MyMedR

Arterial stiffness, inflammatory and pro-atherogenic markers in gestational diabetes mellitus

Salmi AA, Zaki NM, Zakaria R, Nor Aliza AG, Rasool AH

VASA, 2012 Mar;41(2):96-104.

PMID: 22403127 DOI: 10.1024/0301-1526/a000171

This study aims to determine whether gestational diabetes mellitus (GDM) is associated with increased arterial stiffness, inflammatory and pro-atherogenic markers compared to age matched controls.

Matched MeSH terms: Pregnancy Trimester, Third

Comparing topical hydrocortisone cream with Hai's Perianal Support in managing symptomatic hemorrhoids in pregnancy: a preliminary trial

Lim SS, Yu CW, Aw LD

J Obstet Gynaecol Res, 2015 Feb;41(2):238-47.

PMID: 25256125 DOI: 10.1111/jog.12523

The prevalence of hemorrhoids among pregnant women is high in late pregnancy. This study was to evaluate the efficacy between drug treatment with Procort (topical hydrocortisone cream 1%) and mechanical treatment with a Hai's Perianal Support (HPS) toilet seat device in managing symptomatic hemorrhoids during the third trimester of pregnancy.

Matched MeSH terms: Pregnancy Trimester, Third

Pre-pregnancy body mass index, height and physical activity are associated with rate of gestational weight gain among Malaysian mothers

Yong HY, Mohd Shariff Z, Koo SJ, Binti Sa'ari NS

J Obstet Gynaecol Res, 2016 Sep;42(9):1094-101.

PMID: 27226139 DOI: 10.1111/jog.13039

AIM: Both inadequate and excessive weight gain during pregnancy can have immediate and long-term health risks for women and infants. This study investigated rate of gestational weight gain (GWG) and its associated factors in Malaysian pregnant women.
METHODS: This cross-sectional study was conducted at maternal and child health clinics in Selangor and Negeri Sembilan between November 2010 and April 2012. A pre-tested questionnaire was used to obtain sociodemographic, obstetric, dietary intake and physical activity information. Current weight and height were measured using standard procedures. GWG rate was calculated as the average weekly weight gain in that particular trimester of pregnancy and further categorized according to the Institute of Medicine (IOM) recommendations.
RESULTS: Mean GWG rate for all pre-pregnancy BMI categories in the second and third trimesters was higher than the IOM recommendations. Overweight women (adjusted OR, 4.26; 95%CI: 1.92-9.44) and women <153 cm tall (adjusted OR, 1.96; 95%CI: 1.21-3.18) tend to have inadequate GWG rate. Women with high pre-pregnancy body mass index (BMI; ≥25.0 kg/m(2) ; overweight: adjusted OR, 3.88; 95%CI: 2.12-7.09; obese: adjusted OR, 2.34; 95%CI: 1.28-4.29) and low physical activity (adjusted OR, 1.74; 95%CI: 0.77-3.97) were two-threefold more likely to have excessive GWG.
CONCLUSION: Both inadequate and excessive GWG can have detrimental effects on the health of mothers and infants. Pre-pregnancy BMI, height and physical activity should be emphasized in prenatal care to ensure that women have adequate GWG rate.
Study site: maternal and child health clinics (Klinik Kesihatan), Selangor and Negeri Sembilan, Malaysia

Matched MeSH terms: Pregnancy Trimester, Third

Fulltext Role of mid-trimester transvaginal cervical ultrasound in prediction of preterm delivery

Hebbar S, Samjhana K

Med J Malaysia, 2006 Aug;61(3):307-11.

PMID: 17240581 MyJurnal

Ultrasonographic cervical length assessment is increasingly being utilized clinically to identify women at risk for spontaneous preterm delivery. In a randomised prospective longitudinal study involving 200 women, we measured cervical length and internal os diameter by transvaginal scan at 20 - 24 weeks and analysed their ability to predict preterm birth. The risk of spontaneous preterm delivery increased steeply as cervical length decreased. At cut off value of < or = 2.5cm, the cervical length measurements had sensitivity, specificity, positive predictive value and negative predictive value of 77%, 95%, 56% and 98% respectively. However, internal os diameter lacked sensitivity and specificity. Our data suggests that the duration of pregnancy is directly related to length of the cervix: the shorter the cervix, the greater the chance of preterm delivery.

Matched MeSH terms: Pregnancy Trimester, Third

Fulltext Traumatic hip dislocation in late pregnancy: a case report

Kamarul T, Loh WYC

Med J Malaysia, 2005 Jul;60 Suppl C:114-6.

PMID: 16381296

Hip dislocation in pregnancy is an uncommon injury. We report a case of traumatic hip dislocation in the third trimester of pregnancy to highlight potential problems associated with its treatment. The rationale for choosing the preferred treatment options is discussed.

Matched MeSH terms: Pregnancy Trimester, Third

Fulltext Tretinoin in pregnancy complicated with acute promyelocytic leukaemia

Leong KW, Teh A, Bosco JJ

Med J Malaysia, 2000 Jun;55(2):277-9.

PMID: 19839162

Acute promyelocytic leukemia (APL) in pregnancy poses serious danger to both the mother and fetus. Cytotoxic chemotherapy may cause teratogenicity to the fetus. APL is unique because it is usually associated with a coagulopathy that markedly increases the risk for the mother and fetus. A 21 year old lady with APL in her third trimester of pregnancy was treated with oral tretinoin. Tretinoin reversed the coagulopathy and normalised her blood counts without causing cytotoxic damage associated with cancer chemotherapy. Fetal distress occurred at 37 weeks of gestation and an emergency caesarean section was performed without complications and no blood transfusion support was needed as her coagulopathy and thrombocytopenia had resolved. A remission was achieved with only tretinoin induction. She subsequently had consolidation and maintenance chemotherapy. The mother and baby remain well at 4 years from completion of chemotherapy. A total of 10 pregnancies associated with APL have been reported in the current literature. Premature delivery and a fetal arrhythmia were the only complications. Although retinoin is considered teratogenic, its use so far in second and third trimester has been safe.

Matched MeSH terms: Pregnancy Trimester, Third

Partial exchange transfusion in the treatment of severe anaemia in late pregnancy

Ong HC, Chan WF, Hussein N

Med J Malaysia, 1975 Sep;30(1):63-65.

PMID: 1207535

Matched MeSH terms: Pregnancy Trimester, Third

Fatal spontaneous rupture of splenic artery aneurysm in third trimester pregnancy

Samberkar PN, Chow TK, Samberkar SP

Malays J Pathol, 2018 Dec;40(3):337-341.

PMID: 30580366

INTRODUCTION: Unforeseen emergency in late pregnancy can be catastrophic and cause unexpected maternal and foetal demise. Moreover, lack of awareness and failure of prompt treatment raise mortality rate. Such fatalities warrant a forensic autopsy as it may raise redundant medico-legal concerns.

CASE REPORT: We report a case that revealed significant intra-abdominal haemorrhage at autopsy. The source of haemorrhage was at the spleen hilum and histology established rupture of splenic artery aneurysm. There was no associated obstetric cause found.

CONCLUSION: Knowledge of spontaneous rupture of splenic artery aneurysm in late pregnancy is essential for monitoring maternal and foetal, morbidity and mortality. However, in the eventuality of death a comprehensive forensic autopsy is the only investigation to recognise such calamity and clear clinical confusion.

Matched MeSH terms: Pregnancy Trimester, Third

Reference ranges for D-dimer levels in Malaysian women in the three trimesters of pregnancy

Mohmad Sallih N, Subbiah I, Ali A, Jackson N

Malays J Pathol, 2019 Apr;41(1):7-13.

PMID: 31025632

INTRODUCTION: Plasma D-dimer levels rise progressively during pregnancy, so one cannot apply normal reference ranges, or the usual cut-off value (500ng/mL), for the exclusion of venous thromboembolism (VTE), in pregnant women. This study was carried out in pregnant Malaysian women in order to build applicable reference ranges for D-dimer.

MATERIALS AND METHODS: A cross-sectional study was conducted to measure D-dimer in healthy pregnant women, and a non-pregnant control group, using the quantitative HaemosIL D-dimer HS500 assay. Reference ranges were derived using CLSI 'Robust' methods, and differences between group medians were tested using the Kruskal-Wallis and Mann-Whitney U tests.

RESULTS: Plasma D-dimer levels were measured in 92 pregnant women (distributed across the three trimesters)and 31 control women. The medians (and reference ranges) in ng/mL were: control 265 (<799); first trimester 481 (<1070); second trimester 1073 (357-1748); 3rd trimester 1533 (771-2410). There were significant differences between the D-dimer levels of each group and each of the other groups (P<0.001).

CONCLUSIONS: Reference ranges for D-dimer in pregnant Malaysian women have been establised by this study. Whether these ranges can be used to determine cut-off levels for the exclusion of VTE at different stages of pregnancy is doubtful, as the levels rise continuously through pregnancy, and some very high outlying values occur in apparently normal near-term pregnancy.

Matched MeSH terms: Pregnancy Trimester, Third

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: Pregnancy Trimester, Third

Fulltext Second-trimester uterine rupture: lessons learnt

F Abdulwahab D, Ismail H, Nusee Z

Malays J Med Sci, 2014 Jul;21(4):61-5.

PMID: 25977625 MyJurnal

Uterine rupture is a rare life-threatening complication. It mainly occurs in the third trimester of pregnancy and is rarely seen during the first or second trimesters. Our centre experienced three important cases of uterine rupture.

Matched MeSH terms: Pregnancy Trimester, Third

A viable secondary intra-abdominal pregnancy resulting from rupture of uterine scar: role of MRI

Teng HC, Kumar G, Ramli NM

Br J Radiol, 2007 Jul;80(955):e134-6.

PMID: 17704308

Pre-natal diagnosis of intra-abdominal pregnancy is difficult. Ultrasound has been the frontline modality to date; however, it gives a diagnostic error of 50-90% and its use is disappointing. In recent years, MRI has emerged as an appealing imaging modality. With its good soft tissue contrast and non-ionizing property, it acts as a means of definitive non-invasive assessment before surgical intervention when ultrasound is inconclusive.

Matched MeSH terms: Pregnancy Trimester, Third

Fulltext Pregnancy-related hemophagocytic lymphohistiocytosis associated with cytomegalovirus infection: A diagnostic and therapeutic challenge

Tumian NR, Wong CL

Taiwan J Obstet Gynecol, 2015 Aug;54(4):432-7.

PMID: 26384065 DOI: 10.1016/j.tjog.2014.11.023

Hemophagocytic lymphohistiocytosis (HLH) is a disorder characterized by uncontrolled mature histiocyte proliferation, hemophagocytosis, and hypercytokinemia. We describe a previously healthy pregnant patient who presented in the third trimester of pregnancy with HLH.

Matched MeSH terms: Pregnancy Trimester, Third

Fulltext Intrauterine growth of liveborn Malaysian infants between gestation of 28 to 42 weeks

Boo NY, Lye MS, Ong LC

Singapore Med J, 1994 Apr;35(2):163-6.

PMID: 7939812

A cross-sectional study was carried out on 8,478 consecutive normal singleton Malaysian neonates born in the Maternity Hospital, Kuala Lumpur. The objectives were to compare the mean birth-weights, crown-heel lengths and head circumferences of Malay, Chinese and Indian infants at gestation age from 28 to 42 weeks, and to construct the Malaysian growth charts. Above the gestation age of 34 weeks, the birthweights were significantly influenced by maternal gravida status (p < 0.03), ethnic origin (p < 0.001) and/or sex of the neonates (p < 0.026). Above this gestation age, neonates of multigravida mothers were significantly heavier than those of primigravida mothers; Indians were significantly lighter than Malays and Chinese; and males were significantly heavier than females. The head circumferences and body lengths of neonates were significantly influenced by ethnic origin, sex and/or maternal gravida status at gestation above 35 and 36 weeks respectively (p < 0.05). It was most likely due to the small sample size which explained our inability to detect statistically significant difference in all measurements (birthweight, length and head circumference) by sex, ethnicity and maternal gravida status at gestation below 35 weeks. Based on the measurements obtained in this study, percentile charts for the Malaysian population were constructed and made available for the first time. These charts will be useful for the assessment of Malaysian neonates during the perinatal period.

Matched MeSH terms: Pregnancy Trimester, Third

Fulltext Association between maternal food group intake and birth size

LOY S, MARHAZLINA M, HAMID JAN J

Sains Malaysiana, 2013;42(11):1633-1640.

Maternal nutrition is one of the dominant factors in determining fetal growth and subsequent developmental health for both mother and child. This study aimed to explore the association between maternal consumption of food groups and birth size among singleton, termed newborns. One hundred and eight healthy pregnant women in their third trimester, aged 19 to 40 years who visited the Obstetrics and Gynecology Clinic of Hospital Universiti Sains Malaysia completed an interviewed-administered, validated semi-quantitative food frequency questionnaire. The maternal socio-demographic, medical and obstetric histories and anthropometry measurements were recorded accordingly. The pregnancy outcomes, birth weight, birth length and head circumference were obtained from the medical records. The data were analyzed using multiple linear regression by controlling for possible confounders. Among all food groups, fruits intake was associated with higher birth weight (p=0.018). None of the food intake showed evident association with respect to birth length while only fruits intake was associated positively with head circumference (p=0.019). In contrast, confectioneries and condiments were associated with lower birth weight (p=0.013 and p=0.001, respectively). Also, condiments appeared to associate inversely with ponderal index (p=0.015). These findings suggest the potential beneficial effects of micronutrient rich food but detrimental effects of high sugar and sodium food on fetal growth. Such an effect may have long term health consequences to the lives of children.

Matched MeSH terms: Pregnancy Trimester, Third

Fulltext Non-invasive ventilation in a pregnancy with severe pneumonia

Mazlan MZ, Ali S, Zainal Abidin H, Mokhtar AM, Ab Mukmin L, Ayub ZN, et al.

Respir Med Case Rep, 2017;21:161-163.

PMID: 28560149 DOI: 10.1016/j.rmcr.2017.05.002

INTRODUCTION: Non-invasive ventilation (NIV) is not proven to be effective in treating respiratory failure in severe pneumonia. However, some clinicians nevertheless attempt NIV to indirectly deliver adequate oxygenation and avoid unnecessary endotracheal intubation.

CASE PRESENTATION: In this article, we report the case of a 24-year-old woman at 32 weeks' gestation who presented with hypoxemic respiratory failure requiring mechanical ventilation. She was successfully managed by NIV.

DISCUSSION: However, NIV must be managed by providers who are trained in mechanical ventilation. This is of the utmost importance in avoiding any delay should the patient's condition worsen and require endotracheal intubation. Moreover, in pregnant women, the severity of illness may progress quickly due to the immunosuppression inherent in these patients.

CONCLUSION: Special attention should be given to the choices of invasive ventilation and NIV to manage community acquired pneumonia patients in third trimester.

Matched MeSH terms: Pregnancy Trimester, Third

Highly potent stem cells from full-term amniotic fluid: A realistic perspective

Hamid AA, Joharry MK, Mun-Fun H, Hamzah SN, Rejali Z, Yazid MN, et al.

Reprod Biol, 2017 Mar;17(1):9-18.

PMID: 28262444 DOI: 10.1016/j.repbio.2017.02.001

Amniotic fluid (AF) is now known to harbor highly potent stem cells, making it an excellent source for cell therapy. However, most of the stem cells isolated are from AF of mid-term pregnancies in which the collection procedure involves an invasive technique termed amniocentesis. This has limited the access in getting the fluid as the technique imposes certain level of risks to the mother as well as to the fetus. Alternatively, getting AF from full-term pregnancies or during deliveries would be a better resolution. Unfortunately, very few studies have isolated stem cells from AF at this stage of gestation, the fluid that is merely discarded. The question remains whether full-term AF harbors stem cells of similar potency as of the stem cells of mid-term AF. Here, we aim to review the prospect of having this type of stem cells by first looking at the origin and contents of AF particularly during different gestation period. We will then discuss the possibility that the AF, at full term, contains a population of highly potent stem cells. These stem cells are distinct from, and probably more potent than the AF mesenchymal stem cells (AF-MSCs) isolated from full-term AF. By comparing the studies on stem cells isolated from mid-term versus full-term AF from various species, we intend to address the prospect of having highly potent amniotic fluid stem cells from AF of full-term pregnancies in human and animals.

Matched MeSH terms: Pregnancy Trimester, Third

Fulltext Maternal serum and breast milk vitamin D levels: findings from the Universiti Sains Malaysia Pregnancy Cohort Study

Jan Mohamed HJ, Rowan A, Fong B, Loy SL

PLoS One, 2014;9(7):e100705.

PMID: 24992199 DOI: 10.1371/journal.pone.0100705

Vitamin D deficiency has become a global health issue in pregnant women. This study aimed to assess the adequacy of maternal vitamin D status by measuring maternal serum and breast milk 25-hydroxyvitamin D [25(OH)D] levels and to determine the association between maternal serum and milk 25(OH)D levels.

Matched MeSH terms: Pregnancy Trimester, Third/blood*

Fulltext Depression, anxiety, stress and hyperemesis gravidarum: temporal and case controlled correlates

Tan PC, Zaidi SN, Azmi N, Omar SZ, Khong SY

PLoS One, 2014;9(3):e92036.

PMID: 24637791 DOI: 10.1371/journal.pone.0092036

To evaluate the temporal and case-controlled correlations of anxiety, depression and stress with hyperemesis gravidarum.

Matched MeSH terms: Pregnancy Trimester, Third/psychology

Fulltext Syphilis in pregnancy

Wahab AA, Ali UK, Mohammad M, Md Monoto EM, Rahman MM

Pak J Med Sci, 2015 4 17;31(1):217-9.

PMID: 25878647 DOI: 10.12669/pjms.311.5932

Syphilis in pregnancy remains an important medical condition due to its consequences. We present two cases of young pregnant women who were diagnosed syphilis during their antenatal visit. The first case was a 29-year-old Malay lady diagnosed with syphilis during the first trimester of pregnancy, while the second case was a 21-year-old Chinese lady diagnosed with syphilis during the third trimester of pregnancy. The diagnosis and management of the syphilis in pregnancy are discussed.

Matched MeSH terms: Pregnancy Trimester, Third

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