Drought in the Eastern Cape region of South Africa and trends in rainfall characteristics.

Much of the Eastern Cape province in South Africa has been experiencing a severe drought since 2015. This drought has had major socio-economic effects particularly on the large impoverished rural population as well as on some urban areas where supplied water services have broken down in several cases. The region is influenced by both midlatitude and tropical systems leading to a complex regional meteorology that hitherto has not been much studied compared to other parts of South Africa. Here, the ongoing drought is examined in the context of long-term trends and the interannual rainfall variability of the region. Although the region has experienced drought in all seasons since 2015, focus here is placed on the spring (September-November) which shows the most consistent and robust signal. On average, this season contributes between about 25-35% of the annual rainfall total. Based on CHIRPS data, it is found that this season shows a significant decreasing trend in both rainfall totals as well as the number of rainfall days (but not heavy rainfall days) for spring over most of the province since 1981. On interannual time scales, the results indicate that dry (wet) springs over the Eastern Cape are associated with a cyclonic (anticyclonic) anomaly southeast of South Africa as part of a shift in the zonal wavenumber 3 pattern in the midlatitudes. Over the landmass, a stronger (weaker) Botswana High is also apparent with increased (decreased) subsidence over and near the Eastern Cape which is less (more) favourable for cloud band development and hence reduced (enhanced) rainfall during dry (wet) springs. Analysis of mid-century (2040-2060) CMIP5 rainfall projections suggests that there may be a flattening of the annual cycle over the Eastern Cape with the winter becoming wetter and the summer drier. For the spring season of interest here, the multi-model projections also indicate drying but less pronounced than that projected for the summer.

Macrosomia: a new formula for optimized fetal weight estimation.

OBJECTIVES: To develop and test a specific formula for estimating weight in the macrosomic fetus. METHODS: Ultrasound estimations of fetal weight were carried out within 1 week of delivery in 424 singleton fetuses with a birth weight of > or = 4000 g. Exclusion criteria were multiple pregnancy, intrauterine death and major structural or chromosomal anomalies. Stepwise regression modeling was used to derive a prediction formula with birth weight as the dependent variable and maternal booking weight and fetal biometric measurements as independent parameters. After a new formula for estimated fetal weight (EFW) had been developed in a formula-finding group (n = 284), it was compared with commonly used weight equations (evaluation group, n = 140). RESULTS: The new formula (log(e)EFW = 7.6377445039 + 0.0002951035 x maternal weight + 0.0003949464 x head circumference + 0.0005241529 x abdominal circumference + 0.0048698624 x femur length) proved to be superior to established equations, with the smallest mean error (mean +/- SD, -10 +/- 202 g), the smallest mean percentage error (mean +/- SD, -0.03 +/- 4.6%) and the lowest mean absolute percentage error (3.69 (range, 0.05-13.57)%) when studied in the evaluation group. With the new formula, 77.9% of estimates fell within +/- 5% of the actual weight at birth, 97.1% within +/- 10%, and 100% within +/- 15% and +/- 20%. CONCLUSIONS: The new formula allows better weight estimation in the macrosomic fetus.

[Eye disease and mode of delivery]. / Geburtsmodus bei präexistenten Augenerkrankungen.

Many ophthalmologists and obstetricians recommend either an assisted vaginal delivery with forceps or vacuum extraction or a Caesarean section in cases of pre-existing eye diseases such as severe myopia, retinal detachment, diabetic retinopathy, or glaucoma. These recommendations, however, are not evidence-based. None of the published trials have reported any retinal changes after vaginal delivery. In general, eye disease is not an indication for an instrumental or operative delivery provided that regular eye examinations (once each trimester) have been performed.