MyMedR

Fulltext First year experience in assisted reproductive technology (ART) services at IIUM Kuantan

Ahmad Murad, Z., Roszaman, R., Azantee, Y.W., Hayati, M.Y., Norsina, M.A., Siti, K.

International Medical Journal Malaysia, 2013;12(1):3-10.

MyJurnal

Introduction: To analyze the ART outcome and factors associated with successful ART treatment for infertile couples in a newly set up medical university IVF centre. Methods: A six-month cohort study of patients undergoing their first assisted reproductive technique cycle was conducted at IIUM fertility centre, Kuantan (from 15th June until 31st Dec 2009). Outcome measures include clinical pregnancy rate, ongoing pregnancy rate, take home baby rate and complications rate. Results: Fifty-five first cycles of IVF/ICSI were studied. Mean embryo per transfer was 2.1±0.8. Four patients were pregnant (23.5%) from a single embryo transfer (SET). Clinical pregnancy rate was 30.9% (17/55). Ongoing pregnancy rate was 23.6% (13/55) and take home baby rate was 21.8% (12/55). There was only one twin pregnancy. Nine patients (16.4%) had OHSS whereby 77.8% were mild and 22.2% were moderate. Conclusion: Take home baby rate at the IIUM fertility centre is comparable to most established ART centres in Malaysia considering that this is only the first year of operation.

Matched MeSH terms: Pregnancy; Pregnancy Rate; Pregnancy, Twin

Pregnancy and Dumping Syndrome post-bariatric surgery: a case report

Edawati DE, Abigail J, Mardiana K, Ming-Cheng C, Harris NS

Med J Malaysia, 2017 04;72(2):133-134.

PMID: 28473681 MyJurnal

This case report discusses dumping syndrome in the postbariatric mother. Diagnostically a challenge, the symptoms of postprandial hypoglycaemia mimic common early gestation complaints and may go undiagnosed, thus requiring a high index of suspicion. As weight-loss surgery gains traction, it is pertinent to note at booking and followups. The pregnancy is at-risk and multidisciplinary team management is central. The mainstay of management remains diet modification. There have been case reports of successful medical treatment of dumping syndrome in pregnancy with good maternal and fetal outcomes. However, more data is needed regarding the usage of these medical treatments in pregnancy.

Matched MeSH terms: Pregnancy; Pregnancy Complications/etiology*

Amnioscopy in patients with bad obstetric history and high risk pregnancies

Ng KH

Med J Malaya, 1971 Sep;26(1):59-61.

PMID: 4258578

Matched MeSH terms: Pregnancy; Pregnancy Complications/diagnosis*

Intestinal obstruction following hysterectomy for ruptured interstitial pregnancy

RODDIE TW

Med J Malaya, 1957 Dec;12(2):423-5.

PMID: 13515873

Matched MeSH terms: Pregnancy; Pregnancy, Interstitial*

Fulltext Primary hyperparathyroidism with vitamin D deficiency in third trimester of pregnancy

Tong, Chin Voon, Mohamad Rafie Md Kaslan

International e-Journal of Science, Medicine & Education, 2015;9(3):47-51.

MyJurnal

In pregnancy, the diagnosis of primary hyperparathyroidism (PHP) may be delayed due to physiological changes that occur during this period. The maternal related complications of PHP during pregnancy has been reported to be as high as 67%, whilst fetal complications up to 80% of cases.1 The therapeutic gold standard and definitive treatment for PHP in pregnancy is minimally invasive parathyroidectomy in the second trimester. We report a case of a 22-year old primidgravida who underwent parathyroidectomy in the third trimester of her pregnancy for PHP with persistent hypercalcemia. She was also found to have Vitamin D deficiency which probably led to secondary hyperparathyroidism and made her hypercalcemia more apparent during pregnancy

Matched MeSH terms: Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third

Study of perinatal mortality 1970, Maternity Hospital. Kuala Lumpur

Ariffin Bin Marzuki, Thambu JA

Med J Malaysia, 1973 Mar;27(3):198-202.

PMID: 4268924

Matched MeSH terms: Pregnancy; Pregnancy Complications/epidemiology

THE PLACE OF THE VACUUM EXTRACTOR IN OBSTETRICS

SAMBHI JS

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

PMID: 14060507

Matched MeSH terms: Pregnancy; Pregnancy Complications*

A CONCEPT IN THE MANAGEMENT OF TWIN DELIVERY

MARZUKI A

Med J Malaysia, 1963 Jun;17:288-91.

PMID: 14060506

Matched MeSH terms: Pregnancy; Pregnancy, Multiple*

Amniotic fluid creatinine as index foetal weight

Chan WF, Lim MK, Aun LM

Med J Malaysia, 1974 Sep;29(1):54-6.

PMID: 4282631

Matched MeSH terms: Pregnancy; Pregnancy Complications/diagnosis*

The use of imferon (iron dextran) as a total dose infusion

Tharmaratnam A, Vikraman P, Kanagalingam N

Med J Malaya, 1967 Jun;21(4):319-21.

PMID: 4230498

Matched MeSH terms: Pregnancy; Pregnancy Complications, Hematologic/drug therapy*

Fulltext Unruptured left cornual pregnancy with a high serum β-hCG: a case report

Nirmala, C.K., Lim, P.S., Norzilawati, M.N., Zainul, R.A.Z., Mohd. Hashim, O.

Journal of Surgical Academia, 2011;1(1):49-51.

MyJurnal

Ectopic pregnancy in the interstitial part of the fallopian tube (cornual pregnancy) is a rare condition but can be fatal. Traditionally, the treatment had been cornual resection or hysterectomy. More conservative approaches had been advocated recently. There is no consensus on the dose or number of methotrexate injections that should be used in the treatment of interstitial pregnancies. Single dose intramuscular methotrexate is one of the treatment options. However, the failure rate is higher if the serum beta-hCG (beta-human chorionic gonadotrophin) level is more than 5000 IU/L. We report a case of cornual ectopic pregnancy with high initial serum beta-hCG level being successfully treated with multiple doses of systemic methotrexate. MRI was used to assess clinical resolution of cornual ectopic pregnancy.

Matched MeSH terms: Pregnancy; Pregnancy, Interstitial; Pregnancy, Cornual

Haemoglobin H disease and pregnancy in a Malaysian woman

Ong HC, White JC, Sinnathuray TA

Acta Haematol., 1977;58(4):229-33.

PMID: 410224 DOI: 10.1159/000207832

A case of haemoglobin H (HbH) disease associated with pregnancy is presented and discussed in the light of reports in the literature. The variable symptomatology is commented upon, although mild to moderate chronic haemolytic anaemia seems to be a constant feature. The roles of folic acid supplements and of splenectomy; the avoidance of oxidant drugs, and the mode of inheritance in HbH disease are briefly commented upon. Available reports indicate that HbH disease probably has no adverse effect on pregnancy. However, the association of the two conditions is uncommon, and reports are too few, therefore, to allow definite conclusions on the outcome in all instances.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Hematologic*

AMNIOTOMY IN THE TREATMENT OF PLACENTAL INSUFFICIENCY SYNDROME. II. MANAGEMENT OF THE PLACENTAL INSUFFICIENCY SYNDROME AND THE RESULTS OF STUDY

SINNATHURAY TA

Med J Malaysia, 1964 Dec;19:105-16.

PMID: 14279233

Matched MeSH terms: Pregnancy; Pregnancy Complications*

Fulltext Nine months a slave: when pregnancy is involuntary servitude to a foetus

Allotey-Reidpath KD, Allotey P, Reidpath DD

Reprod Health Matters, 2018 Dec;26(52):1451173.

PMID: 29651926 DOI: 10.1080/09688080.2018.1451173

Recent globally compiled evidence suggests that one-quarter of pregnancies end in abortions. However, abortions remain illegal in many countries, resulting in unsafe practices. Debates have largely stalled with the pro-life, pro-choice epithets. To provide further arguments in support of legalising abortion services, we argue that the state cannot demand of a woman that she maintains an unwanted pregnancy because that demand places her in a state of involuntary servitude. Involuntary servitude would put states in breach of international human rights law (Article 8 of International Covenant on Civil and Political Rights). Furthermore, we argue that the fact that a life may be forfeit when a woman withdraws her service is no basis for enforcing the servitude. We draw on the 13th Amendment of the US Constitution as an example to extend the argument and highlight the need to test involuntary servitude in international human rights law through mechanisms offered in the international periodic review of member states. This could provide a robust approach to support and strengthen access to safe abortion services.

Matched MeSH terms: Pregnancy; Pregnancy, Unwanted/psychology*

Fulltext The crucial role of molecular testing to facilitate the diagnosis of pneumocystis pneumonia during pregnancy

Ding CH, Yusoff H, Muttaqillah NAS, Tang YL, Tan TL, Periyasamy P, et al.

Malays J Pathol, 2018 Apr;40(1):69-72.

PMID: 29704387 MyJurnal

Pneumocystis pneumonia is an important human immunodeficiency virus (HIV)-associated opportunistic infection, and especially so in pregnant HIV-positive patients. We report a case of a 40-year-old woman in her first trimester of pregnancy who initially presented with acute gastroenteritis symptoms but due to a history of high-risk behaviour and the observation of oral thrush, she was worked up for HIV infection. Her retroviral status was positive and her CD4+ T cell count was only 8 cells/µL. She was also worked up for pneumocystis pneumonia due to the presence of mild resting tachypnoea and a notable drop in oxygen saturation (from 100% to 88%) following brief ambulation. Her chest radiograph revealed bilaterally symmetrical lower zone reticular opacities and Giemsa staining of her bronchoalveolar lavage (BAL) was negative for Pneumocystis jirovecii cysts. However, real-time P. jirovecii polymerase chain reaction (PCR) testing on the same BAL specimen revealed the presence of the organism. A course of oral co-trimoxazole plus prednisolone was commenced and her clinical condition improved.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Infectious/immunology*

Fulltext Fetal MRI of thoraco-omphalopagus conjoined twins

Abdullah H, Abdul Wahab N, Abu Bakar K

BMJ Case Rep, 2017 Jun 13;2017.

PMID: 28611167 DOI: 10.1136/bcr-2017-219793

Matched MeSH terms: Pregnancy; Pregnancy, Twin*

MPA given orally during the first trimester for threatened miscarriage carries no specific risk for foetal abnormalities albeit the rate is higher than non-threatened pregnancies

Yovich JL, Mariappen U, Hinchliffe PM, Dhaliwal SS, Keane KN

Reprod Biol, 2020 Sep;20(3):424-432.

PMID: 32389607 DOI: 10.1016/j.repbio.2020.03.008

This observational study examines the outcomes of pregnancies arising in women referred for infertility, where those who experienced threatened miscarriage were treated with medroxyprogesterone acetate (MPA) tablets. The 14-year study period covers comprehensive real-time data entries into the validated electronic database including details of the infertility management, pregnancy outcomes and any foetal anomalies among the infants, each being tracked and recorded. Of 4057 clinical pregnancies, 1343 received MPA for threatened miscarriage; 934 (69.6 %) of which continued to livebirths. These were compared with the remaining 2714 clinical pregnancies without threatened miscarriage or MPA and which resulted in 2075 (76.5 %) livebirths. There were 134 developmental abnormalities recorded among the 3009 livebirths of which 78 (2.6 %) were categorised appropriate for the Western Australian Developmental Abnormalities Register; WARDA. These comprised 55 in the MPA group, 36 of which were categorised as serious (being 2.7 % of clinical pregnancies and 3.9 % of births). In the group without MPA, there were 79 abnormalities, of which 42 were categorised as serious (being 1.7 % of clinical pregnancies and 2.2 % of births). Specifically, there were no cases of androgenisation noted among the female infants. The abnormality rates were low overall and well within the annual WARDA ranges. We cautiously suggest that oral MPA can be considered for studies throughout pregnancy including the early first trimester to assess a potential role in reducing miscarriage, as well as advanced pregnancies to evaluate a potential role in reducing stillbirths and preterm delivery.

Matched MeSH terms: Pregnancy; Pregnancy Outcome; Pregnancy, Multiple

An Overview of Adolescents Sexual and Reproductive Health Services Provision in Malaysia

Hazariah AHS, Fallon D, Callery P

Compr Child Adolesc Nurs, 2021 Jun;44(2):144-160.

PMID: 32442024 DOI: 10.1080/24694193.2020.1756983

Safer sex provision, including contraception information and services, should be made available to adolescents regardless of their marital status in strategies to reduce the incidence of unintended teenage pregnancies and the spread of STIs. In Malaysia, this information is still not being delivered formally to adolescents even though unintended teenage pregnancies and the practice of "baby dumping" are serious public health issues. The aims of this article are to describe the Malaysian context in terms of the need for comprehensive sexual and reproductive health information and treatment for unmarried adolescents. The article presents the key aspects of Malaysian society and the potential influence on the provision and delivery of sexual and reproductive health information and treatment to unmarried Malaysian adolescents that can be a reference for healthcare professionals especially school health nurses. The article also describes the establishment of sheltered homes, baby hatches and unregulated adoption processes as the initiatives being taken to address the issue of unintended teenage pregnancies. This article suggests that the policy and laws that require parental consent for accessing the services need to be reviewed and revised to ensure that specific services are available to adolescents in a safe environment that maintains confidentiality.

Matched MeSH terms: Pregnancy; Pregnancy in Adolescence*

Fulltext Trends in Prepregnancy Obesity and Association With Adverse Pregnancy Outcomes in the United States, 2013 to 2018

Wang MC, Freaney PM, Perak AM, Greenland P, Lloyd-Jones DM, Grobman WA, et al.

J Am Heart Assoc, 2021 09 07;10(17):e020717.

PMID: 34431359 DOI: 10.1161/JAHA.120.020717

Background The prevalence of obesity in the population has increased in parallel with increasing rates of adverse pregnancy outcomes (APOs). Quantifying contemporary trends in prepregnancy obesity and associations with interrelated APOs (preterm birth, low birth weight, and pregnancy-associated hypertension) together and individually can inform prevention strategies to optimize cardiometabolic health in women and offspring. Methods and Results We performed a serial, cross-sectional study using National Center for Health Statistics birth certificate data including women aged 15 to 44 years with live singleton births between 2013 and 2018, stratified by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian). We quantified the annual prevalence of prepregnancy obesity (body mass index ≥30.0 kg/m2; body mass index ≥27.5 kg/m2 if non-Hispanic Asian). We then estimated adjusted associations using multivariable logistic regression (odds ratios and population attributable fractions) for obesity-related APOs compared with normal body mass index (18.5-24.9 kg/m2; 18.5-22.9 kg/m2 if non-Hispanic Asian). Among 20 139 891 women, the prevalence of prepregnancy obesity increased between 2013 and 2018: non-Hispanic White (21.6%-24.8%), non-Hispanic Black (32.5%-36.2%), Hispanic (26.0%-30.5%), and non-Hispanic Asian (15.3%-18.6%) women (P-trend

Matched MeSH terms: Pregnancy; Pregnancy Outcome/epidemiology

Fulltext Sonographically abnormal placenta: an association with an increased risk poor pregnancy outcomes

Wan Masliza WD, Bajuri MY, Hassan MR, Naim NM, Shuhaila A, Das S

Clin Ter, 2017 10 19;168(5):e283-e289.

PMID: 29044348 DOI: 10.7417/T.2017.2021

BACKGROUND: The placenta is a most interesting but unfortunately often ignored and misunderstood organ. Placental abnormalities, therefore, can be an "early warning system" for fetal problems. A complete prenatal sonographic examination of the placenta is an essential component as its abnormalities can have a direct effect on fetal or maternal outcomes, obstetrical management and future fertility.

OBJECTIVE: To determine whether any association exists between the finding of an increased thickness of placenta, abnormal placenta shape, placental calcification, placental lake and abnormal cord insertion site at 20-22 and 30-32 weeks gestation with an increased risk of uteroplacental complications or a poor pregnancy outcome.

METHODOLOGY: A real-time ultrasound was used at the time of detail scan (at 20-22 weeks gestation) and at 30-32 weeks gestation to look for placenta appearance, fetal growth and anomaly. The main outcome measures were risk of hypertension disease in pregnancy, fetal growth restriction and poor fetal outcomes such as low Apgar score and low cord pH.

RESULT: The majority of the participants were Malay (77.9%). Abnormal placenta found at both gestations were placental lakes and thickness, and only one case had marginal cord insertion. Approximately 6% of the cases were confirmed placenta previa. No abnormal shape or abnormal calcification found at both gestations. About 10% patient developed hypertensive disease in pregnancy, 15% of the fetus was found to have growth restriction and another 16% have low umbilical cord pH. Majority of them delivered at term (90%) and via vaginal delivery (81%). There was no significance between presence of abnormal placental lake and thickness at both gestations with the maternal and fetal outcome.

CONCLUSION: Presence of abnormal placental thickness and lakes at 30-32 weeks scan associated with maternal hypertensive disease, fetal growth restriction and low umbilical cord pH, however these were not statistically significant.

Matched MeSH terms: Pregnancy; Pregnancy Outcome*

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