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Migration in malaysian aborigines: clinical observations in pregnancy

Southeast Asian J Trop Med Public Health, 1975 Sep;6(3).

This study presents clinical observations in pregnancy made on aborigines of the deep jungle and "outside" populations. Migration out of the jungle results in lowered nutritional status as a result of low socio-economic status in the "outside" aborigine. This, together with food habits, increased family size and higher incidence of helminthic infestations, results in lower mean values of Hb, PVC and MCHC and a higher prevalence of anaemia in pregnancy in the migrant aborigine. A higher population density in the "outside" population resulting in frequent intermingling and increased chances of cross-contamination probably explains the increased vaginal bacterial growth in the "outside" Aborigine women. A higher prevalence of vaginal candidiasis in the "outside" aborigine woman is probably related to exposure to oral contraceptives and broad-spectrum antibiotics. On the other hand, better medical and obstetrical services become more readily available to the "outside" aborigine and this results in a favourable influence on perinatal health.

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

Fulltext Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women

Andiappan H, Nissapatorn V, Sawangjaroen N, Nyunt MH, Lau YL, Khaing SL, et al.

Parasit Vectors, 2014;7:564.

PMID: 25498432 DOI: 10.1186/s13071-014-0564-9

Toxoplasma gondii, an obligate intracellular protozoan parasite, causes a disease called toxoplasmosis which can sometimes be acquired congenitally by a newborn from an infected mother. This study aimed to determine the seroprevalence of Toxoplasma infection and its associated risks among 219 and 215 pregnant women from Malaysia and Myanmar, respectively.

Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*

Vertical transmission in experimentally infected sheep despite previous inoculation with Neospora caninum NcNZ1 isolate

Syed-Hussain SS, Howe L, Pomroy WE, West DM, Hardcastle M, Williamson NB

Vet Parasitol, 2015 Mar 15;208(3-4):150-8.

PMID: 25638717 DOI: 10.1016/j.vetpar.2014.12.036

Recent reports indicate N. caninum has a possible role in causing abortions in sheep in New Zealand. Knowledge about the mode of transmission of neosporosis in sheep in New Zealand is limited. This study aimed to determine the rate of vertical transmission that would occur in lambs born from experimentally inoculated ewes and to determine if previous inoculation would protect the lambs from N. caninum infection. A group of 50 ewes was divided into 2 groups with one group being inoculated with 5×10(6) N. caninum tachyzoites prior to pregnancy in Year 1. In Year 2, each of these groups was subdivided into 2 groups with one from each original group being inoculated with 1×10(7) N. caninum tachyzoites on Day 120 of gestation. Inoculation of N. caninum tachyzoites into ewes prior to mating resulted in no congenital transmission in lambs born in Year 1 but without further inoculation, 7 out of 11 lambs in Year 2 were positive for N. caninum infection. Ewes that were inoculated in both years resulted in all 12 lambs born in Year 2 being positive for N. caninum infection. This indicates that previous inoculation in Year 1 did not result in any vertical transmission in that year but did not provide any protection against vertical transmission in Year 2. These results suggest that vertical transmission occurs readily once the ewe is infected.

Matched MeSH terms: Pregnancy Complications, Parasitic/veterinary*

Fulltext Maternal serum and breast milk vitamin D levels: findings from the Universiti Sains Malaysia Pregnancy Cohort Study

Jan Mohamed HJ, Rowan A, Fong B, Loy SL

PLoS One, 2014;9(7):e100705.

PMID: 24992199 DOI: 10.1371/journal.pone.0100705

Vitamin D deficiency has become a global health issue in pregnant women. This study aimed to assess the adequacy of maternal vitamin D status by measuring maternal serum and breast milk 25-hydroxyvitamin D [25(OH)D] levels and to determine the association between maternal serum and milk 25(OH)D levels.

Matched MeSH terms: Pregnancy Complications/blood*

Fulltext Safe delivery of two parturient women in severe metabolic acidosis

Shariffuddin II, Rai V, Chan YK, Muniandy RK

BMJ Case Rep, 2014;2014.

PMID: 24862427 DOI: 10.1136/bcr-2014-205135

Care of an acutely ill parturient is particularly difficult when we have to balance the needs of both mother and the fetus to survive. The literature suggests there should be emphasis on stabilising the mother's condition. In dealing with metabolic acidosis, however, we believe delivering the baby early might not only relieve the threat of the acidosis on the mother, it may be the only way to deliver a live baby. We report two parturient women with severe metabolic acidosis which was considerably reduced very soon after the delivery and how our timely delivery resulted in the birth of two neurologically intact babies.

Matched MeSH terms: Pregnancy Complications/therapy*

Fulltext Racial variations in booking haemoglobin of primigravidae in Malaysia: a prospective study

Tan ACC, Leong EWK, Chua AC, Moy FM

BMC Res Notes, 2013;6:173.

PMID: 23634656 DOI: 10.1186/1756-0500-6-173

BACKGROUND: Variations in racial haemoglobin had been previously described in multiple studies locally and abroad. This study was conducted to quantify the differences in haemoglobin of booking primigravidae amongst the three major races in Malaysia at the antenatal clinic of University Malaya Medical Centre, Kuala Lumpur.
FINDINGS: One year prospective study of booking full blood count sample of primigravidae taken in one centre was conducted. Multiple comparative analyses of the booking haemoglobin were performed using the One-way ANOVA comparative mean test in each trimester. 622 primigravidae without any known history of haematological disorders were recruited into the study. The mean haemoglobin for the Indian race was the lowest compared to the two other races in the second and the third trimesters, and it was found to be statistically significant lower (p- value 0.001) than the Malay race in the second trimester. It was also found that the Indian race had a significantly higher incidence of moderate to severe anaemia (p- value: 0.029). The prevalence of anaemia in our study population is also significantly higher in the Indian population (p- value: 0.01 ).
CONCLUSIONS: The findings from this study have established that there is racial preponderance to anaemia in pregnancy. The Indian race is at a higher risk of having anaemia in pregnancy particularly in the second trimester.
Study site: Antenatal clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Pregnancy Complications, Hematologic/epidemiology

Utero-cutaneous fistula after caesarean section secondary to red degeneration of intramural fibroid

Lim PS, Shafiee MN, Ahmad S, Hashim Omar M

Sex Reprod Healthc, 2012 Jun;3(2):95-6.

PMID: 22578758 DOI: 10.1016/j.srhc.2012.03.002

A 33 year-old woman had an emergency caesarean section for retained second twin which was complicated by utero-cutaneous fistula due to red degeneration of intramural fibroid. The utero-cutaneous communication was demonstrated by an examination under anaesthesia using dye test. She then underwent excision of the fistula tract and myomectomy. She recovered well following the surgery. This is the first case of utero-cutaneous fistula where the communication is between the endometrial cavity and skin lesion via a necrotic intramural fibroid following caesarean section. Fistulogram might fail to demonstrate the communication. In highly suspected case, other modalities of investigations could be utilised.

Matched MeSH terms: Pregnancy Complications/pathology

Fulltext Urut Melayu, the traditional Malay massage, as a complementary rehabilitative care in postpartum stroke

Fadzil F, Anuar HM, Ismail S, Abd Ghani N, Ahmad N

J Altern Complement Med, 2012 Apr;18(4):415-9.

PMID: 22401300 DOI: 10.1089/acm.2010.0802

The case of a 32-year-old Malay woman who developed postpartum stroke is reported.

Matched MeSH terms: Pregnancy Complications/rehabilitation*

Education and Imaging. Gastrointestinal: massive intraperitoneal haemorrhage in a young woman with hereditary hemorrhagic telangiectasia

Sivarani S, Chan YK, Liam CK, Kumar G, Abdullah BJ, Mahadeva S

J Gastroenterol Hepatol, 2010 Sep;25(9):1587.

PMID: 20796159 DOI: 10.1111/j.1440-1746.2010.06469.x

Matched MeSH terms: Pregnancy Complications, Cardiovascular/etiology*

Fulminant type 1 diabetes associated with pregnancy: a report of 2 cases from Malaysia

Tan F, Loh WK

Diabetes Res Clin Pract, 2010 Nov;90(2):e30-2.

PMID: 20832134 DOI: 10.1016/j.diabres.2010.08.009

Two previously healthy Malaysian women presented abruptly with severe diabetic ketoacidosis during pregnancy and immediate postpartum period. Their clinical courses, biochemical and immunological profiles were consistent with fulminant type 1 diabetes first described in the Japanese. Fulminant type 1 diabetes may not be as rare as currently reported outside Japan.

Matched MeSH terms: Pregnancy Complications/diagnosis*

Fulltext The risk factors for unexplained antepartum stillbirths in Scotland, 1994 to 2003

Sutan R, Campbell D, Prescott GJ, Smith WC

J Perinatol, 2010 May;30(5):311-8.

PMID: 19829298 DOI: 10.1038/jp.2009.158

To determine the factors contributing to unexplained antepartum stillbirth in Scotland.

Matched MeSH terms: Pregnancy Complications/epidemiology*

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 Complications, Cardiovascular/epidemiology*

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 Complications/pathology*

The prevalence of domestic violence against pregnant women in Perak, Malaysia

Jahanfar S, Kamarudin EB, Sarpin MA, Zakaria NB, Abdul Rahman RB, Samsuddin RD

Arch Iran Med, 2007 Jul;10(3):376-278.

PMID: 17604477

Domestic violence during pregnancy is a key issue in maternal and fetal mortality and morbidity. This cross-sectional study aimed at obtaining the prevalence of domestic violence amongst pregnant women who attended Ipoh General Hospital in Perak, Malaysia and to determine the risk factors associated with domestic violence during pregnancy. The prevalence of domestic violence was low (4.5%). Comparison between the two groups of subjects with or without domestic violence did not show any significant difference in terms of risk factors. The effect of domestic violence on pregnancy should be investigated comprehensively in a multicentral or community-based study using a culturally sensitive questionnaire. With the estimated low prevalence of domestic violence in this study, the need for screening it in health-care services in Malaysia is yet to be determined.

Matched MeSH terms: Pregnancy Complications/epidemiology*

Thoughts about populations with unexpected low prevalences of Helicobacter pylori infection

Graham DY, Yamaoka Y, Malaty HM

Trans R Soc Trop Med Hyg, 2007 Sep;101(9):849-51.

PMID: 17658569

Helicobacter pylori is one of the few remaining major pathogens that accompanied humans on their travels from Africa. A recently published study reports the unexpected finding of a low H. pylori prevalence among pregnant women in Zanzibar (Farag, T.H., Stolzfus, R.J., Khalfan, S.S., Tielsch, J.M., 2007. Unexpectedly low prevalence of Helicobacter pylori infection among pregnant women on Pemba Island, Zanzibar. Trans. R. Soc. Trop. Med. Hyg. 101). The apparent epidemiology of higher prevalence with higher socioeconomic status and decrease with age are unprecedented. As with many 'unexpected' events, a search of the literature reveals evidence of low prevalence populations in Java and Malaysia, with clues dating back to the mid-twentieth century. Why some populations apparently lost H. pylori infection remains an open question. However, the tools needed to resolve the dilemma are readily available and we hope investigators will soon rise to the challenge.

Matched MeSH terms: Pregnancy Complications, Infectious/epidemiology*

The evidence for emergency obstetric care

Paxton A, Maine D, Freedman L, Fry D, Lobis S

Int J Gynaecol Obstet, 2005 Feb;88(2):181-93.

PMID: 15694106

We searched for evidence for the effectiveness of emergency obstetric care (EmOC) interventions in reducing maternal mortality primarily in developing countries.

Matched MeSH terms: Pregnancy Complications/prevention & control

Impact of Hypnosis Intervention in Alleviating Psychological and Physical Symptoms During Pregnancy

Beevi Z, Low WY, Hassan J

Am J Clin Hypn, 2016 Apr;58(4):368-82.

PMID: 27003486 DOI: 10.1080/00029157.2015.1063476

Physical symptoms (e.g., vomiting) and psychological symptoms (stress, anxiety, and depression) during pregnancy are common. Various strategies such as hypnosis are available to reduce these symptoms. The objective of the authors in this study is to investigate the impact of a hypnosis intervention in reducing physical and psychological symptoms during pregnancy. A pre-test/post-test quasi-experimental design was employed in this study. The hypnosis intervention was given to the experimental group participants at weeks 16 (baseline), 20 (time point 1), 28 (time point 2), and 36 (time point 3) of their pregnancy. Participants in the control group received only the traditional antenatal care. Participants from both groups completed the Depression Anxiety Stress Scale-21 (DASS-21) and a Pregnancy Symptoms Checklist at weeks 16, 20, 28 and 36 of pregnancy. Results indicated that stress and anxiety symptoms were significantly reduced for the experimental group, but not for the control group. Although mean differences for the depressive symptoms were not significant, the experimental group had lower symptoms at time point 3. The physical symptoms' results showed significant group differences at time point 3, indicating a reduction in the experience of physical symptoms for the experimental group participants. Our study showed that hypnosis intervention during pregnancy aided in reducing physical and psychological symptoms during pregnancy.

Matched MeSH terms: Pregnancy Complications/rehabilitation*

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 Complications/epidemiology*

Urinary incontinence in primigravida: the neglected pregnancy predicament

Abdullah B, Ayub SH, Mohd Zahid AZ, Noorneza AR, Isa MR, Ng PY

Eur J Obstet Gynecol Reprod Biol, 2016 Mar;198:110-115.

PMID: 26808667 DOI: 10.1016/j.ejogrb.2016.01.006

OBJECTIVE: To determine the prevalence of urinary incontinence among primigravida in the third trimester, its risk factors and its effect to quality of life.

STUDY DESIGN: This is a cross sectional study involving primigravida in their third trimester of pregnancy, who attended the Patient Assessment Centre of a tertiary referral hospital in Klang Valley from July 2012 to June 2013. The participants were chosen randomly using convenience sampling. A face-to-face interview and a review of their antenatal record were done by trained interviewers. Data on sociodemographic and risk factors were obtained followed by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). The data was analysed using Statistical Package for Social Science version 20.0.

RESULTS: A total of 306 women were involved. The prevalence of urinary incontinence during third trimester was 34.3% (95%CI: 29.0, 39.7). Stress incontinence (64.8%) is the commonest followed by mixed incontinence (24.8%) and urge incontinence (6.7%). Childhood enuresis (p=0.003) and previous history of urinary incontinence (p<0.001) were significantly associated with urinary incontinence. More than 50 percent of women with urinary incontinence in the third trimester felt that it did not affect their daily activities at all. Only 10% of women felt greatly affected by this problem.

CONCLUSION: Urinary incontinence is not uncommon among primigravida however many women did not feel that it affected their quality of life. Childhood enuresis and history of urinary incontinence were proven risk factors.

Matched MeSH terms: Pregnancy Complications/etiology*

Successful Treatment of Ptyalism Gravidarum With Concomitant Hyperemesis Using Hypnosis

Beevi Z, Low WY, Hassan J

Am J Clin Hypn, 2015 Oct;58(2):215-23.

PMID: 26264544 DOI: 10.1080/00029157.2015.1013186

Ptyalism gravidarum, or sialorrhea, is the excessive secretion of saliva during pregnancy. Treatment of ptyalism gravidarum is often challenging due to its unknown etiologies. This article discusses a case of ptyalism gravidarum with concomitant hyperemesis in which the condition was successfully treated with hypnosis. A 28-year-old woman presented with ptyalism 2 months into her pregnancy and hyperemesis 3 months into pregnancy with associated vomiting that occurred following every meal. Hypnosis was administered at week 16 of pregnancy to eliminate ptyalism and hyperemesis, to prepare for childbirth, and to increase overall psychological well-being. Ptyalism resolved by week 36, concurrent with the final hypnosis session.

Matched MeSH terms: Pregnancy Complications/therapy*

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