Page 68 - University of Pretoria RESEARCH REVIEW 2016

STILLBIRTHS
PROGRESS AND UNFINISHED BUSINESS
South Africa has approximately 32 000 babies stillborn every year, many of whom die before the onset of labour. In the vast majority of cases, there is no obvious cause.
The Research Centre for Maternal, Fetal, Newborn and Child Health, and the South African Medical Research Unit (SAMRU) for Maternal and Infant Health Care Strategies at UP are currently involved in a series of research projects aimed at preventing stillbirths and reducing morbidity of babies and children. Three examples are given of research projects that are concerned with attaining the Sustainable Development Goals (SDGs) and global strategy of survive, thrive and transform in maternal, newborn and child care.
The SAMRU and the Council for Scientific and Industrial Research (CSIR) developed the Umbiflow,
a simple handheld apparatus that detects the
blood flow in the baby’s umbilical cord. Dr Spencer Nkosi, working in Mamelodi, has shown that with
the Umbiflow he can detect babies at risk and has managed to reduce the mortality rate of babies
by half in women who have undergone this test.
This exciting finding is being tested in nine other
sites in South Africa in a study run by Dr Tsakane Hlongwane. Further, the World Health Organisation (WHO) and the Bill and Melinda Gates Foundation (BMGF) are interested in repeating the Mamelodi study in India and Kenya under the auspices of the UP Research Centre for Maternal, Fetal, Newborn and
Professor Robert Pattinson is Director of the SA Medical Research Council/ UP Maternal and Infant Health Care Strategies Research Unit and clinical head of the Department of Obstetrics and Gynaecology in the Faculty of Health Sciences. Here in discussion with Registrars at Kalafong Hospital, Drs Rabothata (left) and Minisi.
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Child Health. If the findings of the Mamelodi study are repeated, a significant breakthrough will have been achieved in preventing stillbirths.
A second example is a new device that can be used to assist mothers at the end of labour who need help in delivering the baby. Traditionally, this has been performed by using a set of forceps or a vacuum apparatus. The UP Research Centre, together with the WHO, is coordinating a study testing a new device, called the Odon device, in five sites in South Africa under Dr Valerie Vannevel.
The device, if proved successful, is much easier and safer to use than the traditional methods and will probably be suitable for use by midwives working in small health units. This method could significantly reduce the number of babies who develop brain damage due to a prolonged second stage of labour. The study is funded by BMGF.
A third example relates to the stunting of children, which is a major problem in South Africa and is also associated with neurodevelopmental delay. This situation is particularly prevalent in children born
to women who are HIV-infected, but the babies themselves are not infected. The reasons are unclear. Professor Ute Fuecht is running a study that includes Professors Theresa Rossouw and Mphele Mulaudzi and Dr Felicia Molokoane where the growth of
the baby in the uterus and the first year after birth will be followed to ascertain whether the cause of stunting is due to the in-utero environment (the response of the mother to the HIV infection, or due to the antiretroviral drugs used), or due to postnatal environmental factors such as diet and feeding practices. Understanding these factors is essential in order to start managing the problem.