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Fulltext Predictors of SLE relapse in pregnancy and post-partum among multi-ethnic patients in Malaysia

Shaharir SS, Mohamed Said MS, Mohd R, Abdul Cader R, Mustafar R, Abdul Rahman R

PLoS One, 2019;14(9):e0222343.
PMID: 31539383 DOI: 10.1371/journal.pone.0222343

Flare of Systemic Lupus Erythematosus (SLE) may occur during pregnancy and puerperium. We studied the prevalence and factors associated with SLE relapse during pregnancy and post-partum period in a multi-ethnic SLE cohort. Consecutive SLE patients who attended the outpatient clinic were reviewed for previous history of pregnancies in our institution. Patients who had a complete antenatal, delivery, and post-partum follow up were included. Their medical records were retrospectively analysed to assess the disease activity at pre-pregnancy/conception, during antenatal, and post-partum period. Presence of flare episodes during pregnancy and puerperium were recorded. The pregnancy outcomes recorded include live birth, foetal loss, prematurity and intra-uterine growth restrictions (IUGR). Univariate and multivariable logistic regression with generalized estimating equations (GEE) analyses were performed to determine the factors associated with disease relapse and the pregnancy outcomes. A total of 120 patients with 196 pregnancies were included, with a live birth rate of 78.6%. Four (2.0%) were diagnosed to have SLE during pregnancy. The flare rate in pregnancy was 40.1% while post-partum 17.4%. Majority of the relapse in pregnancy occurred in haematological system (62.3%) followed by renal (53.2%), musculoskeletal (22.1%), and mucocutaneous (14.3%). In GEE analyses, active disease at conception was the independent predictor of SLE relapse during and after pregnancy, whereas older maternal age and Malay ethnicity were associated with higher flare during post-partum. HCQ use was significantly associated with reduced risk of flare in univariate analysis but it was no longer significant in the GEE analyses. Presence of disease flare in pregnancy was significantly associated with prematurity. In conclusion, pregnancy in SLE need to be planned during quiescent state as pre-pregnant active disease was associated with disease relapse in both during and after pregnancy. Malay patients had an increased risk of post-partum flare but further larger prospective studies are needed to confirm the association between pregnancies in the different ancestral background.

Matched MeSH terms: Pregnancy; Pregnancy Complications/ethnology; Pregnancy Complications/etiology; Pregnancy Complications/epidemiology*
Fulltext Assessment of Awareness of Local Anaesthetic Systemic Toxicity (LAST) among Postgraduate Trainees

Jamaleddin Surani SA, Budiman M, Azman M, Abdul Rahman R

Int J Clin Pract, 2022;2022:4090444.
PMID: 36458263 DOI: 10.1155/2022/4090444

INTRODUCTION: Although uncommon, local anaesthetic systemic toxicity (LAST) may impose fatal risk to the patients. We investigated the awareness of LAST and knowledge on local anaesthetics among our postgraduate trainees.
MATERIALS AND METHODS: A total of 134 postgraduate trainees from the departments of general surgery (Surgical), orthopaedic surgery (Ortho), otorhinolaryngology (ENT), obstetrics and gynaecology (OBGYN), as well as anaesthesiology and intensive care (Anaesth) were recruited. A validated questionnaire was used to assess awareness and knowledge. All participants attended a medical-education session and completed the questionnaire as preassessment and postassessment. Data were analysed, and comparisons between disciplines were conducted.
RESULTS: The trainees' awareness of LAST was overall poor at preassessment which improved almost 6-folds at postassessment. Surprisingly, only 20 (45.5%) participants from the anaesthesiology group had awareness of LAST at preassessment, and none of the participants were from surgical, orthopaedic, and obstetrics and gynaecology departments. Preassessment scores were significantly higher in the anaesth group as compared to all other groups; with a difference in the average score for Anaesth vs Surgical of 3.46 (95%, CI:2.17, 4.74), Anaesth vs Ortho of 3.64 (95%, CI:2.64, 4.64), Anaesth vs ENT of 3.43 (95%, CI:2.20, 4.67), and Anaesth vs OBGYN of 6.93 (95%, CI:5.64, 8.21). However, there was no significant difference of awareness scores between all participants at postassessment scores.
CONCLUSION: The overall level of awareness was poor. However, the implementation of an education session significantly improved the knowledge and awareness across all disciplines.

Matched MeSH terms: Pregnancy
Fulltext Pregnancy with hypoplastic left lung complicated by pneumothorax and pulmonary embolism

Zainudin LD, Abdul Hafidz MI, Zakaria AF, Mohd Zim MA, Ismail AI, Abdul Rani MF

Respirol Case Rep, 2016 Mar;4(1):19-21.
PMID: 26839696 DOI: 10.1002/rcr2.143

We report a case of a 34-year-old lady with past history of asthma and pulmonary tuberculosis, who presented 5 weeks pregnant with acute dyspnea. Her chest X-ray showed left-sided complete lung collapse and concomitant right-sided pneumothorax. The pneumothorax was initially managed conservatively with a chest tube but due to its persistence despite suction, was subsequently changed to a Pneumostat(TM), with which she was later discharged. She had a normal echocardiography (ejection fraction [EF] 67%) at 5 weeks of gestation but developed pulmonary hypertension (EF 55%, pulmonary arterial pressure 40.7 mmHg) as the pregnancy progressed. She delivered a healthy baby at 35 weeks via elective lower section caesarean section with spinal anesthesia. We followed her up postnatally and noted the presence of left-sided pulmonary embolism, hypoplastic left lung, and left pulmonary artery. The management of this complex case involved a multidisciplinary effort between general medical, respiratory, obstetric, and cardiothoracic teams.

Matched MeSH terms: Pregnancy
Fulltext Focus group discussions on female genital cutting

Siti Nur Afiqah Zahari, Yufu Iguchi, Abdul Rashid

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):18-18.
MyJurnal

Introduction: Female Genital Cutting (FGC) is a sensitive issue as this topic is always associated with religion and culture in Malaysia. In the past, FGC is performed by the traditional midwives. However, this practice has been med-icalized nowadays. This study aimed to understand the reasons of performing FGC, the decision making, the practice and the future of FGC among rural community in Northern Malaysia. Methods: Focus group discussions (FGD) were conducted on three groups of young women aged 18-45, older women aged 45 and above and a group of married adult men. All of them were Malay Muslims who were conveniently selected from a rural village in Northern Malay-sia. A semi-structured interview guide was used to conduct the FGD focusing on the reasons, decision making, the practice and the future of FGC. Data was collected until saturation of information was achieved. These participants were chosen based on their willingness to take part in the discussion and also based on their personality of being talkative and able to give feedback to the questions. Results: The result of the interviews revealed that religion is the reason of practicing FGC. All of the participants from each FGD prefer to go to the doctor in the clinic compared to the traditional midwives. The men in this FGD mentioned that they rarely involved in the decision making of the FGC and only the mother or the grandmother to take the responsibility to decide. Conclusion: Generally, majority Malay Muslims community from the rural areas in Northern Malaysia believed that FGC is compulsory in Islam and they prefer to go to the doctors to perform FGC.

Matched MeSH terms: Pregnancy
Contributory Factors for Severe Maternal Morbidity: A 10-Year Review of the Literature

Noor NM, Nik Hussain NH, Sulaiman Z, Abdul Razak A

Asia Pac J Public Health, 2015 Nov;27(8 Suppl):9S-18S.
PMID: 26069164 DOI: 10.1177/1010539515589811

Maternal morbidity is a concept of increasing interest in maternal health. This review aims to assess the contributory factors for severe maternal morbidity over the past one decade worldwide. A comprehensive electronic search was conducted. The search was restricted to articles written in the English language published from 2004 to 2013. Qualitative studies were excluded. A total of 24 full articles were retrieved of which 9 cohort, 7 case-control, 3 cross-sectional studies, and 5 unmentioned designs were included. The contributory factors were divided into 3 components: (a) sociodemographic characteristics, (b) medical and gynecological history, and (c) past and present obstetric performance. This review informs emerging knowledge regarding contributory factors for severe maternal morbidity and has implications for education, clinical practice and intervention. It enables a better understanding of the problem and serves as a foundation for the development of an effective preventive strategy for maternal morbidity and mortality.

Matched MeSH terms: Pregnancy; Pregnancy Complications/epidemiology*
Fulltext Maternal intake of dietary virgin coconut oil modifies essential fatty acids and causes low body weight and spiky fur in mice

Gunasekaran R, Shaker MR, Mohd-Zin SW, Abdullah A, Ahmad-Annuar A, Abdul-Aziz NM

BMC Complement Altern Med, 2017 Jan 28;17(1):79.
PMID: 28129764 DOI: 10.1186/s12906-017-1600-z

Coconut oil is commonly used as herbal medicine worldwide. There is limited information regarding its effects on the developing embryo and infant growth.

Matched MeSH terms: Pregnancy
Fulltext Cranial neural tube defect after trimethoprim exposure

Abdullah NL, Gunasekaran R, Mohd-Zin SW, Lim BH, Maniam P, Mohd-Salleh AS, et al.

BMC Res Notes, 2018 Jul 16;11(1):475.
PMID: 30012199 DOI: 10.1186/s13104-018-3593-1

OBJECTIVES: The Neural Tube Defects Research Group of University of Malaya was approached to analyze a tablet named TELSE, which may have resulted in a baby born with central nervous system malformation at the University of Malaya Medical Centre. In this animal experimental study, we investigated the content of TELSE and exposure of its contents that resulted in failure of primary neurulation.
RESULTS: Liquid Chromatography Tandem Mass spectrophotometry analysis of the TELSE tablet confirmed the presence of trimethoprim as the active compound. The TELSE tablet-treated females produced significant numbers of embryos with exencephaly (n = 8, 36.4%, *P

Matched MeSH terms: Pregnancy
Fulltext Transverse cerebellar diameter as a sonographic parameter for estimating gestational age: an experience from Yemeni population

Muneera A. S. Yahya, Husni A. Al- Goshae, Hameed M. Aklan, Maha Abdul-aziz, Abdullah A. Al-Mikhlafy

Malaysian Journal of Medicine and Health Sciences, 2020;16(107):23-27.
MyJurnal

Introduction: Estimation of gestational age (GA) is clinically crucial for managing pregnancy and assessing the foetal anatomy, growth and development. Transverse cerebellar diameter (TCD) has been reported as an accurate tool for dating the pregnancy. This study aimed to determine the accuracy of foetal TCD for dating the pregnancy and to con- struct a reference chart for GA of Yemeni foetuses. Methods: We conducted this prospective cross-sectional study among 400 Yemeni pregnant women between 18 and 40 weeks of gestation provided that they were with known last menstrual period and singleton normal pregnancies. Sonographic TCDs were measured for each foetus. The mean TCD was measured for gestational weeks separately, and a polynomial regression model was then used to predict the GA by TCD. Results: There was a robust correlation between GA and TCD (r = 0.995, p

Matched MeSH terms: Pregnancy
Fulltext Eclampsia in Kelantan

Nalliah S, Abdullah AR

Med J Malaysia, 1990 Mar;45(1):49-56.
PMID: 2152069

A review of eclampsia in Kelantan was undertaken from 1983-1988. There were 146 documented cases in the state (66 per 100,000 deliveries). Eight maternal deaths occurred. Sixty seven (45.9%) were primigravida. Six of the 79 multiparous women developed eclampsia for the first time following remarriages to new partners. The multisystem dysfunction resulting from eclampsia resulted in varied maternal complications. Fatal cerebral haemorrhage (3 cases), acute pulmonary oedema (8 cases), acute renal failure (6 cases), HELLP Syndrome (8 cases) and acute abruptio placentae were the commoner complications. The average number of convulsions per patient was 1.3. The mean gestation of mothers who delivered prematurely (28.2%) was 34.6 weeks and that for those at term (71.8%) was 39.1 weeks. The caesarean section rate was 42.5%. The perinatal mortality rate was 185.9 per 1000. The implications of this high maternal and fetal mortality and morbidity are discussed in the light of the health delivery system and patient education. A team approach to medical management of eclampsia with the need for intensive care monitoring is suggested.

Matched MeSH terms: Pregnancy; Pregnancy Outcome
Fulltext Spontaneous Rupture in a Non-Laboring Uterus at 20 Weeks: A Case Report

Omar NS, Mat Jin N, Mohd Zahid AZ, Abdullah B

Am J Case Rep, 2020 Aug 10;21:e924894.
PMID: 32776917 DOI: 10.12659/AJCR.924894

BACKGROUND Uterine rupture is uncommon but when it happens, it can cause significant morbidity and mortality to both mother and fetus. Incidence reportedly is higher in scarred than in unscarred uteri. Most cases occur in laboring women in their third trimester with a previous history of uterine surgery, such as caesarean delivery or myomectomy. We present a case of spontaneous uterine rupture in a non-laboring uterus in the mid-trimester of pregnancy. CASE REPORT The patient presented with threatened miscarriage at 17 weeks' gestation and ultrasound findings were that raised suspicion of a morbidly adherent placenta. Her history was significant for two previous cesarean deliveries more than 5 years ago followed by two spontaneous complete miscarriages in the first trimester. The patient was managed conservatively until 20 weeks' gestation, when she presented with acute abdomen with hypotensive shock. Her hemoglobin dropped to a level such that she required blood transfusion. An emergency exploratory laparotomy was performed, which revealed a 5-cm rupture in the lower part of the anterior wall of the uterus, out of which there was extrusion of part of the placenta. Given the patient's massive bleeding, the decision was made to proceed with subtotal hysterectomy. Histopathology of the specimen confirmed the diagnosis of placenta percreta. CONCLUSIONS Identification of uterine scarring with morbidly adherent placenta is crucial because even in early pregnancy, it can lead to uterine rupture. Furthermore, failure to recognize and promptly manage uterine rupture may prove fatal.

Matched MeSH terms: Pregnancy; Pregnancy Trimester, Second
Fulltext Management of Severe Traumatic Brain Injury in Pregnancy: A Body with Two Lives

Kho GS, Abdullah JM

Malays J Med Sci, 2018 Sep;25(5):151-157.
PMID: 30914871 MyJurnal DOI: 10.21315/mjms2018.25.5.14

Traumatic brain injury is the major contributing factor in non-obstetric mortality in developing countries. Approximately 20% of maternal mortality is directly correlated to injuries. Road traffic accidents and domestic violence are the most common nonlethal injuries that can threaten either the maternal or foetal life, and such events occur in one out of every 12 pregnancies. The treatment of severe traumatic brain injury in pregnancy requires a multidisciplinary team approach. The management of a pregnant trauma patient warrants consideration of several issues specific to pregnancy, such as the alterations in the maternal physiology and anatomy. In the case of maternal cardiac arrest with amniotic fluid embolism, intact neonatal survival is linked with the timing of caesarean section after maternal cardiac arrest. Moreover, the decision for perimortem caesarean section is clear after maternal cardiac arrest. The foetal survival rate is 67% if the operation is done before 15 min of cardiopulmonary compromise has occurred, and it drops to 40% at the duration range of 16-25 min. Whether minor or severe, traumatic brain injury during pregnancy is associated with unfavourable maternal outcomes. Injuries considered minor for the general population are not minor for pregnant women. Therefore, these patients should be intensively monitored, and multidisciplinary approaches should always be involved.

Matched MeSH terms: Pregnancy
Fulltext Review on human toxoplasmosis in Malaysia: the past, present and prospective future

Nissapatorn V, Abdullah KA

Southeast Asian J. Trop. Med. Public Health, 2004 Mar;35(1):24-30.
PMID: 15272740

We reviewed various studies regarding human toxoplasmosis in Malaysia. They showed a varying prevalence of specific Toxoplasma antibodies among the Malaysian population. The Malays have shown the highest seroprevalence of toxoplasmosis, by most studies, when compared to other races. Demographic profiles have shown that Toxoplasma seropositivity is higher in males than females, lower in people with higher incomes, higher in the unemployed and tends to increase with age. In general, the route of transmission, such as contact with a cat, consumption of undercooked meat and blood transfusion were shown to have no significant association with Toxoplasma seropositivity (p > 0.05). The immune status (CD4 cell count < 200 cell/mm3) was strongly associated with toxoplasmic encephalitis (p < 0.05).

Matched MeSH terms: Pregnancy; Pregnancy Complications, Parasitic/diagnosis; Pregnancy Complications, Parasitic/epidemiology*
Fulltext Maternal Kangaroo care education program in the neonatal intensive care unit improved mothers' perceptions, knowledge, perceived barriers and stress relates to premature infant

Samsudin S, Chui PL, Kamar ABA, Abdullah KL

Nurs Open, 2023 Jan;10(1):349-357.
PMID: 36514142 DOI: 10.1002/nop2.1311

AIM: To assess the effectiveness of the maternal kangaroo care education programme over 1 month and 3 months on the mother's perception, knowledge, perceived barriers and stress.
DESIGN: A quasi-experimental and longitudinal study was conducted among mothers with premature infants.
METHODS: Forty-eight mother-infant dyads were enrolled per arm in the control and experimental groups. The control group received standard routine care, while the experimental group received a maternal kangaroo care education program. Data were collected through self-administered Kangaroo Care Questionnaires. Chi-square, the general linear model and repeated measures ANOVA were used to analyse data.
RESULTS: The demographics are a majority of Malay mothers with multipara, a caesarean delivery with prematurity. At 3 months post-intervention, the experimental group reported a significant reduction in stress, a positive perception and good knowledge towards kangaroo care implementation. The mothers' perceived barriers towards kangaroo care significantly decreased after 3 months in the experimental group.

Matched MeSH terms: Pregnancy
Fulltext Immunomodulatory properties of Tamm-Horsfall glycoprotein (THP) and uromodulin

Hong CY, Wong NK, Abdullah M

Asian Pac J Allergy Immunol, 2015 Mar;33(1):26-32.
PMID: 25840631 DOI: 10.12932/AP0463.33.1.2015

Tamm-Horsfall glycoprotein (THP) and uromodulin are the most abundant glycoproteins in non-pregnant women's/men's and pregnant women's urine, respectively. However, the bioactivities of these glycoproteins are still unclear.

Matched MeSH terms: Pregnancy
Fulltext Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH) - a prospective follow-up study

Jeevaratnam K, Nadarajah VD, Judson JP, Nalliah S, Abdullah MF

BMC Pregnancy Childbirth, 2010;10:58.
PMID: 20920154 DOI: 10.1186/1471-2393-10-58

Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry.

Matched MeSH terms: Pregnancy/blood; Hypertension, Pregnancy-Induced/blood*; Hypertension, Pregnancy-Induced/pathology*
Fulltext Successful external cephalic version: factors predicting vaginal birth

Lim PS, Ng BK, Ali A, Shafiee MN, Kampan NC, Mohamed Ismail NA, et al.

ScientificWorldJournal, 2014;2014:860107.
PMID: 24587759 DOI: 10.1155/2014/860107

To determine the maternal and fetal outcomes of successful external cephalic version (ECV) as well as factors predicting vaginal birth.

Matched MeSH terms: Pregnancy; Pregnancy Outcome
Vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers in Malaysia

Kalok A, Loh SYE, Chew KT, Abdul Aziz NH, Shah SA, Ahmad S, et al.

Vaccine, 2020 02 24;38(9):2183-2189.
PMID: 32001070 DOI: 10.1016/j.vaccine.2020.01.043

BACKGROUND: Vaccine hesitancy is a complex behaviour which involves various degrees of indecision about specific vaccines or vaccination uptake. Access to antenatal care had been associated with positive vaccine behavior.
OBJECTIVE: To determine the prevalence of vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers and the associated socio-demographic factors.
METHODS: A cross-sectional study was conducted among 1081 women who received antenatal care at a teaching hospital in Kuala Lumpur. Vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines (PACV) Survey in both English and validated Malay versions. The sociodemographic data of the mothers and their partners, source of vaccine information and reasons for hesitancy were analysed.
RESULTS: Eighty-six (8.0%) pregnant mothers were vaccine hesitant. Ethnicity, religion, number of children, educational level and employment status were significantly associated with vaccine hesitancy. Multivariable analysis showed that a low level of education was the most significant risk factor (p

Matched MeSH terms: Pregnancy
Fulltext The determinants of maternal perception of antenatal care services during the COVID-19 pandemic critical phase: A systematic review

Bahari NI, Sutan R, Abdullah Mahdy Z

PLoS One, 2024;19(2):e0297563.
PMID: 38394134 DOI: 10.1371/journal.pone.0297563

INTRODUCTION: The COVID-19 pandemic has exerted devastating effects on healthcare delivery systems, specifically those for pregnant women. The aim of this review was to determine the maternal perception of antenatal health care services during the COVID-19 pandemic critical phase.
METHODS: Scopus, Web of Science, SAGE, and Ovid were systematically searched using the keywords "maternal", "COVID-19 pandemic", "maternal health service", and "maternal perception". Articles were eligible for inclusion if they were original articles, written in English, and published between January 1, 2020, and December 12, 2022. This review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible articles were assessed using the Mixed Methods Appraisal Tool. Thematic analysis was used for data synthesis.
RESULTS: Of 2683 articles identified, 13 fulfilled the inclusion criteria and were included in the narrative synthesis. Five themes emerged regarding the determinants of maternal perception of antenatal healthcare services during the COVID-19 pandemic critical phase: lack of psychosocial support, poor maternal healthcare quality, poor opinion of virtual consultation, health structure adaptation failure to meet women's needs, and satisfaction with maternal health services.
CONCLUSION: Maternal perception, specifically pregnant women's psychosocial and maternal health needs, should be focused on the continuation of maternal care during the COVID-19 pandemic. It is critical to identify the maternal perception of maternal health services during the pandemic to ensure health service equity in the "new normal" future.

Matched MeSH terms: Pregnancy
Maternal hepatitis C (HCV) infection and Anti-D immunoglobulin therapy: study testing antibodies, RNA and Genotype of HCV in Baghdad

Al-Kubaisy W, Daud S, Al-Kubaisi MW, Al-Kubaisi OW, Abdullah NN

J Matern Fetal Neonatal Med, 2019 Oct;32(20):3464-3469.
PMID: 29656685 DOI: 10.1080/14767058.2018.1465557

Introduction: Hepatitis C virus (HCV) infection is a serious health problem. It is a major contributor to end-stage liver disease. Worldwide, 1-8% of all pregnant women were infected. Women with viral hepatitis may be at an increased risk of pregnancy complications. There are several obstetrics intervention acts as risk factors, which are specific to women pertaining the HCV infection; anti-D immunoglobulin (Ig) therapy may be one of them. Our objectives were to estimate the prevalence of HCV antibodies (anti-HCV), RNA, and genotype distribution among women with anti-D Ig therapy. Materials and methods: A cross sectional study was conducted. A sample of 154 Rhesus negative (Rh - ve) pregnant women regardless of the anti-D Ig therapy was collected. Anti-HCV were tested using third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia Tek-111), subsequently. In addition, 89 serum samples were subjected to molecular analysis using RT-PCR and DNA enzyme immunoassay (DEIA) method for the detection of HCV-RNA and genotypes. Results: Anti-HCV, and HCV-RNA seroprevalence were significantly higher (17.1, 35.5%) among women with anti-D Ig than their counter group (6.4, 13.16%), p = .038, .018, respectively. Significant direct positive dose response correlation (r = 0.78, p = .005) had been seen between number of anti-D Ig therapy and anti-HCV seropositive rate. Anti-D Ig therapy act as a risk factor (odds ratio (OR) = 3.01, 95%CI: 1.01-8.9) especially from the third dose onward. Women with anti-D Ig therapy were at higher risk (3.6 times more) of positive HCV-RNA (OR =3.6, 95%CI =1.19-10.837). Genotype HCV-1b showed higher prevalent (52.9%) among the recipients of anti-D Ig therapy while genotype HCV-3a (6.6%) was the lowest. Conclusions: Our study showed that Anti-D immunoglobulin therapy acts as a risk factor for acquiring HCV infection. Screening for HCV should be recommended for all recipients of anti-D Ig. Not only HCV antibodies but HCV-RNA detection being recommended for the diagnosis of HCV infection. A brief rational: Pregnant women with HCV infection are at risk of adverse obstetric outcome. Anti-D Ig therapy may be a risk factor for HCV infection. Hence, we conducted a cross sectional study with the objectives to estimate the prevalence of HCV antibodies (anti-HCV), RNA, and genotype distribution among women with anti-D Ig therapy. We found that anti-HCV and HCV-RNA seroprevalence were significantly higher in women with anti-D Ig. In addition, women with anti-D Ig therapy were 3.6 times more at risk of positive HCV-RNA with genotype HCV-1b showed higher prevalence. Therefore, anti-D Ig therapy is a risk factor for acquiring HCV infection and we recommend screening for HCV for all recipients of anti-D Ig. In addition, the diagnosis of HCV infection, should be made with HCV antibodies and HCV-RNA detection.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Infectious/blood; Pregnancy Complications, Infectious/immunology; Pregnancy Complications, Infectious/therapy*
Changes of perinatal statistics in a semiurban setup between two time periods in Malaysia

al-Mohdzar SA, Haque E, Abdullah WA

Asia Oceania J Obstet Gynaecol, 1993 Dec;19(4):401-5.
PMID: 8135673

Hospital University Sains Malaysia (HUSM) functions as the state referral centre and the only hospital for the state of Kelantan that can offer neonatal intensive care service. The deliveries in HUSM with grand multiparity, late booking and problems of late referrals resembles a hospital serving a semiurban rather than an urban community. A comparison between the year 1989 and 1991 showed marked improvement of perinatal mortality rate from 41.32 to 24.88, which is significantly better than the improvement achieved from 1987 to 1989 (46.0 to 41.32). This was possible due to a marked fall in the early neonatal mortality rate from 10.02 in 1989 to 5.45 in 1991 and fall in the stillbirth rate from 31.61 to 19.53.

Matched MeSH terms: Pregnancy

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