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Maternal, prenatal and traditional practice factors associated with perinatal mortality in Yemen

Al-Shahethi AH, Zaki RA, Al-Serouri AWA, Bulgiba A

Women Birth, 2019 Apr;32(2):e204-e215.
PMID: 30030021 DOI: 10.1016/j.wombi.2018.06.016

BACKGROUND: Perinatal mortality remains a major international problem responsible for nearly six million stillbirths and neonatal deaths.
OBJECTIVES: To estimate the perinatal mortality rate in Sana'a, Yemen and to identify risk factors for perinatal deaths.
METHODS: A community-based prospective cohort study was carried out between 2015 and 2016. Nine-hundred and eighty pregnant women were identified and followed up to 7 days following birth. A multi-stage cluster sampling was used to select participants from community households', residing in the five districts of the Sana'a City, Yemen.
RESULTS: Total of 952 pregnant women were tracked up to 7 days after giving birth. The perinatal mortality rate, the stillbirth rate and the early neonatal mortality rate, were 89.3 per 1000, 46.2 per 1000 and 45.2 per 1000, respectively. In multivariable analysis older age (35+ years) of mothers at birth (Relative Risk=2.83), teenage mothers' age at first pregnancy (<18 years) (Relative Risk=1.57), primipara mothers (Relative Risk=1.90), multi-nuclear family (Relative Risk=1.74), mud house (Relative Risk=2.02), mothers who underwent female genital mutilation (Relative Risk=2.92) and mothers who chewed khat (Relative Risk=1.60) were factors associated with increased risk of perinatal death, whereas a positive mother's tetanus vaccination status (Relative Risk=0.49) were significant protective factors against perinatal deaths.
CONCLUSION: Rates of perinatal mortality were higher in Sana'a City compared to perinatal mortality at the national level estimated by World Health Organization. It is imperative there be sustainable interventions in order to improve the country's maternal and newborn health.

Matched MeSH terms: Prenatal Care/organization & administration; Prenatal Care/statistics & numerical data
Fulltext Syphilis in pregnancy

Wahab AA, Ali UK, Mohammad M, Md Monoto EM, Rahman MM

Pak J Med Sci, 2015 4 17;31(1):217-9.
PMID: 25878647 DOI: 10.12669/pjms.311.5932

Syphilis in pregnancy remains an important medical condition due to its consequences. We present two cases of young pregnant women who were diagnosed syphilis during their antenatal visit. The first case was a 29-year-old Malay lady diagnosed with syphilis during the first trimester of pregnancy, while the second case was a 21-year-old Chinese lady diagnosed with syphilis during the third trimester of pregnancy. The diagnosis and management of the syphilis in pregnancy are discussed.

Matched MeSH terms: Prenatal Care
Maternal mortality amongst the rural Malays

Yusof K

Med J Malaysia, 1974 Mar;28(3):149-53.
PMID: 4278186
Matched MeSH terms: Prenatal Care
Fulltext Improving pre-pregnancy care (PPC) among clients with diabetes and hypertension at health clinics in Kuala Muda District, Kedah

Azira Azmi, Norazdliza Azmi, Norliza Mohd Sabri, Nur Mahfuzah Mohamed Fauzi, Che Zaiton Yahaya, Rosmiza Khazaid, et al.

Q Bulletin, 2019;1(28):46-57.
MyJurnal

Pre-pregnancy care (PPC) is a set of interventions used to identify and reduce women’s risks during reproductive age, especially women with chronic illnesses to achieve a healthy pregnancy. It includes optimisation of care, advice on appropriate contraception, and lifestyle modification. Our project aims to increase the PPC registration percentage of women with diabetes and hypertension from 53% to 100%, hence increasing their chances of receiving appropriate PPC intervention.
Both the cards of diabetic and hypertensive clients were reviewed using the PPC assessment form where the percentages of registered clients, completeness of registration, and aspects of interventions were calculated. We developed a new standardised guideline with a refined registration process into our routine Non-Communicable Disease (NCD) Clinic. The new PPC guideline implementation was reassessed every three months for two cycles by our district PPC team.
Post-intervention, the percentages of diabetes and hypertension clients registered with PPC has increased to 79.2%. Furthermore, proper registration helped to increase the percentages of PPC intervention from 86.6% to 95.3%. The implementation analysis showed that the completeness of five registration components had increased significantly from 1.4% to 16.8%. All elements under optimisation of care showed a positive changed, from 65.1% to 85.6% for optimisation of treatment, 48% to 52.6% for contraception advice, and 30.2% to 44% for lifestyle modifications.
We conclude based on the findings of this study that a well-structured PPC guideline with a few modifications that enhanced the process efficiency was able to increase the PPC registration percentages of eligible women with diabetes and hypertension and in turn, increase their chances of getting appropriate intervention. Continuous assessment and periodic PPC courses for healthcare workers are essential to ensure the sustainability of the implementation.

Matched MeSH terms: Prenatal Care
Perspective of Postpartum Depression Theories: A Narrative Literature Review

Abdollahi F, Lye MS, Zarghami M

N Am J Med Sci, 2016 Jun;8(6):232-6.
PMID: 27500126 DOI: 10.4103/1947-2714.185027

Postpartum depression is the most prevalent emotional problem during a women's lifespan. Untreated postpartum depression may lead to several consequences such as child, infant, fetal, and maternal effects. The main purpose of this article is to briefly describe different theoretical perspectives of postpartum depression. A literature search was conducted in Psych Info, PubMed, and Science Direct between 1950 and 2015. Additional articles and book chapters were referenced from these sources. Different theories were suggested for developing postpartum depression. Three theories, namely, biological, psychosocial, and evolutionary were discussed. One theory or combinations of psychosocial, biological, and evolutionary theories were considered for postpartum depression. The most important factor that makes clinicians' choice of intervention is their theoretical perspectives. Healthcare providers and physicians should help women to make informed choices regarding their treatment based on related theories.

Matched MeSH terms: Prenatal Care
Ante-partum localisation of the placenta with radioactive isotope Indium ( 113m IN)

Ng KH, Sinnathuray TA, Lau KS

Med J Malaya, 1972 Mar;26(3):159-63.
PMID: 5031010
Matched MeSH terms: Prenatal Care
Fulltext A dilemma in management of intrauterine death in mother with major placenta previa

Rima Anggrena, D., Yulianty, A., Nor Azlin, M.I.

Journal of Surgical Academia, 2017;7(2):43-45.
MyJurnal

Placenta previa is a condition when the placental tissue extends over the internal cervical os. It is associated with
maternal and fetal morbidity and mortality. With intrauterine death, the mode of delivery will be more difficult to
decide. Here, we report a case of 30 years old G3P2 with placenta previa major diagnosed with intrauterine death at
29 weeks gestation who was managed conservatively and delivered vaginally with minimal complication. A good
patient selection and thorough counseling, patient with placenta previa major and intrauterine death still can be safely
delivered vaginally.

Matched MeSH terms: Prenatal Care
Fetal Atrial Ectopic Rhythm Detected Using Handheld Doppler

Mohd Jalil R, Radzi NS, Yahaya Z, Muhar M

Malays Fam Physician, 2020;15(1):50-53.
PMID: 32284806

Atrial ectopic rhythm is one of the most common fetal arrhythmias that can present during the prenatal period. Detection of fetal arrhythmia can be made by auscultating fetal heart rate and rhythm using a fetal handheld Doppler, and this can be done even in a resource-limited setting. The finding of an abnormal fetal heart rate and rhythm should prompt early referral to a pediatric cardiologist, as this may improve clinical outcomes. We present a case of atrial ectopic rhythm detected in utero using a handheld Doppler.

Matched MeSH terms: Prenatal Care
Fulltext Selected data on health status of migrant women respondents

Siti Norazah Z

JUMMEC, 2002;7(1):15-23.

Reproductive health is "a state of complete, mental and social well-being in all matters relating to the reproductive system and to its functions and processes. Implicit in this is the right of men and women to be informed and to have access to safe, effective and affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility, which are not against the law, and the right of access to health-care services that enable women to go safely through pregnancy and childbirth." The survey on Health Problems of Migrant Workers included a section on Women's Health covering aspects of reproductive health. This was based on concerns over reproductive health needs of migrant women workers, particularly since the large majority are in the reproductive age-group, and the utilisation of government healthcare facilities. The latter has implications for the potential burden on public healthcare services in terms of resources and costs. Specifically, the Women's Health section included questions on pregnancy, place of delivery of last baby (born in Malaysia), postnatal care related to this delivery, and mode of payment. For those currently pregnant, questions were asked of sources of antenatal care, postnatal care and respective modes of payment for thsoe services. This section also included questions on current contraceptive practices, source of supplies, and mode of payment for contraceptive methods.

Matched MeSH terms: Prenatal Care
Fulltext Rapidly enlarging renal tumor during pregnancy: diagnostic and management dilemma

Tiang KW, Ng KL, Vega-Vega A, Wood S

J Kidney Cancer VHL, 2014;1(1):12-16.
PMID: 28326245 DOI: 10.15586/jkcvhl.2014.6

Urological tumors diagnosed during pregnancy are rare. However, the incidence seems to be increasing largely due to advancements in modern imaging techniques and improved antenatal care. The diagnosis and management of renal tumors during pregnancy poses a dilemma to clinicians. This case report highlights the challenges in managing a large chromophobe renal cell carcinoma in a young primigravida patient. Proper antenatal assessment, a multidisciplinary team approach and appropriate discussion with patient are important determinants to achieve the best clinical outcomes for both the mother and the baby.

Matched MeSH terms: Prenatal Care
Acute leukemia and lymphoma in pregnancy, a retrospective study from a tertiary center in Malaysia

Fann RJ, D'Silv EC, Tanusha K, Wong TK, Lee BS, Sathar J, et al.

Med J Malaysia, 2023 Jul;78(4):429-436.
PMID: 37518908

INTRODUCTION: Most evidence about the management of cancer and hematological malignancy in pregnancy are derived from retrospective observational studies with a small sample size. Availability of sufficiently large data has enabled evidence-based decision-making in this clinical dilemma.
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.

Matched MeSH terms: Prenatal Care
Why Women Are Averse to Facility Delivery in Northwest Nigeria: A Qualitative Inquiry

Tukur I, Chan CK, Tinsu T, Muhammed-Baba T, Aderemi Ijaiya M

Iran J Public Health, 2016 May;45(5):586-95.
PMID: 27398331

In many sub-Saharan African countries the rate of antenatal care (ANC) has been increased but skilled birth attendance rate is still low. The objective of this study was to evaluate the reasons why women prefer home delivery when facility based delivery is available at minimal cost.

Matched MeSH terms: Prenatal Care
Fulltext Quercus infectoria Gall Extract Enhanced the Proliferation and Activity of Human Fetal Osteoblast Cell Line (hFOB 1.19)

Hapidin H, Rozelan D, Abdullah H, Wan Hanaffi WN, Soelaiman IN

Malays J Med Sci, 2015 Jan-Feb;22(1):12-22.
PMID: 25892946 MyJurnal

The present study investigated the effects of Quercus infectoria (QI) gall extract on the proliferation, alkaline phosphatase (ALP), osteocalcin, and the morphology of a human fetal osteoblast cell line (hFOB 1.19).

Matched MeSH terms: Prenatal Care
Determinants of institutional delivery among women in Bangladesh

Kamal SM, Hassan CH, Alam GM

Asia Pac J Public Health, 2015 Mar;27(2):NP1372-88.
PMID: 23666835 DOI: 10.1177/1010539513486178

This study examines the factors that influence institutional delivery among women in Bangladesh extracting data from 2007 Bangladesh Demographic and Health Survey. We employed both bivariate and multivariate statistical analyses in this study. Findings revealed that, only 14.7% of the women went for institutional delivery and 28.8% births were delivered by trained birth attendance. The multivariate logistic regression analysis yielded quantitatively important and reliable estimates of facility delivery. The likelihood of institutional delivery was significantly higher for first-order pregnancy, couples' higher education, the richest, higher autonomy, TV ownership, non-Muslims, who received antenatal care services, pregnancy complications, and urban residents. Government should ensure quality of care, easy accessibility, and availability of all facilities free of cost in the public medical institutions. Women should be informed regarding the long-term benefit of institutional delivery through information, education, and communication program.

Matched MeSH terms: Prenatal Care/statistics & numerical data
Inequality of the use of skilled birth assistance among rural women in Bangladesh: facts and factors

Kamal SM, Hassan CH, Kabir MA

Asia Pac J Public Health, 2015 Mar;27(2):NP1321-32.
PMID: 23572376 DOI: 10.1177/1010539513483823

This study examines the inequality of the use of skilled delivery assistance by the rural women of Bangladesh using the 2007 Bangladesh Demographic and Health Survey data. Simple cross-tabulation and univariate and multivariate statistical analyses were employed in the study. Overall, 56.1% of the women received at least one antenatal care visit, whereas only 13.2% births were assisted by skilled personnel. Findings revealed apparent inequality in using skilled delivery assistance by socioeconomic strata. Birth order, women's education, religion, wealth index, region and antenatal care are important determinants of seeking skilled assistance. To ensure safe motherhood initiative, government should pay special attention to reduce inequality in seeking skilled delivery assistance. A strong focus on community-based and regional interventions is important in order to increase the utilization of safe maternal health care services in rural Bangladesh.

Matched MeSH terms: Prenatal Care/utilization
Fulltext Folic acid in the prevention of neural tube defect--a programme for Malaysia?

Ho JJ

Med J Malaysia, 2004 Mar;59(1):94-9.
PMID: 15535342

There is good evidence that folic acid is safe and efficacious for reducing neural tube defect (NTD). All women capable of becoming pregnant should take 400 microgram daily. This can be given in the form of a daily vitamin supplement, by food fortification, or by increasing natural dietary folates. Compulsory grain fortification has been shown to reduce NTD in a population but supplementation and dietary advice have not. Malaysia should work towards a programme of grain fortification and use alternative strategies to reach sections of the population that would not be covered but several research questions need to be answered before a programme could be implemented in Malaysia.

Matched MeSH terms: Prenatal Care/standards*
The development and evaluation of a health education programme for pregnant women in a regional hospital, southern Thailand

Thassri J, Kala N, Chusintong L, Phongthanasarn J, Boonsrirat S, Jirojwong S

J Adv Nurs, 2000 Dec;32(6):1450-8.
PMID: 11136413

The maternal mortality rate (MMR) in Thailand is higher than neighbouring developing countries including Malaysia and Singapore. The 1993 MMR of Thailand was 249 per 100 000 livebirths which was four times higher than the rates in Malaysia and Singapore (World Health Organization 1995). The major causes of these deaths were haemorrhage, toxaemia of pregnancy and sepsis which were likely to be prevented by adequate prenatal care (Thailand Ministry of Public Health 1996). A large proportion of Thai pregnant women have poor health. Between 1994 and 1995, a national study conducted by Thailand Ministry of Health showed that 39% of pregnant women were anaemic, defined as haemoglobin concentration lower than 33% (Supamethaporn 1997). Another study conducted in the southern region also indicated that 13.8% of pregnant women were anaemic caused by iron deficiency (Phatthanapreechakul et al. 1997). Other behaviours which increased risks associated with child birth included non-antenatal care (ANC) attendance, undertaking physically demanding tasks and failure to increase nutritional intake during their pregnancy period (N. Phiriyanuphong et al. 1992, unpublished report). These factors emphasize the importance of a health education programme which could facilitate women to, for example, increase protein and iron intake during pregnancy which would reduce complications from their poor health status. This study was conducted in a regional hospital in Thailand where there was no systematic and well-planned health education programme for pregnant women. The initial aim was to design a health education programme using input from the hospital health care professionals including obstetricians, nurses, nutritionists, health educators and health promoters. An active involvement of these personnel assisted to sustain the provision of the programme provided for pregnant women after the cessation of the study project. Another aim of the study was to evaluate the outcomes of the programme using a pre-test-post-test method among selected pregnant women who participated in the newly designed health education programme.

Matched MeSH terms: Prenatal Care/methods*
Fulltext Did we do it right?--an evaluation of the colour coding system for antenatal care in Malaysia

Ravindran J, Shamsuddin K, Selvaraju S

Med J Malaysia, 2003 Mar;58(1):37-53.
PMID: 14556325

Identification of pregnancies that are at greater than average risk is a fundamental component of antenatal care. The objective of this study was to assess the level of appropriate management and outcomes among mothers with hypertensive disorders of pregnancy, postdates and anemia in pregnancy, and to determine whether the colour coding system had any effect on the maternal mortality ratios. A retrospective follow-through study confined to users of government health services in Peninsular Malaysia was carried out in 1997. The study areas were stratified according to their high or low maternal mortality ratios. The study randomly sampled 1112 mothers out of 8388 mothers with the three common obstetric problems in the selected study districts. The study showed that the prevalence of anemia, hypertensive disorders in pregnancy and postmaturity among mothers with these conditions were according to known international standards. There was no significant difference in the colour coding practices between the high and low maternal mortality areas. Inappropriate referrals were surprisingly lower in the areas with high maternal mortality. Inappropriate care by diagnosis and by assigned colour code were significantly higher in the areas with high maternal mortality. The assigned colour code was accurate in only 56.1% of cases in the low maternal mortality areas and in 55.8% of the cases in the high maternal mortality areas and these two areas did not differ significantly in their accurate assignment of the colour codes. The colour coding system, as it exists now should be reviewed. Instead, a substantially revised system that takes cognisance of evidence in the scientific literature should be used to devise a more effective system that can be used by health care personnel involved in antenatal care to ensure appropriate level of care and referrals.

Matched MeSH terms: Prenatal Care/classification*
Advances in health in Malaysia

Suleiman AB, Lye MS, Mathews A, Ravindran J

Med J Malaysia, 1995 May;50 Suppl A:S3-10.
PMID: 10968005
Matched MeSH terms: Prenatal Care/trends
SOME MINOR DISCOMFORTS OF PREGNANCY

THARMARATNAM A

Med J Malaysia, 1963 Sep;18:52-8.
PMID: 14064299
Matched MeSH terms: Prenatal Care*

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