AFJOG
African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 2 | 2024 | 51 African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 2 | 2024 | Abstracts AFJOG ABSTRACTS chemical tests in the digital domain from brightfield images of a single unstained sample unlocks enormous potential for fertility labs to improve their service offering to patients. Moreover, the non-destructive nature of our ML technique allows for DNA fragmentation analysis to be done on an individual sperm basis, allowing clinicians to select the optimal spermatazoa at the point of fertilisation. ABSTRACTTITLE: 298: The role of vertical circulating exosomes as biomarkers in preeclampsia AUTHORS: Prof Ray Maharaj obgyn80@gmail.com Ray Maharaj 1 , Kalele Ketki 2 , Nyahatkar Sidhanti 3 , Krishnan Anand 1 1 University of Free State, South Africa 2 Neuron Institute of Applied Research , India 3 VYWS Dental College and Hospital, India Introduction: Preeclampsia (PE) is a complex hypertensive disorder that arises after 20 weeks of pregnancy, endangering both maternal and fetal health. The global prevalence of PE ranges from 2-15% of all pregnancies, and it is responsible for approximately 295,000 maternal deaths annually. Given these alarming statistics, there is an urgent need for accurate and early prenatal screening to improve clinical outcomes and reduce maternal and fetal mortality. Current diagnostic methods are inadequate, highlighting the need for innovative approaches. Methods: This narrative review examines recent advancements in prenatal diagnostics, focusing on the role of exosomes in PE detection. Exosomes are extracellular vesicles secreted by various cells, including placental cells, and play a crucial role in intercellular communication. The review analyzes studies that explore the potential of exosomal microRNAs and proteins as biomarkers for early detection of PE and other pregnancy complications. Data were sourced from peer-reviewed articles, clinical studies, and recent advancements in exosome research. Results: Exosomes in maternal blood have been identified as a promising non-invasive biomarker source for early detection of PE. Studies have shown that exosomal microRNAs, such as miRNA-210 and miRNA-155, are differentially expressed in preeclamptic pregnancies compared to healthy controls, indicating their potential as diagnostic markers. Additionally, exosomal proteins like placental growth factor (PlGF) and sFlt-1 provide valuable information about placental health and the progression of PE. Emerging biomarkers, such as maternal plasma exosome C19MC, have shown promise in detecting intrauterine growth restriction (IUGR) during the first trimester. Conclusion: Exosome-based diagnostic tests offer a promising non-invasive approach to early detection and monitoring of pregnancy complications, particularly PE. Integrating exosome profiling with current clinical parameters could significantly enhance diagnostic accuracy and patient care. Future research into exosome biology and its clinical applications is essential for advancing our understanding and management of PE, ultimately leading to the development of biomarkers that will facilitate the early detection of PE , improving maternal and fetal outcomes globally. ABSTRACTTITLE: 321: Can we predict the treatment required for the management of gestational diabetes mellitus at diagnosis: A retrospective analysis AUTHORS: Dr Solomon Muvhango vasenwana@gmail.com Solomon Muvhango 1 , Danie Van zyl 1 , Loisa Seopela 1 , Sumaiya Adam 1 1 University of Pretoria Introduction: Objective: This retrospective cohort study spanning 13 years aimed to identify patient characteristics at diagnosis of gestational diabetes mellitus during pregnancy (GDM) with an OGTT that predicts the need for specific interventions, such as insulin, metformin, diet, or combination thereof, to achieve glucose control. Methods: Data of pregnant women with GDM were extracted from the diabetes in pregnancy database of KPTH to compile the prediction rule. Data of patients not known with type 1 or type 2 diabetes, diagnosed with GDM with an OGTT. Logistic regression modelling was done to determine predictors for insulin requirement. Results: The predictor model compiled to predict insulin requirement for glucose control included age (OR:0.93), HbA1c (OR: 1.884), Fasting blood glucose (OR: 1.447), and gravidity (OR: 1.434), all these were statistically significant. The model performed well in predicting the need for insulin with an AUC of the ROC curve of 0.856 (CI: 0.809 to 0.902). Conclusion: HBA1c and fasting OGTT, gravidity >4 identify pregnant women with Gestational or Type 2 diabetes who would require any insulin. An HbA1c >6.75% and fasting glucose >6.65 mmol/L, along with gravidity >4 will most likely require antenatal insulin treatment. ABSTRACTTITLE: 333: Transvaginal cervical cerclage Indications and outcomes at Tygerberg Hospital AUTHORS: Dr Grace Gama gracegama@gmail.com Grace Gama MD 1 , Liesl De Waard MD 1 , David Hall PhD 1 1 Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences Stellenbosch University, Cape Town, South Africa Introduction: Preterm birth and second-trimester miscarriages contribute significantly to infant mortality and morbidity. There is a paucity of data from low- to middle- income settings on the utility and outcomes of transvaginal cervical cerclage. Methods: We conducted a retrospective review of all pregnant women managed with a cervical cerclage at Tygerberg
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