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Fulltext Maternal satisfaction towards intrapartum care of designated healthcare facilities and its associated factors among postnatal women attending Klinik Kesihatan Salak

Fadzilah Mohamad, Ping Yein Lee, , Maliza Mawardi

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):164-172.
MyJurnal

Introduction: The World Health Organization recommends evaluation of maternal satisfaction to improve quality of health care during childbirth. Dissatisfaction may lead to undesired outcomes such as unassisted homebirth and delay in seeking treatment. Determining the maternal satisfaction level and its associated factors may help to improve health care services and prevent negative implications to both mothers and infants. This study aimed to determine the maternal satisfaction towards intrapartum care of designated healthcare facilities and its associated factors among postnatal women. Methods: This was a cross-sectional study of postnatal women attended Klinik Kesihatan Salak from December 2017 to February 2018. Systematic random sampling with the ratio of 1:3 was applied to the eligible respondents. A self-administered questionnaire that include respondent’s socio-demographic characteristics and a validated 14-items Maternal Satisfaction with Hospital-based Intrapartum Care Scale was used. Data was analyzed using SPSS 23. Results: 274 respondents were recruited in this study. Overall, only 21.2% of respondents were sat- isfied with the intrapartum care given. The level of satisfaction was highest in interpersonal care domain (36.1%), followed by physical birth environment (34.3%) and the least satisfied was information and decision making domain (27.7%). Binary logistic regression showed that maternal satisfaction was significantly associated with place of birth (AOR (95% CI): 0.046 (0.183, 0.984)) and labour complications (AOR (95% CI): 3.387 (1.345, 8.528)). Conclusion: The overall maternal satisfaction towards intrapartum care was low and the information and decision-making do- main appeared to be the least satisfied. Maternal satisfaction was associated with place of birth and labour compli- cations. Therefore, health care providers should emphasize and improve the quality of services especially for this domain and to consider factor that contribute to dissatisfaction towards the intrapartum care.

Matched MeSH terms: Labor, Obstetric
Fulltext Maternal and foetal outcomes following natural vaginal versus caesarean section (c-section) delivery in women with bleeding disorders and carriers

Karanth L, Abas AB

Cochrane Database Syst Rev, 2021 Dec 09;12(12):CD011059.
PMID: 34881425 DOI: 10.1002/14651858.CD011059.pub4

BACKGROUND: Bleeding disorders are uncommon but may pose significant bleeding complications during pregnancy, labour and following delivery for both the woman and the foetus. While many bleeding disorders in women tend to improve in pregnancy, thus decreasing the haemorrhagic risk to the mother at the time of delivery, some do not correct or return quite quickly to their pre-pregnancy levels in the postpartum period. Therefore, specific measures to prevent maternal bleeding and foetal complications during childbirth, are required. The safest method of delivery to reduce morbidity and mortality in these women is controversial. This is an update of a previously published review.
OBJECTIVES: To assess the optimal mode of delivery in women with, or carriers of, bleeding disorders.
SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Coagulopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the Cochrane Pregnancy and Childbirth Group's Trials Register as well as trials registries and the reference lists of relevant articles and reviews. Date of last search of the Group's Trials Registers: 21 June 2021.
SELECTION CRITERIA: Randomised controlled trials and quasi-randomised controlled clinical trials investigating the optimal mode of delivery in women with, or carriers of, any type of bleeding disorder during pregnancy were eligible for the review.
DATA COLLECTION AND ANALYSIS: No trials matching the selection criteria were eligible for inclusion.
MAIN RESULTS: No trials matching the selection criteria were eligible for inclusion.
AUTHORS' CONCLUSIONS: The review did not identify any randomised controlled trials investigating the safest mode of delivery and associated maternal and foetal complications during delivery in women with, or carriers of, a bleeding disorder. In the absence of high quality evidence, clinicians need to use their clinical judgement and lower level evidence (e.g. from observational trials, case studies) to decide upon the optimal mode of delivery to ensure the safety of both mother and foetus. Given the ethical considerations, the rarity of the disorders and the low incidence of both maternal and foetal complications, future randomised controlled trials to find the optimal mode of delivery in this population are unlikely to be carried out. Other high quality controlled studies (such as risk allocation designs, sequential design, and parallel cohort design) are needed to investigate the risks and benefits of natural vaginal and caesarean section in this population or extrapolation from other clinical conditions that incur a haemorrhagic risk to the baby, such as platelet alloimmunisation.

Matched MeSH terms: Labor, Obstetric*
Fulltext Mistreatment of Women during Childbirth and Associated Factors in Northern West Bank, Palestine

Dwekat IMM, Ismail TAT, Ibrahim MI, Ghrayeb F, Abbas E

Int J Environ Res Public Health, 2022 Oct 13;19(20).
PMID: 36293759 DOI: 10.3390/ijerph192013180

Mistreatment of women during childbirth is a clear breach of women's rights during childbirth. This study aimed to determine the prevalence and associated factors of mistreatment of women during childbirth in the north of West Bank, Palestine. A cross-sectional study was conducted among 269 women within the first 16 weeks of their last vaginal childbirth to understand the childbirth events by using proportionate stratified random sampling. An Arabic valid questionnaire was used as a study instrument. Simple and multiple logistic regression analyses were conducted to determine the factors associated with each type of mistreatment. The mean age of the women was 26.5 (SD 4.77) years. The overall prevalence of mistreatment was 97.8%. There were six types of mistreatment. Nine factors were significantly associated with the occurrence of one or more types of mistreatment. Delivery at a public childbirth facility was associated with all of the six types (aAdjOR: 2.17-16.77; p-values < 0.001-0.013). Women who lived in villages (aAdjOR 2.33; p-value = 0.047), had low education (aAdjOR 5.09; p-value = 0.004), underwent induction of labour (aAdjOR 3.03; p-value = 0.001), had a long duration of labour (aAdjOR 1.10; p-value = 0.011), did not receive pain killers (aAdjOR: 2.18-3.63; p-values = 0.010-0.020), or had an episiotomy or tear (aAdjOR 5.98; p-value < 0.001) were more likely to experience one or more types of mistreatment. With every one-hour increase in the duration of labor, women were 1.099 times more likely to experience a failure to meet the professional standard of care. Women were less likely to experience mistreatment with increasing age. Women with increasing age (aAdjOR: 0.91-0.92; p-values = 0.003-0.014) and parity (aAdjOR 0.72; p-value = 0.010) were less likely to experience mistreatment. Awareness of women's fundamental rights during childbirth, making the childbirth process as normal as possible, and improving the childbirth facilities' conditions, policies, practices and working environment may decrease mistreatment occurrence.

Matched MeSH terms: Labor, Obstetric*
Fulltext Acceptability of epidural analgesia for pain relief during labour among Kelantanese women

Sharma S, Mohamad NA, Monga D, Achana S

Med J Malaysia, 1996 Dec;51(4):453-6.
PMID: 10968033

Three hundred and five primigravid women were interviewed at term to assess the acceptability of epidural during labour, and reasons for the decisions. Data was collected on a prestructured proforma which consisted of background information, socio-economic status, knowledge about epidural analgesia, source of information and reasons for choice. Of the 305 patients only 17.3% were willing to receive epidural analgesia. This group consisted of 56.6% non-Malay women. Those employed in professional or skilled jobs (56.6%) also readily consented for epidural. Nearly half the women willing for epidural had received college (tertiary) education (43.3%) and more than a quarter (26.4%) were over 30 years of age. The majority of those who were unwilling had no prior knowledge about the procedure, and refused either out of fear, ignorance, resistance from husbands, on religious grounds or following poor feedback from friends. In order to advocate epidural analgesia, knowledge has to be targeted to the relatively less educated, unemployed women, mainly through the media or personally in the antenatal clinic by doctors and nurses. Services have to be improved as substandard analgesia may send out wrong messages and actually do more harm than good.

Matched MeSH terms: Labor, Obstetric*
Fulltext Comparison of Pregnancy Outcome between 4 and 6 cm Cervical os Dilatation to Demarcate Active Phase of Labour: A Cross-Sectional Study

Mohd Fathil N, Abd Rahman R, Mohd Nawi A, Kamisan Atan I, Kalok AH, Mohamed Ismail NA, et al.

J Pregnancy, 2023;2023:8243058.
PMID: 37404975 DOI: 10.1155/2023/8243058

This is a cross-sectional study comparing pregnancy outcomes between participants with 4 and 6 cm of cervical os dilatation at the diagnosis of the active phase of labour. It was conducted in a single tertiary centre involving low-risk singleton pregnancies at or beyond 37 weeks with spontaneous onset of labour. A total of 155 participants were recruited, 101 in group 1 (4 cm) and 54 in group 2 (6 cm). Both groups were similar in mean maternal age, mean gestational age at delivery, ethnicity, median haemoglobin level at delivery, body mass index, and parity. There were significantly more participants in group 1 who needed oxytocin augmentation (p < 0.001) for the longer mean duration (p = 0.015), use of analgesia (p < 0.001), and caesarean section rate (p = 0.002). None of the women had a postpartum haemorrhage or a third- or fourth-degree perineal tear, and none of the neonates required admission to the neonatal intensive care unit. There were significantly more nulliparas who had a caesarean section as compared to multiparas. A cervical os dilatation of 6 cm reduces the risk of caesarean section by 11% (95% CI, 0.01-0.9) and increases three times more the need for analgesia (AOR = 3.44, 95% CI, 1.2-9.4). In conclusion, the demarcation of the active phase of labour at a cervical os dilatation of 6 cm is feasible without an increase in maternal or neonatal complications.

Matched MeSH terms: Labor, Obstetric*
Onset of labour

Chong HL, Ong HC, Ang LT

Med J Malaysia, 1974 Sep;29(1):44-53.
PMID: 4282630
Matched MeSH terms: Labor, Obstetric*
Fulltext Maternal and cord folate and vit.B12 levels in Malaysians at parturition

Ali J, Hassan K, Arshat H

Med J Malaysia, 1982 Jun;37(2):160-4.
PMID: 6890140

Folate and vitamin B 12 status in pregnancy was studied in a group of 190 Malaysian mothers belonging to the three major ethnic origins. Cord blood was also analysed for the same vitamins. Ethnic variations with regard to deficiency in these two vitamins was determined. About 58.5 percent of the pregnant mothers suffered from lowered serum folate levels and 32.4 percent had lowered RBC folate levels. In contrast vitamin B 12 levels were within normal limits. Cord blood levels of these vitamins were significantly higher than. the corresponding levels in the maternal blood, suggesting the possible involvement of an active process in the transfer of folates and vitamin B 12 to the fetus.

Matched MeSH terms: Labor, Obstetric*
Some impressions of childbearing in tropical areas. II. Pre-eclampsia and low birthweight

Thompson B, Baird D

J Obstet Gynaecol Br Commonw, 1967 Aug;74(4):499-509.
PMID: 6033270
Matched MeSH terms: Labor, Obstetric
Some impressions of childbearing in tropical areas. 3. Outcome of labour

Thompson B, Baird D

J Obstet Gynaecol Br Commonw, 1967 Aug;74(4):510-22.
PMID: 6033271
Matched MeSH terms: Labor, Obstetric*
Epidural analgesia in primigravidae in spontaneous labour at term: a prospective study

Leong EW, Sivanesaratnam V, Oh LL, Chan YK

J Obstet Gynaecol Res, 2000 Aug;26(4):271-5.
PMID: 11049237

OBJECTIVES: To prospectively study the intervention rate, duration of labour, malpositions, fetal outcome, maternal satisfaction, voiding complications and adverse events in healthy primigravidae in spontaneous labour at term following epidural analgesia.
METHODS: A prospective randomized study involving 55 patients in the epidural group and 68 in the control pethidine--inhalational entonox group.
RESULTS: There were significantly more obstetric interventions (instrumental deliveries) in the epidural group (p < 0.01). The total duration of labour and the duration of the second stage was prolonged in the epidural group (p < 0.01). There were more malpositions at the second stage of labour in the epidural group (p < 0.02). There were no differences in fetal outcome (Apgar scores and Special Care Nursery admissions). Patients in the epidural group were consistently happier with their method of pain relief (p < 0.01). Two patients required blood patches while another 2 patients had persistent backache post epidural analgesia.
CONCLUSION: Epidural analgesia in primigravidae in spontaneous labour at term led to an increased instrumental delivery rate, prolonged duration of labour, greater rate of malpositions in the second stage, increased oxytocin requirements but with no difference in fetal outcomes but with happier mothers as compared to the control group.

Matched MeSH terms: Labor, Obstetric/physiology*
Dexamethasone modulation of gestation length and parturition in rats

Chatterjee A, Singh R, Chatterjee R

Pharmacol Res, 1993 May-Jun;27(4):359-64.
PMID: 8367382

Dexamethasone blocks aromatase and phospholipase A2 enzyme activities that are essentially involved in the formation of oestrogens and prostaglandins, the key chemicals to initiate parturition. The present study was undertaken to determine whether dexamethasone, a potent glucocorticoid, could prolong gestation and/or delay parturition in rats. Dexamethasone at 0.5 mg/rat/day from Day 19 through Day 21 of pregnancy consistently prolonged gestation. Only 36% of the pregnant rats had labour with an extended parturition time. Foetal mortality rate was also high. The remaining 64% pregnant rats that did not deliver showed intrauterine foetal death and resorption. Concomitant injection of oestradiol cyclopentylpropionate or prostaglandin F2 alpha on Day 19 effectively reversed the deleterious effects of dexamethasone. 100% of the pregnant rats had successful labour at term. The parturition time and foetal mortality rate were not different from controls. The results, therefore, indicate that an excess glucocorticoid that initiates parturition in sheep conversely prolongs gestation and delays parturition in rats.

Matched MeSH terms: Labor, Obstetric/drug effects
An analysis of customs related to childbirth in rural Malay culture

Chen PC

Trop Geogr Med, 1973 Jun;25(2):197-204.
PMID: 4717277
Matched MeSH terms: Labor, Obstetric*
Mother’s mental preparedness for pregnancy : The affecting factors and its effect on birth outcomes

Sharifah Sulaiha Syed Aznal, Chee Yoong Wong, Pamela Lee Ling Tan, Vee Vee See, Chui King Wong

International e-Journal of Science, Medicine & Education, 2014;8(3):19-27.
MyJurnal

Background: Increased maternal anxiety level has been reported to have detrimental effects on the physical outcome of pregnancies such as not achieving vaginal births. This study thus aims to determine the level and factors affecting mental preparedness among mothers with normal pregnancies and its correlation with birth outcomes.

Methods: Three hundred healthy mothers above 37 weeks of gestation in the early stage of labour were assessed for their level of mental preparation before birth process and outcomes after births which include general feeling (euphoria), ability to withstand labour pain and bonding with the new born. The successfulness of vaginal birth and other data on factors affecting mental preparation were also collected.

Results: The level of mental preparedness was found good in 78% of the mothers, mainly determined by their socioeconomic status, family support and personal ability to adjust to changes. Age (p= 0.048), parity (0.00) and income (0.01) were found to influence mental preparedness significantly. Race, occupation, education level and marital status are however not significantly related. Poor mental preparedness is associated with greater pain during labour. A correlation analysis also found a positive relationship between the level of mental preparation and mental outcomes following birth in these mothers but it did not significantly influence the mode of delivery.

Conclusion: Mental preparation before birth seems to have an effect on mental outcomes of mothers following birth process. It is vital that mothers of the younger age group with no previous obstetric experience be given more attention in preparing them mentally before they face the painful birth process.

Matched MeSH terms: Labor, Obstetric
Fulltext Placental histopathological changes in COVID-19 in term patients admitted to labor and delivery

Ahmad MFB, Das S

Am J Obstet Gynecol, 2021 09;225(3):353-354.
PMID: 34062121 DOI: 10.1016/j.ajog.2021.05.040
Matched MeSH terms: Labor, Obstetric*
Spontaneous rupture of renal angiomyolipoma in pregnancy mimicking preterm labour

Basri NI, Dasrilsyah RA

BMJ Case Rep, 2024 Feb 06;17(2).
PMID: 38320830 DOI: 10.1136/bcr-2023-258979

Ruptured renal angiomyolipoma in pregnancy is uncommon. Pregnant women may present with nonspecific symptoms such as flank or abdominal pain, contraction pain and haematuria. A thorough assessment is needed to reach the correct diagnosis. Management varies between conservative measures, radiological intervention or surgery depending on the patient's haemodynamic status and foetal condition. We present a case of a woman in her 30s, gravida 5 para 3+1 at 28 weeks of gestation, who presented with pain. The pain worsened, and she went into hypovolaemic shock. An exploratory laparotomy and emergency caesarean section were done. Retroperitoneal haematoma was found intraoperatively, but the source of bleeding was difficult to determine. An abdominal CT angiogram subsequently revealed an ongoing bleeding from a ruptured angiomyolipoma. An emergency nephrectomy was performed, and the bleeding was secured.

Matched MeSH terms: Labor, Obstetric*
Fulltext Understanding Myths in Pregnancy and Childbirth and the Potential Adverse Consequences: A Systematic Review

Ahmad N, Nor SFS, Daud F

Malays J Med Sci, 2019 Jul;26(4):17-27.
PMID: 31496890 MyJurnal DOI: 10.21315/mjms2019.26.4.3

The trend of choosing natural birth at home without proper supervision is gaining more attention and popularity in Malaysia. This is partly due to wrong beliefs of modern medical care. It prompts the need to explore further into other myths and wrong beliefs present in communities around the world surrounding pregnancy and childbirth that may lead to harmful consequences. A total of 25 literatures were selected and reviewed. The most reported wrong belief is the eating behaviour such as avoiding certain nutritious fruits besides eating saffron to produce fairer skinned babies which in fact contains high doses of saffron that may lead to miscarriage. The most worrying myth however, is that unregulated birth attendants such as doulas have the necessary knowledge and skills to manage complications in labour which may well end up in perinatal or even maternal death. Other myths suggested that modern medical care such as vaginal examinations and baby's heart monitoring in labour as unnecessary. A well-enforced health education programme by well-trained healthcare personnel besides sufficient number of antenatal care visits are needed to overcome these myths, wrong beliefs and practices. In conclusion, potential harmful beliefs and practices in pregnancy and childbirth are still abound in today's communities, not just in least developed and developing countries but also in developed countries. Women and children are two very vulnerable groups, therefore debunking myths and eliminating harmful practices should be one of a healthcare provider priority especially those in the primary care settings as they are the closest to the community.

Matched MeSH terms: Labor, Obstetric
The normal third stage of labour

English JS

Malayan Medical Journal, 1929;4:147-8.

Matched MeSH terms: Labor, Obstetric
Oral prostaglandin e2 and amniotomy for induction of labour

Adeeb N, Fong TN

Med J Malaysia, 1974 Jun;28(4):263-6.
PMID: 4278401
Matched MeSH terms: Labor, Obstetric/drug effects
Fulltext The Effect Of 5 Units Oxytocin Preparation In The Augmentation Of Labour – Is It Cost Effective?

Roszaman Ramli, Ghazali Ismail

International Medical Journal Malaysia, 2006;5(1):1-8.
MyJurnal

Objectives: To evaluate the cost-effectiveness of the new oxytocin regimes in the augmentation of labour and the effect on the maternal and fetal outcome. Design: Randomized controlled trial. Setting: Labour ward of Hospital Tengku Ampuan Afzan, Kuantan. Participants: 230 pregnant women in labour at term with obstetric indications for labour augmentation. Methods: The women were randomly assigned to receive new oxytocin regime of 5 units in 500 cc of D/Saline at titration of 5 dpm with increments of 5 dpm to a maximum of 60 dpm. Or, old oxytocin regime of 1/2/4 units with titration of 20/40/60 dpm for primips and half the dosage for multips.
Main outcome measures: Cost analysis, duration of labour, duration of augmentation, complication of labour, post partum hemorrhage (PPH), mode of delivery and perinatal outcome.
Results: There was no significant difference in the mean duration of labour (6.8 h vs 6.7 h ; p = 0.45) and mean augmentation time (3.86 h vs 4.0 h; p = 0.9) between the regimes studied There seemed to be higher incidence of caesarean section in the old oxytocin group (6.5% vs 24.7%; p = 0.001). There was no significant influence on the neonatal morbidity and mortality (p = 0.07). A moderate reduction of annual cost for augmentation of labour was noted (RM 962.34).
Conclusion: The results showed that the new oxytocin regime was more cost-effective without apparent increased in the maternal and fetal mortality and morbidity.

Matched MeSH terms: Labor, Obstetric
Fulltext Analgesia and Anaesthesia Management of Labour and Caesarean Delivery for a Parturient with Paramyotonia Congenita

Najid NM, Razak TA, Günaydın DB

Turk J Anaesthesiol Reanim, 2019 Aug;47(4):345-347.
PMID: 31380517 DOI: 10.5152/TJAR.2019.69094

Anaesthetic management in paramyotonia congenita (PC) or 'paradoxical myotonia' poses perioperative challenges to the anaesthesiologists both in obstetric and non-obstetric surgical patients. There are only a few case reports on the anaesthesia management particularly in the obstetric population. Therefore, we aimed to present the management of analgesia of labour and emergency caesarean delivery for a 26-year-old parturient with PC.

Matched MeSH terms: Labor, Obstetric

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