MATERIALS AND METHODS: Retrospective study looking into patients diagnosed with acute leukemia or lymphoma in pregnancy from 1st January 2014 to 1st January 2020 in Ampang General Hospital including newly or previously diagnosed and relapsed disease RESULTS: 37 cases of acute leukemia or lymphoma in pregnancy occurred in 34 patients. Majority of acute leukemia or lymphoma in pregnancy diagnosed in 1st trimester or in the setting of previously established or relapsed disease was therapeutically terminated. Thirteen pregnancies treated with antenatal chemotherapy resulted in livebirths except one stillbirth. More adverse obstetric outcomes are observed in pregnancies that did not receive antenatal chemotherapy, but association did not reach statistical significance. There was no significant difference in fetal outcome between cohort with and without antenatal chemotherapy. No treatment related mortality was observed in pregnancies with antenatal chemotherapy. Overall survival for newly diagnosed acute leukemia in pregnancy is significantly better with antenatal chemotherapy versus no antenatal chemotherapy.
CONCLUSION: Treatment with chemotherapy in 2nd trimester of pregnancy onwards appears to have tolerable risks with favorable obstetric and fetal outcome. Deferment of treatment for acute leukemia in pregnancy to after delivery may cause increased risk of maternal and fetal adverse outcome.
OBJECTIVES: To determine the efficacy of desmopressin acetate in preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders.
SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coaguopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant and abstract books of conferences proceedings. We also searched for any randomised controlled trials in a registry of ongoing trials and the reference lists of relevant articles and reviews.Date of most recent search: 18 June 2015.
SELECTION CRITERIA: Randomised and quasi-randomised controlled trials investigating the efficacy of desmopressin acetate versus tranexamic acid or factor VIII or rFactor VII or fresh frozen plasma in preventing and treating congenital bleeding disorders during pregnancy were eligible.
DATA COLLECTION AND ANALYSIS: No trials matching the selection criteria were eligible for inclusion.
MAIN RESULTS: No trials matching the selection criteria were eligible for inclusion.
AUTHORS' CONCLUSIONS: The review did not identify any randomised controlled trials investigating the relative effectiveness of desmopressin acetate for bleeding during pregnancy in women with congenital bleeding disorders. In the absence of high quality evidence, clinicians need to use their clinical judgement and lower level evidence (e.g. from observational trials) to decide whether or not to treat women with congenital bleeding disorders with desmopressin acetate.Given the ethical considerations, future randomised controlled trials are unlikely. However, other high quality controlled studies (such as risk allocation designs, sequential design, parallel cohort design) to investigate the risks and benefits of using desmopressin acetate in this population are needed.
STUDY DESIGN: This is a cross sectional study involving primigravida in their third trimester of pregnancy, who attended the Patient Assessment Centre of a tertiary referral hospital in Klang Valley from July 2012 to June 2013. The participants were chosen randomly using convenience sampling. A face-to-face interview and a review of their antenatal record were done by trained interviewers. Data on sociodemographic and risk factors were obtained followed by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). The data was analysed using Statistical Package for Social Science version 20.0.
RESULTS: A total of 306 women were involved. The prevalence of urinary incontinence during third trimester was 34.3% (95%CI: 29.0, 39.7). Stress incontinence (64.8%) is the commonest followed by mixed incontinence (24.8%) and urge incontinence (6.7%). Childhood enuresis (p=0.003) and previous history of urinary incontinence (p<0.001) were significantly associated with urinary incontinence. More than 50 percent of women with urinary incontinence in the third trimester felt that it did not affect their daily activities at all. Only 10% of women felt greatly affected by this problem.
CONCLUSION: Urinary incontinence is not uncommon among primigravida however many women did not feel that it affected their quality of life. Childhood enuresis and history of urinary incontinence were proven risk factors.