Displaying publications 41 - 60 of 64 in total

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  1. A case of painless labour
    Panikker VMB
    Malayan Medical Journal, 1929;4:152.
    Matched MeSH terms: Labor, Obstetric
  2. Fulltext Comparison of Pregnancy Outcome between 4 and 6 cm Cervical os Dilatation to Demarcate Active Phase of Labour: A Cross-Sectional Study
    Mohd Fathil N, Abd Rahman R, Mohd Nawi A, Kamisan Atan I, Kalok AH, Mohamed Ismail NA, et al.
    J Pregnancy, 2023;2023:8243058.
    PMID: 37404975 DOI: 10.1155/2023/8243058
    This is a cross-sectional study comparing pregnancy outcomes between participants with 4 and 6 cm of cervical os dilatation at the diagnosis of the active phase of labour. It was conducted in a single tertiary centre involving low-risk singleton pregnancies at or beyond 37 weeks with spontaneous onset of labour. A total of 155 participants were recruited, 101 in group 1 (4 cm) and 54 in group 2 (6 cm). Both groups were similar in mean maternal age, mean gestational age at delivery, ethnicity, median haemoglobin level at delivery, body mass index, and parity. There were significantly more participants in group 1 who needed oxytocin augmentation (p < 0.001) for the longer mean duration (p = 0.015), use of analgesia (p < 0.001), and caesarean section rate (p = 0.002). None of the women had a postpartum haemorrhage or a third- or fourth-degree perineal tear, and none of the neonates required admission to the neonatal intensive care unit. There were significantly more nulliparas who had a caesarean section as compared to multiparas. A cervical os dilatation of 6 cm reduces the risk of caesarean section by 11% (95% CI, 0.01-0.9) and increases three times more the need for analgesia (AOR = 3.44, 95% CI, 1.2-9.4). In conclusion, the demarcation of the active phase of labour at a cervical os dilatation of 6 cm is feasible without an increase in maternal or neonatal complications.
    Matched MeSH terms: Labor, Obstetric*
  3. Predictors of maternal satisfaction with labor induction: A prospective observational cohort study
    Ramlee N, Azhary JMK, Hamdan M, Saaid R, Gan F, Tan PC
    Int J Gynaecol Obstet, 2023 Nov;163(2):547-554.
    PMID: 37177795 DOI: 10.1002/ijgo.14848
    OBJECTIVE: To identify independent predictors of maternal satisfaction with labor induction.

    METHOD: In this prospective observational cohort study, 769 women prior to their labor induction had sleep and psychological well-being assessed using Pittsburgh Sleep Quality Index and Depression, Anxiety and Stress Scales. Women were asked about the adequacy of labor induction information provided and their involvement and time pressure felt in the decision-making for their labor induction. Maternal characteristics, induction and intrapartum care measures, and labor and neonatal outcomes were also assessed. Prior to discharge, women rated their satisfaction with their birth experience.

    RESULTS: A total of 34 variables were considered for bivariate analysis, with 15 found to have P labor induction, amniotomy, induction to delivery interval, mode of delivery, postpartum hemorrhage, and neonatal admission. Maternal satisfaction was not associated with sleep, depression, anxiety, or stress.

    CONCLUSION: The identification of independent predictors of maternal satisfaction allows for patient selection, targeting of specific preinduction and intrapartum care, and focus on induction methods that can reduce induction to delivery interval, cesarean birth, and delivery blood loss to maximize women's satisfaction with labor induction.

    Matched MeSH terms: Labor, Obstetric*
  4. Fulltext Mistreatment of Women during Childbirth and Associated Factors in Northern West Bank, Palestine
    Dwekat IMM, Ismail TAT, Ibrahim MI, Ghrayeb F, Abbas E
    Int J Environ Res Public Health, 2022 Oct 13;19(20).
    PMID: 36293759 DOI: 10.3390/ijerph192013180
    Mistreatment of women during childbirth is a clear breach of women's rights during childbirth. This study aimed to determine the prevalence and associated factors of mistreatment of women during childbirth in the north of West Bank, Palestine. A cross-sectional study was conducted among 269 women within the first 16 weeks of their last vaginal childbirth to understand the childbirth events by using proportionate stratified random sampling. An Arabic valid questionnaire was used as a study instrument. Simple and multiple logistic regression analyses were conducted to determine the factors associated with each type of mistreatment. The mean age of the women was 26.5 (SD 4.77) years. The overall prevalence of mistreatment was 97.8%. There were six types of mistreatment. Nine factors were significantly associated with the occurrence of one or more types of mistreatment. Delivery at a public childbirth facility was associated with all of the six types (aAdjOR: 2.17-16.77; p-values < 0.001-0.013). Women who lived in villages (aAdjOR 2.33; p-value = 0.047), had low education (aAdjOR 5.09; p-value = 0.004), underwent induction of labour (aAdjOR 3.03; p-value = 0.001), had a long duration of labour (aAdjOR 1.10; p-value = 0.011), did not receive pain killers (aAdjOR: 2.18-3.63; p-values = 0.010-0.020), or had an episiotomy or tear (aAdjOR 5.98; p-value < 0.001) were more likely to experience one or more types of mistreatment. With every one-hour increase in the duration of labor, women were 1.099 times more likely to experience a failure to meet the professional standard of care. Women were less likely to experience mistreatment with increasing age. Women with increasing age (aAdjOR: 0.91-0.92; p-values = 0.003-0.014) and parity (aAdjOR 0.72; p-value = 0.010) were less likely to experience mistreatment. Awareness of women's fundamental rights during childbirth, making the childbirth process as normal as possible, and improving the childbirth facilities' conditions, policies, practices and working environment may decrease mistreatment occurrence.
    Matched MeSH terms: Labor, Obstetric*
  5. 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
  6. Mother’s mental preparedness for pregnancy : The affecting factors and its effect on birth outcomes
    Sharifah Sulaiha Syed Aznal, Chee Yoong Wong, Pamela Lee Ling Tan, Vee Vee See, Chui King Wong
    International e-Journal of Science, Medicine & Education, 2014;8(3):19-27.
    MyJurnal
    Background: Increased maternal anxiety level has been reported to have detrimental effects on the physical outcome of pregnancies such as not achieving vaginal births. This study thus aims to determine the level and factors affecting mental preparedness among mothers with normal pregnancies and its correlation with birth outcomes.

    Methods: Three hundred healthy mothers above 37 weeks of gestation in the early stage of labour were assessed for their level of mental preparation before birth process and outcomes after births which include general feeling (euphoria), ability to withstand labour pain and bonding with the new born. The successfulness of vaginal birth and other data on factors affecting mental preparation were also collected.

    Results: The level of mental preparedness was found good in 78% of the mothers, mainly determined by their socioeconomic status, family support and personal ability to adjust to changes. Age (p= 0.048), parity (0.00) and income (0.01) were found to influence mental preparedness significantly. Race, occupation, education level and marital status are however not significantly related. Poor mental preparedness is associated with greater pain during labour. A correlation analysis also found a positive relationship between the level of mental preparation and mental outcomes following birth in these mothers but it did not significantly influence the mode of delivery.

    Conclusion: Mental preparation before birth seems to have an effect on mental outcomes of mothers following birth process. It is vital that mothers of the younger age group with no previous obstetric experience be given more attention in preparing them mentally before they face the painful birth process.
    Matched MeSH terms: Labor, Obstetric
  7. 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
  8. Fulltext A retrospective review of 25 cases of lethal fetal anomalies
    Dalia, F.A., Hamizah, I., Zalina, N., Yong, S.L., Mokhtar, A.
    International Medical Journal Malaysia, 2016;15(1):19-23.
    MyJurnal
    Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and
    maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25
    women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on
    patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were
    found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound
    and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9
    years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and
    mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%)
    women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight
    (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or
    aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal
    delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to
    emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus.
    Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained
    placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital
    stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various
    maternal morbidities, in this case series , which could have been prevented if they were diagnosed and
    terminated at early trimester. A new direction is needed in our local practice.
    Matched MeSH terms: Labor, Obstetric
  9. 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
  10. Fulltext Ambit determination method in estimating rice plant population density
    Abu Bakar, B., Abdul Rahman, M.S., Teoh, C.C., Abdullah, M.Z.K., Ismail, R.
    Food Research, 2018;2(2):177-182.
    MyJurnal
    Rice plant population density is a key indicator in determining the crop setting and fertilizer application rate. It is therefore essential that the population density is monitored to ensure that a correct crop management decision is taken. The conventional method of determining plant population is by manually counting the total number of rice plant tillers in a 25 cm x 25 cm square frame. Sampling is done by randomly choosing several different locations within a plot to perform tiller counting. This sampling method is time consuming, labour intensive and costly. An alternative fast estimating method was developed to overcome this issue. The method relies on measuring the outer circumference
    or ambit of the contained rice plants in a 25 cm x 25 cm square frame to determine the number of tillers within that square frame. Data samples of rice variety MR219 were collected from rice plots in the Muda granary area, Sungai Limau Dalam, Kedah. The data were taken at 50 days and 70 days after seeding (DAS). A total of 100 data samples were collected for each sampling day. A good correlation was obtained for the variety of 50 DAS and 70 DAS. The model was then verified by taking 100 samples with the latching strap for 50 DAS and 70 DAS. As a result, this technique can be used as a fast, economical and practical alternative to manual tiller counting. The technique can potentially be used in the development of an electronic sensing system to estimate paddy plant population density.
    Matched MeSH terms: Labor, Obstetric
  11. Effectiveness of antepartum breathing exercises on the outcome of labour: A randomized controlled trial
    Karkada SR, Noronha JA, Bhat SK, Bhat P, Nayak BS
    F1000Res, 2022;11:159.
    PMID: 37483553 DOI: 10.12688/f1000research.75960.3
    Background Childbirth is a life-transforming intense event to a woman and her family. Even though a variety of non-pharmacological techniques are readily available to alleviate the distress of women in labour, the majority of women are unaware of its benefits. The objective of the study was to explore the impact of a simple non-pharmacological technique i.e., antepartum breathing exercises on maternal outcomes of labour among primigravid women. Methods A single centre prospective, single-blinded, randomized controlled trial was conducted at the antenatal outpatient clinic of a secondary healthcare institution. Eligible primigravid women were randomized into intervention and standard care groups. Both groups received standard obstetrical care. In addition, the intervention group were taught antepartum breathing exercises and were advised to practise daily and also during the active stage of labour. The primary outcome of the trial was the maternal outcome of labour measured in terms of onset of labour, nature of delivery, duration of labour, and need for augmentation of labour. Data was collected using World Health Organization (WHO) partograph, structured observational record on the outcome of labour. Results A total of 98 (70%) primigravid women who practised antepartum breathing exercises had spontaneous onset of labour. The odds of spontaneous onset of labour after randomization in the intervention group was 2.192 times more when compared to standard care at a (95% confidence interval 1.31-3.36, p
    Matched MeSH terms: Labor, Obstetric*
  12. 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
  13. 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
  14. 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*
  15. Fulltext Combined spinal-epidural analgesia in labour: its effects on delivery outcome
    Singh SK, Yahya N, Misiran K, Masdar A, Nor NM, Yee LC
    Braz J Anesthesiol, 2016 May-Jun;66(3):259-64.
    PMID: 27108822 DOI: 10.1016/j.bjane.2014.09.006
    BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome.

    METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n=55) or Non-CSE (n=55) group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared.

    RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%). The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group) was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5min was similar in both groups.

    CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.
    Matched MeSH terms: Labor, Obstetric*
  16. Cross-cultural perspectives on birth practices
    Laderman C
    Birth, 1988 Jun;15(2):86-7.
    PMID: 3390277
    Matched MeSH terms: Labor, Obstetric*
  17. Effects of an educational intervention on Nigerian midwives' intention to provide planned home birth care
    Muhammed A, Shariff-Ghazali S, Md Said S, Hassan M, Lee K
    Birth, 2023 Sep;50(3):587-595.
    PMID: 36226886 DOI: 10.1111/birt.12681
    BACKGROUND: The majority of women in Sokoto, Nigeria prefer homebirths, but midwives are reluctant to provide care in the home setting. As such, many women continue to give birth at home alone or assisted by untrained attendants, which is associated with an increased risk for maternal and neonatal morbidity and mortality.

    METHODS: A randomized controlled trial was conducted among 226 midwives from 10 health care facilities. The intervention group received an educational program on home birth. A validated questionnaire that evaluated knowledge, attitudes, norms, perceived control, and intention to provide planned home birth care was given at baseline, immediately after the intervention, and at three-months follow-up. Data were analyzed using linear mixed-effect model statistics.

    RESULTS: Following the intervention, the intervention group demonstrated higher knowledge and more positive attitudes, norms, perceived control, and intention to provide planned home birth care compared with the control group (P  0.05).

    DISCUSSION: Educating midwives on planned home birth increases their willingness to provide planned home birth care. Health system administrators, policymakers, and researchers may use similar interventions to promote skilled home birth attendance by midwives. Increasing the number of midwives who are willing to attend planned home births provides women at low risk for medical complications with safer options for labor, delivery, and postpartum care.

    Matched MeSH terms: Labor, Obstetric*
  18. 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
  19. Fulltext Threats by artificial intelligence to human health and human existence
    Federspiel F, Mitchell R, Asokan A, Umana C, McCoy D
    BMJ Glob Health, 2023 May;8(5).
    PMID: 37160371 DOI: 10.1136/bmjgh-2022-010435
    While artificial intelligence (AI) offers promising solutions in healthcare, it also poses a number of threats to human health and well-being via social, political, economic and security-related determinants of health. We describe three such main ways misused narrow AI serves as a threat to human health: through increasing opportunities for control and manipulation of people; enhancing and dehumanising lethal weapon capacity and by rendering human labour increasingly obsolescent. We then examine self-improving 'artificial general intelligence' (AGI) and how this could pose an existential threat to humanity itself. Finally, we discuss the critical need for effective regulation, including the prohibition of certain types and applications of AI, and echo calls for a moratorium on the development of self-improving AGI. We ask the medical and public health community to engage in evidence-based advocacy for safe AI, rooted in the precautionary principle.
    Matched MeSH terms: Labor, Obstetric*
  20. Spontaneous rupture of renal angiomyolipoma in pregnancy mimicking preterm labour
    Basri NI, Dasrilsyah RA
    BMJ Case Rep, 2024 Feb 06;17(2).
    PMID: 38320830 DOI: 10.1136/bcr-2023-258979
    Ruptured renal angiomyolipoma in pregnancy is uncommon. Pregnant women may present with nonspecific symptoms such as flank or abdominal pain, contraction pain and haematuria. A thorough assessment is needed to reach the correct diagnosis. Management varies between conservative measures, radiological intervention or surgery depending on the patient's haemodynamic status and foetal condition. We present a case of a woman in her 30s, gravida 5 para 3+1 at 28 weeks of gestation, who presented with pain. The pain worsened, and she went into hypovolaemic shock. An exploratory laparotomy and emergency caesarean section were done. Retroperitoneal haematoma was found intraoperatively, but the source of bleeding was difficult to determine. An abdominal CT angiogram subsequently revealed an ongoing bleeding from a ruptured angiomyolipoma. An emergency nephrectomy was performed, and the bleeding was secured.
    Matched MeSH terms: Labor, Obstetric*
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