There are four main ethnic groups in South Africa- European, Coloured, Bantu and Indian. Each differs widely from the other in socio-economic status and cultural background. This being so it seems to me that in South Africa one has a unique opportunity for doing comparative research. For many years i have been interested in health rather than in disease, and growth in infancy is, I think, a good index of health. I believe that an examination of the growth pattern of infants from birth to one year gives one a good idea of the health and standard of living of a population in general and of its infants in particular.

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MMed, Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, 2006

MMed (Obstetrics and Gynaecology) Faculty of Health Sciences, University of the Witwatersrand, 2009 / Objectives • To determine the prevalence of macrosomic babies delivered at Coronation (now Rahima Moosa) Hospital. • To compare the maternal and neonatal outcome of vaginally born macrosomic babies versus vaginally born babies less than 4000g. • To determine the impact that mode of delivery of the macrosomic babies had on maternal and neonatal outcome. • To compare clinical variables for macrosomia with those published in the literature, in view of identifying predictive factors. Method Retrospective record review of all women who delivered at Coronation (Rahima Moosa) Hospital from 1 January 2005- 30 June 2005. Results A total of 134 macrosomic infants were identified, of which 76 were delivered vaginally, 14 by elective caesarean section and 44 by emergency caesarean section. During the study period, there were 5800 deliveries. The incidence of macrosomia in the study population was 2.3%. Characteristics specific to the iv cohort of macrosomic infants revealed that male sex was more common (52/74 (70%) in the macrosomic group vs. 32/74 (43%) in the non-macrosomic group, p<0.0009), length of labour was increased (13.7 vs. 10.9 hours, p=0.032), as was use of augmentation (16 vs. 5, p=0.009), perineal trauma (34 vs.19, p=0.010) post partum haemorrhage (10 vs.2, p=0.016) and shoulder dystocia (5 vs. 0, p=0.03). Vaginal delivery, compared to elective or emergency caesarean section resulted in less fetal distress (1 vs. 13, p<0.0001) and puerperal fever (4 vs. 19, p=0.0001). Differences in other fetal and maternal outcomes were not significant. Conclusion Fetal macrosomia was more likely to be associated with advanced gestational age, male sex, prolonged labour, post partum haemorrhage, use of augmentation, increased perineal trauma especially episiotomy and shoulder dystocia . Expectant management, progressing labour according to a standardized partogram and no elective caesarean section on the basis of clinical and or ultrasound diagnosis of an increased estimated fetal weight, appears to be the best form of management for the suspected macrosomic.

Thesis MSc.(Med)(Virology)-- University of Limpopo, 2011 / Background: Intraventricular hemorrhage (IVH) is a known complication occurring in the first week of life in premature neonates. The exact time of its occurrence and the ideal time to perform diagnostic imaging investigation remain controversial. Objectives: 1. To determine the incidence of intraventicular hemorrhage in premature babies at Dr George Mukhari Hospital, Pretoria. 2. To determine the timing at which bleeding occurs. 3. To determine if the rate of diagnosing intraventicular hemorrhage improves when performing ultrasound via the posterior fontanelle. 4. To determine the risk factors for intraventricular haemorrhage Materials and methods: The study included 60 premature babies of gestational age of less than 32 weeks that were admitted to our neonatal Intensive Care Unit over a two months period and screened for IVH. They were grouped into three categories according to their weight at birth, and according to their gestational age. All babies had a cranial ultrasound on day 1, 3 and 7. Results: We found that the overall incidence of IVH among premature babies was 28%. Although it did not reach statistical significance, the incidence was found to be inversely related to the birth weight and gestational age. The majority of the bleeds occurred within the first day of life and were mostly grade I and II according to Papile’s classification. The use of inotropes was found to be significantly associated with development of IVH. We also found that scanning through the posterior fontanelle did not significantly increase the rate of diagnosis for IVH.

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