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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: Obstetric Labor Complications

Relationship of periodontal disease to pre-term low birth weight infants in a selected population--a prospective study

Ali TB, Abidin KZ

Community Dent Health, 2012 Mar;29(1):100-5.

PMID: 22482259

To assess effect of periodontal status of antenatal mothers on pregnancy outcomes in a selected population in Malaysia.

Matched MeSH terms: Obstetric Labor Complications

Long-term postpartum effect of severe maternal morbidity on sexual function

Norhayati MN, Azman Yacob M

Int J Psychiatry Med, 2017 11 08;52(4-6):328-344.

PMID: 29117756 DOI: 10.1177/0091217417738933

There was limited knowledge on the sexual function in women who have survived severe obstetric complications. The aim of this study was to compare the level of sexual functioning among women with and without severe morbidity at six months postpartum and to identify the factors associated with sexual function scores of women. A prospective double-cohort study design was applied at two tertiary hospitals over a six-month period. Postpartum women with and without severe maternal morbidity were selected as the exposed and the non-exposed group, respectively. The study included 145 exposed and 187 non-exposed women. Those with severe maternal morbidity were significantly ( P

Matched MeSH terms: Obstetric Labor Complications/psychology*

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: Obstetric Labor Complications/epidemiology

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.

Matched MeSH terms: Obstetric Labor Complications/etiology*; Obstetric Labor Complications/epidemiology; Obstetric Labor Complications/surgery*

Malaysian antenatal risk coding and the outcome of pregnancy

Geefhuysen CJ, Isa AR, Hashim M, Barnes A

J Obstet Gynaecol Res, 1998 Feb;24(1):13-20.

PMID: 9564100

Measure the effectiveness of the colour coding system in Malaysia for the prediction of risk in pregnancy.

Matched MeSH terms: Obstetric Labor Complications/epidemiology*; Obstetric Labor Complications/prevention & control

Anal sphincter trauma and anal incontinence in urogynecological patients

Guzmán Rojas RA, Kamisan Atan I, Shek KL, Dietz HP

Ultrasound Obstet Gynecol, 2015 Sep;46(3):363-6.

PMID: 25766889 DOI: 10.1002/uog.14845

To determine the prevalence of evidence of residual obstetric anal sphincter injury, to evaluate its association with anal incontinence (AI) and to establish minimal diagnostic criteria for significant (residual) external anal sphincter (EAS) trauma.

Matched MeSH terms: Obstetric Labor Complications/epidemiology; Obstetric Labor Complications/ultrasonography*

Can Anal Sphincter Defects Be Identified by Palpation?

Shek KL, Atan IK, Dietz HP

Female Pelvic Med Reconstr Surg, 2016 Nov-Dec;22(6):472-475.

PMID: 27682743

OBJECTIVES: The aim of this study was to correlate clinical findings of anal sphincter defects and function with a sonographic diagnosis of significant sphincter defects.

METHODS: This is an observational cross-sectional study on women seen 6 to 10 weeks after primary repair of obstetric anal sphincter injuries (OASIs). All patients underwent a standardized interview including the St Mark incontinence score, a digital rectal examination, and 3-/4-dimensional transperineal ultrasound imaging.

RESULTS: Two hundred forty-five patients were seen after primary repair of OASIs. Mean age was 29 (17-43) years. They were assessed at a median of 58 (15-278) days postpartum. One hundred fifty-seven (64%) delivered normal vaginally, 72 (29%) delivered by vacuum, and 16 (7%) delivered by forceps. A comparison of external anal sphincter (EAS) and internal anal sphincter ultrasound volume data and palpation was possible in 220 and 212 cases, respectively. Sphincter defects at rest and on contraction were both detected clinically in 17 patients. Significant abnormalities of the EAS were diagnosed on tomographic ultrasound imaging in 99 cases (45%), and significant abnormalities of the internal anal sphincter were diagnosed in 113 cases (53%). Agreement between digital and sonographic findings of sphincter defect was poor (k = 0.03-0.08). Women with significant EAS defects on ultrasound were found to have a lower resistance to digital insertion (P = 0.018) and maximum anal squeeze (P = 0.009) on a 6-point scale. The difference was however small.

CONCLUSIONS: Digital rectal examination does not seem to be sufficiently sensitive to diagnose residual sphincter defects after primary repair of OASIs. Imaging is required for the evaluation of sphincter anatomy after repair.

Matched MeSH terms: Obstetric Labor Complications/diagnosis*; Obstetric Labor Complications/therapy

Maternal mortality in developing countries: challenges in scaling-up priority interventions

Prata N, Passano P, Sreenivas A, Gerdts CE

Womens Health (Lond), 2010 Mar;6(2):311-27.

PMID: 20187734 DOI: 10.2217/whe.10.8

Although maternal mortality is a significant global health issue, achievements in mortality decline to date have been inadequate. A review of the interventions targeted at maternal mortality reduction demonstrates that most developing countries face tremendous challenges in the implementation of these interventions, including the availability of unreliable data and the shortage in human and financial resources, as well as limited political commitment. Examples from developing countries, such as Sri Lanka, Malaysia and Honduras, demonstrate that maternal mortality will decline when appropriate strategies are in place. Such achievable strategies need to include redoubled commitments on the part of local, national and global political bodies, concrete investments in high-yield and cost-effective interventions and the delegation of some clinical tasks from higher-level healthcare providers to mid- or lower-level healthcare providers, as well as improved health-management information systems.

Matched MeSH terms: Obstetric Labor Complications/mortality; Obstetric Labor Complications/prevention & control

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

Matched MeSH terms: Obstetric Labor Complications

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: Obstetric Labor Complications/prevention & control*

Sudden maternal deaths from amniotic fluid embolism

Nadesan K, Jayalakshmi P

Ceylon Med J, 1997 Dec;42(4):185-9.

PMID: 9476404

Sudden maternal death from amniotic fluid embolism is a rare but serious complication which usually occurs during late pregnancy, often during labour or shortly after, with more than 80% mortality. Such a death causes immense stress to both the relatives and the attending doctors as it is sudden and unexpected. Three such deaths are discussed here. Traditionally, it was believed that this complication usually occurred in prolonged and difficult labour, but there is evidence contrary to this, and it is not possible to predict when and where this fatal complication will occur. Current views and various pathophysiologic mechanisms leading to the fatal outcome are also discussed.

Matched MeSH terms: Obstetric Labor Complications/etiology*

Sudden maternal deaths in Malaysia: a case report

Jegasothy R

J Obstet Gynaecol Res, 2002 Aug;28(4):186-93.

PMID: 12452259

We report on a retrospective study of maternal deaths in Malaysia that occurred within 24 hours of delivery, abortion or operative termination of the pregnancy (defined as sudden deaths) in the years 1995-1996. There were 131 sudden maternal deaths (20.6% of all maternal deaths); postpartum hemorrhage, obstetric embolisms, trauma and hypertensive disorders of pregnancy were the main causes. There was a disproportionately increased risk of sudden maternal deaths in the Chinese and the 'other bumiputra' racial groups. The proportion of mothers who had no obstetric risk factors in the pregnancy that led to death was 16.8%. Fourteen mothers died in transit Twenty mothers died after a cesarean section. The findings of this review emphasize the fact that caregivers in obstetrics need to be forever vigilant. All maternity staff need to be well trained in emergency care and there needs to be quick referral to centers that can provide expertise in handling these emergencies.

Matched MeSH terms: Obstetric Labor Complications/ethnology; Obstetric Labor Complications/etiology; Obstetric Labor Complications/mortality*

Reflections on the maternal mortality millennium goal

Lawson GW, Keirse MJ

Birth, 2013 Jun;40(2):96-102.

PMID: 24635463 DOI: 10.1111/birt.12041

Nearly every 2 minutes, somewhere in the world, a woman dies because of complications of pregnancy and childbirth. Every such death is an overwhelming catastrophe for everyone confronted with it. Most deaths occur in developing countries, especially in Africa and southern Asia, but a significant number also occur in the developed world.

Matched MeSH terms: Obstetric Labor Complications/mortality

Fulltext Spontaneous intra-partum rupture of uterine vein--an uncommon cause of intra-abdominal haemorrhage

Kuppuvelumani P, Rachagan SP, Khin MS

Med J Malaysia, 1994 Jun;49(2):185-6.

PMID: 8090103

A rare case of spontaneous rupture of a branch of the uterine vein in a primigravida is discussed. The patient with an uncomplicated pregnancy presented with signs and symptoms suggestive of abruptio placenta with foetal distress. Lower segment Caesarean section was performed. The cause of acute pain was identified to be intra-abdominal bleeding secondary to the rupture of a branch of the uterine vein. The pathophysiology of the problem is discussed.

Matched MeSH terms: Obstetric Labor Complications/etiology*

"Once a Caesarean section"

Kuah KB

Med J Malaya, 1970 Sep;25(1):38-42.

PMID: 4249492

Matched MeSH terms: Obstetric Labor Complications/surgery*

Fulltext Social drug use in the parturient: implications for the management of obstetrical anaesthesia

Kuczkowski KM

Med J Malaysia, 2003 Mar;58(1):147-54; quiz 155.

PMID: 14556345

Maternal use of social drugs in pregnancy continues to increase--worldwide. Although a great deal has been learned regarding the implications of illicit drug abuse in pregnancy (cocaine, amphetamines, hallucinogens), the use of social drug in pregnancy has received far less attention. This article reviews the consequences of the social drug use in pregnancy including ethanol, tobacco and caffeine and offers recommendation for anaesthetic management of these potentially complicated pregnancies.

Matched MeSH terms: Obstetric Labor Complications/chemically induced*

The partograph in community obstetrics

Lennox CE, Kwast BE

Trop Doct, 1995 Apr;25(2):56-63.

PMID: 7778195

Matched MeSH terms: Obstetric Labor Complications/diagnosis; Obstetric Labor Complications/prevention & control*

THE EFFECT OF AGE AND SOCIAL STATUS ON OBSTETRIC EFFICIENCY

LLEWELLYN-JONES D

J Obstet Gynaecol Br Commonw, 1965 Apr;72:196-202.

PMID: 14273096

Matched MeSH terms: Obstetric Labor Complications*

Fulltext Response of women in high-risk pregnancies in Hulu Terengganu

Lim KG

Med J Malaysia, 1987 Mar;42(1):16-21.

PMID: 3431499

Eleven maternal deaths were recorded in Hulu Terengganu between 1981-1985. This represents a high average maternal mortality rate of 1.4 per thousand deliveries annually over the five years. Nine of the 11 women were high priority pregnancies, but only three had hospital deliveries. The most common cause of death was post-partum haemorrhage (PPH), and PPH with a retained placenta. Hospital deliveries constitute only a low proportion of total deliveries in the district. In a survey of women with high priority pregnancies attending antenatal clinics in Hulu Terengganu, it was found that 79 (69%) out of 115 respondents were resistant to advice for hospital delivery. Grandmultiparae were a significant proportion of this group.
Study site: Maternal Child Health Centre (Klinik Kesihatan), Hulu Terengganu, Malaysia

Matched MeSH terms: Obstetric Labor Complications/psychology*

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