MyMedR

Fulltext Fertility following reversal of female sterilization

Rachagan SP, Jaafar Y

Med J Malaysia, 1993 Jun;48(2):225-8.

This retrospective study presents data from 26 women who underwent a reversal of female sterilization. The intrauterine pregnancy rate and ectopic pregnancy rate were 38.5% and 7.7% respectively. The most successful site of tubal anastomosis was isthmic-isthmic anastomosis. The importance of proper patient selection and factors that affect the success rate in attempted reversals are emphasised. The importance of microsurgical approach is highlighted.

Matched MeSH terms: Pregnancy

Sociobiological risk factors for spontaneous abortion in Malaysia

Tan NH, Yahya A, Adeeb N

J Obstet Gynaecol (Tokyo 1995), 1995 Aug;21(4):313-8.

PMID: 8775898

OBJECTIVE: To evaluate the risk factors of spontaneous abortion.

METHODS: A case-control study was conducted by interviewing 350 women who were admitted to the university gynaecological unit for spontaneous abortion and 350 women who delivered normally at the university obstetric unit. Odds ratios, as the estimators of relative risks, were calculated.

RESULTS: The relative risk for spontaneous abortion among women in the age-group 30 to 39 years was 1.61 and among women above 40 years of age was 3.68 when compared to those below 30 years of age. In relation to career women, the relative risk of spontaneous abortion for housewives was 0.45. Ethnic group, parity, subfertility, previous induced abortion, ectopic pregnancy, contraception and menarcheal age did not influence the risk of spontaneous abortion.

CONCLUSION: Increasing age and a woman's career are significant risk factors of spontaneous abortion.

Matched MeSH terms: Pregnancy

Fetal cerebral Doppler in the recognition of fetal compromise

Chandran R, Serra-Serra V, Sellers SM, Redman CW

Br J Obstet Gynaecol, 1993 Feb;100(2):139-44.

PMID: 8476805

OBJECTIVE: To establish reference ranges for the human fetal middle cerebral artery pulsatility index (MCA PI) for the local obstetric population, and to compare computerised antenatal fetal heart rate (FHR) analysis with the MCA PI as indicators of fetal compromise.

DESIGN: Prospective data collection for selected patients.

SETTING: High risk pregnancy unit of a teaching hospital.

SUBJECTS: Group 1 consisted of 18 healthy women with uncomplicated singleton pregnancies. Group 2 consisted of 27 women admitted to the high risk pregnancy unit over a 9 month period with intrauterine growth retardation and other related problems; all these women were delivered by prelabour caesarean section.

INTERVENTION: Serial Duplex sonography to determine fetal MCA PI in Groups 1 and 2. Serial FHR analysis using computerised numerical techniques in Group 2 only.

MAIN OUTCOME MEASURES: Serial MCA PI values from 24 to 39 completed weeks of gestation in Group 1. Comparison of serial MCA PI values with FHR analysis in relation to fetal outcome in Group 2.

RESULTS: In Group 1 the MCA PI diminished significantly as gestation advanced from 1.73 (SD 0.25) at 24 weeks to 1.38 (SD 0.26) at 39 weeks (P < 0.01). In Group 2 eleven babies were hypoxaemic at delivery: all had low MCA PI values while only nine had an abnormal FHR prior to delivery.

CONCLUSION: In normal pregnancy, there is a fall in the fetal MCA PI with advancing gestation which probably reflects a decreasing vascular resistance to fetal cerebral blood flow. Hypoxaemia at delivery appeared to be better recognised by the fetal MCA flow velocity waveform than the FHR analysis. This increased sensitivity, however, was achieved at the expense of a reduced specificity. Larger studies are needed to confirm the findings of this preliminary investigation.

Matched MeSH terms: Pregnancy

Vertical transmission of dengue

Chye JK, Lim CT, Ng KB, Lim JM, George R, Lam SK

Clin Infect Dis, 1997 Dec;25(6):1374-7.

PMID: 9431381

Dengue, an important mosquito-borne flavivirus infection, is endemic in Southeast Asia. We describe two mothers who had acute dengue 4 and 8 days before the births of their infants. One mother had worsening of her proteinuric pregnancy-induced hypertension, liver dysfunction, and coagulopathy and required multiple transfusions of whole blood, platelets, and fresh frozen plasma. Her male infant was ill at birth, developed respiratory distress and a large uncontrollable left intracerebral hemorrhage, and died of multiorgan failure on day 6 of life. Dengue virus type 2 was isolated from the infant's blood, and IgM antibody specific to dengue virus was detected in the mother's blood. The second mother had a milder clinical course; she gave birth to a female infant who was thrombocytopenic at birth and had an uneventful hospitalization. Dengue virus type 2 was recovered from the mother's blood, and IgM antibody specific to dengue virus was detected in the infant's blood. This report highlights not only the apparently rare occurrence of vertical transmission of dengue virus in humans but also the potential risk of death for infected neonates.

Matched MeSH terms: Pregnancy

Severe bronchospasm during epidural anaesthesia

Wang CY, Ong GS

Anaesthesia, 1993 Jun;48(6):514-5.

PMID: 8322993

A case of severe bronchospasm occurring during epidural anaesthesia in a patient undergoing Caesarean section is described. The aetiology of the bronchospasm may have been related to sympathetic nervous blockade allowing unopposed parasympathetically mediated bronchoconstriction.

Matched MeSH terms: Pregnancy

Fulltext Efficacy of danazol treatment in infertile patients with endometriosis

Kulenthran A

Med J Malaysia, 1992 Mar;47(1):11-4.

PMID: 1387442

The study was done to assess the efficacy of danazol in the treatment of infertile patients with all stages of endometriosis. The cumulative pregnancy rates in 21 patients with Stage I and II endometriosis were compared to 21 patients with Stage III and IV endometriosis. Both groups had danazol treatment for six months. All other fertility related factors were controlled for in both groups. There was a cumulative pregnancy rate of 11% (standard error 7%) at 12 months of follow-up in the group with Stage I and II disease whilst it was 26% (standard error 10%) in the group with moderate or severe disease. These results question the validity of any classification system in prognosticating for fertility in patients with endometriosis.

Matched MeSH terms: Pregnancy

The management of gestational trophoblastic disease in developing countries such as Malaysia

Sivanesaratnam V

Int J Gynaecol Obstet, 1998 Apr;60 Suppl 1:S105-9.

PMID: 9833622 DOI: 10.1016/S0020-7292(98)80012-X

Gestational trophoblastic disease is a common gynaecological problem in Malaysia. The incidence of molar pregnancy is 2.8 per 1000 deliveries, being more common amongst the Chinese. The preferred method of evacuation is suction curettage; complete evacuation of the uterus was not achieved at the first attempt in 25 per cent of cases. Partial moles in our centre comprised 30 per cent of all moles. This is potentially malignant and needs follow-up for a complete mole. In the management of an invasive mole, chemotherapy should not be withheld in the presence of metastases and failure of regression of hCG. The role of prophylactic hysterectomy and prophylactic chemotherapy in the management of molar pregnancy is discussed "Selective preventive chemotherapy" in patients at "risk" appears appropriate. Chemotherapy remains the main modality of treatment for gestational trophoblastic tumours (GTT). We categorised our patients into low, medium and high-risk groups; survivals were 100, 98, and 61.7 percent respectively. These patients when categorised according to FIGO staging had survivals of 100, 80, 78.6 and 68.2 per cent respectively for stages 1, 2, 3 and 4 respectively. The reasons for the poor survival in the 'high-risk' group are discussed. Colour doppler blood flow studies are now being carried out; its role needs further evaluation. Surgery and radiotherapy have only a limited role in the management of these cases.

Matched MeSH terms: Pregnancy

Maternal mortality rate in the Obstetric Unit of University Kebangsaan Malaysia: 1981-1990

Abdullah A, Mahmood JH, Adeeb N

J Obstet Gynaecol (Tokyo 1995), 1995 Jun;21(3):299-303.

PMID: 8590370

This paper analyses maternal mortality as seen in the Obstetric Unit of the University Kebangsaan Malaysia. During the 10 year study period, the maternal mortality rate was 74/100,000 total births. Women who were non-booked, aged above 40 years, gradmultiparous and of India ethnicity were at the highest risk of maternal death. The commonest causes of death were hemorrhage, hypertension, embolism and sepsis. Post-mortem examinations were performed in only 8.2% of women who died.

Matched MeSH terms: Pregnancy

Primary thrombocythaemia presenting as postpartum haemorrhage: a case report

Rashid Z, Hamidah NH, Othman A, Cheong SK, Fairuz AK, Adeeb N

J Obstet Gynaecol (Tokyo 1995), 1995 Jun;21(3):221-5.

PMID: 8590357

A young primigravida presented with postpartum haemorrhage with no apparent cause following a low forceps delivery. She was extremely pale with gross hepatosplenomegaly. Hysterectomy was performed following three episodes of disseminated intravascular coagulation. Investigations revealed an extremely high platelet count with poor aggregatory function. A diagnosis of primary thrombocythaemia was made.

Matched MeSH terms: Pregnancy

Prospects and programs for fertility reduction, 1990-2015

Mauldin WP, Ross JA

Stud Fam Plann, 1994 Mar-Apr;25(2):77-95.

PMID: 8059448 DOI: 10.2307/2138086

What is the likelihood that each of the 37 developing countries with populations of 15 million or more in 1990 will reach replacement fertility by the year 2015? These countries have a combined population of 3.9 billion, 91 percent of the population of all developing countries. For this article, a composite index was used as the basis for predicting future levels of total fertility. The index was constructed from socioeconomic variables (life expectancy at birth, infant mortality rates, percent adult literacy, ratio of children enrolled in primary or secondary school, percent of the labor force in nonagricultural occupations, gross national product per capita, and percent of the population living in urban areas), total fertility rates for the years 1985-90, total fertility rate decline from 1960-65 to 1985-90, family planning program effort scores in 1989, and the level of contraceptive prevalence in 1990. Eight countries are classified as certain to reach replacement fertility by 2015, and an additional thirteen probably will also. Five countries are classified as possibly reaching replacement fertility, and eleven as unlikely to do so.

Matched MeSH terms: Pregnancy

Fulltext Routine coagulation tests in cases of missed abortion--is it really necessary?

Chandran R, Adeeb N

Med J Malaysia, 1992 Dec;47(4):287-9.

PMID: 1303481

Many gynaecological units have a policy of performing routine coagulation tests in cases of missed abortion. For many years now, it has been accepted practice in our unit to perform routinely a platelet count, bleeding time (BT), clotting time (CT) and plasma fibrinogen (P. fib) level prior to evacuation in cases of missed abortion. We are not sure how or why these 4 tests came to be chosen as a coagulation 'screen'. As they are not totally adequate in detecting disseminated intravascular coagulation (DIC), we wondered if these tests added to the management in any way.

Matched MeSH terms: Pregnancy

Fulltext Herpes gestationis: one of the rare skin lesions in pregnancy

Naganathan K, Doi SA, Jamiyah H

Med J Malaysia, 1994 Dec;49(4):401-3.

PMID: 7674975

Herpes gestationis is a rare disease in pregnancy. A 35-year-old G3P2 presented during her third trimester with erythematous pruritic papular eruptions. Direct immunofluorescence of a skin biopsy confirmed the diagnosis of herpes gestationis. The patient responded well to predniosolone treatment.

Matched MeSH terms: Pregnancy

Sudden maternal deaths from amniotic fluid embolism

Nadesan K, Jayalakshmi P

Ceylon Med J, 1997 Dec;42(4):185-9.

PMID: 9476404

Sudden maternal death from amniotic fluid embolism is a rare but serious complication which usually occurs during late pregnancy, often during labour or shortly after, with more than 80% mortality. Such a death causes immense stress to both the relatives and the attending doctors as it is sudden and unexpected. Three such deaths are discussed here. Traditionally, it was believed that this complication usually occurred in prolonged and difficult labour, but there is evidence contrary to this, and it is not possible to predict when and where this fatal complication will occur. Current views and various pathophysiologic mechanisms leading to the fatal outcome are also discussed.

Matched MeSH terms: Pregnancy

Fulltext Single-dose antibiotic prophylaxis in women undergoing elective caesarean section

Huam SH, Lim JM, Raman S

Med J Malaysia, 1997 Mar;52(1):3-7.

PMID: 10968046

This prospective, randomised, controlled trial was performed to evaluate the effectiveness of single-dose antibiotic prophylaxis in decreasing the infectious morbidity following elective caesarean section. Two hundred women undergoing elective caesarean section were randomly assigned to receive either 1.2 g of Augmentin intravenously, or no treatment, just before the start of their caesarean section. The two groups of women were comparable in terms of patient characteristics and operation variables. The overall postoperative morbidity rate was 19% in the Augmentin treated group versus 38% in the group that received no prophylaxis (p < 0.01). The incidence of wound sepsis was 3% in the Augmentin group versus 13% in the control group (p < 0.01). The incidence of febrile morbidity with no identifiable cause was 8% in the Augmentin group versus 18% in the control group (p < 0.05). The duration of hospital stay was significantly shorter in the Augmentin group (p < 0.05). A single-dose of prophylactic Augmentin significantly reduced the postoperative morbidity and duration of hospital stay in women who underwent elective caesarean sections.

Matched MeSH terms: Pregnancy

Fulltext Breastfeeding and the prevention of malnutrition

Jelliffee EF

Med J Malaysia, 1986 Mar;41(1):88-92.

PMID: 3796357

The role of breastfeeding in preventing malnutrition is considered in relation to the Bostock classification of early human development, its relevance to different forms of malnutrition and to general ecological considerations, including economics and the management and prevention of diarrhoea.

Matched MeSH terms: Pregnancy

Fulltext Adequacy of lactation: dysreflexia vs. maternal nutrition

Jelliffe DB

Med J Malaysia, 1986 Mar;41(1):77-83.

PMID: 3796355

Problems with assessing the effect of maternal nutrition and lactation performance are presented in relation to a conceptual mathematical ziggurat. Difficulties, variations and flows are to be found in stages of this sequence of "logic" [e.g., assessment of maternal nutrition, volume and composition of breast milk, nutritional satisfactions of the nursling). It is concluded that the various steps in this process of reasoning are subject to much more variation and adaptation than appreciated. Much so-called "faltering" in the second trimester is physiologically normal ("pseudo-faltering").

Matched MeSH terms: Pregnancy

Fulltext Pharmacological evaluation of aqueous root extract of Selayak Hitam: lack of oxytocic activity

Gan EK, Abdul Razak D, Mohamad M, Lajis R, Tan KC, Sam TW

Med J Malaysia, 1984 Mar;39(1):42-7.

PMID: 6513839

Aqueous root extract of Selayak Hitam a plant commonly found in Malaysian jungles and reported to have abortifacient property was screened for oxytocic effect. Results obtained from in vitro experiments on isolated uterus preparation from both pregnant and non pregnant rats and in vivo experiments on uterus contraction in rats in situ, showed that the extract lacks oxytocic effect. It is concluded that the alleged abortifacient property if any, is not mediated through oxytocin or oxytocic-like effect.

Matched MeSH terms: Pregnancy

East Asia review 1978-79. Malaysia

Aziz NL, Tey NP, Ramli O

Stud Fam Plann, 1980 Nov;11(11):330-4.

PMID: 7456109 DOI: 10.2307/1966036

PIP: While Malaysia's National Family Planning Board is primarily responsible for family planning activities, several organizations and ministries, both governmental and voluntary, participate in various service programs. Current population policy attempts to go beyond family planning. Population education, treatment of infertility, and cancer screening are offered as well as family planning, to make the program more useful to greater numbers of people. The government also wishes to improve the status of women thereby giving them alternative choices of lifestyle. Rural women are reached through the Ministry of Agriculture's community development program. While the National Family Planning Board receives only 0.12% of the national budget, this figure is not expected to increase. Tables giving vital rates show that population fell below the 30 per 1000 mark for the first time in 1977. A higher rate of fertility decline has taken place between 1967 - 1977 than occurred from 1957 - 1967. Current demographic objectives are to reduce crude birthrate to 28.2 per 1000 by 1980. This goal would require 817,963 new acceptors. While the pill accounts for 80% of acceptor's choice, the proportion using condoms has increased from 1.4% during 1969 - 1970 to 11.4% in 1979. Despite reported side effects with the pill and the illegality of induced abortions, virtually all acceptors are well satisfied with the program in its current form.

Matched MeSH terms: Pregnancy

East Asia review 1978-79. Introduction

Clinton JJ, Baker J

Stud Fam Plann, 1980 Nov;11(11):311-6.

PMID: 7456105 DOI: 10.2307/1966032

Matched MeSH terms: Pregnancy

The ambiguity of symbols in the structure of healing

Laderman C

Soc Sci Med, 1987;24(4):293-301.

PMID: 2436303 DOI: 10.1016/0277-9536(87)90148-1

In his article, 'The Effectiveness of Symbols,' Lévi-Strauss contends that the details of a Cuna birth incantation evoke specific physiological responses from parturient women, aiding them through difficult labors. His argument, which analyzes the incantation as a text divorced from its social setting, has drawn criticism from students of Cuna society on a number of substantive points, primarily centering around the difficulties that the special linguistic form of ritual language would present to a non-adept. If the patient lacks a thorough comprehension of the mythic details, how can the incantation change her physiological processes? In an attempt to evaluate the effect of myth upon a woman in labor, this article calls upon Cuna and Malay ethnographic data, and presents a Malay birth incantation as interpreted by the ritual practitioner who recited it. Following a discussion of the non-semantic aspects of the incantation and the extent to which the patient shares the interpretation of the healer in both the Malay and Cuna societies, recent biomedical studies are cited in support of hypotheses concerning the physiological and biochemical effects of myth in the management of childbirth.

Matched MeSH terms: Pregnancy

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