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  1. Kaur S, Kok EY, Jamil NA, Sebayang SK
    BMC Public Health, 2024 Jan 09;24(1):122.
    PMID: 38195450 DOI: 10.1186/s12889-024-17677-w
    INTRODUCTION: Gestational weight gain (GWG) is influenced by various factors during pregnancy. This study attempts to explore the relationship between environmental factors i.e., sunlight exposure and psychological health i.e. psychological well-being and sleep quality during pregnancy with total gestational weight gain.

    METHODS: This was a prospective observational study conducted in government maternity clinics in Kuala Lumpur. Pregnant women aged 19-39 years without comorbidities were recruited during second trimester and followed up until birth. The participants were required to wear a UVB dosimeter for a total of three consecutive days (2 weekdays and 1 weekend) to determine sunlight exposure (SED) during their second trimester. The PSQI and DASS-21 were used to determine sleep quality and psychological wellbeing, respectively. GWG data were collected from clinic health records. The association of sun exposure and psychological health with total GWG was determined using multiple linear regression.

    RESULTS: A total of 73 pregnant women aged 27.9 ± 3.3 years were included in the analysis. The prevalence of pregnant women exhibiting stress, anxiety, and depression symptoms was 11%, 40%, and 16% respectively. The global PSQI median score was 5 (IQR = 3), with 59% having poor sleep quality. Median sleep duration was 7 h (IQR = 2) while median sleep efficiency was 92% (IQR = 14). The median SED was 0.04 (IQR = 0.09), with 51% of them being under the 50th percentile. The majority had adequate GWG (58%). Sleep parameters were not found to be correlated with total GWG except for sleep latency (ρ = -0.356, p = 0.002). Sunlight exposure was found to have no significant relationship with sleep and total GWG. Adjusted multiple linear regression showed that greater depression is associated with higher total GWG (β = 0.239, p = 0.039) while controlling for sleep quality.

    CONCLUSION: Depression was associated with total GWG when sleep quality was controlled for while sunlight exposure had no significant association with GWG. Future studies should study the complex relationship between factors of mental health, sleep, and weight gain during pregnancy. Healthcare providers may be better equipped to develop interventions aimed to prevent negative maternal and fetal health outcomes.

    Matched MeSH terms: Pregnancy
  2. Wan Abdul Rahman WM, Saddki N, Mahmood Z, Hasan R, Samsudin NA
    Med J Malaysia, 2024 Jan;79(1):1-8.
    PMID: 38287750
    INTRODUCTION: Women's important roles within families which include modelling appropriate oral health behaviours require them to have good knowledge and positive attitude in oral health. This study determined knowledge and attitude towards children's oral health among first-time mothers and factors associated with the attributes.

    MATERIALS AND METHODS: A total of 154 first-time mothers in the third trimester of pregnancy who attended two health clinics in the state of Sarawak, Malaysia for antenatal care participated in this cross-sectional study. A structured selfadministered questionnaire was used to measure the variables of interest.

    RESULTS: Most mothers could correctly identify the aetiological factors of dental caries and strategies for preventing the disease in children. However, a substantial portion could not identify certain cariogenic and noncariogenic foods or drinks. Most pregnant women have appropriate attitudes towards children's oral health although some showed unfavourable attitude about care of primary teeth. Women who were older and had attended a talk on children's oral health were more likely to have higher mean knowledge score than their respective counterparts, and higher mean knowledge score was associated with higher mean attitude score.

    CONCLUSION: Most first-time mothers in this study had correct knowledge and favourable attitude about children's oral health, although misunderstandings and misperceptions in several issues were also common. Significant association found between experience of attending oral health talk and oral health knowledge, and between oral health knowledge and attitude, substantiate the importance of an educational intervention program to optimise the mothers' roles in caries prevention in children.

    Matched MeSH terms: Pregnancy
  3. Salari N, Mohammadi A, Hemmati M, Hasheminezhad R, Kani S, Shohaimi S, et al.
    BMC Pregnancy Childbirth, 2023 Dec 02;23(1):830.
    PMID: 38042815 DOI: 10.1186/s12884-023-06151-x
    BACKGROUND: Back pain during pregnancy is often considered as an unavoidable problem and can reduce the quality of life or disability of pregnant women. The aim of this study is to determine the global prevalence of back pain in pregnancy based on a systematic review and meta-analysis.

    METHODS: In this study, Researchers systematically searched electronic databases PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar search engines for studies until September 2023. To analyze data, the random effects model was used, and the heterogeneity of the studies was checked with the I2 index. Data analysis was performed by software (Version 2 Comprehensive Meta-Analysis).

    RESULTS: In the review of 28 studies with a sample size of 12,908 people, the I2 heterogeneity test showed high heterogeneity (I2: 98.4). Based on this, the random effects method was used to analyze the results. Therefore, the meta-analysis reported the global prevalence of back pain at 40.5 (95% CI: 33-48.4) during pregnancy. Also, according to the meta-analysis, the global prevalence of back pain in the first trimester of pregnancy is 28.3 (95%CI: 10.5-57.1), in the second trimester is 36.8 (95%CI: 30.4-43.7) and in the third trimester of pregnancy was reported as 47.8 (95% CI: 37.2-58.6).

    CONCLUSION: In this meta-analysis, the overall prevalence of back pain in pregnant women was reported to be significant, so it is necessary for health policymakers to pay more attention to complications during pregnancy, in addition to increasing society's awareness of pregnant mothers, with timely diagnosis and treatment of such disorders, it can lead to improvement; and reduction in Complications caused by pregnancy and becoming more pleasant during pregnancy.

    Matched MeSH terms: Pregnancy
  4. Rasuli R, Mohamad M, Yaacob SS
    Med J Malaysia, 2023 Dec;78(7):883-889.
    PMID: 38159922
    INTRODUCTION: Despite substantial progress in reducing hepatitis B prevalence in the general population, the indigenous population in Malaysia continues to face a significant burden of infection, with high seroprevalence rates. It is hypothesised that transmission patterns differ between the indigenous and non-indigenous populations. This study aimed to compare key risk factors for hepatitis B transmission in indigenous and non-indigenous cases.

    MATERIALS AND METHODS: This is a comparative crosssectional study using secondary data from the eNotifikasi system and hepatitis B case investigation forms between 2018 and 2022 from four district health offices in Pahang, Malaysia. Demographic data, hepatitis B vaccination status and risk factors were assessed. Data analysis employed were independent chi-squared tests, t-tests and binary logistic regression.

    RESULTS: The study included 285 cases (141 indigenous and 145 non-indigenous). Among the indigenous cases, 72.3% were unvaccinated and 59.6% reported a history of infected mother, followed by percutaneous exposure, multiple sexual partners, and sharing syringe. The odds for those with a history of an infected mother being indigenous group is 2.5 times (95% CI: 1.4-4.4) compared to those with a history of an infected mother being non-indigenous group.

    CONCLUSION: Significant difference exists in hepatitis B risk factors between indigenous and non-indigenous populations. The main risk factor for indigenous community is history of infected mother. Thus, the necessity of incorporating hepatitis B screening into the current practice of antenatal HIV screening, specifically targeting the indigenous community, should be given consideration.

    Matched MeSH terms: Pregnancy
  5. Gan F, Sooriappragasarao M, Sulaiman S, Razali N, Hong JGS, Tan PC
    Sleep, 2023 Dec 11;46(12).
    PMID: 37478474 DOI: 10.1093/sleep/zsad196
    STUDY OBJECTIVES: To evaluate at-home use of eye-mask and earplugs (EMEP) versus sleep hygiene advice leaflet (AL) on actigraphy-derived night sleep duration in sleep-deprived pregnant women.

    METHODS: A randomized controlled trial was conducted in the antenatal clinic of University Malaya Medical Centre from June 2021 to June 2022. Women at 34-36 weeks gestation with self-reported night sleep duration ≤6 hours were recruited. Participants wore an actigraphy device at night for seven consecutive nights (Observation/Baseline week). Only women whose actigraphy-derived night sleep duration was confirmed to be ≤360 minutes were randomized to use EMEP or AL. Actigraphy was continued for another week (Intervention week). Primary outcome was change in actigraphy-derived night sleep duration from observation to intervention week across trial arms. Secondary outcomes include participants' sleep quality, labor, and neonatal outcome. Comparisons were by Student t-test, Mann-Whitney U test, and chi-square test.

    RESULTS: A total of 210 women were randomized: 105 each to EMEP and AL. The increase in night sleep duration over baseline was significantly longer with both EMEP (mean ± SD) 23 ± 41 minutes, p 

    Matched MeSH terms: Pregnancy
  6. Davenport C, Swami V
    Issues Ment Health Nurs, 2023 Dec;44(12):1188-1199.
    PMID: 37819864 DOI: 10.1080/01612840.2023.2262574
    Understandings of paternal postnatal depression (PND) in fathers from the United Kingdom (UK) have received limited attention, particularly in view of changing dynamics of contemporary parenthood. To rectify this, eight UK fathers with PND took part in one-to-one interviews, with Interpretative Phenomenological Analysis used to understand their lived experiences. Our findings demonstrate that UK fathers with PND experienced extremely distressing emotions, including anger and misery, after their babies are born. Their working practices were highly relevant to their fatherhood, with working considered a key responsibility and a source of stress, but also a "legitimate" escape from the home. Fathers' relationships with their partners were experienced as less intimate and conflicted. Fathers often hid their feelings to protect their partners, but also reported their partners as being aware of their challenging and difficult emotions. Healthcare providers should be professionally curious about fathers' mental health and consider the assistance of mothers in identifying cases of paternal PND.
    Matched MeSH terms: Pregnancy
  7. Abdullah NI, Elias NA, Ohte N, Vincenot C
    PeerJ, 2024;12:e16657.
    PMID: 38250723 DOI: 10.7717/peerj.16657
    Resource partitioning among tropical bats in agricultural areas of Peninsular Malaysia remains unclear. This study was conducted to evaluate resource partitioning among bats by examining their fecal samples. The main bat species sampled included: Rhinolophus coelophyllus, Rhinolophus malayanus, Rhinolophus pusillus, Rhinolophus refulgens, Taphozous melanopogon and Hipposideros larvatus. Two harp traps were set at different elevations on a hilltop (Gunung Keriang) and two high nets were used in neighboring rice fields at three sites, for three consecutive nights per sampling from April 2021 to February 2022. A total of 301 bats and 1,505 pellets were analyzed using a conventional approach which examined the fecal sample under the microscope. All of the bat species within the study had insects from the order Coleoptera, Lepidoptera, Diptera and Hemiptera in their diet. Larger bats exhibited a greater variety of prey consumption. Male individuals were observed to be generalists while female individuals were specialists, particularly during pregnancy and lactating reproductive stages. Bat species and insect order had a significant impact on the percentage fragment frequency of the insects consumed. Rhinolophus coelophyllus specialized in feeding on Coleoptera and Diptera, H. larvatus fed on Coleoptera, R. malayanus fed on Hemiptera, R. pusillus and T. melanopogon fed on Lepidoptera. Future molecular analysis can be carried out to further identify the insect pests consumed by these bats up to species level. These findings enhance our understanding of bats' ecological roles in agricultural landscapes and contribute to conservation and pest management strategies.
    Matched MeSH terms: Pregnancy
  8. Rahman M, Ahmad Shariff A, Shafie A, Saaid R, Md Tahir R
    Iran J Public Health, 2014 Jan;43(1):16-27.
    PMID: 26060675
    Caesarean section (c-section) rates have been increasing dramatically in the past decades around the world. This increase has been attributed to multiple factors such as maternal, socio-demographic and institutional fac-tors. Therefore, this study examines the impact of maternal, socio-demographic and relevant characteristics on caesar-ean delivery in the northern region of Bangladesh.
    Matched MeSH terms: Pregnancy
  9. 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: Pregnancy
  10. Hossain MA, Dawson A
    PMID: 36308272 DOI: 10.4103/WHO-SEAJPH.WHO-SEAJPH_144_21
    INTRODUCTION: Approximately 9.2 million refugees live in Asia, with most originating from Afghanistan and Myanmar, and half of them are women, girls, and children. Humanitarian crises disrupt the existing health-care system, limiting access to sexual and reproductive health (SRH) services. This review explores the SRH status of Afghan and Rohingya refugee women of reproductive age in Asia and their needs and experiences in accessing these services and commodities.

    MATERIALS AND METHODS: We used the PRISMA checklist and searched for qualitative and quantitative peer-reviewed studies from five online bibliographic databases, SCOPUS, EMBASE (Ovid), MEDLINE (Ovid), CINAHL, and PROQUEST, from January 2000 to April 2021. Content analysis was undertaken following the minimum initial service package objectives.

    RESULTS: Fifteen studies were included in this review from four countries: Bangladesh (5), Pakistan (5), Iran (4), and Malaysia (1). Approximately 50.91% of Rohingya and 54% of Afghan refugee women used contraceptives. About 56.6% of Afghan refugee mothers experienced pregnancy-related complications, one-third received antenatal care, and low birth weight was 2.6 times higher among infants born to Afghan refugee mothers than to Pakistani-born mothers. One out of five Rohingya women received delivery-related care. Approximately 72% of Rohingya and 79.8% of Afghan refugee women had experienced gender-based violence, and 56.5% of Rohingya women engaged in unwanted sexual intercourse with their husbands.

    CONCLUSION: Social norms, stigma, cultural values, distrust of providers, inadequate staff, and prohibition by family members limit their access to SRH services and influence their needs, knowledge, and perceptions regarding SRH.

    Matched MeSH terms: Pregnancy
  11. Ahmad D
    Malays J Med Sci, 2019 Jan;26(1):1-4.
    PMID: 30914889 DOI: 10.21315/mjms2019.26.1.1
    There have been substantial improvements in the health indicators since Malaysia achieved independence. These were accomplished through strong primary healthcare services addressing maternal and paediatric health, as well as the successful control of communicable diseases. The rate of decline in the mortality statistics has been at a virtual standstill, or at best, almost plateaued since 2000. However, with the plethora of national health issues at both the policy and delivery levels, we cannot continue on with 'business as usual'. Therefore, we must strategise effective and practical approaches to a renewed and revamped national healthcare services for a modern 'New Malaysia' that are compatible with our quest toward the status of a 'truly developed' nation.
    Matched MeSH terms: Pregnancy
  12. Hashim H, Nawawi O
    Malays J Med Sci, 2013 Mar;20(2):76-80.
    PMID: 23983582 MyJurnal
    Uterine arteriovenous malformation (AVM) is a rare condition, with fewer than 100 cases reported in the literature. Despite it being rare, it is a potentially life-threatening condition. This case report describes a 33-year-old woman who presented with secondary post-partum hemorrhage. Transabdominal ultrasound (US) of the pelvis showed increased vascularity with multidirectional flow of the uterus and a prominent vessel, located on the left lateral wall. She also had retained product of conception, which complicated the diagnosis. A uterine artery angiogram confirmed an AVM in the fundal region with an early draining vein. Embolisation of the AVM was performed successfully.
    Matched MeSH terms: Pregnancy
  13. Dharmalingam TK, Ahmad Zainuddin NA
    Malays J Med Sci, 2013 May;20(3):51-4.
    PMID: 23966825 MyJurnal
    This study was undertaken to evaluate patient satisfaction after spinal anaesthesia, which is the most frequently administered anaesthesia in obstetric patients.
    Matched MeSH terms: Pregnancy
  14. Nashreen CM, Hamdan M, Hong J, Kamarudin M, Saaid R, Tan PC
    Acta Obstet Gynecol Scand, 2024 Dec;103(12):2475-2484.
    PMID: 39356052 DOI: 10.1111/aogs.14975
    INTRODUCTION: Our objective was to compare the performance of the first vaginal examination at 8 vs 4 h after amniotomy following Foley ripening in nulliparous labor induction.

    MATERIAL AND METHODS: A randomized controlled trial was conducted from June 2021 to January 2022. 210 nulliparas at term for labor induction were randomized: 105 each to first vaginal examination at 8 or 4 h after Foley balloon ripening and amniotomy. Titrated oxytocin infusion was routinely commenced after amniotomy to expedite labor. Primary outcomes were the amniotomy-to-delivery interval (non-inferiority hypothesis) and maternal satisfaction with their allocated labor care (superiority hypothesis) within 24 h after delivery. Analyses performed using t-test, Mann-Whitney U test, and Chi-squared test as appropriate.

    RESULTS: The amniotomy-to-delivery interval was mean ± standard deviation 8.7 ± 3.4 vs 8.4 ± 3.7, mean difference 0.4 (97.5% CI: -0.7 to 1.5) hours, p = 0.442 within the pre-specified 2-hour non-inferiority margin, and maternal satisfaction score with allocated labor care was median [interquartile range] 8[7.5-10] vs 8[7.0-10], p = 0.248 for 8 vs 4 h arms, respectively. The amniotomy to first vaginal examination intervals was 5.9 ± 2.3 vs 3.6 ± 1.0 h, p 

    Matched MeSH terms: Pregnancy
  15. Kalok A, Kamisan Atan I, Sharip S, Safian N, Shah SA
    Front Public Health, 2024;12:1448940.
    PMID: 39877914 DOI: 10.3389/fpubh.2024.1448940
    Fear of childbirth (FOC) or tokophobia adversely affects women during pregnancy, delivery, and postpartum. Childbirth fear may differ across regions and cultures. We aimed to identify factors influencing the fear of childbirth among the Asian population. A systematic literature search was performed using the PubMed, Scopus, and Web of Science databases in November 2023. Original articles in English with research conducted in Asian countries were included. The independent factors associated with childbirth fear, from the relevant studies were identified and discussed. Forty-six papers met the eligibility criteria but only 26 studies were discussed in this review. The significant factors were categorized into (1) demographics, (2) clinical, (3) healthcare service, (4) childbirth education & information, and (5) COVID-19 pandemic. The prevalence of childbirth fear among Asians ranged between 56.6 and 84.8%. Significant demographic factors included age, education, marital status, economic status, and area of residence. Greater levels of tokophobia were linked to nulliparity, unplanned pregnancy, infertility, miscarriage, and pregnancies at risk. Effective doctor-patient communication and more frequent antenatal visits were shown to alleviate maternal childbirth fear. There was consistent evidence of prenatal childbirth education's benefit in reducing FOC. The usage of smartphone apps and prolonged exposure to electronic devices were linked to a higher degree of tokophobia. Nulliparas who received too much pregnancy-related information also reported increased childbirth fear. There was a positive correlation between maternal fear of COVID-19 infection and FOC. Keeping updated with COVID-19 information increased the maternal childbirth fear by two-fold. In conclusion, a stable economy and relationship contribute to lesser childbirth fear among Asian women. Poor maternal health and pregnancy complications were positive predictors of FOC. Health practitioners may reduce maternal childbirth through women's education, clear communication as well as accurate information and guidance to expectant mothers. Further study is required into the content of childbirth fear among Asian women. These research findings hopefully will lead to the development of culturally adapted screening tools and interventions that reduce the burden of FOC among expectant mothers.
    Matched MeSH terms: Pregnancy
  16. Chong KN, E HC, Zaki RA, Mohd SH, Majid HA, Ng AK, et al.
    Asia Pac J Clin Nutr, 2021 Dec;30(4):632-642.
    PMID: 34967192 DOI: 10.6133/apjcn.202112_30(4).0010
    BACKGROUND AND OBJECTIVES: Maternal diet during pregnancy may impact infant respiratory morbidity. The aim was to determine the association between antenatal maternal diet and respiratory morbidity of their infants during their first 6 months of life.

    METHODS AND STUDY DESIGN: This prospective cohort study included healthy motherinfant pairs. Maternal diet during the last trimester was determined with a validated food frequency questionnaire. Infant respiratory morbidity was solicited at 1, 3 and 6 months.

    RESULTS: Three hundred mother-baby pairs were recruited. Maternal consumption of milk and dairy products was associated with reduced respiratory symptoms at 1 month (aOR 0.29 [95% CI: 0.10, 0.86], p=0.03) and 3 months old (aOR 0.43 [95% CI: 0.20, 0.93], p=0.03), while intake of confectionery items was associated with increased unscheduled doctor visits at 3 months (aOR 2.01 [95% CI 1.33, 3.06], p=0.001) and increased nebuliser treatment at both 3 months (aOR 1.88 [95% CI 1.12, 3.17], p=0.02) and 6 months (aOR 1.64 [95% CI 1.05, 2.54], p=0.03). Finally, at 6 months, hypertensive disorders during pregnancy was associated with increased nebuliser treatment (aOR 17.3 [95% CI 1.50, 199], p=0.02) while exclusive breastfeeding was associated with reduced incidence of respiratory symptoms (OR 0.47 [95% CI 0.26, 0.83], p=0.01).

    CONCLUSIONS: Increased antenatal maternal consumption of milk and dairy products may reduce respiratory morbidity while increased consumption of confectionery items may increase respiratory morbidity in their infants during the first 6 months of life.

    Matched MeSH terms: Pregnancy
  17. Tan ML, Mohd Shukri IA, Ho JJ, O'Sullivan EJ, Omer-Salim A, McAuliffe FM
    Matern Child Nutr, 2024 Apr;20(2):e13608.
    PMID: 38100143 DOI: 10.1111/mcn.13608
    A breastfeeding-friendly city is one where there is an enabling environment to support breastfeeding throughout the first 2 years or more of a child's life. Indicators of a breastfeeding-friendly city have yet to be identified. What are the indicators or criteria used to define breastfeeding friendliness in a geographic area such as a city and the settings within, which we have classified as community, healthcare and workplace? Three major databases and grey literature were searched. Records were screened to identify publications describing criteria such as indicators or descriptions of a breastfeeding-friendly setting, defined as 'criteria-sets'. These criteria-sets were then categorized and summarized by settings. The search up to 2 September 2021 found 119 criteria-sets from a range of settings: geographic locations (n = 33), community entities (n = 24), healthcare facilities (n = 28), workplaces (n = 28) and others (n = 6). Overall, 15 community, 22 healthcare and 9 workplace related criteria were extracted from the criteria-sets. Criteria that were consistently present in all settings were policy, training & education, skilled breastfeeding support and physical infrastructure. Some criteria-sets of geographic locations contained criteria only from a single setting (e.g., the presence of breastfeeding-friendly cafes). Criteria-sets were present for all settings as defined in this review, but few were actual indicators. Specifically, there were no existing indicators of a breastfeeding-friendly city. Several common components of the criteria-sets were identified, and these could be used in developing indicators of a breastfeeding-friendly city. Future studies should determine which of these are important and how each can be measured.
    Matched MeSH terms: Pregnancy
  18. Haniff J, Das A, Onn LT, Sun CW, Nordin NM, Rampal S, et al.
    Asia Pac J Clin Nutr, 2007;16(3):527-36.
    PMID: 17704035
    Anemia is the most prevalent nutritional deficiency during pregnancy. Except for a study conducted 10 years ago in Kelantan, Malaysia's available statistics are based on isolated small urban maternity hospital studies from the 1980s. There was therefore, a need for a large study at national level to estimate the magnitude of the problem in the country as well as to understand its epidemiology. This multi-center, cross-sectional study was conducted from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset consisted of 1,072 antenatal mothers from 56 clinics. The overall prevalence of anemia in this population was 35 % (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis, only gestational age remained significant. These findings are useful for our Maternal Health program planners and implementers to target and evaluate interventions. Work is in progress for outcomes and cost-effectiveness studies to best tackle this problem. In conclusion, the prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays.
    Matched MeSH terms: Pregnancy; Pregnancy Complications, Hematologic/epidemiology*; Pregnancy in Adolescence
  19. Kunasegaran T, Balasubramaniam VRMT, Arasoo VJT, Palanisamy UD, Ramadas A
    PMID: 33572656 DOI: 10.3390/ijerph18031272
    A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute's methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.
    Matched MeSH terms: Pregnancy
  20. Peng HH, Huang KG, Chueh HY, Adlan AS, Chang SD, Lee CL
    Taiwan J Obstet Gynecol, 2014 Sep;53(3):397-400.
    PMID: 25286799 DOI: 10.1016/j.tjog.2013.02.005
    OBJECTIVE: A twin pregnancy consisting of a complete hydatidiform mole with a coexisting normal fetus is extremely rare with an incidence of 1/22,000 to 1/100,000. The incidence of preterm delivery is high and few pregnancies reach near term with a viable fetus.
    CASE REPORT: A 34-year-old woman presented at 20 weeks of gestation with increased levels of serum beta human chorionic gonadotropin (beta-HCG) at 4.74 multiples of the median (310277.7 mIU/mL). Ultrasonography showed a hydatidiform mole together with a normal fetus. Fetal karyotyping revealed 46XY. The serum beta-HCG levels were followed up throughout the remainder of the pregnancy. A male infant weighting 2260 g and the molar tissue were delivered at 37 weeks of gestation. The karyotype of the molar tissue showed 46XX and the histopathological report confirmed our diagnosis. At 4 months postpartum, metastatic gestational trophoblastic disease of the lung was diagnosed in the mother by a computed tomography scan due to increased beta-HCG levels. The patient received three unsuccessful cycles of methotrexate and folinate. Another four cycles of chemotherapy consisting of etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA-CO) were initiated and the beta-HCG levels returned to normal. There was no evidence of recurrence in the subsequent 5 years of regular follow up.
    CONCLUSION: A pregnancy with a complete hydatidiform mole and a living cotwin can be a serious threat to the health of both the mother and the fetus. Early diagnosis depends on a combination of detecting an unusually high level of serum beta-HCG and ultrasound examination. We suggest that continuation of the pregnancy may be an acceptable option and that the pregnancy may continue until term if a normal fetal anatomy is assured and maternal complications are under control. Patients require careful postpartum follow up and any recurrent disease should be managed aggressively.
    KEYWORDS: EMA-CO; metastatic gestational trophoblastic disease; twin pregnancy with one complete hydatidiform mole
    Matched MeSH terms: Pregnancy; Pregnancy, Twin
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