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Fundal pressure during the second stage of labour

  • Authors: Hofmeyr, Georges Justus , Vogel, Joshua. P , Cuthbert, Anna , Singata, Mandisa
  • Date: 03-2017
  • Subjects: South Africa Pregnancy Computer File
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/11260/5766 , vital:44640 , https://DOI:10.1002/14651858.CD006067.pub3
  • Description: Background Fundal pressure during the second stage of labour (also known as the 'Kristeller manoeuvre') involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth and avoid prolonged second stage orthe need for operative birth. Fundal pressure has also been applied using an inflatable belt. Fundal pressure is widely used, however methods of its use vary widely. Despite strongly held opinions in favour of and against the use of fundal pressure, there is limited evidence regarding its maternal and neonatal benefits and harms. There is a need for objective evaluation of the eGectiveness and safety of fundal pressure in the second stage of labour. Objectives To determine if fundal pressure is eGective in achieving spontaneous vaginal birth, and preventing prolonged second stage or the need for operative birth, and to explore maternal and neonatal adverse eGects related to fundal pressure. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (30 November 2016) and reference lists of retrieved studies. Selection criteria Randomised and quasi-randomised controlled trials of fundal pressure (manual or by inflatable belt) versus no fundal pressure in women in the second stage of labour with singleton cephalic presentation. Data collection and analysis Two or more review authors independently assessed potential studies for inclusion and quality. We extracted data using a pre-designed form. We entered data into Review Manager 5 soAware and checked for accuracy. Main results Nine trials are included in this updated review. Five trials (3057 women) compared manual fundal pressure versus no fundal pressure. Four trials (891 women) compared fundal pressure by means of an inflatable belt versus no fundal pressure. It was not possible to blind women and staG to this intervention. We assessed two trials as being at high risk of attrition bias and another at high risk of reporting bias. All other trials were low or unclear for other risk of bias domains. Most of the trials had design limitations. Heterogeneity was high for the majority of outcomes. Manual fundal pressure versus no fundal pressure Manual fundal pressure was not associated with changes in: spontaneous vaginal birth within a specified time (risk ratio (RR) 0.96, 95% confidence interval (CI) 0.71 to 1.28; 120 women; 1 trial; very low-quality evidence), instrumental births (RR 3.28, 95% CI 0.14 to 79.65; 197 women; 1 trial), caesarean births (RR 1.10, 95% CI 0.07 to 17.27; 197 women; 1 trial), operative birth (average RR 0.66, 95% CI 0.12 to 3.55; 317 women; 2 studies; I2 = 43%; Tau2 = 0.71; very low-quality evidence), duration of second stage (mean diGerence (MD) -0.80 minutes, 95% CI -3.66 to 2.06 minutes; 194 women; 1 study; very low-quality evidence), low arterial cord pH in newborn babies (RR 1.07, 95% CI 0.72 to 1.58; 297 women; 2 trials; very low-quality evidence), or Apgar scores less than seven at five minutes (average RR 4.48, 95% CI 0.28 to 71.45; 2759 infants; 4 trials; I2 = 89%; Tau2 = 3.55; very low-quality evidence). More women who received manual fundal pressure had cervical tears than in the control group (RR 4.90, 95% CI 1.09 to 21.98; 295 women; 1 trial). No neonatal deaths occurred in either of the two studies reporting this outcome (very low-quality evidence). No trial reported the outcome severe maternal morbidity or death. Fundal pressure by inflatable belt versus no fundal pressure Fundal pressure by inflatable belt did not reduce the number of women havinginstrumental births (average RR 0.73, 95% CI 0.52 to 1.02; 891 women; 4 trials; I2 = 52%; Tau2 = 0.05) or operative births (average RR 0.62, 95% CI 0.38 to 1.01; 891 women; 4 trials; I2 = 78%; Tau2 = 0.14; very low-quality evidence). Heterogeneity was high for both outcomes. Duration of second stage was reported in two trials, which both showed that inflatable belts shortened duration of labour in nulliparous women (average MD -50.80 minutes, 95% CI -94.85 to -6.74 minutes; 253 women; 2 trials; I2 = 97%; Tau2 = 975.94; very low-quality evidence). No data on this outcome were available for multiparous women. The inflatable belt did not make any diGerence to rates of caesarean births (average RR 0.56, 95% CI 0.14 to 2.26; 891 women; 4 trials; I2 = 70%; Tau2 = 0.98), low arterial cord pHin newborn babies (RR 0.47, 95% CI 0.09 to 2.55; 461 infants; 1 trial; low-quality evidence), or Apgar scores less than seven atfive minutes (RR 4.62, 95% CI 0.22 to 95.68; 500 infants; 1 trial; very low-quality evidence). Third degree perinealtears were increased in the inflatable belt group (RR 15.69, 95% CI 2.10 to 117.02; 500 women; 1 trial). Spontaneous vaginal birth within a specified time, neonatal death, andsevere maternal morbidity or death were not reported in any trial. Authors' conclusions There is insuGicient evidence to draw conclusions on the beneficial or harmful eGects of fundal pressure, either manually or by inflatable belt. Fundal pressure by an inflatable belt during the second stage of labour may shorten duration of second stage for nulliparous women, and lower rates of operative birth. However, existing studies are small and their generalizability is uncertain. There is insuGicient evidence regarding safety for the baby. There is no evidence on the use of fundal pressure in specific clinical settings such as inability of the mother to bear down due to exhaustion or unconsciousness. There is currently insuGicient evidence for the routine use of fundal pressure by any method on women in the second stage of labour. Because of current widespread use of the procedure and the potential for use in settings where other methods of assisted birth are not available, further good quality trials are needed. Further evaluation in other groups of women (such as multiparous women) will also be required. Future research should describe in detail how fundal pressure was applied and consider safety of the unborn baby, perineal outcomes, longer-term maternal and infant outcomes and maternal satisfaction.
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  • Date Issued: 03-2017

Iodine nutrition status in Africa: Potentially high prevalence of iodine deficiency in pregnancy even in countries classified as iodine sufficient

  • Authors: Charles Bitamazire Businge , Benjamin Longo-Mbenza , Andre Pascal Kengne
  • Date: 03-8-2020
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/11260/3377 , vital:43336 , https://www.cambridge.org/core/journals/public-health-nutrition/article/iodine-nutrition-status-in-africa-potentially-high-prevalence-of-iodine-deficiency-in-pregnancy-even-in-countries-classified-as-iodine-sufficient/B3DCB06E75CDDD8EAD410BE090198BA4
  • Description: Objective: To assess the burden of iodine deficiency in pregnancy in Africa using estimated pregnancy median urinary iodine concentration (pMUIC). Design: pMUIC for each African country was estimated using a regression equation derived by correlating the school-age children (SAC) median UIC (mUIC) and pMUIC from countries around the globe, and the SAC mUIC data for African countries obtained from the Iodine Global Network (IGN) 2017 and 2019 Score cards. Setting: Iodine deficiency was endemic in many African countries before the introduction of iodine fortification, mainly through universal salt iodisation programmes about 25 years ago. There is a scarcity of data on the level of iodine nutrition in pregnancy in Africa. Women living in settings with pMUIC below 150 μg/l are at risk of iodine deficiency-related pregnancy complications. Participants: Fifty of the fifty-five African countries that had data on iodine nutrition status. Results: A cut-off school age mUIC ≤ 175 μg/l is correlated with insufficient iodine intake in pregnancy (pregnancy mUIC ≤ 150 μg/l). Twenty-two African countries had SAC mUIC less than 175 μg/l, which correlated with insufficient iodine intake during pregnancy (pMUIC less than 150 μg/l). However, nine of these twenty-two countries had adequate iodine intake based on SAC mUIC. Conclusions: There is likely a high prevalence of insufficient iodine intake in pregnancy, including in some African countries classified as having adequate iodine intake in the general population. A SAC mUIC ≤ 175 μ
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  • Date Issued: 03-8-2020

A Review of Arterial Stiffness and HIV Infection in Adult Africans

  • Authors: Awotedu, Kofoworola Olajire , Iputo, Jehu
  • Date: 09-06-2016
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/11260/3484 , vital:43615 , https://www.hilarispublisher.com/open-access/a-review-of-arterial-stiffness-and-hiv-infection-in-adult-africans-2167-1095-1000221.pdf
  • Description: Aim: To review the impact of the human immunodeficiency virus and antiretroviral therapy on the vasculature. Objectives: This review seeks to identify the burden which the human immunodeficiency virus and antiretroviral therapy have on the vasculature. Method: Medline/PubMed and Google scholar were searched. There were over 100 publications reviewed. Some people who worked in similar fields were also contacted. The present review summarized current understanding of Human immunodeficiency virus, antiretroviral therapy and effect on the vasculature such as arterial stiffness. Atherosclerosis, endothelial dysfunction, the strengths and weaknesses of current testing strategies, and their potential applications in clinical research and patient care. The association of inflammatory biomarkers, blood pressure and ageing with arterial stiffness were also reviewed. Conclusion: Available literature shows that HIV and antiretroviral agents have a great impact on the vasculature and its progression.
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  • Date Issued: 09-06-2016

Medical Education in Decentralized Settings: How Medical Students Contribute to Health Care in 10 Sub-Saharan African Countries

  • Authors: Talib, Zohray , van Schalkwyk, Susan , Cooper , I , Pattanaik , Swaha , Turay , Khadija , Sagay, Atiene S , Baingana , Rhona , Baird , Sarah , Gaede , Bernhard , Iputo, Jehu , Kibore , Minnie , Manongi , Rachel , Matsika , Antony , Mogodi , Mpho , Ramucesse , Jeremais , Ross, Heather , Simuyeba, Moses , Haile-Mariam, Damen
  • Date: 10-2017
  • Subjects: Sub Sahara Africa Medical Education Health Care Medical Students Computer File
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/11260/5786 , vital:44644 , https://doi:10.1097/ACM.0000000000002003
  • Description: Purpose: African medical schools are expanding, straining resources at tertiary health facilities. Decentralizing clinical training can alleviate this tension. This study assessed the impact of decentralized training and contribution of undergraduate medical students at health facilities. Method: Participants were from 11 Medical Education Partnership Initiative-funded medical schools in 10 African countries. Each school identified two clinical training sites-one rural and the other either peri-urban or urban. Qualitative and quantitative data collection tools were used to gather information about the sites, student activities, and staff perspectives between March 2015 and February 2016. Interviews with site staff were analyzed using a collaborative directed approach to content analysis, and frequencies were generated to describe site characteristics and student experiences. Results: The clinical sites varied in level of care but were similar in scope of clinical services and types of clinical and nonclinical student activities. Staff indicated that students have a positive effect on job satisfaction and workload. Respondents reported that students improved the work environment, institutional reputation, and introduced evidence-based approaches. Students also contributed to perceived improvements in quality of care, patient experience, and community outreach. Staff highlighted the need for resources to support students. Conclusions: Students were seen as valuable resources for health facilities. They strengthened health care quality by supporting overburdened staff and by bringing rigor and accountability into the work environment. As medical schools expand, especially in low-resource settings, mobilizing new and existing resources for decentralized clinical training could transform health facilities into vibrant service and learning environments.
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  • Date Issued: 10-2017

Recording African music in the field

  • Authors: Tracey, Hugh T
  • Date: 1955
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481557 , vital:78564 , https://doi.org/10.21504/amj.v1i2.250
  • Description: With the steady increase in the number of persons of Africa who own and operate small recording machines the technique of recording African music, as opposed to any other kind, is coming under discussion.
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  • Date Issued: 1955

The state of folk music in Bantu Africa

  • Authors: Tracey, Hugh T
  • Date: 1955
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481655 , vital:78573 , https://doi.org/10.21504/amj.v1i1.219
  • Description: We Europeans are at a great disadvantage in talking about African music. Unlike most other members of this Conference we do not represent or discuss our own music but that o a people radically unlike ourselves among whom we live. It is only because we have found that the African is pathetically incapable of defending his own culture and indeed is largely indifferent to its fate that we, who subscribe wholeheartedly to the ideals of our International Council, are attempting to tide over the period during which irreparable damage can be done and until Africans themselves will be capable of appearing at our conferences as well-informed representatives of their own peoples.
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  • Date Issued: 1955

Recording in the lost valley

  • Authors: Tracey, Hugh T
  • Date: 1957
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481567 , vital:78565 , https://doi.org/10.21504/amj.v1i4.463
  • Description: By kind invitation of the Director of the Rhodes-Livingstone Institution, Lusaka, Mr. Henry Fosbrooke, and by the Curator of the Rhodes-Livingstone Museum at Livingstone, Northern Rhodesia, Dr. Desmond Clark, the recording unit of the Library visited the valley of the Zambesi to record some of the music of that section of the Valley Tonga tribe -which will be forced to leave their riverside homes when the waters of the Kariba Dam begin to rise next year, 1958.
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  • Date Issued: 1957

African music within its social setting

  • Authors: Tracey, Hugh T
  • Date: 1958
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481491 , vital:78557 , https://doi.org/10.21504/amj.v2i1.531
  • Description: The social setting of present day African Folk Music varies from that of the most remote tribes tucked away in the vast forests, almost oblivious of the outside world, to the homes of the towns people, some of them in the second and third generation of urban families, often of mixed tribal parentage and forming a new lower and middle class of skilled and semi-skilled industrial workers. There is a corres¬pondingly wide range of musics to be found on the Continent from the most complex folk melodies and rhythms to the simplicities of imported dance music.
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  • Date Issued: 1958

Report on the I.L.A.M Nyasaland recording tour (May 7th to June 30th, 1958)

  • Authors: Tracey, Hugh T
  • Date: 1958
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481589 , vital:78567 , https://doi.org/10.21504/amj.v2i1.538
  • Description: Our first objective on this tour was to discover what music might still be available in the two Southern districts of Southern Rhodesia, Chibi and Gutu, on our way up to Nyasaland via Fort Victoria and Salisbury. To test the prevalence of local music we went to two of the regions where I had first recorded in 1931, twenty-seven years ago, the one at Chief Takawarasha’s kraal, Chibi, and the other at the Alheit Mission, Gutu. In both places there were several African people who clearly remembered my previous visit and some wrho possessed my recordings which were made at that time and had been pressed and published by Columbia. Since most of the 1931 artists had already died, they were especially delighted to have their voices still on discs and they expressed their belated understanding of what we were doing for African people through our recordings which, they said, they had not appreciated at the time.
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  • Date Issued: 1958

Towards an assessment of African scales

  • Authors: Tracey, Hugh T
  • Date: 1958
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481675 , vital:78575 , https://doi.org/10.21504/amj.v2i1.522
  • Description: It would appear from the evidence of certain writers on African musics that there still remains much confusion about the subject of African scales and modes. A tenacious misconception continually occurs, namely that African scales or modal systems are but an imperfect imitation of, or striving towards, the western system. Nothing, of course, could be further from the truth. It is with the intention of opening the subject for dis¬cussion by members of the Society and others interested in this aspect of musicology throughout the African world that this short article is now written.
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  • Date Issued: 1958

Bastutoland recording tour, November 19th to December 3rd, 1959

  • Authors: Tracey, Hugh T
  • Date: 1959
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481502 , vital:78558 , https://doi.org/10.21504/amj.v2i2.591
  • Description: Each territory in which the Library records examples of indigenous music presents its own characteristics and its own propositions. Both demand special consideration and understanding. For the short period in which the recording unit is active in the country of the tribes concerned we live intensely in the atmosphere of local society, ruler and ruled, teacher and taught, each with their special contemporary problems, the more so because the nature of our research gives us a background of similar conditions from other regions where we have been to collect music.
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  • Date Issued: 1959

Recording tour of the Tswana tribe

  • Authors: Tracey, Hugh T
  • Date: 1959
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481578 , vital:78566 , https://doi.org/10.21504/amj.v2i2.590
  • Description: Based upon the story of that part of the great Zambezi Valley in Southern Africa which has recently been submerged beneath the waters of the Kariba Dam.
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  • Date Issued: 1959

The future of music in Basutoland

  • Authors: Tracey, Hugh T
  • Date: 1959
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481622 , vital:78570 , https://doi.org/10.21504/amj.v2i2.582
  • Description: There is a popular impression among the general public that folk music is a thing of the past and of no modern importance. This no doubt arises from a misconception of the function of music in society and also from the notion that the practice of European folk musics is a revivalist art, and, therefore, African music must fall into the same category. This is far from the truth which, in this case, is hidden under a mass of false assumptions and prejudices.
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  • Date Issued: 1959

The lost valley: a feature programme or broadcasting

  • Authors: Tracey, Hugh T , Tracey, Peggy
  • Date: 1959
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481633 , vital:78571 , https://doi.org/10.21504/amj.v2i2.588
  • Description: Based upon the story of that part of the great Zambezi Valley in Southern Africa which has recently been submerged beneath the waters of the Kariba Dam.
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  • Date Issued: 1959

Preserving trees

Kamba carvers

  • Authors: Tracey, Andrew
  • Date: 1960
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481698 , vital:78577 , https://doi.org/10.21504/amj.v2i3.611
  • Description: You generally find the carvers on a street corner, sitting under a tree out of the hot sun, behind the neat rows of their carvings arranged on a mat, and it may be any¬where from Francistown to Jinja; the scene is the same. Their round, dark faces, their soft language with its th sounds, and above all the distinctive lines of their carvings mark them out as members of one of the enterprising tribes of Africa, the Kamba from Machakos, to the south east of Nairobi, in Kenya. These people travel over most of central Africa to sell their work, from Southern Rhodesia to the Sudan (not, however, the Portuguese territories), and in addition their carvings stock most of the curio shops all over Africa and are to be found both in America and Europe. Behind them is the Akamba Handcraft Association in Kenya, a society which looks after and promotes their interests and is run entirely by the Kamba.
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  • Date Issued: 1960

Mbira music of Jege A Tapera

  • Authors: Tracey, Andrew
  • Date: 1961
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481720 , vital:78579 , https://doi.org/10.21504/amj.v2i4.705
  • Description: Jege A. Tapera, when I knew him in 1961, was a clothing factory worker in Bula¬wayo, Southern Rhodesia, but, first and foremost, he held himself to be a murid^i n>em-bira, an mbira player. The African inhabitants of the Bulawayo area belong mostly to the Ndebele tribe who do not possess the mbira, but there is also a considerable number of Shona-speaking people resident in Bulawayo itself. Among these, only a very few players of the mbira are to be found, perhaps because Bulawayo is well outside Mashona- land; only two were well-known—Matheu Zvimba, a Zezuru njari player from the Zvimba reserve near Salisbury, and Tapera, who is of the Nohwe clan of the Zezuru tribe of the Shona peoples. He was born in about 1905 in the Mangwendi reserve, fifty miles east of Salisbury in the Mrewa district of Southern Rhodesia, of a Rozvi father and a Zezuru mother.
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  • Date Issued: 1961

Tina’s lullaby

  • Authors: Tracey, Hugh T
  • Date: 1961
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481665 , vital:78574 , https://doi.org/10.21504/amj.v2i4.710
  • Description: The Library was recently requested by Dr. Ruth L. Bartholomew of Paine College, Augusta, Georgia, U.S.A., to assist her in placing an old Negro lullaby which had been handed down by succeeding generations of an American family in that city who were keen to find out from which part of Africa the song might have come. The first transcriptions of the song on paper which she sent us had proved baffling, and so we asked Dr. Bartholomew to send us a tape recording as she said that it was still remembered and could be sung by an old lady of over eighty years, Mrs. Johnson, who was a member of the family.
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  • Date Issued: 1961

A case for the name Mbira

  • Authors: Tracey, Hugh T
  • Date: 1962
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481469 , vital:78554 , https://doi.org/10.21504/amj.v2i4.703
  • Description: It is perhaps strange that one of Africa’s most important small musical instruments should suffer from an incorrect naming at the hands of many ethnomusicologists and museum keepers, those who should be most concerned to give it its rightful name and place in the catalogue of this continent’s instruments.
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  • Date Issued: 1962

The arts in Africa: the visual and the aural

  • Authors: Tracey, Hugh T
  • Date: 1962
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/481600 , vital:78568 , https://doi.org/10.21504/amj.v3i1.734
  • Description: For the purposes of this paper the title “ The Arts in Africa” is interpreted as the Arts of indigenous Africans only. Of all the people living south of the Sahara, over eighty percent, four out of every five persons still live in the country and not in towns or industrial areas. Consequently, about four-fifths of all African arts can still be classed as rural. A s with folk arts the world over, African rural arts play an important part in creating public opinion and upholding social disciplines.
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  • Date Issued: 1962
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