ABSTRACT
OBJECTIVE: Determination of maternal mortality rate (MMR) and the main causes of maternal death after the implementation of free antenatal care in a tertiary center in South Africa. METHODS: Retrospective case study on maternal deaths from 1 January 1993 to 31 July 1997. RESULTS: The maternal mortality rate was 128/100000 births. Hypertension disorders (18%), hemorrhage (18%) and sepsis (13%) were the most important causes of death; 44% of all deaths were considered preventable. CONCLUSIONS: The high percentage (44%) of preventable deaths is a cause of concern and is the result of increased workload, decreased staff numbers and late referrals with low socio-economic class of the patient. The discrepancy in the mortality rate between patients booked at the tertiary institution (29.8/100000) and patients booked elsewhere (304.7/100000) or not booked at all (348.5/100000) indicates the need for improving antenatal care in the periphery.
Subject(s)
Hospital Mortality , Hospitals, Public/statistics & numerical data , Maternal Mortality , Pregnancy Complications/mortality , Prenatal Care , Uncompensated Care , Adult , Age Distribution , Female , Hospitals, Public/economics , Hospitals, Public/standards , Humans , Pregnancy , Prenatal Care/economics , Retrospective Studies , South Africa/epidemiologyABSTRACT
Expression of mutant p53 in 19 patients with stage III moderately differentiated serous cystadenocarcinoma of the ovary, who all had optimal primary cytoreductive surgery and six cycles of cisplatin and cyclophosphamide was analyzed to determine its prognostic significance. All patients were followed up for a minimum of 48 months. Immunohistochemical analysis for mutant p53 was by means of monoclonal antibody DO7 and Pab240. Mean survival for patients expressing mutant p53 was 44 months and 117 months for those not expressing mutant p53. In our study, expression of mutant p53 proved to be a statistically adverse prognostic factor (p = 0.029).
Subject(s)
Adenocarcinoma/genetics , Adenocarcinoma/pathology , Genes, p53 , Mutation , Ovarian Neoplasms/genetics , Ovarian Neoplasms/pathology , Tumor Suppressor Protein p53/genetics , Adenocarcinoma/drug therapy , Adenocarcinoma/surgery , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/administration & dosage , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Female , Humans , Neoplasm Staging , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/surgery , Predictive Value of Tests , Prognosis , Proportional Hazards Models , Retrospective Studies , Tumor Suppressor Protein p53/analysisABSTRACT
OBJECTIVES: To audit our insulin regimen in our antenatal diabetics. METHODS: 170 pregnant diabetic patients were retrospectively analyzed. RESULTS: The perinatal mortality rate was 37/1000, vs. a perinatal mortality rate of 30/1000 in our setting. Cesarean section rate was 49%. Strict blood-glucose control reduced the incidence of macrosomia and polyhydramnios. Routine amniocentesis for fetal-lung maturity was not practiced. CONCLUSION: Satisfactory results in pregnant diabetic patients are achievable with an established insulin regimen in a developing country.
