ObjectiveTo evaluate the rate of HIV/AIDS (and CD4 levels) in women with pre-eclampsia compared to that of a control group.MethodsThis was a retrospective case–control study in a tertiary and regional hospital in South Africa. We reviewed the hospital records of women who had delivered in these hospitals between 1 January 2008 and 30 June 2010. The records of women with pre-eclampsia during the study period were analysed. Their HIV infection rate was compared to that of a control group consisting of normotensive healthy pregnant women.ResultsAmong 492 cases of pre-eclampsia, 130 (26.4%) were HIV infected. In the control group, 183/500 (36.6%) were HIV infected (p = 0.001, OR = 0.62, 95% CI: 0.47–0.82). After adjustment to match the difference in maternal age and parity, the rate of HIV/AIDS was lower in the pre-eclamptic group than in the control group (p = 0.005, OR = 0.658).ConclusionThe rate of HIV/AIDS was significantly lower in women with pre-eclampsia than in normotensive healthy pregnant women.

Background: Occult anal sphincter disruption, following childbirth may contribute to the development of anal incontinence (AI). The type and mechanism of injury may differ between first and subsequent deliveries. Objectives: To describe the effect of pregnancy and delivery on the endosonographic morphology of the anal sphincter and on anal sphincter pressures, and to highlight any differences in these between nulliparous and multiparous Black African and Indian women. Methods: One hundred Black African and Indian women delivering at two hospitals in the Pietermaritzburg area underwent anal endosonography and manometry in the third trimester of pregnancy and 24 hours post-delivery. Those with occult injury were followed up at 6 weeks and six months. Participants were asked about bowel symptoms at each visit. Antenatal and intra-partum obstetric data was also recorded. Results: The majority were Black African (82%), and 76% were multiparous. Symptoms of urgency increased from 9% antenatally to 14.6% post-delivery, decreasing to 8.3% at six months. Symptoms of AI increased from 10% antenatally to 12.5% post-delivery, falling to 3.1% at six months. Internal sphincter defects were more common among primiparous and multiparous women delivering vaginally. There was a significant drop in functional anal length post-delivery, irrespective of the mode of delivery. Anal pressures also fell post-delivery and at six weeks post-partum. However, by six months there appeared to be a return to pregnancy values. Conclusion: Occult anal sphincter injuries and reduced anal pressures occur after delivery, in the absence of clinically detected anal sphincter trauma, irrespective of the mode of delivery.

Background. One of the strategies to reduce maternal mortality includes accessible and appropriate contraceptive services to all women. The intrauterine contraceptive device (IUCD) has been identified as a cheap and effective means of contraception by the South African National Department of Health. Objective. To explore knowledge about the IUCD among women using the public health sector and identify any misconceptions. Methods. A sample of 150 women attending antenatal/postnatal clinics were interviewed using a structured questionnaire. Results. Forty-six percent (n=69) had some experience with the injectable form of contraception, and 2.7% (n=4) had used the IUCD; 70.7% (n=106) knew that the device does not prevent HIV transmission, 40.7% (n=61) knew that HIV-positive women can use the IUCD, 75.3% (n=113) believed that the IUCD causes heavy bleeding, 36.7% (n=55) knew that the device does not stop fertility indefinitely, 33.3% (n=50) knew that the IUCD can be inserted in the immediate postpartum period, and 26.7% (n=40) knew that the duration of use is 10 years. In terms of attitudes, 40.0% (n=60) expressed concern about the pain during insertion, 33.3% (n=50) believed the IUCD can cause cancer, and 32.0% (n=48) believed that the device interferes with normal sexual activity. Most participants 77.3% (n=116) acquired the information they had about the IUCD from the clinic during teaching and counselling sessions. Conclusion. This survey documented poor knowledge about the IUCD among women using the public health sector. However, the fact that there are few misconceptions and that clients rely on the clinic information should be seen as an opportunity to improve the situation.