Displaying publications 1 - 20 of 52 in total

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  1. Raman S, Urquhart R, Yusof M
    Aust N Z J Obstet Gynaecol, 1992 Aug;32(3):196-9.
    PMID: 1445124
    A prospective study was carried out on 50 patients who had their fetal weight estimated by 3 clinicians of different seniority and compared to the ultrasound estimated fetal weights using 3 different formulas. All the patients delivered within 24 hours of their clinical and ultrasound estimates. A wide range of birth-weights (1,800-4,500 g) was estimated among the 3 different races (Malay, Chinese and Indians). The results showed that there was no significant difference in birth-weight estimation amongst the 3 clinicians as well as between the 3 ultrasound formulas used. There was however significant difference between these 2 groups when compared with the actual birthweight with clinical estimation being superior to ultrasound estimation in our population. This level of significance did not extend beyond 4,000 g fetal weight (actual) thus making both clinical and ultrasound estimation of fetal weight equally accurate after 4,000 g. This has important implications for developing countries where there is a lack of technologically advanced ultrasound machines capable of doing sophisticated functions like fetal weight estimations but has experienced clinicians who could perform this function equally well if not better.
  2. Lin S, Atan IK, Dietz HP, Herbison P, Wilson PD
    Aust N Z J Obstet Gynaecol, 2019 08;59(4):590-596.
    PMID: 30793279 DOI: 10.1111/ajo.12948
    BACKGROUND: Levator ani muscle (LAM) and anal sphincter injuries are common after vaginal birth and are associated with pelvic organ prolapse and anal incontinence.

    AIMS: Our objective was to investigate long-term association between delivery mode, LAM avulsion and obstetric anal sphincter injuries (OASIS) in women at least 20 years after their first birth.

    METHODS: All women recruited at 'index birth' of the Dunedin (New Zealand) arm of ProLong (PROlapse and incontinence LONG-term research) Study, were invited to have translabial and transperineal ultrasound assessment of LAM and anal sphincters. Post-processing analysis of imaging data was performed blinded against delivery data. Statistical analysis was performed using the χ2 test and results are expressed as odds ratios (OR).

    RESULTS: Of the initial 1250 participants, 196 women returned for examination. Mean age was 50.8 years with a mean body mass index of 27.6 and median parity was three. They were seen on average 23 years after their first delivery. Four data sets were unavailable and one declined ultrasound assessment, leaving 191 for analysis. LAM avulsion was diagnosed in 29 (15.2%), and 24 women (12.6%) had significant anal sphincter defect. LAM avulsion was associated with forceps delivery (OR 2.45, 95% CI 1.04-5.80, P = 0.041). Forceps conveyed a greater risk of OASIS (21%) compared to a spontaneous vaginal delivery (11%) but did not reach statistical significance.

    CONCLUSIONS: Forceps delivery is associated with long-term injurious effect on pelvic floor structures. Discussions of the long-term negative impact of pelvic floor structures and their functions are necessary to achieve an informed consent toward an operative vaginal delivery.

  3. Arumugam K, Templeton AA
    Aust N Z J Obstet Gynaecol, 1992 May;32(2):164-5.
    PMID: 1520204
    The pelvic findings of 202 infertile women undergoing diagnostic laparoscopy in Kuala Lumpur, Malaysia were compared to that of 464 infertile women undergoing diagnostic laparoscopy in Aberdeen, United Kingdom. Endometriosis was significantly more common in the women from Kuala Lumpur (51% against 22%, p less than 0.001). There was however no significant difference seen in the severity of the disease (AFS Classification, 1985). These findings confirm our clinical impression that endometriosis is more common in Asian women when compared to Caucasian women.
  4. Tay SK, Tay YK
    Aust N Z J Obstet Gynaecol, 2009 Jun;49(3):323-7.
    PMID: 19566569 DOI: 10.1111/j.1479-828X.2009.01000.x
    To investigate the prevalence of high-risk human papillomavirus (HPV) and its associated cytological abnormalities among women attending cervical screening clinics in southern Malaysia and Singapore.
  5. Tan NH, Abu M, Woo JL, Tahir HM
    Aust N Z J Obstet Gynaecol, 1995 Feb;35(1):42-5.
    PMID: 7771998 DOI: 10.1111/j.1479-828x.1995.tb01828.x
    Transvaginal sonography was performed in 70 patients diagnosed to have placenta praevia by transabdominal sonography. The diagnosis was confirmed either by digital examination in theatre at term or operative finding at delivery. Forty-nine cases (70%) were correctly diagnosed to have placenta praevia by both modes of sonography. Transvaginal sonography ruled out placenta praevia in 12 cases (17%) thought to be placenta praevia by transabdominal ultrasound. Both transabdominal and transvaginal sonography demonstrated 'placental migration' in 4 cases (6%) which were no longer praevia at delivery. Five patients (7%) were erroneously believed to have placenta praevia by both sonographic techniques. Overall, the diagnostic accuracy of transvaginal sonography was 92.8% compared with 75.7% for transabdominal sonography. None of the subjects experienced any exacerbation of bleeding or other complications. The results suggest that transvaginal sonographic localization of the placenta is safe and superior to the transabdominal route.
  6. Raman S, Samuel D, Suresh K
    Aust N Z J Obstet Gynaecol, 1991 Aug;31(3):217-20.
    PMID: 1804081
    In this study 24 patients who had conventional erect lateral X-ray pelvimetry had a CT pelvimetry done after delivery to complete the pelvimetry views. The erect lateral pelvimetry was read independently by a Consultant Radiologist, Consultant Obstetrician and a Medical Officer training in Obstetrics and Gynaecology. Using CT pelvimetry as the 'gold standard' (as the error of measurement was known with the machine used) the 3 readings were compared. There was no statistical difference in the values suggesting that X-ray pelvimetry is comparable to CT pelvimetry. However CT pelvimetry is preferred, if available, because of the lower dose of radiation involved, more comfort for the patient and shorter time in performing the procedure. Measurements done are easily read directly from the CT console.
  7. Lee SH, Cheah DS, Poopalarachagan S, Sivanesaratnam V
    Aust N Z J Obstet Gynaecol, 1991 Nov;31(4):372-5.
    PMID: 1799358
    Major perineal injuries following obstetrical complications represent difficult problems of reconstruction. We describe 2 such patients with perineal injuries simulating infantile cloacas. Surgical repair using an abdominoperineal pullthrough procedure in 1 patient, and a Bricker loop type of repair in another resulted in successful restoration of function in both. The operative details and basis for the reconstruction are described.
  8. Cheah SH, Sivanesaratnam V
    Aust N Z J Obstet Gynaecol, 1989 May;29(2):143-5.
    PMID: 2803125
    In this series the incidence of pregnancy in women in the reproductive age group admitted to hospital with burns was 7.8% (9 of 116). The maternal and perinatal outcome is related to the extent, presence or absence of complications of burns and to the gestational age of the fetus. Two maternal deaths in this series occurred in patients with burns involving more than 85% of the skin surface; in both instances stillbirths occurred less than 48 hours after the burns. In view of the high perinatal mortality, patients with extensive burns who are more than 32 weeks' pregnant should be delivered soon after admission. The extensively burned anterior abdominal wall can make assessment of uterine size difficult. An assessment in such a situation would be useful.
  9. Glew SS, Sivanesaratnam V
    Aust N Z J Obstet Gynaecol, 1989 Nov;29(4):450-1.
    PMID: 2631682
    Two cases of late second trimester extrauterine pregnancy are presented--intraabdominal pregnancy in one and an ampullary pregnancy in another. In the former the diagnosis was made only after attempts at induction of labour for fetal death with prostaglandins failed and in the latter only at laparotomy. The diagnostic and surgical problems encountered are discussed.
  10. Jayalakshmi P, Sivanesarathnam V
    Aust N Z J Obstet Gynaecol, 1991 Feb;31(1):87-9.
    PMID: 1872785
    Histopathological features in 89 cases of Stage 1B and early 2A invasive carcinoma of the cervix who underwent Wertheim radical hysterectomy and pelvic lymphadenectomy were studied. Depth of tumour invasion and lymphatic/vascular space permeation by tumour cells were significantly associated with lymph node metastases. The other features such as tumour type, and stromal leucocytic reaction showed no significant relationship to the presence of lymph node metastases.
  11. Goon MS, Raman S, Sinnathuray TA
    Aust N Z J Obstet Gynaecol, 1987 Aug;27(3):173-7.
    PMID: 3435354
    Our experience from 1968 to 1985 in 12 women requiring closed mitral valvotomy during pregnancy is reviewed. All patients had severe mitral stenosis and were in functional class 3 (2 patients) or class 4 (10 patients). Mitral valvotomy was performed between the 18th and the 30th week of pregnancy using a transventricular dilator. Improvement in functional class was noted in all patients postoperatively. One patient had postvalvotomy mitral regurgitation and heart failure, which responded to diuretics; the subsequent course was uneventful. Eleven patients had normal deliveries; whilst one patient had a Caesarean section for an obstetric indication. All babies were normal and there was no maternal death. This series confirms that closed mitral valvotomy can be performed with an acceptable degree of safety during pregnancy, when indicated.
  12. Raman S, Shahla A
    Aust N Z J Obstet Gynaecol, 1992 May;32(2):117-9.
    PMID: 1520194
    A prospective study of temperature drop in 141 normal term newborn infants delivered vaginally at the labour ward, University Hospital, Kuala Lumpur were studied. The effect of various manoeuvres on the temperature drop were also studied. They were randomized into 3 study groups, 63 cases where the babies were wiped with dry cloth alone, 37 cases where the babies were put into a plastic bag immediately after birth and lastly 41 cases where the babies were wiped with dry cloth and then inserted into a plastic bag. There was significant temperature drop in all the 3 groups maximum in the first 15 minutes and the fall continued for 1 hour after delivery (p less than 0.001). This shows that in an air-conditioned labour ward in a tropical country the temperature fall in newborn infants can be significant. This study also showed that plastic is a poor insulator against significant temperature drop.
  13. Naim NM, Mahdy ZA, Ahmad S, Razi ZR
    Aust N Z J Obstet Gynaecol, 2007 Apr;47(2):132-6.
    PMID: 17355303 DOI: 10.1111/j.1479-828X.2007.00699.x
    OBJECTIVE: To compare the effectiveness of the Vabra aspirator and the Pipelle device as an outpatient endometrial assessment tool.
    METHOD: This was a randomised, prospective trial conducted for a period of one year.
    RESULTS: A total of 147 patients were recruited, of which 71 were in the Vabra group and 76 were in the Pipelle arm. The procedure success rate in the Pipelle group was significantly higher than the Vabra arm (98.7 vs 88.7%, P=0.02). Adequate tissue yield was also significantly more in the Pipelle arm (73.3 vs 52.4%, P=0.02). Cost-benefit analysis revealed a higher average cost per patient in the Vabra group compared to the Pipelle arm.
    CONCLUSION: This study proved that the Vabra aspirator was not as effective as the Pipelle device in obtaining endometrial tissue for histological diagnosis. Despite its higher price per unit, the Pipelle device was a more cost-effective tool for outpatient endometrial assessment.
    Study site: Medical clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia.
  14. Oei PL, Ratnam SS
    Aust N Z J Obstet Gynaecol, 1998 May;38(2):141-4.
    PMID: 9653846
    The sales data of oestrogen replacement products for 8 developing countries from 1993 to 1995 were analyzed. The data from Malaysia, Pakistan, Taiwan, Thailand, Indonesia, Philippines and South Korea showed the increasing use of oestrogen replacement products. The total usage however varied widely, from only US$11,153 (Philippines in 1993) to as much as US$6,306,717 (Taiwan in 1995). In Singapore, where oestrogen replacement is an accepted and established form of therapy for the postmenopausal woman, there has been an increase in the usage of the nonoestrogen replacement products. There are multiple reasons for the increasing sales of hormone replacement products in the developing countries and these are explored in this article. In some of the developing countries, for example China and India, hormone replacement therapy has just been introduced. However, in those developing countries in which hormone replacement therapy is already available, sales figures show increasing usage. The future augurs well for hormone replacement therapy.
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