AFJOG

The accreditation of medico-legal experts must urgently be regulated and standardised. Those offering expert opinions should have verifiable qualifications and operate without bias. Ideally, medico-legal expert/s should be appointed independently rather than by the plaintiff or defendant. This may result in more objective opinions, as the plaintiffs’ legal teams will not have to scout around until they obtain the desired opinion to facilitate their case. Currently anyone can be regarded as an expert witness, with no prior training, exposure or experience. The Minister of Health is currently investigating the feasibility of a no-fault compensation model. This idea needs to be thoroughly investigated to ensure it does not have unintended adverse consequences. Such an entity might lead to a flurry of claims that would otherwise not have existed, with consequently higher premiums for private practitioners who will have to fund this model. The profession also bears a collective responsibility to advocate for reforms and foster open communication with patients. Building trust through improved patient education and transparent discussions about risks can reduce the likelihood of litigation. As obstetricians and gynaecologists, we stand at the intersection of medical care and legal accountability. While we must continue striving for excellence in clinical practice, the broader medico-legal ecosystem requires urgent and transformative change. Together, we must strive for and advocate legal reforms that ensure equitable outcomes for patients while safeguarding the sustainability of our profession. Despite these daunting challenges, there is an opportunity to reimagine the medico-legal landscape in South Africa. By prioritising patient safety, supporting clinicians, and fostering dialogue between sectors, we can create an environment that enables obstetricians and gynaecologists to focus on what they should do best: delivering high- quality care to the women of South Africa. As we wrap up 2024, the AFJOG editorial team is proud to inform readers that 2025 heralds the 3rd volume since inception in 2023. Author submission guidelines and pre- application for inclusion in DHET list of SA journals has already been initiated. In this edition Prof LC Snyman highlights core issues regarding the exigent medicolegal climate on SA health care professionals, followed by obstetric issues ranging from ultrasound to clinical guidelines for the use of blood products. The study by Nzenza et al reminds us that post caesarean section wound sepsis still constitutes a substantial burden to the SA health system including maternal mortality as per the 2017 South African Saving Mothers report. In addition, the study by Wawa et al reinforces the fact that all health care providers involved particularly in obstetrics need to familiarise themselves with the clinical guidelines for the use of blood products as in their study cohort of 86 mothers diagnosed with a confirmed ultrasound diagnosis of placenta praevia, 75.6% experienced haemorrhage and 72.1% required blood transfusion. The review on pre-exposure prophylaxis to prevent HIV infection during pregnancy and breastfeeding and the original research for parameters to accurately determine gestational age makes interesting reading. The AFJOG Editorial team wishes you the happiest holidays and a prosperous 2025 ZeelhaAbdool Deputy Editor AFJOG, Department of Obstetrics and Gynaecology, University of Pretoria and Steve Biko Academic Hospital, Pretoria African Journal of Obstetrics & Gynaecology (AFJOG) summary EDITORIAL African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 3 | 2024 | 03