MyMedR

Intravaginal misoprostol for termination of midtrimester pregnancy

Lim JM, Soh EB, Raman S

Aust N Z J Obstet Gynaecol, 1995 Feb;35(1):54-5.

PMID: 7772001

Misoprostol seems to be a drug with many potential uses apart from the treatment of gastric and duodenal ulcers. The oral tablet appears to be effective for termination of midtrimester pregnancy when administered intravaginally. Further research should be carried out to determine its full range of action in order that the drug can be utilized to its maximum potential.

Acute puerperal inversion of the uterus--an obstetric emergency

Rachagan SP, Sivanesaratnam V, Kok KP, Raman S

Aust N Z J Obstet Gynaecol, 1988 Feb;28(1):29-32.

PMID: 3214380

Over a 17-year period, 15 patients with acute puerperal inversion of the uterus were managed at the University Hospital, Kuala Lumpur, an incidence of 1 in 4,836 deliveries. Injudicious traction on the umbilical cord before the uterus was well contracted, was probably the most important causative factor. Haemorrhage was more severe when removal of the placenta was done prior to correction of the inversion. Either the hydrostatic method or manual replacement were used but more often a combination of both techniques was found necessary. With careful management of the third stage of labour, this complication can be avoided.

Effects of Ramadan fasting on fetal health: A systematic review

Ong AKW, Yee AL, Fong AJH, Arasoo VJT, Ramadas A

Aust N Z J Obstet Gynaecol, 2023 Oct;63(5):625-637.

PMID: 37283305 DOI: 10.1111/ajo.13706

BACKGROUND: Ramadan fasting (RF) is mandatory for all healthy Muslims in the ninth month of the Islamic calendar. Although pregnant women are exempt from fasting, many make the decision to practise it. Concerns that fasting during pregnancy harms the fetus remain, as there are no firm recommendations regarding its safety.

OBJECTIVES: To provide a systematic review on the effects of RF on fetal health.

SEARCH STRATEGY: We conducted a literature search for peer-reviewed articles through Ovid MEDLINE, PubMed, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) until 31 December 2021.

SELECTION CRITERIA: All case-control and observational cohort studies that reported on fetal outcomes of pregnant women who underwent RF for at least one day during pregnancy are included.

DATA COLLECTION AND ANALYSIS: Two researchers independently reviewed the eligibility of all studies. A third researcher resolved any conflict between researchers. Findings are extracted from eligible papers and presented as narratives.

MAIN RESULTS: Fourteen articles are included based on eligibility criteria, with a total sample size of 2889. Studies demonstrate negative associations between RF and neonatal weight, amniotic fluid index, preterm birth and growth parameters mainly during the second and third trimesters. However, the evidence is not strongly supported.

CONCLUSION: There is limited data to elucidate the relationship between RF and fetal health, hence the need for more studies to provide a better understanding.

Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome

Lo TS, Tan YL, Cortes EF, Lin YH, Wu PY, Pue LB

Aust N Z J Obstet Gynaecol, 2015 Dec;55(6):593-600.

PMID: 26299981 DOI: 10.1111/ajo.12397

To clinically and sonographically evaluate the influence of anterior vaginal mesh (AVM) surgery with concomitant mid-urethral sling surgery (MUS) for stress urinary incontinence (SUI).

Major gynaecological surgery in patients with severe coronary artery disease--the combined approach

Kannan P, Sivanesaratnam V, Jeyamalar R, Delilkan A, Ong G

Aust N Z J Obstet Gynaecol, 1990 May;30(2):146-9.

PMID: 2400358

The gynaecologist today is likely to encounter elderly patients with severe coronary heart disease requiring major gynaecological surgery. The successful outcome in 2 such patients with compromised coronary circulation and impaired left ventricular function emphasized the importance of combined care with the cardiologist and the anaesthetist. The insertion of a Swan-Ganz catheter for close perioperative monitoring is vital. The intra-and postoperative problems are discussed.

Oral celecoxib versus oral diclofenac for post-perineal repair analgesia after spontaneous vaginal birth: a randomised trial

Lim SS, Tan PC, Sockalingam JK, Omar SZ

Aust N Z J Obstet Gynaecol, 2008 Feb;48(1):71-7.

PMID: 18275575 DOI: 10.1111/j.1479-828X.2007.00808.x

To compare oral celecoxib with oral diclofenac as pain reliever after perineal repair following normal vaginal birth.

Labour and perinatal outcome in women at term with one previous lower-segment Caesarean: a review of 1000 consecutive cases

Tan PC, Subramaniam RN, Omar SZ

Aust N Z J Obstet Gynaecol, 2007 Feb;47(1):31-6.

PMID: 17261097

To compare the outcome in 1000 women at term with one lower transverse Caesarean that was suitable for a trial of labour.

Readmission risk and metabolic, biochemical, haematological and clinical indicators of severity in hyperemesis gravidarum

Tan PC, Jacob R, Quek KF, Omar SZ

Aust N Z J Obstet Gynaecol, 2006 Oct;46(5):446-50.

PMID: 16953861

In a retrospective analysis of 192 cases of presumed hyperemesis gravidarum, there were no biochemical markers that predicted hospital readmission. There was, however, statistically significant negative predictive value in abnormal liver function tests. This could represent acute self-limited illness with a component of hepatitis as the cause for the clinical presentation, rather than hyperemesis.

The use of the semen analysis in predicting fertility outcome

Arumugam K, Omar SZ

Aust N Z J Obstet Gynaecol, 1992 May;32(2):154-7.

PMID: 1520202

The study investigates the use of the various parameters of the semen analysis in predicting the fertility outcome in 82 infertile couples. The sperm density, % progressive motility, % normal morphology were divided into 'normal' and 'abnormal' based on the criteria proposed by WHO. The subsequent cumulative pregnancy rates were then calculated according to this criteria. A life-table method of analysis was used. All female related fertility factors were excluded. With the exception of a sperm density of less than 20 x 10(6) per ml the other parameters showed no significant correlation with the cumulative pregnancy rates at 12 months or 24 months respectively. We concluded that the semen analysis does not predict the probable outcome of the subsequent rates even when female fertility related factors were excluded apart from a sperm density less than 20 x 10(6) per ml.

Induction of labour from 39 weeks in low-risk multiparas with ripe cervixes: A randomised controlled trial

Tan PC, Othman A, Win ST, Hong JGS, Elias N, Omar SZ

Aust N Z J Obstet Gynaecol, 2021 Jun 05.

PMID: 34089525 DOI: 10.1111/ajo.13377

BACKGROUND: Induction of labour (IOL) in low-risk nulliparas at 39 weeks reduces caesarean delivery. Multiparas with ripe cervixes typically have vaginal delivery within eight hours. Delivery at night and weekend are associated with higher maternal and neonatal mortality.

AIMS: To evaluate IOL in full-term multiparas with ripe cervixes to achieve delivery at normal working hours and improve maternal satisfaction.

METHODS: A randomised trial was performed in a tertiary hospital in Malaysia. Low-risk multiparas with ripe cervixes (Bishop score ≥6) were recruited at 38+4 -40+0 weeks, then randomised to planned labour induction at 39+0 weeks or expectant care. Primary outcomes were delivery during 'normal working hours' 09:00-17:00 hours, Monday-Friday and patient satisfaction by visual numerical rating scale.

RESULTS: For IOL (n = 80) vs expectant care (n = 80) arms respectively, primary outcomes of delivery at normal working hours was 27/80 (34%) vs 29/78 (37%), relative risk (RR) 0.9, 95% CI 0.5-1.7, P = 0.41, patient satisfaction was 8.0 ± 1.8 vs 7.8 ± 1.6, P = 0.41; presentation for spontaneous labour or rupture of membranes were 27/80 (34%) vs 70/79 (89%), RR 0.4, 95% CI 0.3-0.5, P

Screening for gestational diabetes at antenatal booking in a Malaysian university hospital: the role of risk factors and threshold value for the 50-g glucose challenge test

Tan PC, Ling LP, Omar SZ

Aust N Z J Obstet Gynaecol, 2007 Jun;47(3):191-7.

PMID: 17550485 DOI: 10.1111/j.1479-828X.2007.00717.x

Background: The best method of screening for gestational diabetes (GDM) remains unsettled. The 50-g glucose challenge test (GCT) is used in a two-stage screening process but its best threshold value can vary according to population.

Aims: To evaluate the role of risk factors in conjunction with GCT and to determine an appropriate threshold for the one-hour venous plasma glucose with the GCT.

Method: In a prospective study, 1600 women at antenatal booking without a history of diabetes mellitus or GDM filled a form on risk factors before GCT. Women who had GCT >or= 7.2 mmol/L underwent the 75-g oral glucose tolerance test (OGTT). GDM was diagnosed according to WHO (1999) criteria.

Result: Thirty-five per cent had GCT >or= 7.2 mmol/L, 32.6% underwent OGTT and 34.5% of OGTT confirmed GDM. The GDM rate in our population was at least 11.4%. Examination of the receiver operator characteristic curve suggested that the best threshold value for the GCT in our population was >or= 7.6 mmol/L. Multivariable logistic regression demonstrated that only GCT >or= 7.6 mmol/L was an independent predictor for GDM (adjusted odds ratio 3.7: P < 0.001). After GCT, maternal age and anthropometry, OGTT during the third trimester, family history, obstetric history and glycosuria were not independent predictors of GDM.

Conclusions: Risk factors were not independent predictors of GDM in women with GCT >or= 7.2 mmol/L. GCT threshold value >or= 7.6 mmol is appropriate for the Malaysian population at high risk of GDM.

Prenatal detection of birth defects in a Malaysian population: estimation of the influence of termination of pregnancy on birth prevalence in a developing country

Ho JJ, Thong MK, Nurani NK

Aust N Z J Obstet Gynaecol, 2006 Feb;46(1):55-7.

PMID: 16441696

We studied 253 women with a pregnancy complicated by a birth defect and 506 controls to determine the frequency and type of prenatal tests and the types of defects detected antenatally. Most women had at least one ultrasound examination, but the frequency of other screening tests was low. Only 38 (15%) of defects were detected antenatally (37 by ultrasound). Birth prevalence is unlikely to be affected by pregnancy termination.

'Lest we forget' as we move forward with cervical screening

Saville M, McNally O

Aust N Z J Obstet Gynaecol, 2018 Jun;58(3):265-266.

PMID: 29864221 DOI: 10.1111/ajo.12813

Severe anaemia in pregnancy (as seen in Kuala Lumpur, Malaysia)

Llewellynjones D

Aust N Z J Obstet Gynaecol, 1965 Nov;5(4):191-7.

PMID: 5215888

An unusual cause of antepartum haemorrhage

Soh EB, Lim JM

Aust N Z J Obstet Gynaecol, 1999 Aug;39(3):389-90.

PMID: 10554965

This is a rare case of antepartum haemorrhage arising from the nonpregnant uterus in a woman with uterine didelphys. The bleeding and subsequent passage of a decidual cast did not have any adverse effect on the ongoing pregnancy.

Eisenmenger syndrome in pregnancy

Jeyamalar R, Sivanesaratnam V, Kuppuvelumani P

Aust N Z J Obstet Gynaecol, 1992 Aug;32(3):275-7.

PMID: 1445144

Scar endometriosis presenting as an acute abdomen: a case report

Khoo JJ

Aust N Z J Obstet Gynaecol, 2003 Apr;43(2):164-5.

PMID: 14712976

Recurrent hydatidiform mole: a report of a patient with 7 consecutive moles

Thavarasah AS, Kanagalingam S

Aust N Z J Obstet Gynaecol, 1988 Aug;28(3):233-5.

PMID: 3233084

A rare case of hydatidiform mole occurring 7 consecutive times in a Chinese woman is presented. She was first seen in 1979 at the age of 23 years, with a molar pregnancy and subsequently had 6 consecutive moles, the last being in July, 1986; at this visit the patient and her husband were very depressed, and convinced that a normal pregnancy was unlikely and requested a hysterectomy. They were warned earlier several times, of the possible long-term consequences of a recurrent mole and that their chance of having a normal baby was very remote. A total hysterectomy was performed at her last presentation as the patient requested one, instead of dilatation and curettage for a persistently high HCG and bulky uterus following suction evacuation. Histology revealed an invasive mole. The beta HCG level was less than 4IU/l by the end of September, 1986 and she is still being followed-up.

Myocardial infarction in a young Indian grandmultipara

Kannan P, Raman S, Ramani VS, Jeyamalar R

Aust N Z J Obstet Gynaecol, 1993 Nov;33(4):424-6.

PMID: 8179560

Adjuvant cytotoxic chemotherapy following Wertheim radical hysterectomy for cervical cancer

Sivanesaratnam V, Sen DK, Jayalakshmi P

Aust N Z J Obstet Gynaecol, 1987 Aug;27(3):231-3.

PMID: 2449159

Patients at high risk of recurrence or metastases following radical surgery for Stage 1B and 2A cervical carcinoma include those with pelvic node metastases, lymphatic or vascular space permeation in the cervix by tumour cells, large size of the primary tumour, involvement of the full thickness of the cervix and parametrial spread. We report the initial results of adjuvant chemotherapy using a combination of cisplatinum, bleomycin and vinblastine in 22 patients who had undergone Wertheim radical hysterectomy and were thought to be at high risk of developing recurrence. The mean duration of follow-up was 23 months. All are alive after follow-up ranging from 13 to 43 months. Three patients developed recurrences--one in the pelvis, another at the posterior aspect of the urethral meatus and the third developed pulmonary secondaries at 20 to 23 months after surgery. Toxicity from the chemotherapy was acceptable.

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