MyMedR

Fulltext "Postpartum morbidity--what we can do"

Zainur RZ, Loh KY

Med J Malaysia, 2006 Dec;61(5):651-6.

Postpartum is a crucial period for a mother. During this period a mother is going through the physiological process of uterine involution and at the same time adapting to her new role in the family. Many postpartum complications occur during this period. Among the important obstetric morbidities are postpartum hemorrhage, pregnancy related hypertension, pulmonary embolism and puerperal sepsis. Common surgical complications are wound breakdown, breast abscess and urinary fecal incontinence. Medical conditions such as anemia, headache, backache, constipation and sexual problems may also be present. Unrecognized postpartum disorders can lead to physical discomfort, psychological distress and a poor quality of life for the mothers. Providing quality postnatal care including earlier identification of the problems (correction) and proper intervention will help the mother to achieve full recovery and restore her functional status back to the pre-pregnancy state sooner.

Matched MeSH terms: Obstetrics/methods

Fulltext Prevalence of plasmid-bearing and plasmid-free Chlamydia trachomatis infection among women who visited obstetrics and gynecology clinics in Malaysia

Yeow TC, Wong WF, Sabet NS, Sulaiman S, Shahhosseini F, Tan GM, et al.

BMC Microbiol, 2016 Mar 18;16:45.

PMID: 26987367 DOI: 10.1186/s12866-016-0671-1

BACKGROUND: The 7.5 kb cryptic plasmid of Chlamydia trachomatis has been shown to be a virulence factor in animal models, but its significance in humans still remains unknown. The aim of this study was to investigate the prevalence and potential involvement of the C. trachomatis cryptic plasmid in causing various clinical manifestations; including infertility, reproductive tract disintegrity, menstrual disorder, and polycystic ovarian syndrome (PCOS) among genital C. trachomatis-infected patients.
RESULTS:A tot l of 180 female patients of child bearing age (mean 30.9 years old, IQR:27-35) with gynecological complications and subfertility issues, who visited Obstetrics and Gynecology clinics in Kuala Lumpur, Malaysia were recruited for the study. Prevalence of genital chlamydial infection among these patients was alarmingly high at 51.1% (92/180). Of the 92 chlamydia-infected patients, 93.5% (86/92) were infected with plasmid-bearing (+) C. trachomatis while the remaining 6.5% (6/92) were caused by the plasmid-free (-) variant. Our data showed that genital C. trachomatis infection was associated with infertility issues, inflammation in the reproductive tract (mucopurulent cervicitis or endometriosis), irregular menstrual cycles and polycystic ovarian syndrome (PCOS). However, no statistical significance was detected among patients with plasmid (+) versus plasmid (-) C. trachomatis infection. Interestingly, plasmid (+) C. trachomatis was detected in all patients with PCOS, and the plasmid copy numbers were significantly higher among PCOS patients, relative to non-PCOS patients.
CONCLUSION: Our findings show a high incidence of C. trachomatis infection among women with infertility or gynecological problems in Malaysia. However, due to the low number of plasmid (-) C. trachomatis cases, a significant role of the plasmid in causing virulence in human requires further investigation of a larger cohort.
KEYWORDS: Chlamydia trachomatis; Infertility; Plasmid; Reproductive system disorders
Study site: Obstetrics and Gynecology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Obstetrics/statistics & numerical data

Fulltext 24-hour discharge post Laparoscopic Ovarian Cystectomy: a feasibility study

Wan Ahmad Hazim, Nur Hidayah Aeshah Ng, Salleha Khalid

Pertanika Journal of Science & Technology, 2018;26(2):719-728.

MyJurnal

Minimally invasive surgery results in faster recovery. The objective of this study is to identify criteria for the feasibility of 24-hour discharge post laparoscopic ovarian cystectomy. This is a prospective cross-sectional study that was carried out at the Obstetrics and Gynaecology Department in Putrajaya Hospital between 1 January and 31 December, 2016. The inclusion criteria were: age between 15 and 45, no comorbidities, no family history of malignancy, BMI of less than 30, mass size less than 18 weeks, single uninoculated simple cyst and no ascites. The exclusion criteria were post-menopause women, known medical illness, family history of malignancy, mass size more than 18 weeks, multiloculated or bilateral ovarian cyst, presence of solid area within the cyst and ascites. The sample size was calculated to be 14. A total of 16 participants were identified. Results showed that using the Visual Analogue Score (VAS), the mean pain score post operatively in the first six hours, 24 hours, 48 hours, two weeks and three months were 3.67, 2.57, 0.5, 0 and 0, respectively. Two of the subjects experienced post-operative nausea and vomiting, one had urinary tract infection and one had minor bleeding from the surgical site. All the participants were discharged within 24 hours post-operatively. There was no readmission. In conclusion, 24-hour discharge post laparoscopic cystectomy is safe and feasible. Factors determining the success must be adhered to closely to ensure a good and satisfactory outcome. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Matched MeSH terms: Obstetrics

Fulltext COVID-19 and gynecological cancers: Asia and Oceania Federation of Obstetrics and Gynecology oncology committee opinion

Tse KY, Domingo EJ, Konar H, Kumarasamy S, Pariyar J, Tjokroprawiro BA, et al.

J Obstet Gynaecol Res, 2021 May;47(5):1643-1650.

PMID: 33650217 DOI: 10.1111/jog.14579

Since the outbreak of COVID-19, there have already been over 26 million people being infected and it is expected that the pandemic will not end in near future. Not only the daily activities and lifestyles of individuals have been affected, the medical practice has also been modified to cope with this emergency catastrophe. In particular, the cancer services have faced an unprecedented challenge. While the services may have been cut by the national authorities or hospitals due to shortage of manpower and resources, the medical need of cancer patients has increased. Cancer patients who are receiving active treatment may develop various kinds of complications especially immunosuppression from chemotherapy, and they and their carers will need additional protection against COVID-19. Besides, there is also evidence that cancer patients are more prone to deteriorate from COVID-19 if they contract the viral infection. Therefore, it is crucial to establish guidelines so that healthcare providers can triage their resources to take care of the most needed patients, reduce less important hospitalization and visit, and to avoid potential complications from treatment. The Asia and Oceania Federation of Obstetrics and Gynecology (AOFOG) hereby issued this opinion statement on the management of gynecological cancer patients during the COVID-19.

Matched MeSH terms: Obstetrics*

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: Obstetrics

Screening in obstetrics and gynaecology

Teoh SK

Family Practitioner, 1981;4<I> </I>:23-26.

Matched MeSH terms: Obstetrics

Fulltext Antenatal HIV screening--knowledge, attitudes and practices of obstetricians in KKH

Tan TY, Teo KP, Tan KH

Singapore Med J, 1999 Dec;40(12):733-7.

PMID: 10709422

To determine the knowledge, attitudes and practices of obstetricians with regards to HIV screening in pregnant women.

Matched MeSH terms: Obstetrics/standards*

Contemporary approaches to hyperemesis during pregnancy

Tan PC, Omar SZ

Curr Opin Obstet Gynecol, 2011 Apr;23(2):87-93.

PMID: 21297474 DOI: 10.1097/GCO.0b013e328342d208

PURPOSE OF REVIEW: Nausea and vomiting of pregnancy (NVP) affects 90% of pregnant women and its impact is often underappreciated. Hyperemesis gravidarum, the most severe end of the spectrum, affects 0.5-2% of pregnancies. The pathogenesis of this condition remains obscure and its management has largely been empirical. This review aims to provide an update on advances in pregnancy hyperemesis focusing on papers published within the past 2 years.

RECENT FINDINGS: The cause of hyperemesis is continuing to be elaborated. Recent data attest to the effectiveness of the oral doxylamine-pyridoxine in NVP. Follow-up data of children exposed in early pregnancy to doxylamine-pyridoxine for NVP are reassuring. Evidence is increasing for ginger as an effective herbal remedy for NVP. Metoclopramide is effective in NVP and hyperemesis gravidarum, with a good balance of efficacy and tolerability. A recent large-scale study on first trimester exposure to metoclopramide is reassuring of its safety. Evidence is emerging for the treatment of acid reflux to ameliorate NVP. The role of corticosteroids for hyperemesis gravidarum remains controversial. Transpyloric feeding may be warranted for persistent weight loss, despite optimal antiemetic therapy.

SUMMARY: Women with significant NVP should be identified so that they can be safely and effectively treated.

Matched MeSH terms: Obstetrics/methods

The changing role of the family practitioner in obstetrics and gynaecology

Tan FEH

Family Practitioner, 1975;2(1):30-31.

Matched MeSH terms: Obstetrics

Observations on obstetric practice in a multicultural setting

TambyRaja RL

Matern Child Health J, 1999 Jun;3(2):111-3.

PMID: 10892419

Singapore provides a rich environment for investigations into ethnic differences in pregnancy outcome, as it is populated by Malays, Indians, and Chinese. Years of clinical practice and obstetric research in this environment have affirmed the observation that many factors interact in determining length of gestation and birth weight, and that these factors have differential affects among these three different ethnic groups. Although technological advances have furthered our understanding of obstetrical outcomes and provided essential tools to promote the survival of premature infants, the persistent use of uniform growth standards hampers our ability to assure positive outcomes for women of different ethnicity. Recognition of ethnic differences has resulted in declines in certain negative pregnancy outcomes for women in Singapore. The development of race-specific uterine growth curves will enhance the provision of perinatal care for all women.

Matched MeSH terms: Obstetrics/trends

Intrauterine insemination: an alternative to GIFT in the treatment of patients with unexplained infertility

Tai C, Rachagan SP

Family Physician, 1991;3:30-32.

Matched MeSH terms: Obstetrics

Improving undergraduate obstetrics and gynaecology education through the use of WhatsApp™

Soe MZ, Pang NTP, Loo JL

Eur J Obstet Gynecol Reprod Biol, 2020 Apr;247:269.

PMID: 32145995 DOI: 10.1016/j.ejogrb.2020.02.036

Matched MeSH terms: Obstetrics/education*

Hormonal therapy in obstetrics and gynaecology. TA Sinnathuray

Sinnathuray TA

Family Practitioner, 1975;2:40-42.

Matched MeSH terms: Obstetrics

Fulltext Commitment of medical graduates educated with and without community-based medical education towards community health care-A study from Malaysia

Shahid Hassan

Education in Medicine Journal, 2013;5(4):42-50.

MyJurnal

Context: Community-based medical education (CBME) has become widely accepted as an important innovation in undergraduate medical education. In curriculum featuring CBME, students are acquainted with the community early in their studies however; the impact of this training can be judged best to see them practice the required aspects of CBME. Malaysia is a multiracial country with a very strong community dependant life style. Main national health problems have called for a change in health profession education from traditional hospital based health care to community-based delivery system. Three major university's medical schools that either practice community oriented or community based medical education in undergraduate medical curriculum are evaluated. Universiti Sains Malaysia (USM) has a community based medical education (CBME) curriculum as Community and Family Case Study (CFCS) compared to a community oriented education curriculum (COE) adopted by Universiti Malaya (UM) and Universiti Kebangsaan Malaysia (UKM). However, UM at the time of undertaking this study back in 2005 was though practicing COE has also later opted CBME as CFCS.

Objective: To determine whether medical graduates from USM with a community-based medical education in its curriculum for more than 25 years are inspired to have stronger commitment towards community health as shown in their on-job practice of medicine compared to other graduates from UM and UKM, who have adopted community-oriented medical education program.

Method: A questionnaire-based pilot study with 12 items (variables) was designed to obtain supervisor's opinion on commitment of interns towards the health of community they serve. The questionnaire was administered to a randomized group of 85 specialists supervising the internship training program in five major disciplines including internal medicine, surgery, orthopaedic, gynaecology and obstetrics and paediatric medicine. The data received from 62 respondents from five major disciplines was analyzed utilizing SPSS version 12.0.1.

Result: The responses received from 62 supervisors on an inventory in which 9 out of 12 variables were directly related to community commitments of interns. It was shown that the USM graduates who were taught through a CBME curriculum have performed better than the graduates from UM and UKM who followed a COE curriculum. P-value (< 0.001) was highly significant and consistent with higher mean score in those variables.

Conclusion: The graduates taught through a CBME curriculum performed better in community commitments towards patients care compared to graduates from COE curriculum.

Matched MeSH terms: Obstetrics

Fulltext Morbidly adherent placenta at extreme prematurity: can major haemorrhage and hysterectomy be prevented?

Shafiee, M.N., Rahana, A.R., Lim, P.S., Nor Azlin, M.I., Wan Faraliza, Z.A., Isa, M.R., et al.

Journal of Surgical Academia, 2011;1(1):56-60.

MyJurnal

Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage.

Matched MeSH terms: Obstetrics

THE PLACE OF THE VACUUM EXTRACTOR IN OBSTETRICS

SAMBHI JS

Med J Malaysia, 1963 Jun;17:292-301.

PMID: 14060507

Matched MeSH terms: Anesthesia, Obstetrical*; Extraction, Obstetrical*; Obstetrics*

AIDS in pregnancy - the growing threat

Ravi C

Family Physician, 1991;3:33-38.

Matched MeSH terms: Obstetrics

A comparative study of X-ray pelvimetry and CT pelvimetry

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.

Matched MeSH terms: Obstetrics

In-utero fetal therapy - current status and future directions

Raman S, Sivanesaratnam V

Family Practitioner, 1987;10:45-48.

Matched MeSH terms: Obstetrics

Preventive obstetrics

Raman S, Kulenthran A

Family Practitioner, 1985;8:25-26.

Matched MeSH terms: Obstetrics

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