Search PubMed⌕ Search

Biomedical subjects

A B Amoa

Publications and source records attributed to A B Amoa.

At least 19 recordsLinked to original sources
PubMed2002

Factors associated with success or failure in trials of vacuum extraction.

Failure rates for vacuum extraction of between one in 16 and one in 600 have been reported. Most studies report that unexpected failure carries a greater risk to both mother and fetus. The aim of this study was to determine factors that were likely to predict success or failure in trials of vacuum extraction. At the Port Moresby General Hospital, 59 trials of vacuum extraction were performed between 1 December 1997 and 30 November 1999. These cases were analysed according to whether vacuum extraction was achieved with more than or less than three pulls, or an alternative method of delivery was required to effect delivery Factors that were predictive of failure were: (i) Highlands origin of the mother; (ii) longer duration of the second stage of labour; (iii) severe moulding of the fetal head; (iv) cup detachments and deflexing cup applications; and (v) operator persisting with the procedure after three pulls. The cervix being less than fully dilated when the trial was commenced was not associated with a higher risk of failure, nor was it associated with a significantly higher risk of cervical trauma. Perinatal death and serious fetal scalp trauma were associated with deflexing cup applications, making more than three pulls and failed vacuum extractions.

Adult↗
PubMed1999

Anaemia and perinatal outcome in Port Moresby.

In 1987, a computerized obstetric database was set up at the Port Moresby General Hospital. Between 1987 and 1992, 27,117 births took place. The mean haemoglobin value amongst the 83% of women in whom a haemoglobin value was tested was 10.0 +/- 1.7 g/dL. High stillbirth rates (94 per 1,000) were associated with a haemoglobin value < 6 g/dL. The stillbirth rate was slightly lower (14 per 1,000) in woman whose lowest haemoglobin value was in the range 10.0-10.9 g/dL than in those with a haemoglobin value > or = 11 g/dL (18 per 1,000). The stillbirth rate was increased in women with haemoglobin values > or = 14.0 g/dL. With respect to low birth-weight (< 2,500 g), the rates were also higher when the haemoglobin value was above 14.0 g/dL. The reason for these findings is not apparent and may be due to the impact of an uncharacterized confounding variable rather than the haemoglobin value.

Anemia↗
PubMed1997

A survey of under-18 year old and 20-29 year old primigravidae delivered at the Port Moresby General Hospital: a comparative study of their sociodemographic and sexuality characteristics and contraceptive knowledge and experience.

From July 1992 to August 1993, 330 under-18 year old primigravidae (cases) and 330 randomly selected 20-29 year old primigravidae (controls) who were delivered at the Port Moresby General Hospital were sequentially studied, using a standardized, pretested, precoded questionnaire. In stepwise logistic regression analysis, significantly more of the cases had menarche at less than 15 years of age, learned before menarche that sex causes pregnancy, were of highland origin, were unemployed, or had partners who were unemployed; significantly fewer of the cases thought that one sexual act could cause pregnancy, had knowledge of or had ever used a family planning method, or had planned this pregnancy.

Adolescent↗
PubMed1997

A case of factor V deficiency presenting as menorrhagia.

Factor V deficiency is a rare hereditary disorder. We report a patient with factor V deficiency who presented with menorrhagia and pelvic haematoma. The Haematology Department at the Royal Brisbane Hospital performed the definitive factor assays leading to the diagnosis. The challenges of her management were obtaining adequate supplies of factor V and her socioeconomic circumstances. The main future challenge will be the supervision of her pregnancies.

Adult↗
PubMed1996

A case-control study of meconium staining of amniotic fluid in labour at Port Moresby General Hospital to determine associated risk factors and perinatal outcome.

AIM: To identify sociodemographic and obstetric characteristics which could be used as markers for thick meconium staining of the amniotic fluid (MSAF) in labour. METHODS: The design was an unmatched case-control study. The setting was the Port Moresby General Hospital labour ward. The eligibility criteria were: patients with a singleton pregnancy, cephalic presentation and baby alive at the time of admission in labour. Cases were parturients who had MSAF during labour. The cases were sequentially enrolled according to the time of delivery recorded in the labour ward register. A control was a patient who did not have MSAF and who was the first to deliver after a case. Data were collected using an interviewer-administered questionnaire and patients' hospital records. RESULTS: Logistic regression analysis showed the following variables to have a positive significant association with MSAF: low social status, betelnut chewing, grand multiparity, past history of perinatal death and rupture of membranes to delivery interval. Preterm delivery was negatively associated with MSAF. Compared with the controls, the cases had a higher caesarean section rate; more of their babies were admitted to the Special Care Nursery (SCN); the mean stay of their babies in the SCN was longer; and the perinatal mortality was higher.

Adolescent↗
PubMed1995

A survey of Papua New Guinean parturients at the Port Moresby General Hospital: family planning.

A survey of 673 consecutive Papua New Guinean parturients at the Port Moresby General Hospital, in May and June 1990, showed that 28% had ever used a family planning (FP) method, chiefly a hormonal method (93% of ever-users). Only seventeen of 239 (7.1%) nulliparae had ever used an FP method, compared with 170 of 434 (39.2%) parous subjects. Education of mother and of husband were independently and significantly associated with FP ever-use. Seventeen (4.9%) of 347 women who had a surviving child, had not breast-fed the child. The interval between the birth of the surviving child and the start of the index pregnancy was significantly associated with the duration of breast-feeding; the longer the duration of breast-feeding, the longer the inter birth interval.

Adolescent↗
PubMed1995

Prevalence of vaginal infections with bacterial vaginosis, Trichomonas vaginalis and Candida albicans among pregnant women at the Port Moresby General Hospital Antenatal Clinic.

A clinico-sociodemographic and microbiological survey was carried out at the Port Moresby General Hospital Antenatal Clinic to determine the prevalences of bacterial vaginosis, Trichomonas vaginalis and Candida albicans vaginal infections in pregnancy and to examine if the infections had any association with some suspected sociodemographic risk factors. The study was carried out between December 1990 and January 1991. Of 206 consecutive subjects surveyed, 79 (38%) had symptomatic infection. However, on speculum examination, abnormal discharge was seen in 188 (91%). 118 (57%) had microbiologically confirmed infection. The prevalences of the individual infections were T. vaginalis 19%, C. albicans 23% and bacterial vaginosis 23%. Combined infection, i.e. two infections occurring together in the same subject, was uncommon. None of the infections had an association with any of the sociodemographic characteristics studied. Of the 118 positive subjects, 52 (44%) complained of vaginal discharge and 55 (47%) complained of pruritus.

Adult↗
PubMed1993

Abdominal pain in pregnancy.

Abdominal pain in pregnancy is most commonly caused by complications of the pregnancy, e.g., abortion, ectopic pregnancy and abruptio placentae. A careful history and methodical physical examination and, if necessary, simple ultrasonographic investigations will reveal the cause in most of these conditions. In a few cases of abdominal pain in pregnancy a gynaecological condition, such as torsion of an ovarian cyst, or a nongynaecological (medical or surgical) one is the cause. Some of these conditions are serious, e.g., acute appendicitis, and unless the correct diagnosis is made and the appropriate management promptly instituted both the mother and her baby may suffer tragic consequences. Moreover, these conditions are more likely to be misdiagnosed during pregnancy. This is because the anatomical and physiological changes which occur in pregnancy tend to change and obtund the expected clinical features and laboratory data which are used to diagnose these conditions. Their early diagnosis therefore requires a high index of suspicion together with awareness of the ways in which they may present in pregnancy.

Abdominal Pain↗
PubMed1993

Longitudinal fetal biometry of normal pregnant Melanesian Papua New Guineans to construct standards of reference for Papua New Guinea.

In a longitudinal study at the Port Moresby General Hospital Antenatal Clinic between May 1990 and December 1991, 1514 biparietal diameter (BPD), 1294 femur length (FL) and 1229 abdominal circumference (AC) measurements were made on 425 fetuses during normal pregnancy. Weekly mean values with 2 standard deviations were calculated for BPD, FL and AC between 12 and 42 weeks. Growth curves were also constructed. Ethnic origin, height, parity, weight gain per week and socioeconomic status made no difference to these measurements. The mean values for BPD were compared with those obtained from studies in Africa and Europe. No differences were found.

Abdomen↗
PubMed1993

The prevalence of toxoplasma antibodies in pregnant patients attending the Port Moresby General Hospital antenatal clinic: a seroepidemiological survey.

In a survey of 197 consecutive pregnant patients who were attending the Port Moresby General Hospital antenatal clinic for the first time in the index pregnancy, the prevalence of IgG antibodies to Toxoplasma gondii was 18%. Only one patient had IgM antibodies. Of the sociodemographic characteristics examined, only highlands origin of the patient had a significant association with the presence of IgG antibodies.

Animals↗
PubMed1992

Endocervical Chlamydia trachomatis infection in pregnancy: direct test and clinico-sociodemographic survey of pregnant patients at the Port Moresby General Hospital antenatal clinic to determine prevalence and risk markers.

The prevalence of endocervical C. trachomatis infection in 181 consecutive antenatal clinic patients at the first attendance and who had not received antibiotic therapy in the previous 4 weeks, was 17.7%. The direct fluorescent antibody test was used for diagnosis. There was no significant clinical or sociodemographic factor which distinguished patients who tested positive from those who tested negative.

Adult↗
PubMed1992

Antepartum haemorrhage at the Port Moresby General Hospital: a retrospective study of 130 consecutive cases.

In a retrospective study of 130 out of 141 consecutive cases of antepartum haemorrhage admitted to the Obstetrics Unit of the Port Moresby General Hospital in the three years 1987 to 1989, 33% had abruptio placentae, 48% had placenta praevia and in 19% the cause of the APH could not be determined. Delivery was by caesarean section in 56% of cases compared to a caesarean section rate of 3% for the total obstetric population. Stillbirth rates per 1000 total births were 223 for all the 130 cases, 81 for the praevia group, 488 for the abruptio group and 120 for the indeterminate group. The stillbirth rate for all deliveries in the hospital in the year 1989 was 21.5/1000.

Abruptio Placentae↗
PubMed1991

Breech presentation and delivery.

What constitutes proper management for the singleton baby who presents by the breech at term has remained one of the most contentious subjects in obstetric practice. Perinatal morbidity and mortality are much higher in breech than in cephalic presentation. Elective caesarean section has been increasingly used in an attempt to improve the perinatal outcome. But caesarean section has immediate and late maternal complications. Some of these complications can be catastrophic. External cephalic version (ECV) at term, under tocolysis if necessary, will reduce the incidence of vaginal breech delivery and the incidence of caesarean section. Where ECV fails, the use of a selective management protocol will allow trial of breech labour in suitable cases, thus further reducing the incidence of elective section. Symphysiotomy may save the life of the baby whose head is trapped by disproportion.

Breech Presentation↗
PubMed1989

Epidemiology of rheumatic heart disease among primary school children in western Kenya.

A community survey was conducted to determine the prevalence of rheumatic heart disease in Kenyan children in all primary schools in 2 sublocations in Western Kenya. In total, 3631 children (97% school attendance) aged from 5 to 15 years were examined by one experienced physician and 2 cardiologists between September and December 1985. Six children were found to have evidence of rheumatic heart disease, giving a prevalence rate of 1.7/1000. As all cases occurred in the age group between 10 and 15 years, the rate was calculated for this group as 2.4/1000. None of these patients had previously been diagnosed as having rheumatic fever. There were 3 males and 3 females. Four patients had mitral regurgitation, one had aortic regurgitation and one had mitral stenosis. Three had electrocardiographic evidence of left atrial abnormality and one showed findings of left ventricular hypertrophy but two patients had normal tracings. Half were symptomatic with dyspnoea on exertion and two gave a history of fleeting polyarthritis. The socio-economic status (peasant), family size (mean = 6 siblings) and the number of children sleeping per room were the same in both the cases with rheumatic heart disease and their controls. The health workers achieved low scores (mean 26%) with regard to the clinical diagnosis, treatment and prevention of rheumatic fever at the level of primary health care. Rheumatic heart disease, nonetheless, was relatively insignificant in the overall picture of health care of school children in Western Kenya.

Adolescent↗
PubMed1979

Ergometrine or oxytocin? Blood loss and side-effects at spontaneous vertex delivery.

Blood loss and the frequency of vomiting were assessed at 88 spontaneous vertex deliveries. An i.v. injection of oxytocin 10 u was as effective as ergometrine 0.5 mg in controlling bleeding from the uterus after delivery. The continuous infusion of a dilute solution of oxytocin in the first stage of labour was not followed by an increased blood loss at delivery. Oxytocin infusions were maintained for 1 h after delivery. Vomiting or retching occurred in 13% of the mothers who received i.v. ergometrine. None of the women who received oxytocin suffered emetic sequelae.

Clinical Trials as Topic↗
PubMedDate not supplied

A case-control study of primary caesarean section at the Port Moresby General Hospital, Papua New Guinea, to identify epidemiological predictors of abdominal delivery.

A retrospective study of 274 consecutive primary caesarean sections and 274 unmatched controls was carried out at Port Moresby General Hospital from January to December 1992. The primary caesarean section rate was 3.5%. Stepwise logistic regression analysis showed that primary caesarean section was significantly associated with maternal height of less than 150 cm; nulliparity; symphysis-fundal height of more than 38 cm at admission in labour; cervical dilatation of less than 4 cm at admission in labour; and the level of fetal head at admission in labour of 3/5 or higher.

Adolescent↗