = 0.014), from 69% (SD 13.7) to 75.6% (SD 14.2), with no changes in the control towns. The mean score achieved for the completion of the partogram did not change in the study town or control towns. Conclusions. The improved scores obtained for the antenatal card in the study town reflects improved quality of antenatal care. Documentation that improved significantly included important aspects of antenatal care, i.e. previous obstetric history, gestational age, special investigations and correct charting of fundal growth. Three of the four subunits that did not improve were already familiar to the midwives before the study. Documentation of the partogram did not improve for reasons outside the control of the PEP.
The epidemiology of hepatitis B virus infection in HIV-infected and HIV-uninfected pregnant women in the Western Cape, South Africa
(Elsevier, 2013-11) Andersson, M. I.; Maponga, T. G.; Ijaz, S.; Barnes, J.; Theron, G. B.; Meredith, S. A.; Preiser, Wolfgang; Tedder, R. S.
OBJECTIVES: Persistent hepatitis B virus (HBV) infection is a major cause of morbidity and mortality in sub-Saharan Africa. The HIV epidemic has the potential to affect its biology. Immunisation protocols established in the pre-HIV era are based upon data showing predominantly horizontal infant transmission. This study aimed to determine whether HIV co-infection will change the epidemiology of HBV both by increasing infectivity and by favouring the escape of viruses bearing phenotypically altered HBsAg. METHODS: This retrospective cross-sectional study used antenatal samples from the 2008 Antenatal Sentinel HIV and Syphilis Prevalence Survey in the Western Cape, South Africa. All HIV-infected women were age and race-matched to HIV-uninfected women. Samples were tested for serological markers of HBV and HDV infection. HBV viral load, consensus sequencing and genotyping were performed. Luminex technology was used to determine HBsAg phenotype. All samples from HIV-infected women were tested for traces of antiretroviral drugs by mass spectrometry. RESULTS: This study showed a trend toward loss of immune control of HBV in HIV-infected women with 3.4% of samples containing HBsAg, 18.9% contained HBeAg. In contrast, 2.9% of samples from HIV-uninfected women contained HBsAg and 17.1% of these HBeAg. The median HBV load in the HIV-infected group was 9.72×10(7)IU/ml and in the HIV-uninfected group 1.19×10(6)IU/ml. Genotyping showed 63/68 samples belonged to genotype A and the remainder genotype D. Mutations in the precore region were found in 35% and 33% of samples from HIV-infected and HIV-uninfected respectively. Although no major epitope ablation was found, marked variation in HBsAg profiles in HIV-infected group was demonstrated. No HDV infection was detected. CONCLUSION: HIV-HBV co-infected women exhibit a degree of immune escape. One in six HBV-infected pregnant women, irrespective of HIV status is HBeAg seropositive. HBV immunization of newborns in sub-Saharan Africa should be implemented.
HIV seroconversion during pregnancy in the Tygerberg region of Cape Town
(Health & Medical Publishing Group, 2006) Theron, G. B.; Schoeman, J.; Carolus, E.
[No abstract available]
Inter-observer variation in symphysis-fundus measurements : a plea for individualised antenatal care
(Health & Medical Publishing Group, 1989) Pattinson, R. C.; Theron, G. B.
Two groups of midwives were compared with regard to ability to detect small-for-gestational-age (SGA) babies using symphysis-fundus (S-F) measurements. The patients were all low-risk obstetric patients. In group A 2 midwives provided antenatal care to 97 patients; 14 delivered SGA babies, of which 12 were identified by S-F measurements (sensitivity 85,7%). In group B 15 midwives provided antenatal care to 126 patients, 12 delivered SGA babies, and 5 of these were identified (sensitivity 41,2%). It is considered that this difference was due to inter-observer variability. A plea is made for individualised antenatal care.
Primary causes of total perinatally related wastage at Tygerberg Hospital
(Health & Medical Publishing Group, 1989-01) Pattinson, R. C.; De Jong, G.; Theron, G. B.
The primary obstetric cause of total perinatally related wastage (TPRW) (i.e. all antepartum or postpartum deaths of infants ≥ 500 g and who died before hospital discharge) was studied in a clearly defined population in the western Cape over a 1-year period. There were 302 deaths from 7,923 singletons and 31 deaths from 65 pairs of twins delivered from patients cared for by Tygerberg Hospital maternity services. Thirty per cent of the deaths were late abortions, 42% stillbirths, 18% early neonatal deaths, 7% late neonatal deaths and 4% perinatally related infant deaths. The major primary obstetric events leading to TPRW in singletons were antepartum haemorrhage (27,8%), spontaneous preterm labour (24,8%), unexplained intra-uterine deaths (11,9%), infections (9,3%) and fetal abnormalities (7,9%). Multiple pregnancies accounted for 9,3% of the TPRW of all deliveries. The cause, risk factors associated and methods of prevention of abruptio placentae, spontaneous preterm labour and infections should receive priority in perinatal research in the western Cape.
Saving mothers : report on the confidential enquiries into maternal deaths in South Africa
(Medpharm Publications, 2000) Theron, G. B.
In 1952 the Maternal Mortality Ratio (MMR), excluding early pregnancy deaths, was 54/100 000 births for England andWales. This was the first year of the Confidential Enquiry in Maternal Deaths in England and Wales. fn the triennium,1994-1996 the MMR for the United Kingdom was 12.2/100 000 maternities. It is estimated that the MMR for South Africa is about 150/100 000 live births. Clearly the approximately twelve times higher MMR in South Africa is not due to a global lack of knowledge on how to manage severely ill pregnant women, bur due to maternity services in SouthAfrica not implementing available knowledge. There may be many reasons for this, medical education, availability of resources and socio-economic problems immediately spring to mind. The establishment of the Confidential Enquiry into Maternal Deaths in South Africa allows us to determine at what level there is a breakdown in the health system and in turn this will allow for remedial action. Information for "saving Mothers" comes from an analysis of data on women who died in South Africa during pregnancy, Iabour or the puerperium during 1998 and were reported to the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD).
The value of histopathology of the placenta in a tertiary referral hospital in South Africa
(Health and Medical Publishing Group, 2019) Malusi, Z.; Schubert, P. T.; Theron, G. B.; Wright, C. A.
Background. Unexplained intrauterine death (IUD) remains the most common cause of perinatal death in babies of <1 000 g in South Africa (SA). Information from examination of the placenta subsequent to an adverse perinatal outcome is often underutilised and placental histology can contribute to determining the cause of perinatal death and other adverse outcomes in many instances. Objectives. To correlate placental histopathology with the clinical indication for submission and to demonstrate the value of placental histopathology in understanding adverse perinatal outcomes. Methods. We reviewed 2 years’ singleton placental histology reports at a tertiary academic hospital in the Western Cape, SA. All samples were from placentas of >24 weeks’ gestation. Results. The total sample (N=822) comprised 60.9% live-birth placentas and 39.1% IUD placentas. In the IUD group, the cause of death was clinically unexplained in 55.9% of cases. Histopathology identified in this group included chorioamnionitis (CA) (34.5%), maternal vascular malperfusion (32.1%), abruptio placentae (31.5%), delayed villous maturation (17.8%) and toxoplasmosis, other agents, rubella, cytomegalovirus and herpes simplex (TORCH) infections (6.1%), most commonly syphilis. No pathology was found in only 2% of IUD cases. Among live births, preterm labour accounted for 41.9% of placental submissions, of which the cause was unknown in 46.2% of cases. Clinically indicated and histologically defined CA was poorly correlated. Conclusion. This study demonstrates the value of placental histopathology in cases of adverse perinatal outcome.

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