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Cervicograms of normal labour in Malaysian women

Peng WW, Aun LM, Sinnathuray TA, Lin WM

Med J Malaysia, 1976 Jun;30(4):261-3.
PMID: 979726
Matched MeSH terms: Labor, Obstetric*
Characteristics of normal labour among different racial groups in Malaysia

Lim MA, Wong WP, Sinnathuray TA

Br J Obstet Gynaecol, 1977 Aug;84(8):600-4.
PMID: 889748

The characteristics of normal labour in 977 Malay, Chinese and Indian parturients were established from a retrospective study. Indian babies were found to be significantly smaller than Malay babies which were significantly smaller than Chinese babies (P less than 0-05, P less than 0-05). The mean duration of the first stage of labour taken from the time of admission to the labour ward was 3-4 hours in primiparae and 2-7 hours in multiparae. The mean durations of the second stage of labour were 23-7 minutes and 13-1 minutes respectively. Curves of mean dilatation of cervix and probit analysis at 80% revealed significant differences in the progress of normal labour in primiparae among the three racial groups. The Indian primiparae not only had a slower rate of cervical dilatation but seemed to reach the accelerated phase of dilatation later. No significant differences were noticed in the labours of multiparae.

Matched MeSH terms: Labor, Obstetric*
Maternal blood pressure in pregnancy and newborn irritability

Chisholm JS, Woodson RH, da Costa Woodson EM

Early Hum Dev, 1978 Jul;2(2):171-8.
PMID: 720272

The neonatal period is being recognized as an important period for the development of patterns of interaction between mother and infant, and infant state has been shown to have a significant impact on mother--infant interactions. A major dimension of infant state, with implications for this interaction and for the development of later behaviour disorders, is the infant's irritability. Research with Navajo, Malay, Chinese and Tamil mothers and infants showed that normal variation in maternal blood pressure during pregnancy was related to newborn irritability as assessed with the Brazelton Scale. This relationship is discussed in terms of possible underlying mechanisms.

Matched MeSH terms: Labor, Obstetric
Fulltext Maternal and cord folate and vit.B12 levels in Malaysians at parturition

Ali J, Hassan K, Arshat H

Med J Malaysia, 1982 Jun;37(2):160-4.
PMID: 6890140

Folate and vitamin B 12 status in pregnancy was studied in a group of 190 Malaysian mothers belonging to the three major ethnic origins. Cord blood was also analysed for the same vitamins. Ethnic variations with regard to deficiency in these two vitamins was determined. About 58.5 percent of the pregnant mothers suffered from lowered serum folate levels and 32.4 percent had lowered RBC folate levels. In contrast vitamin B 12 levels were within normal limits. Cord blood levels of these vitamins were significantly higher than. the corresponding levels in the maternal blood, suggesting the possible involvement of an active process in the transfer of folates and vitamin B 12 to the fetus.

Matched MeSH terms: Labor, Obstetric*
Fulltext Towards better perinatal health

Ong HC

Med J Malaysia, 1983 Sep;38(3):176-7.
PMID: 6672555
Matched MeSH terms: Labor, Obstetric
Destructive heat and cooling prayer: Malay humoralism in pregnancy, childbirth and the postpartum period

Laderman C

Soc Sci Med, 1987;25(4):357-65.
PMID: 3686085 DOI: 10.1016/0277-9536(87)90274-7

Malaya, an ancient crossroads of trade, was the recipient of Chinese and Ayurvedic humoral ideas and, later, those of medieval Islam. These ideas were readily accepted by Malays, since they are highly congruent with pre-existing notions among aboriginal peoples of Malaya involving a hot-cold opposition in the material and spiritual universe and its effects upon human health. Islamic Malays have adapted these aboriginal beliefs to correspond to the Greek-Arabic humoral model in matters concerning foods, diseases, and medicines. Although Malay theories of disease causation include such concepts as soul loss and spirit attack, along with 'naturalistic' ideas such as dietary imbalance and systemic reactions to foods, all of these theories can either be reinterpreted in humoral terms, or, at least, are congruent with the basic tenets of Islamic humoral pathology. Behaviors and beliefs regarding human reproduction, however, while essentially following a humoral pattern, diverge from Islamic, as well as traditional Chinese and Indian Ayurvedic, humoral theories. Unlike any other major humoral doctrine, Malay reproductive theory (like that of non-Islamic aboriginal peoples of Malaya) equates coldness with health and fertility and heat with disease and sterility. These ideas, in turn, are related to beliefs regarding the nature of the spirit world: the destructiveness of spiritual heat and the efficacy of cooling prayer.

Matched MeSH terms: Labor, Obstetric
Cross-cultural perspectives on birth practices

Laderman C

Birth, 1988 Jun;15(2):86-7.
PMID: 3390277
Matched MeSH terms: Labor, Obstetric*
Ethnic influence on uterine activity in spontaneous normal labour

Arulkumaran S, Gibb DM, Chua S, Singh P, Ratnam SS

Br J Obstet Gynaecol, 1989 Oct;96(10):1203-6.
PMID: 2590656

Uterine activity in spontaneous normal labour was studied in Singaporean Malay women at term with a singleton vertex presentation. Nulliparae had significantly higher uterine activity compared with their multiparous counterparts. Uterine activity in the Malay population was compared with that of a similar Chinese population. When controlled for parity, maternal height and birthweight of babies, there was no difference in uterine activity between the two groups.

Matched MeSH terms: Labor, Obstetric/ethnology*; Labor, Obstetric/physiology
Dexamethasone modulation of gestation length and parturition in rats

Chatterjee A, Singh R, Chatterjee R

Pharmacol Res, 1993 May-Jun;27(4):359-64.
PMID: 8367382

Dexamethasone blocks aromatase and phospholipase A2 enzyme activities that are essentially involved in the formation of oestrogens and prostaglandins, the key chemicals to initiate parturition. The present study was undertaken to determine whether dexamethasone, a potent glucocorticoid, could prolong gestation and/or delay parturition in rats. Dexamethasone at 0.5 mg/rat/day from Day 19 through Day 21 of pregnancy consistently prolonged gestation. Only 36% of the pregnant rats had labour with an extended parturition time. Foetal mortality rate was also high. The remaining 64% pregnant rats that did not deliver showed intrauterine foetal death and resorption. Concomitant injection of oestradiol cyclopentylpropionate or prostaglandin F2 alpha on Day 19 effectively reversed the deleterious effects of dexamethasone. 100% of the pregnant rats had successful labour at term. The parturition time and foetal mortality rate were not different from controls. The results, therefore, indicate that an excess glucocorticoid that initiates parturition in sheep conversely prolongs gestation and delays parturition in rats.

Matched MeSH terms: Labor, Obstetric/drug effects
Fulltext Acceptability of epidural analgesia for pain relief during labour among Kelantanese women

Sharma S, Mohamad NA, Monga D, Achana S

Med J Malaysia, 1996 Dec;51(4):453-6.
PMID: 10968033

Three hundred and five primigravid women were interviewed at term to assess the acceptability of epidural during labour, and reasons for the decisions. Data was collected on a prestructured proforma which consisted of background information, socio-economic status, knowledge about epidural analgesia, source of information and reasons for choice. Of the 305 patients only 17.3% were willing to receive epidural analgesia. This group consisted of 56.6% non-Malay women. Those employed in professional or skilled jobs (56.6%) also readily consented for epidural. Nearly half the women willing for epidural had received college (tertiary) education (43.3%) and more than a quarter (26.4%) were over 30 years of age. The majority of those who were unwilling had no prior knowledge about the procedure, and refused either out of fear, ignorance, resistance from husbands, on religious grounds or following poor feedback from friends. In order to advocate epidural analgesia, knowledge has to be targeted to the relatively less educated, unemployed women, mainly through the media or personally in the antenatal clinic by doctors and nurses. Services have to be improved as substandard analgesia may send out wrong messages and actually do more harm than good.

Matched MeSH terms: Labor, Obstetric*
Epidural analgesia in primigravidae in spontaneous labour at term: a prospective study

Leong EW, Sivanesaratnam V, Oh LL, Chan YK

J Obstet Gynaecol Res, 2000 Aug;26(4):271-5.
PMID: 11049237

OBJECTIVES: To prospectively study the intervention rate, duration of labour, malpositions, fetal outcome, maternal satisfaction, voiding complications and adverse events in healthy primigravidae in spontaneous labour at term following epidural analgesia.
METHODS: A prospective randomized study involving 55 patients in the epidural group and 68 in the control pethidine--inhalational entonox group.
RESULTS: There were significantly more obstetric interventions (instrumental deliveries) in the epidural group (p < 0.01). The total duration of labour and the duration of the second stage was prolonged in the epidural group (p < 0.01). There were more malpositions at the second stage of labour in the epidural group (p < 0.02). There were no differences in fetal outcome (Apgar scores and Special Care Nursery admissions). Patients in the epidural group were consistently happier with their method of pain relief (p < 0.01). Two patients required blood patches while another 2 patients had persistent backache post epidural analgesia.
CONCLUSION: Epidural analgesia in primigravidae in spontaneous labour at term led to an increased instrumental delivery rate, prolonged duration of labour, greater rate of malpositions in the second stage, increased oxytocin requirements but with no difference in fetal outcomes but with happier mothers as compared to the control group.

Matched MeSH terms: Labor, Obstetric/physiology*
Membrane sweeping at initiation of formal labor induction: a randomized controlled trial

Tan PC, Jacob R, Omar SZ

Obstet Gynecol, 2006 Mar;107(3):569-77.
PMID: 16507926

To determine the benefit of membrane sweeping at initiation of labor induction in conjunction with formal methods of labor induction.

Matched MeSH terms: Labor, Obstetric/physiology*; Labor, Obstetric/psychology
Fulltext The Effect Of 5 Units Oxytocin Preparation In The Augmentation Of Labour – Is It Cost Effective?

Roszaman Ramli, Ghazali Ismail

International Medical Journal Malaysia, 2006;5(1):1-8.
MyJurnal

Objectives: To evaluate the cost-effectiveness of the new oxytocin regimes in the augmentation of labour and the effect on the maternal and fetal outcome. Design: Randomized controlled trial. Setting: Labour ward of Hospital Tengku Ampuan Afzan, Kuantan. Participants: 230 pregnant women in labour at term with obstetric indications for labour augmentation. Methods: The women were randomly assigned to receive new oxytocin regime of 5 units in 500 cc of D/Saline at titration of 5 dpm with increments of 5 dpm to a maximum of 60 dpm. Or, old oxytocin regime of 1/2/4 units with titration of 20/40/60 dpm for primips and half the dosage for multips.
Main outcome measures: Cost analysis, duration of labour, duration of augmentation, complication of labour, post partum hemorrhage (PPH), mode of delivery and perinatal outcome.
Results: There was no significant difference in the mean duration of labour (6.8 h vs 6.7 h ; p = 0.45) and mean augmentation time (3.86 h vs 4.0 h; p = 0.9) between the regimes studied There seemed to be higher incidence of caesarean section in the old oxytocin group (6.5% vs 24.7%; p = 0.001). There was no significant influence on the neonatal morbidity and mortality (p = 0.07). A moderate reduction of annual cost for augmentation of labour was noted (RM 962.34).
Conclusion: The results showed that the new oxytocin regime was more cost-effective without apparent increased in the maternal and fetal mortality and morbidity.

Matched MeSH terms: Labor, Obstetric
Fulltext Gartner duct cyst in pregnancy presenting as a prolapsing pelvic mass

Arumugam A, Kumar G, Si L, Vijayananthan A

Biomed Imaging Interv J, 2007 Oct;3(4):e46.
PMID: 21614298 MyJurnal DOI: 10.2349/biij.3.4.e46

Gartner duct cysts are the remnants of the Wolffian duct and they are rarely seen in adulthood. We present a case of a pregnant patient with a prolapsing vaginal mass. A diagnosis of Gartner duct cyst was made after MRI was performed. The Gartner duct cyst was drained when the patient went into labour allowing vaginal delivery to be performed.

Matched MeSH terms: Labor, Obstetric
Fulltext Understanding the decision-delivery interval in cesarean births

Naseem, Rashid, Nalliah, Sivalingam

International e-Journal of Science, Medicine & Education, 2007;1(2):61-68.
MyJurnal

Avoiding the adverse neonatal effects of perinatal asphyxia has been one of the common indications for cesarean deliveries in current obstetric practice. Expeditious delivery is dependent on decision to perform cesarean delivery and time lines achieved. A decision-delivery interval of 30 minutes, a concept initiated by the American College of Obstetricians and Gynecologists has open to debate as controversy reins about neonatal outcome when this time interval is considered in isolation. Time lines alone are probably not the only criteria to be employed, and may contribute to errors in interpretation by professional regulatory bodies and the society at large. Procedures prior to decision making like trial of labour, fetal scalp sampling and readily available resources for instituting emergent cesarean delivery invariably need to be considered. Though decision to delivery time is an integral component of critical conduct intervals in the acutely compromised fetus, a more pragmatic approach needs to be taken considering potential and known logistical and obstetric factors in line with good obstetric practice.

Matched MeSH terms: Labor, Obstetric
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: Labor, Obstetric
Fulltext Coitus and orgasm at term: effect on spontaneous labour and pregnancy outcome

Tan PC, Yow CM, Omar SZ

Singapore Med J, 2009 Nov;50(11):1062-7.
PMID: 19960160

INTRODUCTION: Coitus and orgasm in late pregnancy are believed to facilitate the onset of labour. We aim to evaluate the relationship at term of reported coitus and orgasm with spontaneous labour.
METHODS: Women at term scheduled for non-urgent labour induction were asked to keep a coitus and orgasm diary. These women were recruited for a randomised trial on the effect of coitus to promote spontaneous labour. For this analysis, the women were categorised into coitally-active and abstinent groups according to their coital diary. Spontaneous labour prior to the date of scheduled labour induction was the primary outcome. Labour, delivery and neonatal outcome were also evaluated. Multivariable logistic regression analysis was used to control for significant variables.
RESULTS: On univariate analysis, the inverse association of coitus with spontaneous labour was borderline (odds ratio [OR] 0.6; 95 percent confidence interval [CI] 0.3-1.0; p-value is 0.052). Orgasm was not associated with spontaneous labour (p-value is 0.33). After adjustment, coitus (adjusted OR 0.4; 95 percent CI 0.2-0.8; p-value is 0.009) displayed a significant inverse association with spontaneous labour. Coitus and orgasm were not associated with any other adverse pregnancy outcome.
CONCLUSION: Women who reported coitus were less likely to go into spontaneous labour prior to their scheduled labour induction. Reported coitus and orgasm were not associated with adverse pregnancy outcome.

Matched MeSH terms: Labor, Obstetric/physiology
Fulltext Second stage fetal heart rate patterns and neonatal acid-base status

Faridah Hanim Zam Zam, Nazimah Idris, Tham, Seng Woh

International e-Journal of Science, Medicine & Education, 2012;6(2):18-23.
MyJurnal

Background: Fetal surveillance in labour is performed mostly to identify fetuses at risk of hypoxia in order to reduce neonatal morbidity and mortality by initiating timely intervention. While normal and abnormal fetal heart rate (FHR) patterns have been well recognised and characterized for the first stage of labour, FHR patterns during the second stage of labour commonly showed some forms of abnormalities leading to problems in interpretation, particularly in predicting fetal hypoxia and acidosis. This study aims to identify patterns of FHR tracing during the second stage of labour associated with neonatal acidosis. Methods: A prospective cross sectional study was conducted in the Labour Ward of a state referral hospital. The study population were patients with low-risk
singleton pregnancies between 37 to 42 weeks gestation who had normal cardiotocograph (CTG) tracing in the first stage of labour. CTG was recorded during the second stage of labour and neonatal umbilical cord blood was obtained for acid-base analysis immediately after birth prior to the delivery of placenta. FHR patterns were grouped according to modified Melchior and Barnard’s
classification and matched with neonatal acid-base status. Patients with normal FHR pattern in the second stage acted as control. Results: A total of 111 matched pairs were analysed. Ninety nine (89.2%) second stage FHR tracings showed abnormal features when compared to control. There were significantly more neonatal acidosis and hypercapnia in type 1b, type 2a, type 2b and type 3 CTG patterns compared to control, in increasing order of severity. In addition, types 2b and 3 showed significant difference in the base excess. Conclusion: Certain second stage fetal heart rate
patterns were found to be associated with neonatal acidosis.

Matched MeSH terms: Labor, Obstetric
Fulltext Relationship between plasma cord blood zinc and infant birth weight in Fatemieh hospital, Hamadan, Iran

Mojgan, N., Sharifah Zainiyah, S.Y., Munn Sann, L., Zalilah, M.S.

Malaysian Journal of Public Health Medicine, 2012;12(1):49-56.
MyJurnal

The relationship between zinc and infant birth weight is still contradictory and up until today there is still no research on this issue done in Iran. This unmatched case control study to evaluate the association between plasma cord blood zinc and infant birth weight at the time of delivery was carried out in the labor ward, Fatemieh Hospital, Hamadan, Iran from the 6 th December 2009 to 18 October 2010. Plasma venous cord blood zinc was measured by AtomicAbsorption Spectro-photometry (AAS) and the weight of 134 Low Birth Weight (LBW) infants (cases) and 134 normal
weight infants (control) were measured at the time of delivery. All mothers with history of chronic diseases, obstetric complications, anemia, twin pregnancy, smoking, using illicit drugs, and alcohol and infants with any obvious anomalies were excluded from this study. Data were analyzed using SPSS version 16. Logistic regression was used to assess the contribution of other risk factors on infant birth weight. The result showed there was significant relationship between infant birth weight and plasma cord blood zinc. The risk of having LBW infant is more than 12 times in mothers who have severe zinc deficiency (OR=12.234,CI 95% 1.122, 133.392, p-value= 0.040). Also in mothers
who have mild to moderate zinc deficiency the risk of having LBW was more than one (OR=1.148, CI 95% 0.358, 3.900, p-value= 0.797). A significant relationship between maternal pre-pregnancy Body Mass Index (BMI) (p< 0.002), maternal weight gain during pregnancy (p< 0.021), previous LBW (p< 0.016), maternal age (p< 0.034) and parity (p< 0.004) with infant birth weight were also found. Logistic regression showed that zinc deficiency along with maternal pre-pregnancy BMI, maternal weight gain during pregnancy, previous LBW, maternal age and parity were predictors
for infant birth weight.

Matched MeSH terms: Labor, Obstetric
Fulltext Case Study on the effect of Epidural Analgesia on pain management during labour

Ho, S.E., Sumathi, U., Ismail, M.S., Choy, Y.C., Ahmad Zailani, H., Liu, C.Y.

Medicine & Health, 2013;8(1):33-36.
MyJurnal

Child birth is associated with severely painful experience for the parturient, and often exceeds one’s expectations. Even though, severe pain is non life-threatening condition in healthy parturient women, it may lead to undesired neuropsychological consequences. When no analgesia was used, postnatal depression may be more common, and this labour pain leads to the development of post-traumatic stress disorder. Epidural analgesia is now considered gold standard for effective pain relief during labour. We here report a case of a 37-year-old G1 P0 patient at term gestation who successfully used epidural analgesia for labour pain management.

Matched MeSH terms: Labor, Obstetric

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