Thesis (MMed)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The Objective: To review the difference in short term neonatal and maternal outcomes
among singleton infants with breech presentation delivered by vaginal or elective caesarean
section route at term, at Tygerberg Academic Hospital (TBH) in Cape Town.
The study design was a retrospective case control study.
Method:
Part I
A total of 120 patients were selected. 60 vaginal breech deliveries and 60 elective caesarean
sections for breech presentation (comprising the control group). 60 cases of vaginal
deliveries were collected and 60 control cases of planned elective caesarean sections, where
the indication for CS was breech presentation, were collected in the same manner.
Part II
Nineteen registrars completed a questionnaire regarding their subjective experiences of
vaginal breech deliveries at Tygerberg Academic Hospital.
Results:
Part I
An analysis of the results found statistically significant differences in maternal ages between
the two groups, with younger women delivering by CS; gravidity and parity was lower in the
CS group; blood loss was observed to be higher in the CS group with more women requiring
a blood transfusion when compared to vaginal delivery; there were more neonatal
admissions in the vaginal delivery group as well as more birth trauma, neonatal seizures and
death in this group; Apgar scores were higher in the CS group and finally, neonates born by
CS were more commonly discharged at the same time as their mothers in the CS group.
Part II
When analyzing the registrar questionnaire it can be noted that although clinicians are
performing an adequate number of breech vaginal deliveries, with an average of 10
deliveries per year, the skills training for clinicians is invaluable. Not all registrars learned
skills from a senior clinician and skills training in skills labs are essential for initial and even
continual training of these clinicians. It is suggested that these skills training programs be made compulsory for all registrars and that a biyearly attendance and completing of such a
course be mandatory for those wishing to work in the labour ward.
Conclusions:
Although not statistically significant, there was more morbidity and mortality associated
with vaginal breech delivery. / AFRIKAANSE OPSOMMING: Doel: Om die korttermyn neonatale en moederlike uitkomste van enkeling swangerskappe
met stuitligging wat vaginaal of met elektiewe keisersnee verlos is by die Tygerberg
Akademiese Hospitaal in Kaapstad, te bepaal.
Die werkstuk is ‘n retrospektiewe gekontroleerde-gevallestudie.
Metode:
Deel 1
‘n Totaal van 120 pasiënte is gekies. 60 gevalle van vaginale stuitverlossings en 60 kontrolegevalle
van beplande elektiewe keisersnitte waar die indikasie stuitligging was.
Deel 2
Negentien kliniese assistente het die vraelys oor hul persoonlike ervaring van vaginale
stuitverlossing by die Tygerberg Akademiese Hospitaal ingevul.
Resultate:
Deel 1
‘n Ontleding van die resultate wys statisties betekenisvolle verskille in die moederouderdom
van die twee groepe, met meer jong vroue wat met keisernit geboorte gee.
Graviditiet en pariteit was laer in die keisersnit-groep. Bloedverlies was hoër in die
keisersnit-groep en in vergelyking met die vaginale verlossings met meer vroue wat
bloedoortapping benodig. In die vaginale verlossingsgroep was meer neonatale toelatings
nodig asook meer geboortetrauma, neonatale konvulsies en sterftes. Apgar-tellings was
hoër in die keisersnitgroep en neonate wat met ‘n keisersnitte gebore is, is meer dikwels
saam met hul moeders ontslaan.
Deel II
Ontleding van die vraelys vir kliniese assistente wys dat hoewel klinici ‘n genoegsame getal
van gemiddeld 10 vaginale stuitverlossings per jaar uitvoer, vaardigheidsopleiding vir klinici
van onskatbare waarde sal wees.
Nie alle kliniese assistente leer vaardighede by senior klinici nie en opleiding in ‘n
vaardigheidslaboratorium is noodsaaklik vir die aanvanklike en selfs voortdurende opleiding
van dié kliniese assistente. Dit word voorgestel dat hierdie vaardigheidkursusse verpligtend gemaak word vir alle kliniese asssistente en bywoning en voltooiing van die kursus twee
maal per jaar verpligtend moet wees vir diegene wat in ‘n kraamsaal wil werk.
Gevolgtrekking:
Vaginale stuitverlossings, hoewel nie stastisties betekenisvol nie, het met meer morbiditeit
en sterftes gepaardgegaan.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/18074 |
| Date | 12 1900 |
| Creators | Lindeque, L. X. |
| Contributors | Theron, G. B., Stellenbosch University. Faculty of Health Sciences. Dept. of Obstetrics and Gynaecology. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 44 p. |
| Rights | Stellenbosch University |
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