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.

VOLUME 28  I ISSUE 2

This edition of the O&G Forum is dedicated to various aspects of Obstetrical and Gynaecological care of nadolescents. In modern medical ethics, patient autonomy is considered a major principle in decision-making regarding one’s health. Those receiving healthcare should be allowed to exercise that right consciously and freely. Healthcare providers are obligated to respect this right and allow patients to practice their autonomy in the cause of their treatment.

Prof S Adam, Prof BG Lindeque

Introduction
Adolescence refers to the transitional phase of physical and psychological development that occurs from puberty to adulthood. This phase includes a desire for autonomy and an increase in sexual risk-taking behaviours, making adolescents particularly vulnerable to sexually transmitted diseases. The Youth Risk Behaviour Surveillance Systems trend from 1991 to 2015 reports a decrease in the rate of sexual activity from 54% to 41% and the rate of sex with more than four partners from 19% to 12% In the United States, approximately 5 to 10% of teens identify as lesbian, gay, or bisexual Youth from 15 to 24 years of age account for a disproportionate number of new sexually transmitted infections (STI’s) and approximately 25% of sexually active adolescent females have had a sexually transmitted infection.

A Naidoo

Menstrual disorders are common conditions in adolescents, with Heavy Menstrual Bleeding (HMB) having a prevalence of 37% in adolescents compared to 10-20% in adults, and dysmenorrhoea accounting for approximately 15% of adolescent complaints.1 Menstrual disorders have serious effects on quality of life due to school absenteeism and limitation of sport or social activity participation.

A Maphalala

Introduction
The female adolescent patient has a variety of gynaecological issues which the healthcare practitioner needs to understand and pay particular attention to, ranging from screening for sexual health history, teenage pregnancies, sexually transmitted infections (STI’s), contraceptive needs (both for the prevention of pregnancy as well as for medical indications such as acne, dysmenorrhoea or heavy menstrual bleeding), termination of pregnancy (TOP) and vulnerability to sexual assault, trafficking and rape. Proper management of these issues is crucial in order to promote healthy sexual choices in this age group, because risk-taking behaviours learnt at this stage of development are more than often carried into adulthood.

N Rajoo

Teen pregnancy has serious consequences for young women, their children and communities as a whole. Teenage pregnancy is defined as a teenage girl, usually within ages of 13 – 19, becoming pregnant. This refers to girls who have not reached legal adulthood, who become pregnant. A significant number of these pregnancies are unplanned and unwanted. This contributes to the high maternal mortality plus obstetric complications and the burden of unsafe abortion. Teenage pregnancy is the leading cause of mortality in girls aged 15 to 19 years, and 90% of the deaths are occurring in low to middle income countries and most of them are preventable.

F Molokoane

Obesity is defined as a body mass index (BMI) in excess of 30kg/m2 in adults and a BMI per age above the 95th centile for children.1 In the past two decades obesity has become a world-wide epidemic, mostly due to a sedentary lifestyle and consumption of fast foods and refined carbohydrate diets. In the United States 17% of girls between the ages of 6 and 19 years are obese.1 According to the Heart and Stroke foundation of South Africa, 14.2% of primary school children are overweight, whilst in urban areas 30% of girls have a BMI above 25.2

A Venter

In counselling expecting parents concerning prenatal screening for chromosomal abnormalities e.g. Down’s syndrome (T21), the key principle is that it should be voluntary, should be easily understood with clear and complete information that allows patients to make informed, preference–based screening and diagnostic testing decisions.

I Bhorat, L Chauke, E Coetzee, L Geerts, H Lombaard, E Nicolaou,
L Pistorius, P Soma-Pillay

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
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