Displaying publications 101 - 120 of 201 in total

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  1. Uterine arteriovenous malformation - Possible association to uterine fibroids?
    Gan F, Vikneswaran V, Yu KK
    Med J Malaysia, 2021 03;76(2):273-274.
    PMID: 33742646
    A 32-year-old, gravida 2 para 0+1, was managed in Selayang Hospital, Selangor for uterine fibroids in pregnancy and placenta previa major. The lady went into preterm labour at 33 weeks, requiring emergency Caesarean section. Intraoperatively, we found a thinned-out bulge between the intramural uterine fibroids at the posterior uterine wall, which then perforated and was repaired. Persistent bleeding post operatively led to relaparotomy and hysterectomy. Histology of the uterus reported arteriovenous malformation (AVM). We postulate the possibility of these lesions coexisting with uterine fibroids. Screening for uterine AVMs in patients with fibroids may lead to early detection with option of embolization; deferring the need for hysterectomy.
    Matched MeSH terms: Cesarean Section
  2. Fulltext Pregnancy with COVID-19 in Malaysia: A case series
    Siti Hayati Mohd Nahwari, Bahiyah Abdullah, Suzanna Daud, Norhana Mohd Kasim, Norhana Mohd Kasim
    Journal of Clinical and Health Sciences, 2021;6(1):58-63.
    MyJurnal
    This case series highlights the outcome of four pregnancies complicated with COVID-19, as
    the pandemic of coronavirus disease 2019 (COVID-19) poses a lot of uncertainties due to lack
    of scientific evidence in guiding the management of pregnancy with COVID-19. The women
    were between 25 and 31 years of age and of 35 - 39 weeks of gestation with no underlying
    medical problems. Three women were delivered via caesarean section and one woman was
    delivered via ventouse delivery due to poor progress during the second stage of labour. Two
    women were in stage 4 of the disease (having breathing difficulties and requiring oxygen
    support) at presentations. One of them was treated with hydroxychloroquine (HC) only while
    another one was treated with both HC and antiviral medications; none required assisted
    ventilation during their hospitalizations. There is no vertical transmission of COVID-19 disease
    observed in this case series.
    Matched MeSH terms: Cesarean Section
  3. Adult giant hydronephrosis diagnosed in the second trimester of pregnancy: A case report and literature review
    Ramly F, Mohamad NAN, Zahid AZM, Kasim NM, Teh KY
    Case Rep Womens Health, 2021 Jan;29:e00275.
    PMID: 33304832 DOI: 10.1016/j.crwh.2020.e00275
    Adult giant hydronephrosis in a normally sited kidney is unusual during pregnancy. The most frequent cause is congenital obstruction at the ureteropelvic junction. Ultrasound accompanied by magnetic resonance imaging (MRI) are valuable in reaching the diagnosis, especially when clinical assessment of an abdominal mass is inconclusive regarding aetiology. We report a case of giant hydronephrosis in a woman who presented at 23 weeks of gestation with abdominal distension. She was managed conservatively. Unfortunately, the pregnancy was complicated by severe pre-eclampsia at 32 weeks of gestation, necessitating delivery via emergency caesarean section. She had a smooth postpartum recovery, and subsequently standard imaging was performed before nephrectomy. The literature and previously reported cases of giant hydronephrosis in pregnancy are reviewed.
    Matched MeSH terms: Cesarean Section
  4. Fulltext Lumbar tinea versicolor and spinal anaesthesia
    Mazlan MZ, Chong SE, Salmuna Ayub ZN, Mohamad NAN
    IDCases, 2019;16:e00520.
    PMID: 31024798 DOI: 10.1016/j.idcr.2019.e00520
    Infection to the meningeal layer causing meningitis is one of the most feared complications of spinal anaesthesia. Anaesthetists will avoid spinal anaesthesia for those who are having skin infection at the puncture site. However in obstetric population, anaesthetist will try their best to avoid general anaesthesia due to its unwanted effects and complications. Strict and appropriate antiseptic measures such as chlorhexidine 0.5% with 70% alcohol has been suggested to reduce risk of transmission of microorganisms into subarachnoid space. We reported a parturient who had generalized tinea versicolor at the lumbar area, safely anaesthetized under spinal anaesthesia through meticulous antiseptic skin preparation who required delivery by caesarean section.
    Matched MeSH terms: Cesarean Section
  5. Outcomes of an In Vitro Fertilization Pregnancy With COVID-19 and the Perinatal Outcome in Riyadh, Saudi Arabia
    Alhamoud AH, Matary F, Bukhari S, Kelantan M, Bajahzer M
    Cureus, 2020 Dec 26;12(12):e12296.
    PMID: 33510990 DOI: 10.7759/cureus.12296
    Coronavirus disease 2019 (COVID-19) caused by the novel severe respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pandemic and potentially fatal disease. COVID-19 cases are on the rise globally; this also includes risk groups such as pregnant women and neonates. Herein, we report the first COVID-19 cesarean delivery case of an in vitro fertilization (IVF) pregnancy in a Saudi woman. A postdate pregnant healthy woman tested positive with COVID-19 on her 38 weeks + five days. On her 40 weeks + five days, the woman had dilation without contractions; thereby, cesarean delivery was decided. The delivery was successful, with no complications in the mother and neonate. The preferable outcomes of this case could be attributable to some factors: multidisciplinary medical management, the mother's young age, and COVID-19 infection during the late trimester.
    Matched MeSH terms: Cesarean Section
  6. Fulltext Post spinal meningitis with subdural collection:an uncommon complication after spinal anaesthesia for caesarean section
    Seng, Wee Cheo, Qin, Jian Low, Yee, Ann Tan, Yuen, Kang Chia
    Neuroscience Research Notes, 2018;1(2):1-5.
    MyJurnal
    Abstract: Meningitis after spinal anaesthesia is a rare yet devastating complication of spinal anaesthesia. The exact incidence is unknown. Our patient developed signs and symptoms of meningitis 48 hours after spinal anaesthesia and required intensive care unit admission. Her cerebrospinal fluid was sterile. Computed tomography of brain showed left subdural collection. She recovered well after 6 weeks of intravenous antibiotics. No neurological sequela noted from subsequent follow-upexaminations. Our case provides an important insight of meningitis with subdural collection after spinal anaesthesia for emergency caesarean section.
    Matched MeSH terms: Cesarean Section
  7. Fulltext Survey dataset of women perception on caesarean section
    Woon YH, Suhaini SA
    Data Brief, 2021 Apr;35:106501.
    PMID: 33997187 DOI: 10.1016/j.dib.2020.106501
    A caesarean section (CS) is a common birth delivery mode, which involves delivery of the baby through a surgical incision on the mother's abdomen and uterus. This article presents a survey dataset on the perception and response of women about the CS. This survey employed a quantitative research design. The data were collected by means of a face to face questionnaire. Majority of the respondents are in the age range of 31 - 40 years old. The findings indicate that the respondents mainly refer to the internet to obtain information about the birth delivery mode that helped the respondents to decide on their mode of preference. This is followed by obstetrician/midwife and friends. Various statements were used to determine the perception of respondents towards CS.
    Matched MeSH terms: Cesarean Section
  8. Mapping timely access to emergency and essential surgical services: The Malaysian experience
    Hoh SM, Wahab MYA, Hisham AN, Guest GD, Watters DAK
    ANZ J Surg, 2021 Jun 01.
    PMID: 34075677 DOI: 10.1111/ans.16986
    BACKGROUND: Surgical conditions form a significant proportion of the global burden of disease. Since the 2015 World Health Assembly resolution A68.15, there is recognition that the provision of essential surgical care is an integral part of universal access to health care. The Lancet Commission on Global Surgery proposed its first surgical indicator to measure a population's access to the Bellwether procedures (laparotomy, caesarean section and treatment of open fracture) within two hours. Bellwether access is a proxy for emergency and essential surgical care. This project aims to map essential surgical access to the Bellwether procedures in Malaysia.

    METHODS: The location and capability of hospitals to perform the Bellwether procedures was obtained from the Ministry of Health (MoH) and MoH hospital specific websites. The Malaysian population data were retrieved from the national department of statistics. Times for patients to travel to hospital were calculated by combining manual contouring and geospatial mapping.

    RESULTS: There were 49 Bellwether-capable MoH hospitals serving a national population of 32.5 million. Overall 94% of Malaysia's population have access to the Bellwethers within two hours. This coverage is universal in West (Peninsular) Malaysia, but there is only 73% coverage in East Malaysia, with 1.8 million residents of Sabah and Sarawak not having timely access. Malaysia's Bellwether capacity compares well with other countries in World Health Organisation's Western Pacific region.

    CONCLUSION: There is good access to essential and emergency surgical services in Malaysia. The incomplete access for 1.8 million people in East Malaysia will inform national surgical planning.

    Matched MeSH terms: Cesarean Section
  9. Chlorhexidine-alcohol versus povidone-iodine for skin preparation before elective cesarean section: a prospective observational study
    Elshamy E, Ali YZA, Khalafallah M, Soliman A
    J Matern Fetal Neonatal Med, 2020 Jan;33(2):272-276.
    PMID: 30021481 DOI: 10.1080/14767058.2018.1489533
    Introduction: The ideal antiseptic agent for skin preparation before elective cesarean section (CS) is not yet determined. The aim of the study was to assess the impact of skin preparation by chlorhexidine-alcohol compared with povidone-iodine before elective CS on the rate of surgical site infection (SSI).Materials and methods: This prospective observational study included a total of 1424 pregnant women at term who were candidates for the elective CS and were divided into two equal groups of 712 patients in each, group 1 (chlorhexidine-alcohol group) and group 2 (povidone-iodine group). Patients were followed up at 1 week and 1 month postoperative to determine the rate of SSI.Results: The rate of SSI was 3.7% (26 patients) in the chlorhexidine-alcohol group compared with 4.6% (33 patients) in the povidone-iodine group (odds ratio: 0.7798, 95% CI: 0.46-1.3, p = .35), nine patients in the chlorhexidine-alcohol group, and 10 patients in the povidone-iodine group required resuturing (odds ratio: 0.9, 95% CI: 0.36-2.2, p = .82). Four patients (0.56%) in the chlorhexidine-alcohol group and five patients (0.7%) in the povidone-iodine group developed endometritis (p = .74). The rate or readmission because of SSI was 2.7% (19 patients) in the chlorhexidine-alcohol group and 2.9% (21 patients) in the povidone-iodine group (p = .75).Conclusions: Skin preparation with either chlorhexidine-alcohol or povidone-iodine resulted in comparable rates of SSIs. Accordingly, both are suitable antiseptic agents for skin preparation before elective CS.
    Matched MeSH terms: Cesarean Section
  10. Fulltext Ultrasound guided transversus abdominis plane block versus intrathecal morphine for analgesia post caesarean section: which is better?
    Aizatul Isla, A.L., Wan Rahiza, W.M., Azrin, M.A., Thohiroh, A.R., Nurlia, Y., Nadia, M.N.
    Journal of Surgical Academia, 2013;3(2):39-45.
    MyJurnal
    The tranversus abdominis plane (TAP) block for postoperative analgesia after caesarean section may confer potential benefits comparable to that of intrathecal opioids. We compared postoperative analgesia, and the incidence of nausea, vomiting, pruritus and sedation between the TAP block and intrathecal morphine (ITM) in patients undergoing Caesarean section. This was a prospective, randomised clinical study. Fifty American Society of Anaesthesiologists physical status I or II patients, planned for elective caesarean section under spinal anaesthesia, were randomly allocated to the TAP group (patients receiving spinal anaesthesia with bilateral TAP block without ITM) or ITM group (patients receiving spinal anaesthesia with ITM without a TAP block). Assessment for pain, postoperative nausea and vomiting, pruritus and sedation was done upon arrival and discharge from recovery, and at 6, 12 and 24 hours, postoperatively in the post natal ward. Results were analysed using analysis of variance (ANOVA). There was no pain at rest in either groups. Both groups experienced pain on movement at the 12th (p = 0.6) and 24th hour (p = 0.4). None of the patients in the TAP group experienced nausea, vomiting, pruritus or sedation. However, these incidences were found to be significantly higher in the ITM group. Ultrasound guided TAP block provided comparable postoperative analgesia to ITM without the side effects of the latter.
    Matched MeSH terms: Cesarean Section
  11. Pregnancy and Dumping Syndrome post-bariatric surgery: a case report
    Edawati DE, Abigail J, Mardiana K, Ming-Cheng C, Harris NS
    Med J Malaysia, 2017 04;72(2):133-134.
    PMID: 28473681 MyJurnal
    This case report discusses dumping syndrome in the postbariatric mother. Diagnostically a challenge, the symptoms of postprandial hypoglycaemia mimic common early gestation complaints and may go undiagnosed, thus requiring a high index of suspicion. As weight-loss surgery gains traction, it is pertinent to note at booking and followups. The pregnancy is at-risk and multidisciplinary team management is central. The mainstay of management remains diet modification. There have been case reports of successful medical treatment of dumping syndrome in pregnancy with good maternal and fetal outcomes. However, more data is needed regarding the usage of these medical treatments in pregnancy.
    Matched MeSH terms: Cesarean Section
  12. Antenatal diagnosis and management of foetal intestinal volvulus
    Yip KW, Cheng YKY, Leung TY
    Med J Malaysia, 2017 04;72(2):126-127.
    PMID: 28473678 MyJurnal
    In-utero intestinal volvulus is a rare but potential life threatening foetal complications. It is a surgical emergency and delay in diagnosis or treatment can increase the morbidity and mortality to the foetus. We report a case of mild foetal bowel dilatation diagnosed at 21 weeks of gestation. She was closely follow up and at 31 weeks of gestation, in-utero intestinal volvulus was diagnosed with the characteristic 'whirlpool' sign on ultrasound examination. This case emphasises the importance of early recognition and quick decision to delivery when intestinal volvulus is diagnosed. This enabled early surgical intervention to prevent further foetal morbidity.
    Matched MeSH terms: Cesarean Section
  13. 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: Cesarean Section
  14. Fulltext A randomized controlled study comparing subcutaneous pethidine with oral diclofenac for pain relief pain relief after caesarean section
    Marzida, M.
    JUMMEC, 2009;12(2):63-69.
    MyJurnal
    It is important to provide effective postoperative analgesia following a Caesarean section because mothers wish to be pain-free, mobile and alert while caring for their babies. The role of regular oral diclofenac as postoperative analgesia was evaluated in a randomized controlled study and it was compared to the established method of parenteral pethidine. Forty healthy women scheduled for elective Caesarean section under spinal anaesthesia with 2-2.5 mg of heavy bupivacaine 0.5% were randomized to receive either 75 mg of oral diclofenac twice daily or 1 mg/kg of subcutaneous pethidine every 8 hourly. Efficacy of pain relief (visual analogue score), patients' satisfaction and side effects such as sedation, nausea and vomiting were recorded for three days. The demographic variables were similar in both groups. Pain relief was adequate and comparable in both groups with similar mean visual analogue score during the second and third day of the study period. However, on the first postoperative day, 60% of the diclofenac group population required rescuemedication consisting of subcutaneous pethidine in order to achieve the same pain scores as those in the pethidine group who did not require any rescue medications. Women who received oral diclofenac reported lower sedation and higher overall satisfaction. The incidence of nausea and vomiting was similar in both groups. This concluded that although oral diclofenac 75mg twice daily may not be superior to the traditional method of subcutaneous pethidine for pain relief following caesarean section, it can still be used alone as an alternative, as it has other benefits of a non-opioid analgesia.
    Matched MeSH terms: Cesarean Section
  15. 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: Cesarean Section
  16. Fulltext Comparing cost for elective lower segment caesarean section costing using top-down and activity based costing methods
    Aniza I., Putri, N., Azimatun Noor, A., Amrizal, M.N., Saperi, S., Aljunid, S.M.
    Malaysian Journal of Public Health Medicine, 2011;11(1):36-46.
    MyJurnal
    Top-down costing and activity based costing are the most frequent costing methodologies used for analyzing cost. Top-down costing is accomplished by assigning total expenditure of hospital to patient by apportioning the expenditure of cost centers (unit of service) in hospital to give the cost per patient per visit, per day or per admission. Conversely, activity based costing is accomplished by tracking every resource used by patient individually. Since this study started in 2009, Top-down costing calculation was based on financial year in 2009 with adjusted up to 12.6% from 2008 data. This percentage was taken based on the trend of hospital expenditure during 2005 till 2008. An assumption was made that non-financial data (performance and administrative data) for 2009 was similar to 2008. Top-down costing was calculated using Clinical Cost Modeling Software developed by Unit Case-mix of UKMMC to obtain cost of elective lower segment caesarean section (LSCS) per day at ward which was RM922. Whereas activity based costing was calculated using clinical pathway of elective LSCS. Given the average length of stay in 2009 was 4 days, the cost of elective LSCS according to top-down costing was RM3, 688 and activity based costing was RM1774. As a result, cost of elective LSCS is 108% higher using top-down costing.
    Matched MeSH terms: Cesarean Section
  17. Fulltext Early versus late ecv in primigravidae with breech presentation: a pilot study
    Nor Azlin, M.I., Norliza, H., Norzilawati, M.N., Mahdy, Z.A., Shuhaila, A., Jamil, M.A.
    Malaysian Journal of Public Health Medicine, 2013;13(1):20-27.
    MyJurnal
    This was a pilot study comparing the success between early versus late external cephalic version (ECV) involving primigravidae with singleton breech pregnancy. They were randomised into early (34–36 weeks) and late (37-40 weeks) ECV groups. A total of 44 women were initially randomised into 22 women for each group. The overall ECV success rate was acceptable in both groups although insignificantly higher in the late ECV group (55.6% versus 46.7%, p= 0.732.) Caesarean
    section in the early ECV group was higher (80% versus 72.2%). Early ECV group had women with higher BMI (29.5 versus 26.8 kg/m2, p=0.107), anterior placentation (60% versus 38.9%) and extended breech presentation (55.6% versus 44.4%; p= 0.296). In conclusion, early ECV in primigravidae showed no better success rate than late ECV. Maternal obesity, anterior placentation and extended breech presentation should alert to failure risk.
    Matched MeSH terms: Cesarean Section
  18. Fulltext Congenital peritoneal band causing bowel ischaemia post caesarean section: a rare occurrence
    Phon, S.E., Ng, W.Y.L., Ng, B.K., Rahman, R.A., Zainuddin, A.A, Mahdy, Z.A.
    Journal of Surgical Academia, 2017;7(2):28-31.
    MyJurnal
    Congenital peritoneal band is an extremely rare condition, but may induce small bowel obstruction (SBO) at any age, predominantly in childhood and rarely in adults. We report a case of extensive bowel ischaemia following caesarean section, due to trapping of an intestinal loop between a congenital peritoneal band and the mesentery. A 42-year-old, Gravida 2 Para 1, who has no history of prior abdominal surgery or trauma, presented in spontaneous labour and underwent an uncomplicated emergency lower segment caesarean section, for fetal distress. Postoperatively, she had worsening abdominal distension and pain, followed by vomiting. Computed Tomography Scan of the abdomen showed gross fluid retention with marked small bowel dilatation and fluid filled bowel loops. An emergency exploratory laparotomy was performed which revealed a congenital band, extending between the right fimbrial end and the small bowel mesentery, looping over the small bowel, causing extensive small bowel ischemia. Post-operative course was uneventful. In conclusion, congenital peritoneal band causing small bowel obstruction, although rare, should be considered in the differential, especially for patients with virgin abdomen.
    Matched MeSH terms: Cesarean Section
  19. Single nucleotide polymorphism for certain genes involved in gestational diabetes with risk factors and complications positive
    NOR AZLIN MOHAMED ISMAIL, NORKHATIJAH MOHD ARIS, ZALEHA ABDULLAH MAHDY, SHUHAILA AHMAD, NORZILAWATI MOHD NAIM, HARLINA HARLIZAH SIRAJ, et al.
    Sains Malaysiana, 2013;42:1613-1618.
    Gestational Diabetes Mellitus (GDM) is associated with pregnancy complications, however its mechanism has not been fully understood. The aim of this study was to investigate the single nucleotide polymorphism (SNP) for identifying candidate genes involve in risk factors and complications of GDM. A total of 174 pregnant women with GDM and 114 healthy pregnant women were genotyped with 384 SNPs from 236 genes. The SNPs identified were rs10946398 (CDKAL1) in GDM risk factors; rs328 (LPL) and rs1042778 (OXTR) in complications of caesarean section; rs5404 (SLC2A2), rs5400 (SLC2A2) and rs13306465 (IRS1) for neonatal intensive care admission. Whereby SNPs rs12255372, rs7901695 and rs7903146 from TCF7L2 gene had six times higher risk (OR, 6.40-6.53) for T2DM at postpartum. In conclusion, although the above SNPs were identified with GDM risk factors and complications among pregnant Malaysian women with GDM, a larger study is needed to ascertain this candidate genes actual association.
    Matched MeSH terms: Cesarean Section
  20. Which and what headache were we treating? Epidural blood patch for atypical headache following obstetric epidural anaesthesia
    Chiu CL, Chan YK
    Int J Obstet Anesth, 2000 Oct;9(4):273-5.
    PMID: 15321079 DOI: 10.1054/ijoa.2000.0397
    We present a case of headache following epidural anaesthesia for caesarean section. The patient did not exhibit the classical features of post dural puncture headache and the cause was uncertain. The headache was complicated by post partum seizure and a history of pregnancy-induced hypertension. A diagnostic lumbar puncture had to be done to exclude meningitis as she had a raised white blood count. An epidural blood patch performed 12 days post partum resolved the headache immediately.
    Matched MeSH terms: Cesarean Section
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