MyMedR

Fulltext [Combined spinal-epidural analgesia in labour: its effects on delivery outcome]

Singh SK, Yahya N, Misiran K, Masdar A, Nor NM, Yee LC

Rev Bras Anestesiol, 2016 May-Jun;66(3):259-64.

PMID: 26993410 DOI: 10.1016/j.bjan.2014.09.009

Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome.

Matched MeSH terms: Labor, Obstetric

Fulltext Understanding the decision-delivery interval in cesarean births

Naseem, Rashid, Nalliah, Sivalingam

International e-Journal of Science, Medicine & Education, 2007;1(2):61-68.

MyJurnal

Avoiding the adverse neonatal effects of perinatal asphyxia has been one of the common indications for cesarean deliveries in current obstetric practice. Expeditious delivery is dependent on decision to perform cesarean delivery and time lines achieved. A decision-delivery interval of 30 minutes, a concept initiated by the American College of Obstetricians and Gynecologists has open to debate as controversy reins about neonatal outcome when this time interval is considered in isolation. Time lines alone are probably not the only criteria to be employed, and may contribute to errors in interpretation by professional regulatory bodies and the society at large. Procedures prior to decision making like trial of labour, fetal scalp sampling and readily available resources for instituting emergent cesarean delivery invariably need to be considered. Though decision to delivery time is an integral component of critical conduct intervals in the acutely compromised fetus, a more pragmatic approach needs to be taken considering potential and known logistical and obstetric factors in line with good obstetric practice.

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

Fulltext Towards better perinatal health

Ong HC

Med J Malaysia, 1983 Sep;38(3):176-7.

PMID: 6672555

Matched MeSH terms: Labor, Obstetric

Fulltext Threats by artificial intelligence to human health and human existence

Federspiel F, Mitchell R, Asokan A, Umana C, McCoy D

BMJ Glob Health, 2023 May;8(5).

PMID: 37160371 DOI: 10.1136/bmjgh-2022-010435

While artificial intelligence (AI) offers promising solutions in healthcare, it also poses a number of threats to human health and well-being via social, political, economic and security-related determinants of health. We describe three such main ways misused narrow AI serves as a threat to human health: through increasing opportunities for control and manipulation of people; enhancing and dehumanising lethal weapon capacity and by rendering human labour increasingly obsolescent. We then examine self-improving 'artificial general intelligence' (AGI) and how this could pose an existential threat to humanity itself. Finally, we discuss the critical need for effective regulation, including the prohibition of certain types and applications of AI, and echo calls for a moratorium on the development of self-improving AGI. We ask the medical and public health community to engage in evidence-based advocacy for safe AI, rooted in the precautionary principle.

Matched MeSH terms: Labor, Obstetric*

The surgical induction of labour

LLEWELLYN-JONES D

Med J Malaya, 1958 Sep;13(1):80-5.

PMID: 13589375

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

The Effectiveness of Hypnosis Intervention for Labor: An Experimental Study

Beevi Z, Low WY, Hassan J

Am J Clin Hypn, 2017 Oct;60(2):172-191.

PMID: 28891771 DOI: 10.1080/00029157.2017.1280659

Hypnosis has been shown to help pregnant women experience improved labor and postpartum periods. The present study compares the differences between experimental (n = 23) and control groups (n = 22) on specific variables measured both during labor and 24 hr postpartum. The participants in the experimental group received the hypnosis intervention at weeks 16, 20, 28, and 36 of pregnancy, while those in the control group received only routine antenatal care. The data collected at the labor stage describe the length of the labor stage, pain relief used during labor, the method of delivery, and the type of assisted vaginal delivery. Within 24 hr of delivery, data on neonatal birth weight, neonatal Apgar scores, and self-reported pain were obtained. The labor stage results showed no significant differences in the length of the second and third stages of labor. Although the participants in the experimental group reported higher pain levels immediately prior to, during, and immediately after delivery, their use of pethidine during labor was significantly lower than the control group participants. None of the experimental group participants opted for an epidural, and they had a greater number of assisted vaginal deliveries than the control group participants. The 24 hr postpartum results showed that the neonates of the experimental group participants had nonsignificantly higher Apgar scores than those of the women in the control group. Group differences in neonatal weight were not significant. The results of the present study indicate that hypnosis is useful for assisting pregnant women during labor and the postpartum period.

Matched MeSH terms: Labor, Obstetric/physiology*

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

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*

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*

Fulltext Second stage fetal heart rate patterns and neonatal acid-base status

Faridah Hanim Zam Zam, Nazimah Idris, Tham, Seng Woh

International e-Journal of Science, Medicine & Education, 2012;6(2):18-23.

MyJurnal

Background: Fetal surveillance in labour is performed mostly to identify fetuses at risk of hypoxia in order to reduce neonatal morbidity and mortality by initiating timely intervention. While normal and abnormal fetal heart rate (FHR) patterns have been well recognised and characterized for the first stage of labour, FHR patterns during the second stage of labour commonly showed some forms of abnormalities leading to problems in interpretation, particularly in predicting fetal hypoxia and acidosis. This study aims to identify patterns of FHR tracing during the second stage of labour associated with neonatal acidosis. Methods: A prospective cross sectional study was conducted in the Labour Ward of a state referral hospital. The study population were patients with low-risk
singleton pregnancies between 37 to 42 weeks gestation who had normal cardiotocograph (CTG) tracing in the first stage of labour. CTG was recorded during the second stage of labour and neonatal umbilical cord blood was obtained for acid-base analysis immediately after birth prior to the delivery of placenta. FHR patterns were grouped according to modified Melchior and Barnard’s
classification and matched with neonatal acid-base status. Patients with normal FHR pattern in the second stage acted as control. Results: A total of 111 matched pairs were analysed. Ninety nine (89.2%) second stage FHR tracings showed abnormal features when compared to control. There were significantly more neonatal acidosis and hypercapnia in type 1b, type 2a, type 2b and type 3 CTG patterns compared to control, in increasing order of severity. In addition, types 2b and 3 showed significant difference in the base excess. Conclusion: Certain second stage fetal heart rate
patterns were found to be associated with neonatal acidosis.

Matched MeSH terms: Labor, Obstetric

Fulltext Relationship between plasma cord blood zinc and infant birth weight in Fatemieh hospital, Hamadan, Iran

Mojgan, N., Sharifah Zainiyah, S.Y., Munn Sann, L., Zalilah, M.S.

Malaysian Journal of Public Health Medicine, 2012;12(1):49-56.

MyJurnal

The relationship between zinc and infant birth weight is still contradictory and up until today there is still no research on this issue done in Iran. This unmatched case control study to evaluate the association between plasma cord blood zinc and infant birth weight at the time of delivery was carried out in the labor ward, Fatemieh Hospital, Hamadan, Iran from the 6 th December 2009 to 18 October 2010. Plasma venous cord blood zinc was measured by AtomicAbsorption Spectro-photometry (AAS) and the weight of 134 Low Birth Weight (LBW) infants (cases) and 134 normal
weight infants (control) were measured at the time of delivery. All mothers with history of chronic diseases, obstetric complications, anemia, twin pregnancy, smoking, using illicit drugs, and alcohol and infants with any obvious anomalies were excluded from this study. Data were analyzed using SPSS version 16. Logistic regression was used to assess the contribution of other risk factors on infant birth weight. The result showed there was significant relationship between infant birth weight and plasma cord blood zinc. The risk of having LBW infant is more than 12 times in mothers who have severe zinc deficiency (OR=12.234,CI 95% 1.122, 133.392, p-value= 0.040). Also in mothers
who have mild to moderate zinc deficiency the risk of having LBW was more than one (OR=1.148, CI 95% 0.358, 3.900, p-value= 0.797). A significant relationship between maternal pre-pregnancy Body Mass Index (BMI) (p< 0.002), maternal weight gain during pregnancy (p< 0.021), previous LBW (p< 0.016), maternal age (p< 0.034) and parity (p< 0.004) with infant birth weight were also found. Logistic regression showed that zinc deficiency along with maternal pre-pregnancy BMI, maternal weight gain during pregnancy, previous LBW, maternal age and parity were predictors
for infant birth weight.

Matched MeSH terms: Labor, Obstetric

Prolonged labour

LLEWELLYN-JONES D

Med J Malaya, 1958 Sep;13(1):43-8.

PMID: 13589368

Matched MeSH terms: Labor, Obstetric*

Fulltext Prevalence and pattern of use of herbal medicines during pregnancy in tumpat district, kelantan

Rahman AA, Sulaiman SA, Ahmad Z, Daud WN, Hamid AM

Malays J Med Sci, 2008 Jul;15(3):40-8.

PMID: 22570588 MyJurnal

The objective of this cross-sectional study is to determine the prevalence and pattern of herbal medicines use during pregnancy among women in Tumpat district, Kelantan. A total of 210 mothers were interviewed using a structured questionnaire. There were 108 mothers (51.4%) who used at least one type of herbal medicines during pregnancy. The most common herbal medicines used (63.9%) was coconut oil which was ingested during the third trimester of pregnancy only. The most common indication was (89.8%) to facilitate labour. The majority of users (79.6%) used herbal medicines during the third trimester of pregnancy only. Many of them (81.5%) believed that herbal medicines were effective to solve their health problems and fulfilled the indications for use. The older generation like parents and in laws (63.9%) were the most common persons who suggested using herbal medicines. The majority of them used the herbs only once (56.5%) and one type (87.0%) throughout the pregnancy. Further research focusing on local commonly used herbal medicines is to be carried out to evaluate the safety and efficacy of the herbs.

Matched MeSH terms: Labor, Obstetric

Predictors of maternal satisfaction with labor induction: A prospective observational cohort study

Ramlee N, Azhary JMK, Hamdan M, Saaid R, Gan F, Tan PC

Int J Gynaecol Obstet, 2023 Nov;163(2):547-554.

PMID: 37177795 DOI: 10.1002/ijgo.14848

OBJECTIVE: To identify independent predictors of maternal satisfaction with labor induction.

METHOD: In this prospective observational cohort study, 769 women prior to their labor induction had sleep and psychological well-being assessed using Pittsburgh Sleep Quality Index and Depression, Anxiety and Stress Scales. Women were asked about the adequacy of labor induction information provided and their involvement and time pressure felt in the decision-making for their labor induction. Maternal characteristics, induction and intrapartum care measures, and labor and neonatal outcomes were also assessed. Prior to discharge, women rated their satisfaction with their birth experience.

RESULTS: A total of 34 variables were considered for bivariate analysis, with 15 found to have P labor induction, amniotomy, induction to delivery interval, mode of delivery, postpartum hemorrhage, and neonatal admission. Maternal satisfaction was not associated with sleep, depression, anxiety, or stress.

CONCLUSION: The identification of independent predictors of maternal satisfaction allows for patient selection, targeting of specific preinduction and intrapartum care, and focus on induction methods that can reduce induction to delivery interval, cesarean birth, and delivery blood loss to maximize women's satisfaction with labor induction.

Matched MeSH terms: Labor, Obstetric*

Postpartum haemorrhage and manual removal of placenta

MENG LY

Med J Malaya, 1958 Sep;13(1):74-9.

PMID: 13589374

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*

Oral prostaglandin e2 and amniotomy for induction of labour