The introduction of free mother and child services in South Africa in 1994, changed the way in which the services were delivered. There was an increase in the number of women seeking services, therefore a need arose to look at what constituted essential, basic services. The introduction of the maternal held card in State hospitals enabled the women to seek ante-natal care at the venue most accessible to her. This document also involved her in the responsibility of her own care and that of her unborn child. This study explored the information which mothers had been given ante-natally to assist them with the task of bearing the responsibility of their unborn child's health, which they had unilaterally been given by the Healthcare providers. A descriptive study was undertaken and 221 primigravid patients were interviewed at a large academic hospital post-delivery using a structured interview schedule. Their records were also reviewed retrospectively for type of delivery and foetal outcome. Results of the studies found that the mothers were given insufficient information to equip them with responsibility of assessing foetal health. Healthcare providers, it was found, did not give specific information and it appeared that at times, the mothers report of decreased foetal movement was disregarded. Implications of the study are that healthcare providers need to pay attention to how they provide information. The women interviewed clearly made the distinction between what was seen as 'teaching' and what was perceived as information given. It is also important to note that although the health workers understand the implications of foetal well-being, patients do not necessarily share the same insight or sense of responsibility. This has implications for the delivery of antenatal services in South Africa.

Analysis of the waveforms obtained from the umbilical artery using Doppler ultrasound has been claimed in a number of recent reports to be a highly specific method of identifying babies with intrauterine growth retardation. Because of the morbidity and mortality associated with this condition it was important to evaluate the validity of those claims before introducing the method into obstetric practise. The work in this thesis was carried out in four parts. Firstly the technique was found to be reproducible with small intra and inter-observer errors. Secondly, possible influencing factors were studied, and it was found that the fetal heart rate and fetal breathing movements have a significant effect on the waveform. Thirdly, a longitudinal study of 50 healthy women with normal pregnancies was performed to define the normal range of A/B ratios (the principle method of analysis of the waveforms was the A/B ratio: ratio of peak systolic to end-diastolic frequency). Finally, Doppler ultrasound was performed in 205 women with high risk pregnancies, and results were compared to the normal reference data. When high risk cases with abnormal Doppler results (A/B ratio > 95th centile) were compared with high risk cases with normal Doppler results (A/B ratio < 95th centile) the Doppler abnormal group were found to have a significantly increased incidence of preterm delivery, operative delivery, late fetal heart rate decelerations in labour, increased admission to the special care baby unit, and increased neonatal morbidity. Although an abnormal Doppler result was associated with small for gestational age in 61% of cases, only 41% of cases of small for gestational age had abnormal Doppler results. The conclusion from this thesis is that Doppler flow velocity waveform analysis, although lacking the previously claimed diagnostic precision of detecting intrauterine growth retardation, could contribute to fetal management by identifying babies at high risk of intrapartum complications.

Thesis (Ph.D.) - University of Queensland, 2006. / Includes bibliography.

Thesis (M.S.)--Michigan State University. Dept. of Epidemiology, 2006. / Title from PDF t.p. (viewed on Nov. 20, 2008) Includes bibliographical references (p. 60-65). Also issued in print.

Thesis (M.S.)--University of Michigan, 1993.

Thesis (M.S.)--University of Michigan, 1993.

Thesis (M.D.)--Dept. of Obstetrics and Gynaecology, University of Adelaide, 1970. / Includes bibliographical references (leaves 284-298).

Thesis (doctoral)--Rijksuniversiteit te Groningen.

This thesis is focused on the analysis of fetal ECG records measured by indirect method from mother´s abdomen. The thesis consists of the theoretical part is focused on fetal, heart development and description of fetal ECG signal. This thesis also offers an overview of fECG signal processing methods used nowadays. The practical part of the thesis deals with the implementation of algorithms based on wavelet transformation and Least Mean Square LMS method in Matlab programming environment. The final part of the thesis consists of the analysis of achieved results.

Introduction: An assessment of the role of Doppler ultrasound velocity waveform analysis of the fetal umbilical arteries in the diagnosis of fetal distress in labour is made from a review of the literature and clinical study. Study objectives: 1) To determine the value of screening with Doppler ultrasound in high-risk labours in the prediction of the development of indicators of fetal distress. 2) To determine whether Doppler velocimetry indices of the umbilical arteries change with the development of indicators of fetal distress in labour. Design: Repeated Doppler velocimetry in selected high risk labours. Setting: Groote Schuur Hospital, Cape Town, South Africa, a large tertiary referral centre. Subjects: Thirty six women with singleton pregnancies complicated either by gestational proteinuric hypertension or by intrauterine growth retardation or both with a normal cardiotocographic tracing at the onset of labour. Main outcome measures: 1) Acid-base status of the fetus was assessed after deli very by analysis of umbilical artery blood. 2) Apgar score was recorded at 1 and 5 minutes. 3) Neonates were carefully examined for clinical signs of perinatal hypoxia. Results: Twenty seven fetuses were followed through labour. No relation was found between umbilical artery Pourcelot ratio (resistance index) on admission in labour and umbilical artery base deficit. Six fetuses were born with an umbilical artery base deficit of more than 10 mmol 1-1. Zero change in mean Pourcelot ratio was noted in both normal and acidotic fetuses. None of the acidotic fetuses showed a change in Pourcelot ratio of more than 0.03. The study had an 80% power to detect a change in mean Pourcelot ratio of 0.07 in the normal fetuses and 0.16 in the acidotic fetuses at a 95% confidence level. No relation was found between Pourcelot ratio on admission in labour or change in Pourcelot ratio during labour and Apgar score. None of the neonates showed clinical signs of perinatal hypoxia. Conclusions: Doppler velocimetry of the umbilical arteries in labour as measured by the Pourcelot ratio does not contribute to the diagnosis of fetal distress in labour.