Displaying publications 21 - 40 of 124 in total

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  1. The pattern of maternal mortality at maternity hospital Kuala Lumpur
    Nafisah Adeeb
    Malays J Reprod Health, 1983 Jan;1(1):34-9.
    PMID: 12279887
    Matched MeSH terms: Delivery, Obstetric
  2. Fulltext Nutritional anemia in pregnancy: a study at the maternity hospital, Kuala Lumpur
    Tee ES, Kandiah M, Ali J, Kandiah V, Zahari MR, Kuladevan R, et al.
    Malays J Reprod Health, 1984 Jun;2(1):32-50.
    PMID: 12267519
    The study presents recent data on the prevalence and pattern of nutritional anemia in the Maternity Hospital, Kuala Lumpur. A total of 309 pregnant women in their third trimester, of Malay, Chinese and Indian origin from the lower socio-economic strata were randomly selected for the study. Hematological indices (including Hb, PCV, MCHC, and TRBC), serum iron, transferrin saturation and ferritin, serum folate as well as protein and albumin were determined. Based on Hb and PCV values, 30-40 percent of the women could be considered anemic; approximately 50 percent of them presented with unsatisfactory serum iron, transferrin saturation and ferritin values; 60.9 percent had low serum folate levels; and about 30 percent may be considered to be of poor protein nutriture. Anemia in the study population was seen to be related mostly to iron and to a lesser extent, folate deficiency. Hematological, iron, folate and protein status was observed to be the poorest amongst the Indian women, better in the Malay group and generally the best amongst the Chinese women. Birth records of 169 of these women revealed that all of them had live births. Nearly all the infants were delivered by normal vaginal delivery (NVD) The mean gestational age was 38.6 weeks. One of the infants had a birth weight of <2.0 kg; incidence of low birth weight, <2.5 kg, was 8.3 percent. Although there was a trend of deteriorating hematological, iron and protein status of women from the 0, 1 -3 and >=4 parity groups, these differences were not statlstlcally significant.
    Matched MeSH terms: Delivery, Obstetric
  3. Fulltext Foreign bodies in the vagina after childbirth
    Goh TH
    Med J Malaysia, 1985 Mar;40(1):54-5.
    PMID: 3831738
    Matched MeSH terms: Delivery, Obstetric*
  4. Combined team management of diabetes mellitus in pregnancy
    Ng CS, Lim LS, Chng KP, Lim P, Cheah JS, Yeo PP, et al.
    Ann Acad Med Singap, 1985 Apr;14(2):297-302.
    PMID: 4037689
    225 women with diabetes in pregnancy were managed by a team of obstetricians, physicians (endocrinologists) and paediatricians from the National University of Singapore. A protocol of management was formulated and followed. The incidence of 1.1% or 1 in 90 pregnancies was found, with significantly higher incidence in Indians and lower in Malays. There were 37 established diabetics and 188 diagnosed during pregnancy. Of these (188), 74 were gestational diabetics. All the women were treated with Insulin and Diet or Diet alone. 177 (79%) were treated with Insulin and Diet. Blood sugar profiles were done for monitoring diabetic control. 72.8% of the women were between para 0 and 1 and 85.2% between the ages of 20 and 34. 72.5% of the women delivered at 38 weeks gestation or later. 48.9% went into spontaneous labour, 32.4% were induced and 18.7% had elective caesarean section. 62.2% of the women had labour of less than 12 hours. The overall caesarean section rate was 41.7%. There were 3 stillbirths and 2 neonatal deaths. The perinatal mortality rate was 2.2%. Thirteen babies had congenital malformations (5.8%). 77.8% of the babies had Apgar score of 7 or more at 5 minutes after delivery. 79.1% of the babies weighed between 2.5 kgm and 3.9 kgm. Pre-eclamptic toxaemia was the commonest complication in pregnancy followed by Urinary Tract Infection and Polyhydramnios. Postpartum complications in the mother were confined to 14 women (6.2%), and wound infection or breakdown was the commonest cause.
    Matched MeSH terms: Delivery, Obstetric/methods
  5. Differential utilisation of health facilities and services for childbirth in Peninsula Malaysia--the ethnic factor
    Arhsat H, Tan BA, Tey NP
    Malays J Reprod Health, 1985 Dec;3(2):105-14.
    PMID: 12314737
    Matched MeSH terms: Delivery, Obstetric*
  6. Fulltext Recurrent cystitis due to retained Jacques catheter--a case report
    Tharmaseelan NK
    Med J Malaysia, 1989 Sep;44(3):252-4.
    PMID: 2626140
    A case of persistent cystitis due to a Jacque's catheter as a foreign body in the bladder after an assisted vaginal delivery is described.
    Matched MeSH terms: Delivery, Obstetric
  7. Fulltext Three decades of breast-feeding trends in Singapore
    Chua S, Viegas OA, Ratnam SS
    Asia Pac Popul J, 1990 Mar;5(1):125-34.
    PMID: 12283342
    Matched MeSH terms: Delivery, Obstetric*
  8. Fulltext GIFT triplets and management problems--a case report
    Wong KK, Lim CT
    Med J Malaysia, 1991 Sep;46(3):294-6.
    PMID: 1839929
    Pregnancies conceived through assisted reproduction can present considerable management problems to the obstetric and paediatric staff. Multiple pregnancies are common. The complication of prematurity increases the morbidity and mortality rates of the neonates.
    Matched MeSH terms: Delivery, Obstetric
  9. Factors associated with clinically significant perinatal asphyxia in the Malaysian neonates: a case-control study
    Boo NY, Lye MS
    J Trop Pediatr, 1992 12;38(6):284-9.
    PMID: 1844086 DOI: 10.1093/tropej/38.6.284
    A 2-month prospective study was carried out in a Kuala Lumpur maternity hospital to determine the antenatal and intrapartum factors associated with perinatal asphyxia in the Malaysian neonates. The incidence of perinatal asphyxia was 18.7 per 1000 livebirths. Of the 75 asphyxiated neonates born during this period, 70 (93.3 per cent) were of term or post-term gestation. The incidence of perinatal asphyxia was more common in the neonates with one of the following characteristics: low birth weight (< 2500 g), breech delivery, or delivery by instrumentation or lower segment Caesarean section (P < 0.001). Conditional logistic regression analysis of the asphyxiated and the control neonates in a nested case-control study (after controlling for sex, race, birth weight, modes of delivery, and maternal gravida) showed that there were two associated factors which were of statistical significance. These were: small-for-gestation neonates and the presence of intrapartum problems. Our study suggests that to reduce the incidence of perinatal asphyxia, the common causes of small-for-gestation neonates and the common types of intrapartum problems should be identified to enable appropriate preventive measures to be carried out.
    Matched MeSH terms: Delivery, Obstetric/methods
  10. The use of medical audit to improve the care of high risk deliveries
    Hamzah-Sendut, I., Tee, Ah Chuan
    Malaysian Journal of Child Health, 1992;4(1):13-15.
    MyJurnal
    A medical audit is defined as a systematic and critical analysis carried out by doctors looking at the things that doctors do. The concept of auditing is relatively new to the medical profession. It is indeed an excellent instrument to institute change to medical practices which have been "institutionalized". A properly carried out audit can provide highly revealing data that can often sway an administrator to institute change. At the University Hospital Kuala Lumpur we chose to audit the paediatric attendances at high risk deliveries. High risk deliveries were defined as any delivery to which the obstetrician requested a paediatric attendance prior to delivery. A paediatrician must be on hand at all high risk deliveries to ensure proper resuscitation of the new born. The aim of the audit was to determine if paediatric attendance at high risk deliveries were optimal at the University Hospital. (Copied from article).
    Matched MeSH terms: Delivery, Obstetric
  11. A study on infant feeding practices amongst Malaysian mothers in a post-natal ward in Maternity Hospital, Kuala Lumpur
    Mohd Sham Kasim, Siti Norjinah Moin
    Malaysian Journal of Child Health, 1993;5(1):31-39.
    MyJurnal
    Cross-sectional studies on infant feeding practices in Malaysia have shown that even though there is a high percentage of initial breastfeeding, there is also a very rapid fall-off of full breastfeeding to be replaced by mixed feeding or full formula feeding. This paper gives the findings of a study conducted on 148 mothers who had just delivered their babies at the Maternity Hospital, Kuala Lumpur. 56 of these mothers were followed up to identify the feeding practices up to 6 months of the infant's life. Just after delivery, 83 .1% of the 148 motftrs had indicated interest to breasffeed either fully or partially. However, in the 56 mothers followed up later, 15 (26.7%) babies were not breasffed or breasffed for less than 1 week and only 15 (26.5%) were breasffed at least 6 months. Several factors affect breastfeeding rate amongst these mothers. Breastfeeding rate was significantly higher and longer amongst the Malays and least and shortest amongst the Chinese. The number of Malay mothers breastfeeding less than 1 week was 2 out of 24 (8.3%) whereas the number of Chinese mothers was 10 out of 19 (52.6%). Similarly, the number of Malay mothers breastfeeding beyond 3 months was 16 out of 24 (67.7%) and Chinese mothers only 4 out of 19 (21.0%). Other important factors are the type of initial feeding and the onset of initial formula feeding. Out of 26 babies initiated on breastmilk as the first feed, 12 were breasffed for at least 6 months whereas 8 of the 18 started on formulas were not breasffed at all or for less than 7 days and only one breastfed for at least 6 months. Similarly, out of 27 babies given formula feeding in the first 2 days, 15 were not breasffed at all or for less than 1 week and only 3 breasffed at least 6 months. This suggests the importance of early mixed feeding in the rapid decline of breastfeeding. The employment status of the mother and the family income do not seem to affect the breastfeeding rate and its duration for the baby.
    Matched MeSH terms: Delivery, Obstetric
  12. WHO partograph cuts complications of labour and childbirth
    Safe Mother, 1994 Jul-Oct;?(15):10.
    PMID: 12345820
    Matched MeSH terms: Delivery, Obstetric*
  13. Fulltext Outcome of inborn compared with outborn very low birth weight infants admitted to level 3 Malaysian nurseries. Neonatal Data Collection Group
    Med J Malaysia, 1995 Mar;50(1):42-51.
    PMID: 7752976
    To investigate whether a neonatal retrieval system would have any impact on the survival of infants < 1550g birthweight, data from the Malaysian Paediatric Association Very Low Birth Weight (VLBW) study were analyzed. Inborns had a significantly better survival than outborns. Outborn babies had more hypothermia, were more likely to die from hypothermia, received more blood and plasma transfusions, more exchange transfusions, and had more infections. Length of stay was significantly longer for outborns. A neonatal retrieval system could reduce the mortality of VLBW babies as well as reduce length of stay, antibiotic usage, and blood product usage.
    Matched MeSH terms: Delivery, Obstetric*
  14. Outcome of external cephalic version: our experience
    Teoh T
    J Obstet Gynaecol Res, 1996 Aug;22(4):389-94.
    PMID: 8870425
    The aim is to assess the outcome of external cephalic version (ECV) for term breech in our clinical setting and the factors involved. Patients with no contraindications and who consented to ECV were recruited into this prospective study. Terbutalin infusion was used. There were 42 ECV attempts of which 21 (50%) were successful. Seventeen of the patients with successful ECV delivered vaginally and 4 had cesarean section for various indications. Only 5 of the 21 unsuccessful ECV delivered vaginally. Thirteen had elective cesarean section and 2 had emergency cesarean during trial of breech. One patient from the unsuccessful ECV group was lost to follow-up. There were 31 (74%) primipara. The birth weight of the babies was not a significant factor in the outcome of ECV. The type of breech and parity did influence the success rate. External cephalic version should be included in the routine management of our breech presentation.
    Matched MeSH terms: Delivery, Obstetric
  15. Fulltext Central serous choroidopathy in pregnancy
    Normalina M, Zainal M, Alias D
    Med J Malaysia, 1998 Dec;53(4):439-41.
    PMID: 10971992
    Central serous choroidopathy is a spontaneous serous detachment of the sensory retina, usually affecting adults between 20 to 50 years of age but is also found in patients older than 60 years of age. This disease usually affects males with a male to female ratio of 8-10 to 1. Many aetiological or associated factors have been described. Here we report a 39-year-old pregnant lady presented with left central serous chorioretinopathy preceded by an unusual emotional disturbance. She was not given any photocoagulative treatment to avoid possible photocoagulative complications. Post delivery, she presented with resolution of the CSC.
    Matched MeSH terms: Delivery, Obstetric
  16. Human immunodeficiency virus prevalence in women at delivery using unlinked anonymous testing of newborns in the Malaysian setting
    Amar HS, Ho JJ, Mohan AJ
    J Paediatr Child Health, 1999 Feb;35(1):63-6.
    PMID: 10234638
    OBJECTIVE: To determine the community prevalence of human immunodeficiency virus (HIV) in women at the time of delivery in a Malaysian setting.

    METHODOLOGY: Cord blood samples from a pilot screening programme for congenital hypothyroidism in 1995 at Ipoh city and surrounding district hospitals were screened anonymously for HIV 1 and 2. HIV status was determined using chemiluminescent technology. Positive samples were retested using the Genelavia Mixt assay.

    RESULTS: A total of 4927 samples were tested. The ethnic breakdown included 51.7% Malays, 18.9% Chinese, 14.3% Indian, 2.3% Others and 12.9% unknown. The geographical distribution of samples was 73.9% urban, 24.2% rural and 1.9% unknown. The seroprevalence of HIV positivity was 3.25 per 1000 deliveries (95% CI: 1.92-5.16). Seroprevalence was higher for samples from rural and Malay mothers.

    CONCLUSION: The high seroprevalence in this study suggests that the spread of HIV is far wider than that anticipated by mandatory national reporting. It also supports antenatal screening and the use of antiretroviral therapy as an important strategy to reduce perinatal transmission.

    Matched MeSH terms: Delivery, Obstetric*
  17. Fulltext Revisiting the obstetric flying squad
    Ravindran J, Parampalam SD
    Med J Malaysia, 2000 Jun;55(2):280-2.
    PMID: 19839163
    The obstetric flying squad has been used in obstetric practice since 1933 to manage obstetric emergencies occurring in domicilliary practice. It has often been criticised in such situations as only delaying effective treatment to the patient. We have introduced the obstetric flying squad in an urban setting to cater for obstetric emergencies occurring in private practice. This service has been used on ten occasions since its inception without any maternal deaths being recorded or any delay in the provision of emergency care. The flying squad has led to closer cooperation between the government and private sectors in providing obstetric care.
    Matched MeSH terms: Delivery, Obstetric*
  18. Perinatal characteristics and outcome of neonates born in thick meconium-stained liquor
    Ida, S.B.O., Teh, K.H., Quah, B.S.
    Malaysian Journal of Paediatrics and Child Health, 2000;12(1):16-21.
    MyJurnal
    Meconium aspiration syndrome (MAS) frequently occurs in neonates born in thick meconium-stained liquor (TMSL). It continues to be a significant cause of neonatal morbidity and mortality despite aggressive approaches to intervention. This study aims to identify the perinatal characteristics of deliveries with TMSL associated with the development of MAS and to describe the outcome of those babies who developed MAS.
    All newborns with TMSL born in Hospital Alor Setar, Kedah from 1 October 1998 to 30 April 1999 were prospectively studied. In the hospital, all newborns with TMSL were routinely admitted to the Special Care Nursery for observation. Relevant data regarding pregnancy, delivery, resuscitation and outcome of newborns with and without MAS were collected and analysed. The incidence of TMSL among hospital deliveries was 2.2% (95% C.I. 1.8-2.5%). Thirty-six percent (95% C.I. 28.4-44.7%) of newborns with TMSL developed MAS. Significant risk factors associated with the development of MAS were non-Malay mothers (p=0.04, OR=3.32), resuscitation by paediatric medical officers (p=0.02, OR=2.84) and direct tracheal suction during resuscitation (p=0.02, OR=2.61). The presence of non-Malay mothers or resuscitation by paediatric medical officers or direct tracheal suction during resuscitation gave a sensitivity of 88.2%, specificity of 36.7%, a positive predictive value of 44.1% and a negative predictive value of 84.6% for the development of MAS. Asphyxia, pneumothorax and persistent pulmonary hyper-tension occurred in 25.5%, 7.8% and 5.9% of the babies with MAS respectively. Mechanical ventilation was required in 51% and the mortality rate was 3.9%. In conclusion, the incidence of TMSL and MAS and the mortality rate of neonates with MAS were comparable with that in developed countries. The presence of any one of the significant risk factors had high sensitivity but low specificity for the development of MAS. Newborns were unlikely to develop MAS if all these risk factors were absent.
    Matched MeSH terms: Delivery, Obstetric
  19. Delivery of macrosomic babies: management and outcomes of 330 cases
    Lim JH, Tan BC, Jammal AE, Symonds EM
    J Obstet Gynaecol, 2002 Jul;22(4):370-4.
    PMID: 12521456
    This study reviews the deliveries of macrosomic babies and their outcomes. A total of 330 macrosomic (birth weight > or =4 kg) cases were studied retrospectively from July 1999 to December 1999 in the Maternity Hospital of Kuala Lumpur. The variables studied included induction of labour, mode of delivery and the incidence of maternal and perinatal complications. Three hundred and thirty macrosomic infants were delivered during the period of study. Vaginal delivery was achived in 56% of the study cases. The percentage of vaginal delivery was higher among those who had induction of labour (63%) compared to the group without induction of labour (50%). Vaginal delivery was planned in 267 mothers and of these 69% achieved vaginal delivery. Twelve per cent of the macrosomic infants were delivered by elective caesarean section. Shoulder dystocia occurred in 4.9% of vaginal deliveries. Eighty-eight neonates were admitted to the special care nursery unit and 57% of these infants were delivered by elective caesarean section. Perineal trauma occurred in 26% of vaginal deliveries. Post-partum haemorrhage occurred in 32% of caesarean deliveries compared to 4% in vaginal deliveries. Two cases of stillbirths were documented but no maternal death occurred during the period of study. Vaginal delivery is the most frequent mode of delivery for a fetus weighing in excess of 4 kg and vaginal delivery should be attempted in the absence of contraindications, because vaginal delivery has less maternal morbidity compared to caesarean delivery. However, shoulder dystocia remains a significant complication of vaginal delivery for macrosomic fetuses.
    Matched MeSH terms: Delivery, Obstetric/statistics & numerical data*
  20. Fulltext A study of the place of deliveries in Terengganu 1999. [Kajian pilihan tempat bersalin di Negeri Terengganu 1999]
    Nordiyanah Hassan
    Malaysian Journal of Public Health Medicine, 2002;2(2):63-70.
    MyJurnal
    The number of deliveries increased very signdicantly in all hospitals in Terengganu since 1986. It is in line with the promotion of Safe Motherhood Initiative' with the aim to reduce maternal mortality and morbidity in a Terengganu. The aim of the study was to determine the pattern of choice for place of deliveries by local people in Terengganu and also to identdy risk factors related to their place of choice. A total of 9741 deliveries home January 1999 to 30”’ of June 1999 were included in the study. About 46% delivered in Hospital Kuala Terengganu, where 72% of them were high-risk mothers. Whereas deliveries in the district hospitals were 9.9% in Kemaman Hospital, 9.7% in Besut Hospital, 7.2% in Dungun Hospital and 3.4% in Hulu Terengganu Hospital. About 67% of district hospital deliveries were high-risk mothers. Only 12.4% of deliveries were home deliveries, however 49% of them were high-risk mothers. Utilization of alternative birthing centre in health clinics was only 1.7%. The study revealed that mothers’ risk factors are the factors signaicantly influence the place of choice for deliveries. The study jindings call for an urgent need of three essential services, Firstly an urban birthing centre conducted by obstetrician or the medical ojicers to be developed at the vicinity of the present general hospital to cater for the high percentage of high—risk pregnancies in the state. Secondly, all or selected district hospital to be given post for obstetrician, and thirdly it is a need to evaluate the current ‘High Risk Checklist for Antenatal Mothers’ to ensure treatment priority is indeed given to those really in need based on appropriate risk factors.
    Matched MeSH terms: Delivery, Obstetric
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