OBSTETRICS & GYNAECOLOGY FORUM is written by specialists in the field. It aims, primarily, to present articles on the practice of Obstetrics and Gynaecology in South Africa and is distributed to G.P’s and to Specialists concerned with the rendering of healthcare to women.

The views expressed in individual articles are the personal views of the Authors and are notnecessarily shared by the Editors, the Advertisers or the Publisher. No articles may bereproduced in any way without the writtenconsent of the Publisher.


This edition of the Obstetrics and Gynecology Forum focusses on some of the common causes of maternal deaths in South Africa over the 2014-2016 period. Despite reductions in maternal mortality, the numbers, maternal mortality ratios and frequency of preventable deaths, as shown by the 2008- 2010, 2011-2013, 2014-2016 triennial reports published as the Saving Mothers Reports by the National Department of Health, remain unacceptably high.

J Moodley

Human Immunodeficiency Virus (HIV) infection remains the most significant risk factor for maternal death in South Africa. The increase in iMMR (institutional maternal mortality ratio) with each triennial report from 2002-2004 to 2008- 2010 was due to a rapid rise in HIV related maternal deaths.

Dr MR Ramogale-Zungu, Dr Rosie Burton

The death of a woman during pregnancy, child birth or the puerperium is one of the greatest possible tragedies. On average every two minutes, somewhere in the world, a pregnant women dies. Hemorrhage (27%), hypertensive disorders (14%) and sepsis (11%) are the three biggest causes of direct obstetric mortality. With Sustainable Development Goal, the United Nations has pledged to reduce the global maternal mortality rate (MMR) to less than 70 per 100,000 live births by 2030, as opposed to the 216 deaths per 100,000 live births that occurred in 2015.

Sylvia Cebekhulu, Laura Cornelissen, Robert Pattinson

Worldwide unplanned pregnancy rates reach almost 50%.1 South Africa (SA) is no different and might be worse.2,3 In addition to this we have a high abortion rate, teenage pregnancy rate and maternal mortality ratio.4,5 Ironically, South Africans have a high knowledge and use of contraceptive methods.6 Sustained use, which might be the caveat that explains the disparity in our reproductive health statistics, however, requires more effort and skill on providers’ part.

Mala Panday

This article discusses maternal deaths resulting from early pregnancy loss. These deaths are divided into two broad categories: deaths from miscarriage and deaths from ectopic pregnancy.

Neil F Moran

The key findings and trends on deaths associated with early pregnancy and miscarriage reported by the Saving Mothers’ Report 2014-2016 are presented. In addition, vignettes involving deaths from ectopic and miscarriage used to highlight avoidable factors and make recommendations to reduce deaths from these maternal deaths

AC Lundgren

There is on-going concern at the slow rate of reduction of mortality from obstetric haemorrhage in South Africa despite several educational interventions. Obstetric haemorrhage (OH) was the third most common cause of maternal death for the triennium 2014 to 2016, accounting for 624 deaths or 16.9% of the total.

Sue Fawcus

Hypertensive disorders of pregnancy (HDP) which include the categories chronic hypertension, gestational hypertension, pre-eclampsia, eclampsia and the HELLP syndrome (hemolysis, elevated liver enzymes and low platelet counts < 100,000 x 109/L), are a common direct cause of maternal mortality.

Jack Moodley

Zane Wilson Founder SADAG

  • Neil Amoore,
  • Psychologist, Johannesburg
  • Kevin Bolon,
  • Psychologist, Johannesburg
  • Dr Jan Chabalala,
  • Psychiatrist, Johannesburg
  • Dr Lori Eddy,
  • Psychologist, Johannesburg
  • Lee-Ann Hartman,
  • Psychologist, Johannesburg
  • Dr Frans Korb,
  • Psychiatrist/Psychologist, Johannesburg
  • Professor Crick Lund,
  • Psychiatrist, Cape Town
  • Dr Rykie Liebenberg,
  • Psychiatrist, Johannesburg
  • Dr Colinda Linde,
  • Psychologist, Johannesburg
  • Zamo Mbele,
  • Psychologist, Johannesburg
  • Nkini Phasha,
  • SADAG Director, Johannesburg
  • David Rosenstein,
  • Psychologist, Cape Town
  • Professor Dan Stein,
  • Psychiatrist, Cape Town
  • Professor Bernard van Rensburg,
  • Johannesburg
  • Dr Sheldon Zilesnick,
  • Psychiatrist, Johannesburg