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 27  I ISSUE 4 I Oct/ Nov 2017

Stillbirth is one of the most devastating experiences in pregnancy and affects parents, the extended family and the healthcare provider. In South Africa, unexplained stillbirths constitute almost 35% of perinatal deaths. For the couple involved, it is the sudden loss of an antenatal investment which was laden with expectation and aspirations for a joyful future. To the immediate and extended family, it is the loss of an anticipated family member. The desolation and despair at the time of stillbirth diagnosis is immeasurable and quite often our healthcare infrastructure and human resources are ill-prepared to manage patients experiencing stillbirth.\ Short and long-term sequelae include depression, anxiety, post-traumatic stress disorder and partnership breakdown.

M Matjila

Introduction
Psychology is defined as the scientific study of the human mind and it’s functions, especially those affecting behaviour in a given context. Childbirth represents a significant milestone in the lives of all those involved, and a woman’s experience of this process has the potential to affect her both physically and emotionally in the short and long term. As stated in the National Institute for Clinical Excellence (NICE) Clinical Guidelines, the overall objective when caring for a woman during childbirth should be that of creating a positive birth experience for the woman and her family, while also preserving their physical and psychological wellbeing.1 In order to achieve this, an important balance needs to be met between the principles of evidence based practice and womancentered care (Figure 1). Identifying and understanding
a woman’s expectations, fears and desires, as well as the possible underlying reasons for these, is fundamental in helping to facilitate the positive birth experience.

TA Horak

Introduction
Preterm labour (PTL) is defined by the World Health Organisation (WHO) as the onset of labour after the gestational age of viability, i.e. 24 weeks, and before 37 completed weeks or 257 days of pregnancy.1 It is clinically confirmed by demonstrable uterine contractions associated with documented cervical changes. Threatened preterm labour is diagnosed when there are documented uterine contractions without cervical changes.

K Appiah-Sakyi, H Shaikh, H Abid

THE EVOLVING DEFINITION
The Interstitial cystitis / Bladder pain syndrome (IC/BPS) nomenclature is a controversial issue and has evolved significantly since IC was originally described by Hanash and Pool in 1969 as a condition characterized by urinary symptoms of a severely reduced bladder capacity in addition to the cystoscopic findings of Hunner’s ulcers.1,2 This definition of “classic” ulcerative IC remained the gold standard until 1978 when Messing and Stamey described the more frequent “non-ulcer” IC which was characterized by glomerulations and submucosal haemorrhages seen at cystoscopy.

KJ Brouard

Introduction
Operative vaginal delivery rates vary considerably from country to country depending on the training and expertise of the obstetricians at various institutions. These were first described in the 6th century in Hindu medicine.1 Between 500 BC and 500 AD these instruments were used mainly to remove a dead fetus after a prolonged obstructed labour in order to avoid maternal mortality.

S Allie

Introduction
Few exposed to the ravages of war escape unscathed. Ultimately all participants, both active and passive are victims. The role of the soldier is well chronicled with tales of valour and fortitude. More recently the long term consequences of battle have gained prominence and there are numerous articles on both the physical injuries and the psychological impact such as post traumatic stress disorder (PTSD). War, however, remains a quintessentially masculine realm. Men are perceived to start wars, do the fighting and dying and finally negotiate the peace. Memorial services perpetuate this with dedications to fallen soldiers and supports marches through the streets to encourage recognition of the returning soldiers.

M Slack

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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