MyMedR

INTRODUCTION: Pregnancy in women with systemic lupus erythematosus (SLE) is known to be associated with adverse pregnancy outcomes (APO). We aimed to determine the frequency of APO, the associated variables and predictors.

MATERIALS AND METHODS: This retrospective study included all pregnancies seen at the SLE Clinic, Kuala Lumpur Hospital from January 2008 to May 2020. Maternal outcomes included SLE flare during pregnancy, preeclampsia and eclampsia. Foetal outcomes included foetal loss, preterm birth and small-for-gestational age (SGA) neonates. Clinical and laboratory variables were examined. Variables from univariate analysis were entered into logistic regression model. Odds ratio and 95% confidence interval were reported.

RESULTS: Of the 131 pregnancies, 106 (80.9%) were live births. Twenty-six (24.5%) babies were born preterm and 35 (33%) neonates were SGA. Twenty-four (18.3%) women had disease flare during pregnancy, with the majority (22/24) being mild to moderate flares. Four women experienced preeclampsia while none had eclampsia. Predictors of adverse maternal outcomes included high SLEDAI-2K score, proteinuria and hypocomplementemia within 6 months before conception and during pregnancy; history of lupus nephritis (LN), pre-existing hypertension, antiphospholipid syndrome (APS), antiphospholipid antibodies, anti-Ro antibody and anti-RNP antibody. Predictors of adverse foetal outcomes comprised APS, preeclampsia, anti-Sm antibody, history of neuropsychiatric systemic lupus erythematosus (NPSLE) and azathioprine use.

CONCLUSION: Pregnancy in SLE women is best deferred until disease activity is in remission for at least 6 months before conception. A history of LN is associated with a 3-fold risk of renal flare during pregnancy. Haematological abnormalities are rare in disease flare during pregnancy.

Matched MeSH terms: Pregnancy; Pregnancy Outcome/epidemiology

Catching an ectopic caesarean scar pregnancy - Radiological perspective

Seah SC, Laili SAL, Hairiah A, Ab Rahim AG

Med J Malaysia, 2018 02;73(1):51-53.

PMID: 29531205

Caesarean scar implantation is one of the rarest form of ectopic pregnancies and most unwanted complication of caesarean scar. However, with the increasing numbers of caesarean section performed, caesarean scar pregnancy (CSP) may be on the rise. The diagnosis is often difficult, but establishing an accurate diagnosis of CSP in the early first trimester is utmost important to prevent its detrimental consequences of uterine rupture and fatal haemorrhage. Hence, we present a case to highlight the role of imaging in diagnosing and managing this condition to prevent its associated high morbidity and mortality.

Matched MeSH terms: Pregnancy; Pregnancy Trimester, First; Pregnancy, Ectopic

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: Pregnancy; Pregnancy Outcome*

Fulltext SARS-CoV-2 in Pregnant Women: Consequences of Vertical Transmission

Chaubey I, Vignesh R, Babu H, Wagoner I, Govindaraj S, Velu V

Front Cell Infect Microbiol, 2021;11:717104.

PMID: 34568094 DOI: 10.3389/fcimb.2021.717104

Matched MeSH terms: Pregnancy; Pregnancy Complications, Infectious*

Prevalence, risk factors, and adverse outcomes of bacterial vaginosis among pregnant women: a systematic review

Sethi N, Narayanan V, Saaid R, Ahmad Adlan AS, Ngoi ST, Teh CSJ, et al.

BMC Pregnancy Childbirth, 2025 Jan 20;25(1):40.

PMID: 39833700 DOI: 10.1186/s12884-025-07144-8

INTRODUCTION: Bacterial vaginosis (BV) is one of the most common genital tract infections among women of reproductive age. The existence of BV among pregnant women has momentously attracted the attention of both clinicians and the scientific community due to its potential link with adverse clinical outcomes in pregnancy.

METHODS: To evaluate the prevalence, risk factors, and adverse outcomes of bacterial vaginosis among pregnant women, a comprehensive systematic review was conducted based on the preferred reporting items for systematic review and meta-analyses (PRISMA) criteria. PubMed, ScienceDirect, ClinicalTrials.gov and Cochrane database searches were conducted independently by two authors until May 13th, 2023.

RESULTS: The search strategies yielded a total of 2237 records; among them, 12 studies met the inclusion criteria and were included in the qualitative synthesis. Majority of the included studies demonstrated a high prevalence of BV among African women. The risk of developing BV during pregnancy was highest among women with multiple sexual partners. Additionally, factors including age, socioeconomic status, unhygienic practices, ethnicity, 2nd trimester, spontaneous abortion, vaginal douching, symptoms, and history of sexually transmitted infections (STIs) were also associated with a higher prevalence of BV. Overall, 7 studies reported adverse outcomes during pregnancy which was directly associated with BV. Based on the review, it was found that PROM, PTB, and LBW were the most frequently reported adverse outcomes in pregnant women with BV.

CONCLUSION: In summary, the high prevalence of bacterial vaginosis necessitates a global surveillance approach to delineate the health risks imposed on both mother and child, and promote cost-effective strategic measures to alleviate the undesired consequences of BV during pregnancy.

Matched MeSH terms: Pregnancy; Pregnancy Outcome/epidemiology

Fulltext A rare case of incarcerated bochdalek diaphragmatic hernia in a pregnant lady

Islah MA, Jiffre D

Med J Malaysia, 2010 Mar;65(1):75-6.

PMID: 21265257 MyJurnal

The occurrence of congenital diaphragmatic hernia in a pregnant adult is rare. In contrast to neonatal diaphragmatic hernias, most of the adult patients present with vague gastrointestinal symptoms mimicking other diseases hence the importance of high index of suspicion. We report a case of a young pregnant lady with congenital diaphragmatic hernia presenting with symptoms and clinical signs suggestive of acute pancreatitis. The patient had a laparotomy performed to reduce the hernial content and the diaphragmatic defect was successfully repaired.

Matched MeSH terms: Pregnancy; Pregnancy Complications/diagnosis*; Pregnancy Complications/pathology

Fulltext Arteriovenous malformation of the pregnant uterus

Kathiravan C, Emilia SH, Mutum SS

Med J Malaysia, 2007 Jun;62(2):179-80.

PMID: 18705462

Arteriovenous malformation of the pregnant uterus is very rare, and may present with unexplained torrential bleeding. We report a patient with absence of the conventional risk factors, and was saved by quick recourse to hysterectomy to control the bleeding.

Matched MeSH terms: Pregnancy; Pregnancy Complications/diagnosis*; Pregnancy Complications/therapy

Fulltext An Older Woman in Early Pregnancy: What Antenatal Screening is Appropriate?

Syed Aznal SS

Malays Fam Physician, 2008;3(3):137-9.

PMID: 25606138 MyJurnal

Matched MeSH terms: Pregnancy

Ruptured ectopic pregnancy presenting as an irreducible inguinal hernia

Prasannan S, Jabar MF, Gul YA

Acta Chir. Belg., 2004 Oct;104(5):591-2.

PMID: 15571031

An inguinal hernia that suddenly becomes irreducible may be secondary to a variety of other underlying conditions which can occasionally mislead the attending surgeon. Benign, inflammatory or neoplastic processes, as well as surgical emergencies such as intraperitoneal or retroperitoneal haemorrhage, have all been previously reported to mimic an inguinal hernia that suddenly becomes irreducible with or without clinical features of strangulation. We add an additional interesting presentation to this list in the form of a ruptured ectopic pregnancy, which is the first such case reported in the literature. A swelling in the groin may be much more complicated than it seems on superficial consideration and good clinical acumen is constantly required in managing such cases if a satisfactory outcome without any morbidity is to be expected.

Matched MeSH terms: Pregnancy; Pregnancy, Ectopic/diagnosis; Pregnancy, Ectopic/surgery

A retrospective study of the accuracy of sonographic chorionicity determination in twin pregnancies

Menon DK

Twin Res Hum Genet, 2005 Jun;8(3):259-61.

PMID: 15989753

The aim of this study was to determine the accuracy of sonographic chorionicity determination in the largest sample of twin pregnancies to date. We retrospectively analyzed 463 twin pregnancies delivered over a 6-year period to determine in each case what the antenatal sonographic prediction of chorionicity was, and then what the subsequent post partum pathological diagnosis of chorionicity was. Out of 436 twin pregnancies, 428 were correctly diagnosed for chorionicity as confirmed by pathology reports. Sonography as a screening tool for monochorionic twin pregnancies has a sensitivity of 100%, a specificity of 97.9% and a predictive value positive of 88.2%. Transvaginal scanning in the first trimester determined twin chorionicity with a sensitivity and a specificity of 100%. This study has confirmed in the largest sample to date that sonographic chorionicity determination is best done in the first trimester using vaginal scans, where it has 100% accuracy.

Matched MeSH terms: Pregnancy; Pregnancy Outcome; Pregnancy, Multiple*

Fulltext Risk profile of pregnant mothers in Kelantan

Zulkifli A, Rogayah J, Hashim MH, Shukri O, Azmi H

Med J Malaysia, 1995 Dec;50(4):359-64.

PMID: 8668057

A demographic and obstetric profile of pregnant mothers attending antenatal clinics in Kelantan over period of one year was determined by a retrospective study of 10,032 registered pregnant mothers. The prevalence of risk factors related to the age of the mother, parity, weight, haemoglobin level, bad obstetric history and pregnancy related diseases were determined. Prevalence of teenage pregnancy and primigravida accounted for 4.3 and 17.2 percent respectively. Nearly 3.9 percent of the mothers weighed less than 40 kg and 44.5 percent of mothers were found to be anaemic (Hb less than 11g/d) at the first antenatal visit. Only 3.2 percent of the mothers did not have any designated risk factor. Previous bad obstetric history and pregnancy related disease accounted for 17.1 and 3.5 percent of mothers respectively.
Study site: Antenatal clinics, klinik kesihatan, Kelantan, Malaysia

Matched MeSH terms: Pregnancy; Pregnancy Complications/etiology*; Pregnancy in Adolescence

Fulltext Severe post-coital bleeding in the second trimester

Ravindran J, Anandaraj N

Med J Malaysia, 1993 Dec;48(4):459-60.

PMID: 8183175

Matched MeSH terms: Pregnancy; Pregnancy Complications/etiology*; Pregnancy Trimester, Second

Fulltext Co-existing tubal ectopic pregnancy and appendicitis--a case report

Chia P, Jeyarajah A

Med J Malaysia, 1996 Dec;51(4):485-7.

PMID: 10968040

Appendicitis in pregnancy has a well documented high morbidity due to the difficulty in diagnosis. However, synchronous ectopic pregnancy and appendicitis is a rare event. This report describes the case of a 22-year-old lady of Bangladeshi origin who presented with both these conditions. The importance of prompt diagnosis and early surgical intervention, the inherent difficulties in diagnosis and the possible interrelated aetiological factors are discussed.

Matched MeSH terms: Pregnancy; Pregnancy, Ectopic/pathology; Pregnancy, Ectopic/surgery

Fulltext Clomid induced combined extrauterine and intrauterine pregnancy--a case report

Ng YT, Wong WP, Puraviappan AP

Med J Malaysia, 1983 Jun;38(2):150-2.

PMID: 6621446

A 23 year old Indian lady, gravida 1 para 0, with Clomid induced pregnancy was admitted to the University Hospital on 29 August 1981 with signs and symptoms of pregnancy and intraperitoneal bleed. Period ofamenorrhoea at time of admission was eight weeks. Emergency laparotomy revealed a right leaking ectopic pregnancy and an enlarged gravid uterus. Ultrasound done on the 7th post operative day confirmed concurrent intrauterine pregnancy which progressed normally to term, ending with a normal healthy baby at 39 weeks through an assisted breech delivery.

Matched MeSH terms: Pregnancy*; Pregnancy, Ectopic*

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: Pregnancy*; Pregnancy Complications/therapy

The prenatal value of fluoridated water

Majid ZA

Dent J Malaysia Singapore, 1973 May;13(1):41-4.

PMID: 4521125

Matched MeSH terms: Pregnancy

The problem of cervical incompetence in Malaysian women

Chan WF, Sinnathuray TA, Singh G

Med J Malaya, 1972 Dec;27(2):103-6.

PMID: 4268034

Matched MeSH terms: Pregnancy

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