MyMedR

Pre- and postnatal toxicity of diazinon induces disruption of spermatogenetic cell line evidenced by increased testicular marker enzymes activities in rat offspring

Jayachandra S, D'Souza UJ

J Environ Pathol Toxicol Oncol, 2013;32(1):73-90.

PMID: 23758154

The objective of this study was to study the possible reproductive adverse effects of the diazinon on rat offspring exposed in utero and during lactation. Dams were gavaged daily (10, 15, and 30 mg/kg) before mating, during mating, and during pregnancy and lactation in separate groups. Reproductive outcome data of dams were examined. Body weight, testis weight, testicular marker enzyme activities (alkaline phosphatase, acid phosphatase, lactate dehydrogenase, and glucose-6-phosphate dehydrogenase), qualitative and quantitative testicular and epididymal histology, and immunohistochemisty for 3-β-hydroxysteroid dehydrogenase (HSD) were examined in male offspring at puberty and adulthood. The 30-mg/kg dose induced significant adverse effects at both puberty and adulthood in offspring. At puberty the male offspring showed a decrease in testicular weight, degenerative changes, and 3-β-HSD. Moreover, an increase in activity of alkaline and acid phosphatase also was observed. At adulthood, there was a decrease in testicular weight and 3-β-HSD with an increase in the levels of testicular marker enzyme. There was evidence of some adverse reproductive effects in male offspring at the 15-mg/kg dose. Most of the adverse effects were irreversible and were evident at both puberty and adulthood in offspring, although a few parameters reverted back to the normal growth pattern. Hence, diazinon is a reproductive toxicant in male offspring, which caused significant damage to the testes when exposed during prenatal and postnatal life.

Matched MeSH terms: Pregnancy Outcome

Fulltext Pregnancy outcomes compared in women with mechanical heart valve replacements anticoagulated with warfarin and enoxaparin in pregnancy

Vijayan V, Rachel T

Med J Malaysia, 2012 Dec;67(6):591-4.

PMID: 23770951 MyJurnal

The anticoagulation of choice for mechanical heart valves is the oral anticoagulant warfarin. Warfarin is associated with increased risk of miscarriage, intrauterine fetal deaths and warfarin embryopathy. This longitudical cross-over study of 5 women observed all 5 having livebirths of healthy infants after heparin-managed pregnancies. Their earlier 8 pregnancies had all resulted in perinatal losses or miscarriages when on regimes based on warfarin.

Matched MeSH terms: Pregnancy Outcome

Successful pregnancy outcome following gamete intra-Fallopian transfer in a patient with Müllerian dysgenesis

Lee CS, Lie AT

Reprod Biomed Online, 2012 May;24(5):547-9.

PMID: 22410277 DOI: 10.1016/j.rbmo.2012.01.021

A 29-year-old lady with Müllerian dysgenesis was keen to have a baby. Clinically, she was medium built with well-developed secondary female sexual characteristics. There was a short and blind vagina. She had undergone surgery for an imperforated hymen. Her FSH and LH concentrations were normal. Laparoscopy revealed a patent right Fallopian tube, a rudimentary right uterus and extensive pelvic endometriosis. She subsequently underwent gamete intra-Fallopian transfer (GIFT). Oocyte retrieval was carried out laparoscopically and a total of nine oocytes were retrieved. Four of the oocytes were transferred together with motile spermatozoa into the right Fallopian tube and the remaining five oocytes were inseminated with spermatozoa for IVF. Three embryos resulted and were frozen. She subsequently developed moderate ovarian hyperstimulation syndrome. Serum β-human chorionic gonadotrophin concentration 14 days after GIFT was 1612 IU/l. Her antenatal care was relatively uneventful until 31 weeks of gestation when she was diagnosed to have intrauterine growth retardation and oligohydramnios. She then underwent an emergency Caesarean section at 32 weeks of pregnancy delivering a normal baby. This case study describes a successful pregnancy outcome following gamete intra-Fallopian transfer (GIFT) in a woman with malformation of the vagina (Müllerian dysgenesis). A 29-year-old lady with Müllerian dysgenesis diagnosed at 16 years of age was keen to become pregnant. Upon examination, a decision was made for a William's vulvovaginoplasty but as the patient was indecisive the surgery was deferred. Clinically, she is a medium-built lady with well-developed secondary female sexual characteristics. There was a short and blind vagina. Her serum FSH and LH concentrations were normal. Laparoscopy revealed a patent right Fallopian tube, a rudimentary right uterus and extensive pelvic endometriosis. She subsequently underwent GIFT. Nine oocytes were retrieved through laparoscopy. Four of the oocytes were transferred together with motile sperm into the right Fallopian tube and the remaining five oocytes were inseminated with sperm for IVF. Three embryos resulted and were frozen. Serum β human chorionic gonadotrophin concentration measured 14 days after GIFT was 1612 IU/l. An abdominal ultrasonography performed at 5 weeks showed one intrauterine gestational sac. Her antenatal care was uneventful until 31 weeks of gestation when she developed a deficiency of amniotic fluid in the amniotic sac. She then underwent an emergency Caesarean section at 32 weeks of pregnancy. She delivered a healthy, normal 1.24 kg baby boy. Her post-natal care was uneventful.

Matched MeSH terms: Pregnancy Outcome*

Relationship of periodontal disease to pre-term low birth weight infants in a selected population--a prospective study

Ali TB, Abidin KZ

Community Dent Health, 2012 Mar;29(1):100-5.

PMID: 22482259

To assess effect of periodontal status of antenatal mothers on pregnancy outcomes in a selected population in Malaysia.

Matched MeSH terms: Pregnancy Outcome

Single dose 17 alpha-hydroxyprogesterone caproate in preterm labor: a randomized trial

Tan PC, King AS, Vallikkannu N, Omar SZ

Arch Gynecol Obstet, 2012 Mar;285(3):585-90.

PMID: 21796421 DOI: 10.1007/s00404-011-2026-3

To evaluate the effect of a single 250-mg dose of 17 alpha-hydroxyprogesterone caproate (17-OHPC) intramuscularly as adjunct to nifedipine tocolysis in preterm labor.

Matched MeSH terms: Pregnancy Outcome

Fulltext Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomised trial

Raheem IA, Saaid R, Omar SZ, Tan PC

BJOG, 2012 Jan;119(1):78-85.

PMID: 21985500 DOI: 10.1111/j.1471-0528.2011.03151.x

To compare oral nifedipine with intravenous labetalol in their rapidity to control hypertensive emergencies of pregnancy.

Matched MeSH terms: Pregnancy Outcome

Fulltext Spinal cord compression following traditional confinement massage

Sahathevan R, Tan HJ, Abdullah S, Shahizon AM, Hamidon BB, Raymond AA

Med J Malaysia, 2011 Dec;66(5):495-6.

PMID: 22390109 MyJurnal

We describe a case of tetraparesis in a 33-year-old woman following neck manipulation performed by a traditional confinement mid-wife. An MRI of the cervical spine revealed a fracture of the second cervical vertebra with atlanto-axial subluxation that resulted in cord compression.

Matched MeSH terms: Pregnancy Outcome

Systemic lupus erythematosus pregnancies: the Sarawak experience and review of lupus pregnancies in Asia

Teh CL, Wong JS, Ngeh NK, Loh WL

Rheumatol Int, 2011 Sep;31(9):1153-7.

PMID: 20349069 DOI: 10.1007/s00296-010-1435-0

We performed a cross-sessional study of all systemic lupus erythematosus (SLE) pregnancies during a 4-year period (2006-2009) to describe the clinical features, maternal and foetal outcomes in our centre. There were 48 pregnancies in 44 women with SLE. Our patients have a mean age of 30.0 years (SD 6.36) and a mean disease duration of 40.67 months (SD 48.23). Our patients have complicated pregnancies: 32.7% have SLE flares, 17.3% have preeclampsia and 48.9% needed caesarean sections. There were 20.0% foetal losses and 17.8% preterm deliveries in our patients. SLE flares contributed to 60.0% of foetal losses in our patients. Lupus pregnancies in our centre generally have a good maternal and foetal outcome comparable to developed countries in Asia. The low incidence of APS, the high usage of hydroxychloroquine and the high SLE remission rate in our patients prior to conceptions contributed to the good outcome.

Matched MeSH terms: Pregnancy Outcome/epidemiology

Fulltext Associated factors affecting the successful pregnancy rate of intrauterine insemination at International Islamic University Malaysia (IIUM) Fertility Centre

Azantee YW, Murad ZA, Roszaman R, Hayati MY, Norsina MA

Med J Malaysia, 2011 Aug;66(3):195-8.

PMID: 22111439 MyJurnal

The aim was to determine pregnancy rate and its associated factors in Intrauterine Insemination (IUI) at IIUM Fertility Centre.

Matched MeSH terms: Pregnancy Outcome

Heart failure in pregnancy: an overview

Ahmad WA, Khanom M, Yaakob ZH

Int J Clin Pract, 2011 Aug;65(8):848-51.

PMID: 21762308 DOI: 10.1111/j.1742-1241.2011.02714.x

The treatment of heart failure in pregnant women is more difficult than in non-pregnant women, and should always involve a multidisciplinary team approach. Knowledge required includes hemodynamic changes in pregnancy and the resultant effect on women with pre-existing or pregnancy-related cardiovascular disease, cardiovascular drugs in pregnancy, ethical issues and challenges regarding saving mother and baby. In addition, women having high risk cardiac lesions should be counselled strongly against pregnancy and followed up regularly. Pregnancy with heart failure is an important issue, demanding more comprehensive studies.

Matched MeSH terms: Pregnancy Outcome

Mode of delivery and outcomes in preterm births

Sangkomkamhang U, Pattanittum P, Laopaiboon M, Lumbiganon P

J Med Assoc Thai, 2011 Apr;94(4):415-20.

PMID: 21591525

To compare maternal and neonatal outcomes by mode of delivery in preterm births.

Matched MeSH terms: Pregnancy Outcome/epidemiology*

Contemporary approaches to hyperemesis during pregnancy

Tan PC, Omar SZ

Curr Opin Obstet Gynecol, 2011 Apr;23(2):87-93.

PMID: 21297474 DOI: 10.1097/GCO.0b013e328342d208

PURPOSE OF REVIEW: Nausea and vomiting of pregnancy (NVP) affects 90% of pregnant women and its impact is often underappreciated. Hyperemesis gravidarum, the most severe end of the spectrum, affects 0.5-2% of pregnancies. The pathogenesis of this condition remains obscure and its management has largely been empirical. This review aims to provide an update on advances in pregnancy hyperemesis focusing on papers published within the past 2 years.

RECENT FINDINGS: The cause of hyperemesis is continuing to be elaborated. Recent data attest to the effectiveness of the oral doxylamine-pyridoxine in NVP. Follow-up data of children exposed in early pregnancy to doxylamine-pyridoxine for NVP are reassuring. Evidence is increasing for ginger as an effective herbal remedy for NVP. Metoclopramide is effective in NVP and hyperemesis gravidarum, with a good balance of efficacy and tolerability. A recent large-scale study on first trimester exposure to metoclopramide is reassuring of its safety. Evidence is emerging for the treatment of acid reflux to ameliorate NVP. The role of corticosteroids for hyperemesis gravidarum remains controversial. Transpyloric feeding may be warranted for persistent weight loss, despite optimal antiemetic therapy.

SUMMARY: Women with significant NVP should be identified so that they can be safely and effectively treated.

Matched MeSH terms: Pregnancy Outcome

Maternal obesity and pregnancy outcome

Begum KS, Sachchithanantham K, De Somsubhra S

Clin Exp Obstet Gynecol, 2011;38(1):14-20.

PMID: 21485717

The increasing prevalence of maternal obesity worldwide provides a major challenge to obstetric practice from preconception to postpartum. Maternal obesity can result in unfavorable outcomes for the woman and fetus. Maternal risks during pregnancy include gestational diabetes and chronic hypertension leading to preeclampsia. The fetus is at risk for stillbirth and congenital anomalies. Intrapartum care, normal and operative deliveries, anesthetic and operative interventions in the obese demand extra care. Obesity in pregnancy can also affect health later in life for both mother and child. For women, these risks include heart disease and hypertension. Children have a risk of future obesity and heart disease. Women and their offspring are at increased risk for diabetes. Obstetrician-gynecologists should be well informed to prevent and treat this epidemic. Interventions directed at weight loss and prevention of excessive weight gain during pregnancy must begin in the preconception period.

Matched MeSH terms: Pregnancy Outcome

Fulltext Morbidly adherent placenta at extreme prematurity: can major haemorrhage and hysterectomy be prevented?

Shafiee, M.N., Rahana, A.R., Lim, P.S., Nor Azlin, M.I., Wan Faraliza, Z.A., Isa, M.R., et al.

Journal of Surgical Academia, 2011;1(1):56-60.

MyJurnal

Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage.

Matched MeSH terms: Pregnancy Outcome

Adolescent pregnancy outcomes and risk factors in Malaysia

Omar K, Hasim S, Muhammad NA, Jaffar A, Hashim SM, Siraj HH

Int J Gynaecol Obstet, 2010 Dec;111(3):220-3.

PMID: 20800837 DOI: 10.1016/j.ijgo.2010.06.023

OBJECTIVE: To assess the outcomes and risk factors of adolescent pregnancies in 2 major hospitals in Malaysia.
METHODS: We conducted a case-control study of pregnant girls aged 10 through 19 years. The controls were women aged 20 through 35 years who did not become pregnant in their adolescence. Cases and controls were matched for parity and place of delivery. Data were collected from questionnaires and the hospitals' medical records.
RESULTS: The study included 102 cases and 102 controls. There were significant associations between adolescent pregnancy and low education level, low socioeconomic status, being raised by a single parent, not engaging in extracurricular school activities, engaging in unsupervised activities with peers after school, and substance abuse (P<0.05 for all); being anemic, being unsure of the expected delivery date, and having few antenatal visits and a late delivery booking; and low Apgar scores and perinatal complications.
CONCLUSION: Adolescent pregnancies are high-risk pregnancies. Better sexual health strategies are required to address the associated complications.

Matched MeSH terms: Pregnancy Outcome/epidemiology*

Pascual's beautiful home waterbirth in Malaysia

Beyer V

Midwifery Today Int Midwife, 2010.

PMID: 20397536

Matched MeSH terms: Pregnancy Outcome/psychology*

Fulltext Monoamniotic Twin Pregnancy; is There a Need for Frequent Fetal-Doppler Surveillance?

Suhaiza, A., Che Anuar, C.Y., Nik Zuky, N.L., Mokhtar, A.

International Medical Journal Malaysia, 2010;9(2):57-58.

MyJurnal

Monoamniotic twin pregnancy is a rare type of twin pregnancy which poses risk of cord entanglement and
sudden death of either one or both fetuses. The role of antenatal surveillance by Ultrasound Doppler for
umbilical cord and ultrasonic evidence of cord entanglement or knotting may predict the pregnancy outcome
but yet unavoidable. The discussion will include antenatal surveillance in this rare type of pregnancy.

Matched MeSH terms: Pregnancy Outcome

Fulltext Placenta accreta: clinical risk factors, accuracy of antenatal diagnosis and effect on pregnancy outcome

Sofiah S, Fung YC

Med J Malaysia, 2009 Dec;64(4):298-302.

PMID: 20954554 MyJurnal

The aim of this study is to evaluate the clinical risk factors, accuracy of antenatal ultrasound for diagnosis, and the effect of these on pregnancy outcome. It is a retrospective study looking at cases which had hysterectomy following vaginal or caesarean section deliveries from 1993 to 2005. Data regarding the maternal demographic characteristics, number of previous CS, number of previous termination/curettage, antenatal scan findings (state features) and the gestation at which accreta was first suspected/diagnosed, MRI scan findings, pregnancy outcome (need for hysterectomy, amount of blood loss, amount of transfusion, length of ICU and hospital stay, other maternal complications, and neonatal outcome) were collected and evaluated. There were a total of 40 cases diagnosed to have abnormal placental attachment and majority of these were actually diagnosed antenatally by sonography. Visualisation of an absence or thinning of hypoechoic myometrial zone had the highest sensitivity to detect placenta accreta followed by intraplacental lacunae, focal mass tissue elevation and disruption of uterine serosal bladder wall.

Matched MeSH terms: Pregnancy Outcome

Fulltext Coitus and orgasm at term: effect on spontaneous labour and pregnancy outcome

Tan PC, Yow CM, Omar SZ

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

PMID: 19960160

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

Matched MeSH terms: Pregnancy Outcome

Maternal plasma soluble fms-like tyrosine kinase-1 and placental growth factor levels as biochemical markers of gestational hypertension for Malaysian mothers

Nadarajah VD, Min RG, Judson JP, Jegasothy R, Ling EH

J Obstet Gynaecol Res, 2009 Oct;35(5):855-63.

PMID: 20149032 DOI: 10.1111/j.1447-0756.2009.01037.x

To establish baseline levels of maternal plasma soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) among normotensive Malaysian mothers and to compare the marker levels between normotensives and mothers with gestational hypertension (GH).

Matched MeSH terms: Pregnancy Outcome

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