Introduction: Perinatal mortality is regarded as an indicator of the social status and obstetrical care within a given community. The developed world has witnessed a dramatic decline in perinatal mortality as standards of living improved. Unfortunately, this turn of events has not been seen in the Third World where mortality remains very high. When improved perinatal autopsy techniques are applied the causes of perinatal deaths are readily appreciated. No previous autopsy study has been conducted at our hospital. The application of new techniques has stimulated the present study, which is also intended to monitor current and future clinical practice. Problem formulation: What are the common causes of death in the perinatal period at Ga-Rankuwa Hospital? Aims of the study: a. To assess the common causes of fetal and neonatal deaths at our hospital. b. To determine those causes which are preventable and propose specific obstetric interventions. c. To obtain a baseline for future studies along the same line. d. To lay a foundation for clinicopathologic discussion with clinical colleagues. Research Methodology: An autopsy study is to be conducted on each and every stillbirth and neonatal death that occurs during the period of study. The technique will be discussed in detail in Chapter 3.

Includes bibliography. / Between 1985 and 2000, 43 children (age range 6 months-13 years) underwent liver transplantation at Red Cross Children's Hospital. In 46% of these cases, viral infections resulted in considerable morbidity and mortality. Included in this group were: de novo hepatitis B (5 patients, 2 deaths), EBV-related post-transplantation lymphoproliferative disease (6 patients, 4 deaths) and CMV disease (9 patients, 4 deaths).

Includes bibliographical references. / Objective: To investigate the difference in expression of CD146 immunohistochemical staining on intermediate trophoblast in early and late onset pre-eclampsia placentas as well as comparing this expression to gestational age matched control placentas. Study Design: Retrospective case series of 100 placentas: 25 early onset and 25 late onset pre-eclampsia placentas as well as 25 early and 25 late gestational age matched control placentas. Placentas were obtained from patients delivering in Tygerberg Hospital. Methods: Placentas were routinely fixed and processed. 2 sections of one preselected block from each case was cut and stained with CD146 and MNF116 immunohistochemical stain. The expression of the staining would be performed by means of analytical and image analysing software. Results: The study failed to demonstrate differences in CD146 expression by the intermediate trophoblast in the pre-eclampsia and control placentas. The analytical approach was deemed to be subjective and the image analysing software had too much background staining and inaccurate identification of the intermediate trophoblast in order to produce reproducible consistent results. Conclusion: Dual staining, using immunofluorescent staining of CD146 and MNF116 on smaller biopsies of the decidua are thought to be able to produce much better material for image analyses software.

Pneumonia due to polymicrobial infection is known to increase the severity and risk of fatality among young children. A retrospective study was undertaken on Sudden Unexpected Infant Death cases occurring, between 1 May and 30 September 2009, which were admitted to a medico-legal mortuary servicing the Cape Town western metropole. Published studies have shown the risk factors for lower respiratory tract infection to include lack of breast feeding, prenatal and environmental tobacco smoke exposure, prematurity, immunosuppression, underlying medical conditions and overcrowding. The present study was aimed at determining which of the known epidemiological factors were associated with SUDI death types admitted to this mortuary and to describe the associated histopathology. In addition, in the knowledge that drugs, specifically Methamphetamine are widely used on the Cape Flats from where almost all this mortuary's SUDI cases are derived, this study has attempted to find out whether or not the usage of drugs by the caregiver at the time of infant death was another independent risk factor in SUDI deaths.

Medulloblastoma is the most frequently occurring childhood malignant brain tumour, affecting 1 of 5 children presenting with a brain tumour, between the ages of 0 and 9 years. The basic prognostic stratification that relies on clinical and histological findings alone has proven unsatisfactory as an outcome predictor. Distinct molecular genetic profiles have been described, with four molecular variants of medulloblastoma with specific demographic and prognostic features. These are the WNT subgroup, SHH subgroup, Group 3 and Group 4 tumours. The aim of this study was to describe the expression status of β-catenin, and MYCN, using IHC and FISH respectively, and to correlate these findings with clinico-pathological and demographic characteristics and clinical outcome. Materials and Methods This study was a nested retrospective analytical study, reviewing 54 cases of childhood medulloblastoma diagnosed between 1988 and 2014. Results Classic histology accounted for 40.7% of cases, LCA 37%, ND 16.7% and 5.6% MBEN). Based on β-catenin IHC, the WNT subgroup accounted for 16.7% of cases. This group had no mortalities or recurrences. Seven patients showed amplification of MYCN gene. The SHH group, defined by ND/MBEN histology and/or MYCN amplification, accounted for 27.7% of patients. Non-WNT/non-SHH tumours 30 patients (55.6%) showed a male predilection, and accounted for 37.5% recurrences and 50%. mortalities also falling in this group. Conclusions Nuclear β-catenin identifies WNT tumours. Nodular desmoplastic morphology is useful in identifying some, but not all cases of SHH group medulloblastomas. MYCN positive tumours also showed classical, and LCA morphology.. Patients of all the beta-catenin positive cases were free of recurrence and alive at last follow up. Patients with MYCN amplification and non-ND histology (LC/A or classic) had poorer outcomes than patients with ND histology. One patient showed both MYCN amplification and nuclear β-catenin translocation, and had good clinical outcome. This finding requires validation with other molecular techniques.