MyMedR

Ultrasound and clinical predictors for Caesarean delivery after labour induction at term

Tan PC, Suguna S, Vallikkannu N, Hassan J

Aust N Z J Obstet Gynaecol, 2006 Dec;46(6):505-9.

To assess the relationship of ultrasound assessment for amniotic fluid, fetal weight, cervical length, cervical funneling and clinical factors on the risk of Caesarean delivery after labour induction at term.

Total perineal reconstruction after major obstetrical injuries with extensive tissue loss: a report of 2 cases

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.

Total parenteral nutrition (TPN) and steroid usage in the management of hyperemesis gravidarum

Subramaniam R, Soh EB, Dhillon HK, Abidin HZ

Aust N Z J Obstet Gynaecol, 1998 Aug;38(3):339-41.

PMID: 9761170

The use of the semen analysis in predicting fertility outcome

Arumugam K, Omar SZ

Aust N Z J Obstet Gynaecol, 1992 May;32(2):154-7.

PMID: 1520202

The study investigates the use of the various parameters of the semen analysis in predicting the fertility outcome in 82 infertile couples. The sperm density, % progressive motility, % normal morphology were divided into 'normal' and 'abnormal' based on the criteria proposed by WHO. The subsequent cumulative pregnancy rates were then calculated according to this criteria. A life-table method of analysis was used. All female related fertility factors were excluded. With the exception of a sperm density of less than 20 x 10(6) per ml the other parameters showed no significant correlation with the cumulative pregnancy rates at 12 months or 24 months respectively. We concluded that the semen analysis does not predict the probable outcome of the subsequent rates even when female fertility related factors were excluded apart from a sperm density less than 20 x 10(6) per ml.

The role of transvaginal sonography in the diagnosis of placenta praevia

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.

The prevalence and significance of high-risk human papillomavirus DNA test in southern Malaysia and Singapore

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.

The absence of factor V Leiden mutation in Malays with recurrent spontaneous abortions

Yusoff NM, Abdullah WZ, Ghazali S, Othman MS, Baba AA, Abdullah N, et al.

Aust N Z J Obstet Gynaecol, 2002 May;42(2):164-6.

PMID: 12069143 DOI: 10.1111/j.0004-8666.2002.00164.x

OBJECTIVES: The objectives of this study were to investigate the prevalence of factor V Leiden mutation in Malay women with recurrent spontaneous abortion and to clarify the contribution of the factor V Leiden mutation to recurrent miscarriages in these women.

DESIGN: A prospective case control study between June 1999 and April 2000.

SETTING: Hospital University Science of Malaysia, Kubang Kerian, Kelantan, and Maternal and Child Health Clinic, Pasir Mas, Kelantan, Malaysia.

SAMPLES: A total of 46 Malay women with a history of three or more first or second trimester miscarriages were studied. The control group consisted of 46 parous women without obstetric complications.

METHODS: Diagnosis of factor V Leiden mutation was made by examination of factor V Leiden allele product following Mnl I digestion of factor V Leiden alleles amplified by polymerase chain reaction.

RESULTS: None of the 46 women with recurrent spontaneous abortion carried the mutation. Also, we found no subject carrying the factor V Leiden alleles in the control group.

CONCLUSION: These results suggest that that there is no association between the factor V Leiden mutation and recurrent spontaneous abortion in the Malay population.

The Vabra aspirator versus the Pipelle device for outpatient endometrial sampling

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.

Term viable abdominal pregnancy: a case report and review

Vela V, Teo J

Aust N Z J Obstet Gynaecol, 2001 Aug;41(3):344-5.

PMID: 11592558 DOI: 10.1111/j.1479-828x.2001.tb01245.x

Temperature drop in normal term newborn infants born at the University Hospital, Kuala Lumpur

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.

Severe anaemia in pregnancy (as seen in Kuala Lumpur, Malaysia)

Llewellynjones D

Aust N Z J Obstet Gynaecol, 1965 Nov;5(4):191-7.

PMID: 5215888

Screening for gestational diabetes at antenatal booking in a Malaysian university hospital: the role of risk factors and threshold value for the 50-g glucose challenge test

Tan PC, Ling LP, Omar SZ

Aust N Z J Obstet Gynaecol, 2007 Jun;47(3):191-7.

PMID: 17550485 DOI: 10.1111/j.1479-828X.2007.00717.x

Background: The best method of screening for gestational diabetes (GDM) remains unsettled. The 50-g glucose challenge test (GCT) is used in a two-stage screening process but its best threshold value can vary according to population.

Aims: To evaluate the role of risk factors in conjunction with GCT and to determine an appropriate threshold for the one-hour venous plasma glucose with the GCT.

Method: In a prospective study, 1600 women at antenatal booking without a history of diabetes mellitus or GDM filled a form on risk factors before GCT. Women who had GCT >or= 7.2 mmol/L underwent the 75-g oral glucose tolerance test (OGTT). GDM was diagnosed according to WHO (1999) criteria.

Result: Thirty-five per cent had GCT >or= 7.2 mmol/L, 32.6% underwent OGTT and 34.5% of OGTT confirmed GDM. The GDM rate in our population was at least 11.4%. Examination of the receiver operator characteristic curve suggested that the best threshold value for the GCT in our population was >or= 7.6 mmol/L. Multivariable logistic regression demonstrated that only GCT >or= 7.6 mmol/L was an independent predictor for GDM (adjusted odds ratio 3.7: P < 0.001). After GCT, maternal age and anthropometry, OGTT during the third trimester, family history, obstetric history and glycosuria were not independent predictors of GDM.

Conclusions: Risk factors were not independent predictors of GDM in women with GCT >or= 7.2 mmol/L. GCT threshold value >or= 7.6 mmol is appropriate for the Malaysian population at high risk of GDM.

Scar endometriosis presenting as an acute abdomen: a case report

Khoo JJ

Aust N Z J Obstet Gynaecol, 2003 Apr;43(2):164-5.

PMID: 14712976

Rupture of the pregnant uterus--a 21-year review

Rachagan SP, Raman S, Balasundram G, Balakrishnan S

Aust N Z J Obstet Gynaecol, 1991 Feb;31(1):37-40.

PMID: 1872771

Uterine rupture is still a common problem in developing countries although even here the incidence varies from urban to rural settings. This article is a review of uterine rupture in an urban referral hospital in Malaysia. It examines aetiology, clinical presentation, complications and management of the problem. Meticulous screening of patients together with optimal antenatal and intrapartum care will markedly reduce the incidence of uterine rupture. Early diagnosis and prompt treatment will further help reduce morbidity and mortality to both mother and fetus.

Recurrent hydatidiform mole: a report of a patient with 7 consecutive moles

Thavarasah AS, Kanagalingam S

Aust N Z J Obstet Gynaecol, 1988 Aug;28(3):233-5.

PMID: 3233084

A rare case of hydatidiform mole occurring 7 consecutive times in a Chinese woman is presented. She was first seen in 1979 at the age of 23 years, with a molar pregnancy and subsequently had 6 consecutive moles, the last being in July, 1986; at this visit the patient and her husband were very depressed, and convinced that a normal pregnancy was unlikely and requested a hysterectomy. They were warned earlier several times, of the possible long-term consequences of a recurrent mole and that their chance of having a normal baby was very remote. A total hysterectomy was performed at her last presentation as the patient requested one, instead of dilatation and curettage for a persistently high HCG and bulky uterus following suction evacuation. Histology revealed an invasive mole. The beta HCG level was less than 4IU/l by the end of September, 1986 and she is still being followed-up.

Readmission risk and metabolic, biochemical, haematological and clinical indicators of severity in hyperemesis gravidarum

Tan PC, Jacob R, Quek KF, Omar SZ

Aust N Z J Obstet Gynaecol, 2006 Oct;46(5):446-50.

PMID: 16953861

In a retrospective analysis of 192 cases of presumed hyperemesis gravidarum, there were no biochemical markers that predicted hospital readmission. There was, however, statistically significant negative predictive value in abnormal liver function tests. This could represent acute self-limited illness with a component of hepatitis as the cause for the clinical presentation, rather than hyperemesis.

Prenatal detection of birth defects in a Malaysian population: estimation of the influence of termination of pregnancy on birth prevalence in a developing country

Ho JJ, Thong MK, Nurani NK

Aust N Z J Obstet Gynaecol, 2006 Feb;46(1):55-7.

PMID: 16441696

We studied 253 women with a pregnancy complicated by a birth defect and 506 controls to determine the frequency and type of prenatal tests and the types of defects detected antenatally. Most women had at least one ultrasound examination, but the frequency of other screening tests was low. Only 38 (15%) of defects were detected antenatally (37 by ultrasound). Birth prevalence is unlikely to be affected by pregnancy termination.

Physiological weight changes in pregnancy in Malaysian women

Sinnathuray TA, Wong WP

Aust N Z J Obstet Gynaecol, 1972 May;12(2):122-5.

PMID: 4509097

Pelvic lymph node metastases in early invasive carcinoma of the cervix--histopathological 'risk' factors

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.

Pelvic floor ultrasound findings in Ugandan women with obstetric fistula, unrepaired fourth degree obstetric tear, and pelvic organ prolapse

Krause HG, Wong V, Ng SK, Tan GI, Goh JTW

Aust N Z J Obstet Gynaecol, 2019 08;59(4):585-589.

PMID: 31146301 DOI: 10.1111/ajo.12990

BACKGROUND: While pelvic floor ultrasound is commonly utilised in high-resource locations, our understanding of pelvic floor characteristics in women suffering with obstetric fistula and unrepaired fourth degree obstetric tears in low-resource areas is limited.

AIMS: This study aimed to assess the pelvic floor ultrasound characteristics of Ugandan women suffering with obstetric fistula, unrepaired fourth degree obstetric tears and pelvic organ prolapse, and determine whether obstructed labour resulting in obstetric fistula causes more levator muscle defects compared to parous women without a history of obstructed labour.

MATERIALS AND METHODS: This was a prospective study in western Uganda assessing 82 women with obstetric fistula, unrepaired fourth degree obstetric tears and pelvic organ prolapse with a pelvic floor ultrasound scan.

RESULTS: Demographic characteristics were significantly different, with women suffering pelvic organ prolapse being older and more parous. Hiatal area on Valsalva was significantly smaller in the obstetric fistula group (mean 21.45 cm2 ) compared to non-obstetric fistula group (unrepaired fourth degree obstetric tears and pelvic organ prolapse; mean 30.44 cm2 ); a mean difference of 9.0 cm2 (95% CI: 5.4-12.6 cm2 , P

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