Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 128-143).

Thesis (MHSc)--Unitec New Zealand, 2008. / Coda (electronic version) title-page has 2009 date. Includes bibliographical references (leaves 162-173).

Thesis (M.S.)--Rochester Institute of Technology, 1995. / Typescript. Includes bibliographical references (leaves 63-70).

Thesis (M.D.)--University of Hong Kong, 1995. / Includes bibliographical references (leaf 208-230). Also available in print.

M.Tech. / It is difficult to manage a pregnancy when fetal age, health status or potential pregnancy risks are not known. The aim of this study was to assess the impact of routine ultrasound screening as compared to selective use of ultrasound in the mid-trimester of pregnancy, on women using South African government health services. The three objectives investigated included assessment of the availability of reliable menstrual histories in the study population, the influence of ultrasound dating on obstetric management and the effect of ultrasound on pregnancy outcome due to the early detection of high risk pregnancies. A cluster randomised trial of 962 women was performed to test the hypothesis that midtrimester routine ultrasound screening in low risk pregnancies would result in improved antenatal care and perinatal outcome. Groups of eligible pregnant women were randomly selected to have either a routine scan followed by normal antenatal care or routine antenatal care which only allows for the selective use of ultrasound, in line with South African Antenatal Care Policy. Statistical analysis of the results confirmed that ultrasound dating is a more accurate predictor of the expected date of delivery when compared to other dating methods. Improved pregnancy dating resulted in a significant reduction in induction of labour for post-term pregnancy in the ultrasound screening group, suggesting a positive effect of ultrasound screening on obstetric management. No improvement was demonstrated in perinatal morbidity or mortality. The early detection of anomalous fetuses only led to one therapeutic abortion. The study did not possess the statistical power to demonstrate improved outcomes when multiple pregnancies were detected early in pregnancy. Currently there appears to be no urgent need to implement a routine antenatal screening programme in the Gauteng public health sector. In view of the fact that a third of the participants indicated that they were unsure of menstrual dates, and one third of the participants in the ultrasound screening group presented with an unreliable menstrual history, it is proposed that unsure dates be considered as a valid indication for the selective use of ultrasound in mid-trimester pregnancy.

No description available.

Thesis (MMed (Obstetrics and Gynaecology))--University of Stellenbosch, 2010. / Please refer to full text for abstract.

published_or_final_version / Medicine / Master / Doctor of Medicine

published_or_final_version / Obstetrics and Gynaecology / Master / Master of Philosophy

M.Tech. (Radiography) / Monitoring the growth and wellbeing of the foetus is a major purpose of antenatal care. The use of diagnostic ultrasound to assess foetal wellbeing has become an important part of prenatal care in both low and high risk pregnancies. Pre-eclampsia and foetal growth restriction (FGR) remains important causes of maternal and perinatal mortality and morbidity. Pre-eclampsia is characterised by an abnormal vascular response to placentation and is a multisystem disorder of unknown cause specific to pregnancy which affects the health of both mother and fetus. Prep-eclampsia complicates between 2 and B % of all pregnancies and is the second most common cause of maternal deaths in the developing world. The aim of this study was to assess the sensitivity of uterine artery spectral Doppler screening in the prediction of pregnancies with a high risk of developing pre-eclampsia or FGR before the clinical onset of the disease. The research objectives were to: 1) Determine the sensitivity of first and second trimester uterine artery spectral Doppler assessment in predicting pre-eclampsia or FGR Identify associations between normal and abnormal uterine artery Doppler waveforms and pregnancy outcomes. 2) Determine the most effective Doppler indices 3) Develop ultrasound management guidelines The data was statistically analyzed to determine the sensitivity of uterine artery Doppler screening. In this study uterine artery Doppler screening performed well. in the risk assessment of the most severe cases of pre-eclampsia and FGR. A larger prospective multicenter trial in South Africa is long overdue and therefore a follow-up study to assess Doppler as a screening tool in a high risk population, as per the guidelines formulated.