AFJOG

African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 2 | 2024 | 47 African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 2 | 2024 | Abstracts AFJOG ABSTRACTS 1 Obstetrician and Gynaecologist, University of Pretoria (UP) and Steve Biko Academic Hospital Background: Stillbirths remain one of the neglected tragedies in global health. In South Africa, approximately 16000 stillbirths occur per year. Most are classified as unexplained intrauterine deaths. Many of these deaths maybe due to undetected fetal growth restriction (FGR). Continuous wave Doppler ultrasound of the umbilical artery (CWDU-UmA) is a simple method of assessing placental function. Screening with CWDU-UmA may detect these growth restricted fetuses allowing for appropriate management. Methods: A cohort study was conducted in nine sites around South Africa. Pregnant women attending primary healthcare clinics between 28-34 week’s gestation, were screened using CWDU-UmA on specific days of the week. Women not screened at those antenatal clinics served as control group 1. Control group 2 consisted of the sub-set of control group 1 with women detected with antenatal complications at any time excluded from analysis. Women with fetuses identified with an abnormal CWDU-UmA test were referred and managed according to a standard protocol. A comparison between the study and control groups was performed. Results: The study group consisted of 6536 pregnancies and there were 66 stillbirths (stillbirth rate– SBR 10.1/1000 births). In control group 1 there were 193 stillbirths in 10832 women (SBR 17.8/1000 births) and in control group 2, 152 stillbirths in 9811 women (SBR 15.5/1000 births) [Risk Ratio 0.57, 95% Confidence Intervals 0.29–0.85 and 0.65, 0.36–0.94 respectively]. Conclusion: Screening a low-risk pregnant population with continuous wave Doppler ultrasound of the umbilical artery, coupled with a standard protocol for foetuses with abnormal RIs was associated with a significant reduction in stillbirths. Screening a low-risk pregnant population as described was associated with a step-change reduction in stillbirths. PARALLELSESSIONABSTRACTS: ABSTRACTTITLE: 18: Diagnosis in women suspected of pulmonary embolism at Chris Hani Baragwanath Academic Hospital – A retrospective review AUTHORS: Dr Siseko Gqola sisekogqola@yahoo.com Siseko Gqola 1 , Yasmin Adam 1 , Langanani Mbodi 1 1 Wits University Introduction: Pulmonary embolism accounts for 3.6% of maternal deaths in South Africa and 9.2% of all pregnancy- related deaths in the United States. Pulmonary Embolism is often one of the conditions that are considered in the differential diagnosis of many of the women attended/ admitted at Chris Hani Baragwanath Academic Hospital Obstetric High Care Unit. There is an increase in the number of radiological examinations aimed to exclude Pulmonary Embolism. The objectives were to describe the clinical factors and investigations done in pregnant or postpartum women who had clinical suspicion of Pulmonary Embolism. Methods: This was a cross-sectional descriptive study. We reviewed the medical notes of women who were investigated with CTPA and/or VQ scans between 1st July 2018 and 30th June 2019. The demographic information, clinical findings (history and examination at presentation), laboratory tests (FBC, D-dimer, CRP), and pregnancy information (booking blood results, gestational age, type of delivery and complications) were extracted and analyzed using STATA version 14.2 (StataCorp, 4905 Lakeway Drive, College Station, Texas 77845 USA). We used simple descriptive statistics (Frequencies with percentages, means with SD or medians with IQR). Results: There were 135 women who were investigated with VQ scan and 46 women who were investigated using CTPA. There were 12 (6.6%) women diagnosed as having features of PE, 6 (3.3%) were diagnosed using CTPA and 6 (3.3%) with VQ scan. There were 5 (2.8%) women diagnosed with DVT. There were 9.4% of women who had a proven VTE in our study. Our results showed that clinical suspicion for PE differed between the trimester and pregnancy period in women who are investigated. The finding of 68.11% who were in the post-partum period correlates with what is reported in literature where more than half of pregnancy-related VTE occurred during the postpartum. The mean age of the overall women who were suspected of PE and those in whom the diagnosis was confirmed did not differ (28 years versus 29 years). Recent surgery is associated with an increased risk of PE. In our study 103 of the 126 (82%) women that were post- partum had a caesarean delivery. In our study, 10 of the 17 women who had VTE were delivered by caesarean section. Our study again shows that the existence of co-morbid medical conditions did not increase the risk to be investigated for PE as well as the actual diagnosis of PE. The measured median D-dimer was raised in all women with a VTE and those whom did not have the diagnosis. There was 1 mortality from PE, (confirmed on CTPA and post-mortem reports). Conclusion: If clinical viewpoint is to be ignored, 90.6% of examination may be considered unneeded and unjustified in all women who undergo negative examinations. However, pulmonary embolism is a life-threatening condition. Thus, pregnancy, delivery, and postpartum CTPA/VQ scan examinations are appropriate. The use of the algorithm does not assist in limiting the list of investigations. We are of the opinion that the CTPA/VQ scan investigation is still warranted and needs to be explored in bigger studies. ABSTRACTTITLE: 38: An audit of the indications for peripartum hysterectomies performed at a tertiary institution in Johannesburg, South Africa: Retrospective Study AUTHORS: Dr Rogers Mmabatswa mmabatswarogers@gmail.com Rogers Mmabatswa 1 , Shastra Bhoora 1 , Reubina Wadee 2