Browsing by Author "Brink, A. L."

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    Early detection of poor fetal prognosis by serial Doppler velocimetry in high-risk pregnancies
    (Health & Medical Publishing Group, 1991) Pattinson, R. C.; Brink, A. L.; De Wet, P. E.; Odendaal, H. J.
    Fifty-three high-risk pregnancies were followed up serially with Doppler velocimetry of the umbilical artery and uterine vessels from early on to investigate whether abnormalities in Doppler waveforms can predict the outcome of pregnancy accurately before other clinical signs develop. Results of Doppler velocimetry were withheld from the clinicians managing the patients. When the absence of end-diastolic velocities was first detected (in 13 fetuses) (AEDV group) there was no clinical difference between these pregnancies and those in which enddiastolic velocities were present (EDV group). Nine of the 13 fetuses with AEDVs died, compared with 3 of 40 with EDVs (P < 0,0001). In deaths associated with AEDVs, the latter were detected a median of 5,5 (range 3-11) weeks before death and are present from the first Doppler examination. In the 4 fetuses with AEDVs that survived, the AEDVs were not persistent. The only significant association of Doppler velocimetry of the uterine vessels was with proteinuric hypertension (P < 0,05), but the prediction was not strong enough to be of clinical value. Persistent AEDVs of the umbilical artery are an accurate predictor of poor fetal outcome and occur before other clinical signs of impending problems.
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    In search of more representative cervical cytology : a preliminary prospective study
    (Health & Medical Publishing Group, 1989-07) Brink, A. L.; Du Toit, J. P.; Deale, C. J. C.
    Non-representative cervical smears represented 26.5% of the 105,165 smears screened by the cytology laboratory at Tygerberg Hospital during the period 1986-1987. This figure varied from 21% to 41% depending on the skill of the performer. In an effort to secure more representative smears a preliminary prospective study was conducted to ascertain the value of a variety of devices (Ayre wooden spatula, saline-soaked cotton-wool swabs, Cytobrush). Initially these devices were employed by one specific clinician and subsequently by a variety of medical personnel. This study proved that in the hands of all the personnel endocervical cells were present in all smears taken by the Cytobrush technique, obviating the need for repeat smears. The combination of an ectocervical scrape by an Ayre wooden spatula with an endocervical Cytobursh smear applied to one slide should result in more representative smears at screening. The resultant higher cost should be offset by minimising repeat smears.
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    Risk factors for abruptio placentae
    (Health & Medical Publishing Group, 1987) Brink, A. L.; Odendaal, H. J.
    In a prospective study 90 patients who had confirmed abruption of the placenta were compared with a control group. Significantly more patients who had abruptio placentae were unmarried, smoked cigarettes, received no antenatal care, had coitus within the 48 hours preceding delivery, developed intrapartum hypertension and had a lower ponderal index than the controls. More patients with abruptio placentae had proteinuria and antepartum hypertension but statistic al significane was not reached. In addition, the incidence of intra-uterine growth retardation was higher in these patients.