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Biomedical subjects

C J van Gelderen

Publications and source records attributed to C J van Gelderen.

11 recordsLinked to original sources

Cervical length at 23 weeks' gestation--relation to demographic characteristics and previous obstetric history in South African women.

OBJECTIVES: To determine the distribution of cervical length in a routine population of singleton pregnancies; to examine the relationship between cervical length, demographic characteristics, and previous obstetric history; and to compare these data with data from a similar study undertaken in the UK. PATIENTS AND METHODS: The study was conducted among women attending routine antenatal clinics at Coronation, Johannesburg General and Chris Hani Baragwanath hospitals. Cervical length was measured by means of transvaginal ultrasound at 23 weeks' gestation in women with singleton pregnancies attending these clinics, as part of a multicentre randomised trial investigating the value of cerclage in a short cervix. The distribution of cervical length was determined and the significance of differences in median cervical lengths between subgroups was calculated according to maternal age, ethnic origin, maternal body mass index (BMI), cigarette smoking, alcohol intake, and previous obstetric history. RESULTS: Cervical screening was offered to women (N = 2 173) attending clinics for a 23-week scan during the study period (July 1999-September 2002). Most women (N = 1 920) accepted, while 253 declined. Complete outcomes (date and mode of delivery, gestation at delivery, birth weight, Apgar scores, maternal blood loss, whether the patient was cerclaged or not, and any complications) were obtained for 1 603 women who accepted screening. Cervical length was measured successfully in all cases. Median cervical length was 33.7 mm and in 64 cases (3.3%) the length was 15 mm or less. Significantly shorter cervical lengths were found in those with a history of previous miscarriage, preterm delivery, those aged less than 20 years and those with an abnormal BMI. Cervical length was not significantly shorter in black women than in coloured and white women. CONCLUSIONS: At 23 weeks' gestation the median cervical length in a South African population was 33.2 mm. In 3.3% of the population the length was < or = 15 mm. There was an association between cervical length, demographic characteristics and previous obstetric history.

Adult↗

Polycystic ovarian syndrome. Evidence for an autoimmune mechanism in some cases.

Antiovarian autoantibodies localized to the granulosa cells were detected in 50% of a group of eight patients diagnosed with polycystic ovarian syndrome. An analogy is drawn to other endocrinopathies characterized by hypersecretion of hormones, notably thyroid and adrenal, and a pathogenetic mechanism involving stimulating antibody is postulated.

Adult↗

Meconium during labour--self-medication and other associations.

Prior to artificial rupture of membranes, 498 women were questioned about obstetric and social factors including self-medication during pregnancy. Caesarean section (P less than 0,01) and low Apgar scores (P less than 0,001) were significantly more common in pregnancies complicated by fetal meconium passage. Meconium passage was more common in women who had recently taken castor oil (P less than 0,01) and possibly herbal substances called 'sihlambezo' (trend P less than 0,2). Use of laxatives or enemas and other obstetric risk factors were not associated with meconium passage.

Castor Oil↗

Oestrogen and progesterone receptor concentrations in leiomyoma and normal myometrium.

The content of cytoplasmic 17 beta oestradiol and progesterone receptors in human uterine leiomyoma and normal myometrium in the Negroid population was determined. Eighteen women of reproductive age, at various stages of the menstrual cycle, were included in the study. The serum oestrogen and progesterone concentrations were also measured. This is the first report in the literature in which oestrogen and progesterone receptors in leiomyoma are significantly higher than in normal myometrium (P = 0.0002). The steroid dependence of the growth of leiomyomas may be related to the steroid receptor level. The presence of persistently high concentrations of oestrogen and progesterone receptors in leiomyoma should be helpful in the treatment of this benign tumour.

Adult↗

Labour in patients with a caesarean section scar. The place of oxytocin augmentation.

Fifty-two patients who had had a single previous caesarean section were submitted to a trial of scar. Labour was monitored by internal tocography and direct fetal heart rate monitoring. Oxytocin infusion was employed when uterine work proved to be inadequate. The oxytocin-augmented and unstimulated groups were compared. Oxytocin augmentation improved uterine work and did not result in significant fetal or maternal morbidity or mortality. Internal tocography was found to be of value, but fetal heart rate monitoring was essential.

Asphyxia Neonatorum↗

Pregnancy complicated by maternal hydrocephalus. A report of 3 cases.

The obstetric management of 3 women with stable hydrocephalus is presented. The few obstetric complications were unrelated to the maternal hydrocephalus, and specific management of the maternal condition was not necessary. Better management of hydrocephalus in infancy, as well as of the other forms of non-tumoral hydrocephalus, has led to more adults in a stable state with the condition and pregnancy will occur in some of these. A plea is made for all female patients with hydrocephalus to have a ventriculoperitoneal shunt rather than a ventriculoatrial one, with a view to reduction of complications in later pregnancies.

Adolescent↗

'One-visit' therapy for pelvic inflammatory disease.

Acute pelvic inflammatory disease is a very common gynaecological disorder, and more often than not it is caused by a mixed infection of aerobic and anaerobic organisms. Routine bacteriological investigation is consequently of little practical value in determining the therapeutic approach. In an open comparative trial, 60 patients were divided into two treatment groups of 30 patients each. Both groups received a combination of penicillins, probenecid, a sulphonamide and an imidazole derivative active against protozoa and anaerobes. Both regimens resulted in virtually the same therapeutic response in patients hospitalized for 6 days. The regimen consisting of ornidazole (as opposed to metronidazole) and the ultralong-acting sulphonamide, sulphadoxine (as opposed to sulphadimidine), can be given in a once-only administration, thereby greatly reducing the possibility of non-compliance in patients treated, as is customary, on an outpatient basis.

Acute Disease↗

Maternal intensive care.

The evolution of a maternal intensive care unit (ICU) is described and the management of the patients treated over a 10-month period is outlined. The principles, practice and methods of intensive care for the parturient are discussed.

Female↗