MyMedR

Can First-trimester AST to Platelet Ratio Index Scores Predict HELLP Syndrome?

Soe MZ, Hayati F, Abdul Rahim SSS

J Coll Physicians Surg Pak, 2022 Mar;32(3):409-410.

PMID: 35148605 DOI: 10.29271/jcpsp.2022.03.409

Null.

Matched MeSH terms: Pregnancy; Pregnancy Trimester, First

Fulltext Association between marital status and the outcome of teenage pregnancy: a retrospective review in year 2009-2012 in Hospital Ampang

Salleha Khalid, Muhammad Shamsir Mohd Aris

Pertanika Journal of Science & Technology, 2017;25(104):159-168.

MyJurnal

Teenage pregnancy is associated with maternal and neonatal morbidity. Some postulate that it is due to biological immaturity, while others postulate that it is due to inadequate antenatal care. The objective of this study is to compare the maternal and neonatal outcome between married and unmarried teenage mothers. A retrospective study was conducted from 2009 to 2012, where mothers aged below 20 year old were included. Maternal and neonatal outcome was assessed. A total of 750 patients aged below 20 year old delivered at Hospital Ampang. The trend of teenage pregnancy decreased from 3.1% in 2009 to 2.2% in 2012. A total of 578 (77.1%) mothers were married, while 172 (22.9%) were unmarried. Being unmarried was significantly associated with unbooked (p<0.001), preterm birth (p= 0.00468), and lower birth weight (p< 0.0001, and unpaired T-Test with 95% CI -0.2607 to -0.0933). However there is no significant difference in the number of mothers with hypertensive disease (p= 0.88428), diabetes in pregnancy (p= 0.39602), mode of delivery (p= 0.055 vaginal delivery, p = 0.4419 caesarean section, and p= 0.9097 instrumental deliveries) and NICU admission (p= 0.3779) between the two groups. Unmarried teenage pregnancy is associated with a lack of antenatal care, preterm birth, and lower birth weight compared to their married counterpart.
Keywords: Marital status, pregnancy outcome, teenage pregnancy

Matched MeSH terms: Pregnancy in Adolescence*

Fulltext Watermelon and dietary advice compared to dietary advice alone following hospitalization for hyperemesis gravidarum: a randomized controlled trial

Tan PC, Ramasandran G, Sethi N, Razali N, Hamdan M, Kamarudin M

BMC Pregnancy Childbirth, 2023 Jun 17;23(1):450.

PMID: 37330467 DOI: 10.1186/s12884-023-05771-7

BACKGROUND: Hyperemesis gravidarum (HG) affects about 2% of pregnancies and is at the severe end of the spectrum of nausea and vomiting of pregnancy. HG causes severe maternal distress and results in adverse pregnancy outcomes long after the condition may have dissipated. Although dietary advice is a common tool in management, trial evidence to base the advice on is lacking.

METHODS: A randomized trial was conducted in a university hospital from May 2019 to December 2020. 128 women at their discharge following hospitalization for HG were randomized: 64 to watermelon and 64 to control arm. Women were randomized to consume watermelon and to heed the advice leaflet or to heed the dietary advice leaflet alone. A personal weighing scale and a weighing protocol were provided to all participants to take home. Primary outcomes were bodyweight change at the end of week 1 and week 2 compared to hospital discharge.

RESULTS: Weight change (kg) at end of week 1, median[interquartile range] -0.05[-0.775 to + 0.50] vs. -0.5[-1.4 to + 0.1] P = 0.014 and to the end of week 2, + 0.25[-0.65 to + 0.975] vs. -0.5[-1.3 to + 0.2] P = 0.001 for watermelon and control arms respectively. After two weeks, HG symptoms assessed by PUQE-24 (Pregnancy-Unique Quantification of Emesis and Nausea over 24 h), appetite assessed by SNAQ (Simplified Nutritional Appetite Questionnaire), wellbeing and satisfaction with allocated intervention NRS (0-10 numerical rating scale) scores, and recommendation of allocated intervention to a friend rate were all significantly better in the watermelon arm. However, rehospitalization for HG and antiemetic usage were not significantly different.

CONCLUSION: Adding watermelon to the diet after hospital discharge for HG improves bodyweight, HG symptoms, appetite, wellbeing and satisfaction.

TRIAL REGISTRATION: This study was registered with the center's Medical Ethics Committee (on 21/05/2019; reference number 2019327-7262) and the ISRCTN on 24/05/2019 with trial identification number: ISRCTN96125404 . First participant was recruited on 31/05/ 2019.

Matched MeSH terms: Pregnancy; Pregnancy Outcome

Term interstitial pregnancy with uterine conservation

Ng PH, NorAzlin MI, Nasri NI

Int J Gynaecol Obstet, 2007 Dec;99(3):251.

PMID: 17888439

Matched MeSH terms: Pregnancy; Pregnancy Complications/pathology*; Pregnancy, Ectopic/drug therapy*; Pregnancy, Ectopic/pathology

Fulltext Performance of elderly primigravidae in Kelantan

Achanna S, Monga D

Med J Malaysia, 1995 Mar;50(1):37-41.

PMID: 7752974

The obstetric performance of 59 elderly primigravidae delivering at the University Hospital, Kelantan, between January 1, 1987 and December 12, 1988 is compared with that of 60 young primigravidae delivering during the same time period. The total number of deliveries during this period was 16,284, and the predominant ethnic group was Malays. Apart from an increased incidence of preeclampsia (23.7% vs. 13.3%), breech presentation (6.78% vs. 3.33%) and Caesarean sections (74.6% vs. 10%) among the study group, there were no other statistically significant obstetric complications. Majority of Caesarean sections were done as emergency procedures, the principal indications being poor progress of labour and foetal distress. The neonatal outcome (in terms of birthweight, gestational age and breastfeeding at discharge) was similar in the two groups. For most women in both groups this was the first marriage, though a higher proportion in the study group had an interval of more than two years between marriage and childbirth.

Matched MeSH terms: Pregnancy/physiology*; Pregnancy Complications/epidemiology; Pregnancy, High-Risk*

Obstetric performance in the elderly Malaysian primigravida

Urquhart DR, Tai C

Asia Oceania J Obstet Gynaecol, 1991 Dec;17(4):321-5.

PMID: 1801677

The obstetric performance of 240 elderly primigravida delivering at the University Hospital, Kuala Lumpur, Malaysia between January 1987 and February 1990 was compared with a random group of 250 young primigravida delivering during the same time period. The incidence of impaired glucose tolerance, diabetes mellitus, preterm delivery, antepartum haemorrhage and malpresentation was all increased in the elderly primigravida group. The incidence of caesarean section in the older group was 40.4% compared with 6.8% in the younger (p less than 0.001). Recent studies suggest that the perinatal mortality in women who delay having their first baby until after the age of 35 is not significantly different from the rest of the obstetric population. However, in our own population of elderly primigravida, although not quite reaching statistical significance the perinatal mortality rate of 46 per 1,000 is three times that of primigravida aged 20-25. This may reflect our low induction rate (7.5%) and assisted vaginal delivery rate (8.3%) in those women in this high risk group who are allowed to labour. The implications of these findings are discussed.

Matched MeSH terms: Pregnancy; Pregnancy Complications/mortality; Pregnancy Complications/epidemiology*; Pregnancy Outcome/epidemiology

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; Pregnancy Complications/epidemiology; Pregnancy in Adolescence/prevention & control; Pregnancy in Adolescence/statistics & numerical data*; Pregnancy Outcome/epidemiology*; Pregnancy, High-Risk

Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia

Fadzil A, Balakrishnan K, Razali R, Sidi H, Malapan T, Japaraj RP, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:7-13.

PMID: 23857831 DOI: 10.1111/appy.12036

Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics.

Matched MeSH terms: Pregnancy; Pregnancy Complications/etiology; Pregnancy Complications/epidemiology; Pregnancy Complications/psychology*

Effect of melatonin supplementation on pregnancy outcome in Wistar-Kyoto and Sprague-Dawley rats

Singh HJ, Saleh HI, Gupalo S, Omar E

Sheng Li Xue Bao, 2013 Apr 25;65(2):149-57.

PMID: 23598870

Although melatonin supplementation is known to influence numerous physiological functions, little is however known of its effects on pregnancy outcome. This study investigated the effects of melatonin supplementation on pregnancy outcome in Wistar-Kyoto (WKY) and Sprague-Dawley (SD) rats aged 12-13 weeks. Upon confirmation of proestrus, each female rat was housed overnight with a male of the same strain. On the next morning, following confirmation of mating (vaginal smear), WKY female rats were isolated into individual metabolic cages and given 0, 25, 50 or 100 mg/kg per day of melatonin in drinking water from day 1 of pregnancy to day 21 postpartum. SD females were given 0 or 100 mg/kg per day of melatonin. Maternal weight, duration of pregnancy, litter size, birth weight and body weight of pups up to day 42, and pup mortality were recorded. Data were analyzed using ANOVA for repeated measures. Compared to controls, maternal weight gain during pregnancy was significantly lower in melatonin-supplemented dams (P < 0.01). Litter size was significantly smaller in melatonin-supplemented dams (P < 0.01). Mean birth weight of pups was significantly lower only in pups of dams given 100 mg/kg per day of melatonin (P < 0.001). Mean body weight of pups of dams given melatonin was significantly lower than controls (P < 0.01). Pup mortalities were 9.5% and 21.6% in WKY dams given 25 and 100 mg/kg per day of melatonin respectively, and all pup deaths occurred after day 21 of weaning. The results suggest that melatonin supplementation during antenatal and postpartum period appears to adversely affect litter size, pup growth and mortality in WKY and SD rats. The precise mechanism causing the death is not clear.

Matched MeSH terms: Pregnancy; Pregnancy Outcome*; Pregnancy, Animal/drug effects*

Dengue infection in pregnancy: prevalence, vertical transmission, and pregnancy outcome

Tan PC, Rajasingam G, Devi S, Omar SZ

Obstet Gynecol, 2008 May;111(5):1111-7.

PMID: 18448743 DOI: 10.1097/AOG.0b013e31816a49fc

To estimate prevalence rate of recent dengue infection in parturients, as well as the vertical transmission rate, and to compare pregnancy outcomes among infected women.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Infectious/epidemiology*; Pregnancy Outcome*

Prevalence and outcome of peripartum cardiomyopathy in Malaysia

Chee KH, Azman W

Int J Clin Pract, 2009 May;63(5):722-5.

PMID: 18028390

Peripartum cardiomyopathy (PPCM) is an uncommon form of congestive heart failure, afflicting obstetric patients around the time of delivery. The epidemiology of PPCM is infrequently reported. To the best of our knowledge, there has been no report from Asia.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Cardiovascular/epidemiology*; Pregnancy Outcome/epidemiology

A viable secondary intra-abdominal pregnancy resulting from rupture of uterine scar: role of MRI

Teng HC, Kumar G, Ramli NM

Br J Radiol, 2007 Jul;80(955):e134-6.

PMID: 17704308

Pre-natal diagnosis of intra-abdominal pregnancy is difficult. Ultrasound has been the frontline modality to date; however, it gives a diagnostic error of 50-90% and its use is disappointing. In recent years, MRI has emerged as an appealing imaging modality. With its good soft tissue contrast and non-ionizing property, it acts as a means of definitive non-invasive assessment before surgical intervention when ultrasound is inconclusive.

Matched MeSH terms: Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Third; Pregnancy, Abdominal/diagnosis*

Dydrogesterone in threatened abortion: pregnancy outcome

Omar MH, Mashita MK, Lim PS, Jamil MA

J Steroid Biochem Mol Biol, 2005 Dec;97(5):421-5.

PMID: 16293412

To determine whether therapy with dydrogesterone in threatened abortion during the first trimester of pregnancy will improve pregnancy outcome.

Matched MeSH terms: Pregnancy; Pregnancy Outcome*; Pregnancy Trimester, First; Pregnancy Trimester, Second

Pre-pregnancy body mass index, height and physical activity are associated with rate of gestational weight gain among Malaysian mothers

Yong HY, Mohd Shariff Z, Koo SJ, Binti Sa'ari NS

J Obstet Gynaecol Res, 2016 Sep;42(9):1094-101.

PMID: 27226139 DOI: 10.1111/jog.13039

AIM: Both inadequate and excessive weight gain during pregnancy can have immediate and long-term health risks for women and infants. This study investigated rate of gestational weight gain (GWG) and its associated factors in Malaysian pregnant women.
METHODS: This cross-sectional study was conducted at maternal and child health clinics in Selangor and Negeri Sembilan between November 2010 and April 2012. A pre-tested questionnaire was used to obtain sociodemographic, obstetric, dietary intake and physical activity information. Current weight and height were measured using standard procedures. GWG rate was calculated as the average weekly weight gain in that particular trimester of pregnancy and further categorized according to the Institute of Medicine (IOM) recommendations.
RESULTS: Mean GWG rate for all pre-pregnancy BMI categories in the second and third trimesters was higher than the IOM recommendations. Overweight women (adjusted OR, 4.26; 95%CI: 1.92-9.44) and women <153 cm tall (adjusted OR, 1.96; 95%CI: 1.21-3.18) tend to have inadequate GWG rate. Women with high pre-pregnancy body mass index (BMI; ≥25.0 kg/m(2) ; overweight: adjusted OR, 3.88; 95%CI: 2.12-7.09; obese: adjusted OR, 2.34; 95%CI: 1.28-4.29) and low physical activity (adjusted OR, 1.74; 95%CI: 0.77-3.97) were two-threefold more likely to have excessive GWG.
CONCLUSION: Both inadequate and excessive GWG can have detrimental effects on the health of mothers and infants. Pre-pregnancy BMI, height and physical activity should be emphasized in prenatal care to ensure that women have adequate GWG rate.
Study site: maternal and child health clinics (Klinik Kesihatan), Selangor and Negeri Sembilan, Malaysia

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

Fulltext Cesarean scar pregnancy: What can we offer?

Ng BK, Lim PS, Ahmad S, Kampan NC, Abdul Karim AK, Omar MH

Taiwan J Obstet Gynecol, 2015 Apr;54(2):208-10.

PMID: 25951734 DOI: 10.1016/j.tjog.2014.11.022

Matched MeSH terms: Pregnancy; Pregnancy, Ectopic/drug therapy; Pregnancy, Ectopic/etiology; Pregnancy, Ectopic/ultrasonography*

Fulltext A successful pregnancy outcome in treated vulval rhabdomyosarcoma

Ariza M, Rafaee T, Adeeb N, Muhaizan WM, Isa MR

Med J Malaysia, 1999 Sep;54(3):371-3.

PMID: 11045067

A 14 year old girl presented in 1986 with a huge perineal swelling which was progressively increasing in size and associated with loss of weight and loss of appetite. Biopsy from the mass revealed rhabdomyosarcoma of the vulva. She was treated with chemotherapy and radium implant. She responded well to the regime. Fibrosis of the vulva and vagina caused difficulty in consummation. Once it was corrected, she conceived easily and proceeded to a normal pregnancy and delivery.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Neoplastic*; Pregnancy Outcome*

Fulltext Spontaneous rectus sheath haematoma in pregnancy

Ramzisham ARM, Sagap I, Ismail AM

Med J Malaysia, 2003 Mar;58(1):125-7.

PMID: 14556338

Bleeding into the rectus sheath is an uncommon but a well-recognised condition that mimics several other diagnoses of acute abdomen. A wide range of etiology has been proposed in association with this condition. It is often self-limiting, but can lead to unnecessary laparotomy if the diagnosis is not recognised.

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

Fulltext Breast cancer in pregnancy--our experience with six patients in the University Hospital, Kuala Lumpur

Yip CH, Taib NA, Abdullah MM, Wahid I

Med J Malaysia, 2000 Sep;55(3):308-10.

PMID: 11200709

Presentation of breast cancer during pregnancy is a rare situation and one that requires a multidisciplinary approach involving an obstetrician, surgeon and oncologist. Management should be along the same principles as in non-pregnant patients and delay is not justifiable. Mastectomy and axillary clearance is the best option, followed by chemotherapy, which is safe after the first trimester. Radiation if required should be delayed until after delivery of the baby. We present here our experience with 6 patients who presented with breast cancer during pregnancy. Five patients refused any treatment until after delivery, while one underwent only a mastectomy and axillary clearance. The outcome was poor; all of them died between 14 months and 52 months. The poor outcome probably reflects the late stage at presentation in four of the patients (State 3 and 4) rather than the delay in treatment, while delay in treatment in the two who presented with early cancer (Stage 1 and 2) led to a more advanced stage after delivery.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Neoplastic/mortality; Pregnancy Complications, Neoplastic/radiotherapy; Pregnancy Complications, Neoplastic/surgery*

Myocardial infarction in a young Indian grandmultipara

Kannan P, Raman S, Ramani VS, Jeyamalar R

Aust N Z J Obstet Gynaecol, 1993 Nov;33(4):424-6.

PMID: 8179560

Matched MeSH terms: Pregnancy; Pregnancy Complications, Cardiovascular/diagnosis*; Pregnancy Complications, Cardiovascular/physiopathology; Pregnancy Complications, Cardiovascular/therapy

Pulmonary hypertension, cardiac disease and pregnancy

Tahir H

Int J Gynaecol Obstet, 1995 Nov;51(2):109-13.

PMID: 8635630

OBJECTIVE: To ascertain the significance of coexisting pulmonary hypertension in cardiac disease in pregnancy.

METHODS: Over a 3-year period a group of pregnant women with cardiac disease was followed until 6 weeks postpartum. Twenty women with pulmonary hypertension were compared with 20 controls without pulmonary hypertension with particular reference to maternal and fetal outcome. Analysis of data was carried out using Fisher's exact test and Student's t-test.

RESULTS: Except for Eisenmenger's syndrome, there were no differences in maternal morbidity and mortality between the two groups. There were more low birth weight babies but no significant differences in premature delivery rate, mode of delivery or perinatal mortality.

CONCLUSION: Except for Eisenmenger's syndrome, coexisting pulmonary hypertension complicating cardiac disease in pregnancy generally has a favorable outcome for both mother and fetus.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Cardiovascular*; Pregnancy Outcome*

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