AFJOG

African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 2 | 2024 | 44 AFJOG ABSTRACTS African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 2 | 2024 | Abstracts 68.2%/81.6%/29.6%/95.8%; GeneXpert 64.1%/85.1%/33.6%/95.3%; Aptima 36.2%/90.0%/29.2%/92.5% and PreTect Proofer-8 38.7%/89.9%/32.9%/92.0%. In HPW, respective sensitivity/specificity/PPV/ NPV to detect CIN3+ were: cytology(ACSUS+) 75.5%/70.9%/44.0%/90.5%; Onclarity 80.8%/67.5%/44.7%/91.6%; HC2 77.1%/63.0%/36.0%/91.1%; Roche cobas 82.1%/61.7%/39.4%/91.9%; GeneXpert 80.2%/64.4%/40.7%/91.4%; Aptima 42.2%/77.0%/36.8%/80.8% and PreTect Proofer-8 74.0%/74.3%/45.2%/74.2%. Relative sensitivity measured against cytology(ASCUS+) for Onclarity/HC2/Roche cobas/GeneXpert/Aptima/PreTect- Proofer-8 in HNW were: 1.08/1 .00/1.15/1.08/0.61/0.65 and in HPW 1.07/1.02/1.09/1.06/0.56/0.98 respectively. Conclusion: We report an unexpected low sensitivity to detect biopsy-confirmed CIN3+ for all hrHPV DNA-tests in HNW. Sensitivity for hrHPV DNA tests were higher than cytology in both HIV-groups. Specificity and NPV were better for HNW than HPW, as is widely reported. Testing for HPV integration (mRNA-testing) and limiting the number of HPV types (Aptima and PreTect) increased specificity, making these tests suitable for molecular triage of hrHPV DNA positives. ABSTRACTTITLE: 195: Investigating the patterns of abnormal uterine bleeding in women using intramuscular depot medroxyprogesterone acetate, a copper intra-uterine device or levonorgestrel implant for contraception AUTHORS: Dr Natasha Di Rago tash.dirago@gmail.com Natasha Di Rago 1 , Amy Wise 2 , Mags Beksinska 3 , Jenni Smit 3 1 Registrar, University of Witwatersrand 2 Sub-specialist Maternal and Fetal Medicine, Head of Department Rahima Moosa Mother and Child, University of Witwatersrand 3 Maternal, Adolescent and Child Health Research Unit (MatCH) Introduction: Access to contraception forms a fundamental role in human rights, significantly impacting women's health globally. In South Africa, over 80 percent of women access contraceptives through the public health sector. However, varying side effects often lead to method discontinuation. Understanding menstrual cycle changes related to common contraceptive methods can empower healthcare providers to offer tailored counselling, fostering shared decision-making, and ultimately enhancing method uptake, continuation, and reducing unwanted pregnancies. Methods: This study was a secondary analysis of data from participants enrolled in the ECHO trial (ClinicalTrials.gov Identifier: NCT02550067), a multicenter trial focusing on women seeking effective contraception. Data was extracted from case report forms from 5743 participants across nine healthcare facilities in South Africa. Statistical analyses, performed using R software, involved categorical data analysis through Pearson’s chi-squared contingency tables. Standardized residuals were assessed for significant outcomes to gauge variables' contributions, with analyses set at a significance level of 0.05. Results: Usable data from 3026 patients was analysed, including those using copper IUD (n = 1595), intramuscular depot (DMPA-IM) (n = 561), and levonorgestrel implants (n = 870). Findings indicated significant alterations in bleeding patterns within approximately six months of contraceptive use (p = 0.035). Parameters such as frequency, duration, volume of blood loss, and patients' perceptions of their bleeding were significantly impacted at follow-up visits. Obesity and smoking also had an influence on bleeding patterns within the sample. Moreover, the study identified a graded response regarding the role of bleeding in contraceptive method discontinuation, with heavy and prolonged menstrual bleeding playing a more significant role than irregular menstruation or amenorrhea (χ2 = 80.17, df = 4, p < 0.001). Conclusion: This research highlights the impact of different contraceptive modes on bleeding patterns, influenced by method type and duration of use. Armed with this knowledge, healthcare workers can adopt a more comprehensive counselling approach, helping patients select methods appropriate to their specific needs. This approach has the potential to lead to increased compliance and continuation rates thereby generating an overall improvement in contraceptive outcomes in South Africa. ABSTRACTTITLE: 203: Ten years’ experience offering non-invasive prenatal testing (NIPT) in South Africa AUTHORS: Dr Yvonne Holt yvonne.holt@nextbiosciences.co.za Yvonne Holt 1 , Gloudi Agenbag 1 1 Next Biosciences, International Business Gateway, Midrand, South Africa Introduction: The discovery of circulating cell-free fetal DNA in maternal blood has revolutionised prenatal testing allowing for an early, non-invasive screening test for aneuploidies. International guidelines recommend that non- invasive prenatal testing (NIPT) be offered to all pregnant women, regardless of their risk profile. The objective of this study was to evaluate the utilisation of NIPT in South Africa and determine the value of NIPT as a screening test for both high- and low-risk pregnancies. Methods: A retrospective data review was conducted for the 10 period from 2014 to 2023, which included all referrals to Next Biosciences, a private diagnostic testing laboratory offering NIPT. Testing was initially done at a referral laboratory, but samples have been processed locally since 2018 on the Illumina CE-IVD VeriSeq NIPT v1 and later v2 platform, which utilises low-coverage whole genome next generation sequencing and counting statistics to determine aneuploidy risk. Results: Since first offering NIPT in 2014, the uptake has continuously increased. All chromosome testing was first offered in 2020, with an average of 30% of patients selecting