The aim of this thesis is to highlight the severity of sleep-disordered breathing at risk pregnancies, as these disorders have a high share on the occurrence of cardiovascular problems at a later age. In the group of high-risk pregnant patients, breathing disorders in sleep lead to higher morbidity of patient as well as newborns. Currently, there are increasing risk factors in the population of pregnant women. Risk factors for the development of OSAS, which are examined in detail in this thesis in pregnant women, include BMI, age, pregestational and gestational hypertension and diabetes mellitus. The theoretical part of the thesis contains the findings of the risk pregnancies. The most serious unit is preeclampsia. For that reason, the greatest attention within high- risk pregnancies is aimed to the incidency, ethiopathogenesis, diagnosis and treatment of preeclampsia. Furthermore, the theoretical part includes findings related to sleep- disordered breathing and focuses on OSAS and its health complications. In the special part of the thesis, there is an assessment of results regarding risk pregnant women with the presence of OSAS and without present OSAS. Keywords Preeclampsia, hypertension, OSAS, pregnancy, risk factors

Thesis (MA (Psychology))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The purpose of this study was to determine the prevalence of antenatal distress in Cape Town periurban settlements, and the social factors associated with it in this population. Participants were 756 pregnant women from Khayelitsha and Mfuleni, Cape Town. Each women was interviewed in her home language using a structured questionnaire which included the Edinburgh Postnatal Depression Scale (EPDS), measures for social support and alcohol use, and questions concerning socio-demographics, intimate partner violence, and the current pregnancy. A threshold score of 14 and above on the EPDS was used to determine antenatal distress. Data were analysed using descriptive statistics and bivariate analysis initially, followed by multivariate logistical regression. Results indicated a prevalence of 46% for antenatal distress, which is substantially greater than the prevalence found in high income countries. Women in their first trimester of pregnancy were more likely to experience antenatal distress than were women in their second and third trimesters. The strongest predictors of antenatal distress were poor partner support, intimate partner violence and having a household income below R2000 per month. The high prevalence found in this study has harmful implications for infant health in South Africa, and is reason to suggest that early screening and intervention is crucial. More research is needed to develop and evaluate the effectiveness and scalability of community-based interventions for maternal depression in South African peri-urban settlements, as well as to establish the specific infant outcomes of antenatal distress in this population. / AFRIKAANSE OPSOMMING: Hierdie studie het ten doel om die voorkoms van voorgeboorteangs in buitestedelike nedersettings in Kaapstad te bepaal, sowel as die maatskaplike faktore wat met voorgeboorteangs by dié populasie verband hou. Die studiedeelnemers was 756 swanger vroue van Khayelitsha en Mfuleni, Kaapstad. ʼn Gestruktureerde vraelys is gebruik om met elke vrou ʼn onderhoud in haar huistaal te voer. Die vraelys het die Edinburg-nageboortedepressieskaal (EPDS), maatstawwe vir maatskaplike steun en alkoholgebruik, en vrae oor sosiodemografie, bedmaatgeweld en die vrou se huidige swangerskap ingesluit. ʼn Drempeltelling van 14 en hoër op die EPDS is gebruik om voorgeboorteangs te bepaal. Die data is aanvanklik met behulp van beskrywende statistiek en tweeveranderlike analise ontleed, waarna dit aan meerveranderlike logistiese regressie onderwerp is. Studieresultate toon ʼn 46%-voorkoms van voorgeboorteangs, wat beduidend hoër is as dié in hoëinkomstelande. Vroue in hul eerste trimester van swangerskap blyk meer geneig te wees om voorgeboorteangs te ervaar as vroue in hul tweede en derde trimester. Die sterkste voorspellers van voorgeboorteangs is swak ondersteuning van lewensmaats, bedmaatgeweld en ʼn huishoudelike inkomste onder R2 000 per maand. Die hoë voorkomssyfer van voorgeboorteangs waarop die studie dui, het nadelige implikasies vir babagesondheid in Suid-Afrika, en maak vroeë toetsing en ingryping noodsaaklik. Verdere navorsing word vereis om die doeltreffendheid en skaleerbaarheid van gemeenskapsgegronde ingrypings vir moederdepressie in Suid-Afrikaanse buitestedelike nedersettings te ontwikkel en te beoordeel, sowel as om die bepaalde uitwerkings van voorgeboorteangs op pasgeborenes in dié populasie te bepaal

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Maternal drinking during pregnancy and its consequences are a growing health concern worldwide. It has also been identified as a significant problem in South African communities with some of the highest prevalence rates of Fetal Alcohol Spectrum Disorder (FASD) reported in South Africa. The primary aim of this study was to explore how women in a South African community in the Northern Cape Province perceive the personal and general risk of drinking during pregnancy. The secondary aims were to ascertain whether there was evidence of unrealistic optimism, to examine whether there were personal characteristics that are associated with high or low risk perception, and to examine women‟s knowledge of FASD. A total of 128 women from De Aar in the Northern Cape, an area with a high prevalence of FASD, and therefore drinking during pregnancy, were recruited to take part in the study. Participants had previously taken part in a FASD prevention programme. Questionnaires were administered assessing the perception of the risk posed to a participant‟s own child should she drink during pregnancy, and the risk posed to others‟ children should they drink during pregnancy. The questionnaire also contained questions on FASD knowledge and demographic variables. Participants were between 18 and 44 years of age and reported high rates of unemployment. Most women had more than one child and 7.8% had a child diagnosed with FASD. No evidence for unrealistic optimism was found. Multiple regression analyses revealed both FASD knowledge, and the perception of how easy it would be for oneself to stop drinking, were significant predictors for both personal and general risk. A model including the perception of general risk, FASD knowledge and the perception of how easily one could stop drinking accounted for the most variance in the perception of personal risk (66.4%). Perception of personal risk on its own was the strongest predictor of the perception of general risk accounting for 56.1% of variance. There was no significant correlation between passage of time and FASD knowledge, but possible gaps in FASD knowledge were identified. The study provides an overview of the perception of the risk of drinking during pregnancy in the target population. It also suggests improvements to the research design and materials for further research. / AFRIKAANSE OPSOMMING: Moederlike drankgebruik gedurende swangerskap en die gevolge daarvan word wêreldwyd met groeiende kommer beskou. Dit is ook as ʼn wesenlike probleem in Suid-Afrika geïdentifiseer, met van die hoogste voorkomssyfers van Fetale Alkohol Spektrumafwykings (FASA) wat in Suid-Afrika aangeteken is. Die primêre doel van hierdie studie was om, in ʼn Suid-Afrikaanse gemeenskap in die Noord Kaap provinsie, die persepsie van persoonlike en algemene risiko van drink tydens swangerskap onder vrouens, te ondersoek. Die sekondêre doelstellings was om vas te stel of daar bewyse van onrealistiese optimisme is; te bepaal of daar persoonlike eienskappe is wat korreleer met ʼn hoë of lae risiko-persepsie, en om ook die vroue se kennis van Fetale Alkohol Spektrumafwykings (FASA) te ondersoek. 128 vroue van De Aar in die Noord-Kaap is gewerf om aan die studie deel te neem. Die gebied het 'n hoë FASA voorkoms, en dus ook alkoholgebruik tydens swangerskap. Deelnemers het voorheen deelgeneem aan 'n FASA voorkomingsprogram. Vraelyste is voltooi rakende die persepsie van die risiko vir 'n deelnemer se eie kind sou sy tydens swangerskap drink, en die risiko vir ander se kinders, sou hulle tydens swangerskap drink. Die vraelys het ook vrae oor FASA kennis en demografiese veranderlikes ingesluit. Deelnemers was tussen 18 en 44 jaar oud en het hoë vlakke van werkloosheid gerapporteer. Meeste vrouens het meer as een kind gehad en 7.8% het ʼn kind wat met FASA gediagnoseer is gehad. Geen bewyse vir onrealistiese optimisme is gevind nie. Meervoudige regressie-ontleding het bevind dat beide FASA-kennis en die persepsie van hoe maklik dit vir ‟n deelnemer self sou wees om op te hou drink, beduidende voorspellers vir beide persoonlike en algemene risiko is. 'n Model wat die persepsie van algemene risiko, FASA-kennis en die persepsie van hoe maklik 'n deelnemer self kan ophou drink, het die grootste variansie in die persepsie van persoonlike risiko verduidelik (66,4 %). Persepsie van persoonlike risiko op sy eie, was die sterkste voorspeller van die persepsie van algemene risiko, opsigself verantwoordelik vir 56,1% van die variansie. Daar was geen beduidende korrelasie tussen die verloop van tyd en FASA kennis nie, maar moontlike gapings in die kennis van FASA is geïdentifiseer. Die studie bied 'n oorsig van die persepsie van die risiko van drankgebruik tydens swangerskap in die teikenbevolking. Dit stel ook verbeteringe vir die navorsingsmetodiek voor vir toekomstige navorsing.

Abortion and severe pre-eclampsia/eclampsia remain the major causes of maternal mortality in Zimbabwe. Based on this problem, factors associated with maternal mortality due to abortion and severe pre-eclampsia/eclampsia were investigated to improve pregnancy outcomes. Cases and controls were selected from 4895 abortion and 318 severe preeclampsia/ eclampsia obstetric records to conduct a retrospective case-control study. Significant risk factors identified for reducing maternal mortality due to postabortion complications included the administration of oxytocic drugs and evacuations of the uterus whilst anaemia and sepsis apparently reduced these women's chances of survival. No significant factors could be identified which influenced maternal deaths among women suffering from severe pre-eclampsia/eclampsia. Magnesium sulphate was not routinely administered, as recommended internationally. In both groups, cases apparently received better reported quantitative care than controls. Recommendations based on this research report include improved midwifery education and in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

Abortion and severe pre-eclampsia/eclampsia remain the major causes of maternal mortality in Zimbabwe. Based on this problem, factors associated with maternal mortality due to abortion and severe pre-eclampsia/eclampsia were investigated to improve pregnancy outcomes. Cases and controls were selected from 4895 abortion and 318 severe preeclampsia/ eclampsia obstetric records to conduct a retrospective case-control study. Significant risk factors identified for reducing maternal mortality due to postabortion complications included the administration of oxytocic drugs and evacuations of the uterus whilst anaemia and sepsis apparently reduced these women's chances of survival. No significant factors could be identified which influenced maternal deaths among women suffering from severe pre-eclampsia/eclampsia. Magnesium sulphate was not routinely administered, as recommended internationally. In both groups, cases apparently received better reported quantitative care than controls. Recommendations based on this research report include improved midwifery education and in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

The purpose of the study is to determine the knowledge of midwives on implementing clinical guidelines for the management of pre-eclampsia with the aim of improving midwifery practice and preventing maternal and neonatal death due to pre-eclampsia. A quantitative, descriptive, cross sectional study design was used for the study. Data was collected using a self-administered questionnaire from 100 midwives working in the maternity section of the clinic referring to the regional hospital in UMgungundlovu District. The Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. The findings show that respondents to the study have a high mean value (3.6) of knowledge but need support in terms of providing training on the new guidelines. The study also showed that there is need to improve on distribution of guidelines. There was no significant association between demographic factors and the knowledge of midwives on clinical guidelines for the management of pre-eclampsia. A clinical audit of maternity records as well as a quality care project can be developed based on the findings / Health Studies / M.A. (Health Studies)