Displaying all 13 publications

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  1. Ng BK, Annamalai R, Lim PS, Aqmar Suraya S, Nur Azurah AG, Muhammad Abdul Jamil MY
    Arch Gynecol Obstet, 2015 Jan;291(1):105-13.
    PMID: 25078052 DOI: 10.1007/s00404-014-3388-0
    BACKGROUND: Study objective To assess the efficacy of outpatient misoprostol administration versus inpatient misoprostol administration for the treatment of first trimester incomplete miscarriage.
    MATERIALS AND METHODS: A prospective randomised controlled trial was conducted at a tertiary hospital from May 2012 to April 2013. A total of 154 patients with first trimester incomplete miscarriage were randomised to receive misoprostol either as outpatient or inpatient. Intra-vaginal misoprostol 800 mcg was administered eight hourly to a maximum of three doses. Complete evacuation is achieved when the cervical os was closed on vaginal examination or ultrasound showed no more retained products of conception evidenced by endometrial thickness of less than 15 mm. Treatment failure was defined as failure in achieving complete evacuation on day seven hence surgical evacuation is offered.
    RESULTS: Outpatient administration of misoprostol was as effective as inpatient treatment with success rate of 89.2 and 85.7 % (p = 0.520). The side effects were not significantly different between the two groups. Side effects that occurred were minor and only required symptomatic treatment. Duration of bleeding was 6.0 days in both groups (p = 0.317). Mean reduction in haemoglobin was lesser in the outpatient group (0.4 g/dl) as compared to in the inpatient group (0.6 g/dl) which was statistically significant (p = 0.048).
    CONCLUSION: Medical evacuation using intra-vaginal misoprostol 800 mcg eight hourly for a maximum of three doses in an outpatient setting is as effective as in inpatient setting with tolerable side effects.

    Study site: tertiary hospital
  2. Wahab NA, Chalermchockchareonkit A, Chaisilwattana P, Mustafa KB
    Arch Gynecol Obstet, 2012 Jun;285(6):1695-8.
    PMID: 22189619 DOI: 10.1007/s00404-011-2177-2
    To analyse and describe cases of unexpected ovarian malignancy after conservative laparoscopic surgery for an apparent benign ovarian mass at our centre.
  3. Tan PC, King AS, Vallikkannu N, Omar SZ
    Arch Gynecol Obstet, 2012 Mar;285(3):585-90.
    PMID: 21796421 DOI: 10.1007/s00404-011-2026-3
    To evaluate the effect of a single 250-mg dose of 17 alpha-hydroxyprogesterone caproate (17-OHPC) intramuscularly as adjunct to nifedipine tocolysis in preterm labor.
  4. Lim PS, Singh S, Lee A, Muhammad Yassin MA
    Arch Gynecol Obstet, 2011 Nov;284(5):1073-9.
    PMID: 21136267 DOI: 10.1007/s00404-010-1785-6
    Retained placenta is potentially life threatening due to possible complications associated with manual removal. Our aim was to determine whether umbilical vein injection of oxytocin in saline reduces the need for manual removal of placenta.
  5. Low CF, Mohd Tohit ER, Chong PP, Idris F
    Arch Gynecol Obstet, 2011 Jun;283(6):1255-60.
    PMID: 20552210 DOI: 10.1007/s00404-010-1548-4
    Diabetes and pregnancy can be associated in two ways: pregnancy that occurs in women who are already diabetic (diabetes of pre-gestational origin); and diabetes that occur in women who are already pregnant [gestational diabetes mellitus (GDM) (O'sullivan 1961)]. Patients with previous GDM history have higher risk of developing diabetes outside of pregnancy. Accumulating literature had suggested that adiponectin plays a role in the pathophysiology of this metabolic syndrome, and several of the common single nucleotide polymorphisms (SNP) in adiponectin gene have been identified in type 2 diabetes. Thus, one of the commonly found SNP was studied to determine its association with GDM.
  6. Daud S, Zahid AZM, Mohamad M, Abdullah B, Mohamad NAN
    Arch Gynecol Obstet, 2019 11;300(5):1279-1285.
    PMID: 31435778 DOI: 10.1007/s00404-019-05273-y
    PURPOSE: This study aims to determine the prevalence of sexual dysfunction during pregnancy and to determine its associated factors.

    METHODS: This 6-month cross-sectional study adopted convenience sampling; inclusion criteria were healthy pregnant women, sexually active and living together with their partner for 3 months prior to recruitment into this study. Women who received advice to avoid sexual intercourse, with any medical illness and/or those conceived via assisted reproductive technology were excluded. Participants filled in a questionnaire consisting of demographic details and Malay Version Female Sexual Function Index Questionnaire. Data were analysed using SPSS 24.0; categorical data were analyzed by Chi-square and Fisher exact test.

    RESULTS: One hundred pregnant women with a mean age of 31 + 4.31 years old participated. By using the cut-off FSFI score of 26.55, 81 (81%) participants were diagnosed to have sexual dysfunction. The mean FSFI score was 20.41 ± 8.45 (range 2.6-33.5; median 23.6). All the mean FSFI scores of first, second and third trimesters were low with 22.80 ± 10.67, 23.81 ± 7.18 and 18.74 ± 8.43, respectively. The mean score for desire, arousal, satisfaction and pain were significantly lower in the third trimester than earlier gestation. There was a significant difference in the incidence of difficulties in desire, arousal, lubrication, satisfaction and pain between first and second trimester combined, as compared to the third trimester of pregnancy. Trimester of pregnancy was found to have a significant association with the incidence of sexual dysfunction.

    CONCLUSION: Sexual dysfunction among pregnant women is a significant burden. Despite being a common health problem, it is often neglected.

  7. Arffin F, Al-Bayaty FH, Hassan J
    Arch Gynecol Obstet, 2012 Nov;286(5):1187-91.
    PMID: 22718098 DOI: 10.1007/s00404-012-2417-0
    BACKGROUND: Exposure of pregnant women to environmental tobacco smoke has been shown to be associated with low birth weight. Many studies have suggested that stress have a role in the etiology of preterm birth.

    AIMS: This study carried out from June 2008 to March 2009 to find the relation between environmental tobacco smoke, stress and miscarriage and preterm births.

    METHODS: A total of 33 subjects consisted of multiparous pregnant women that were in their early third trimester were chosen for this investigation. Subjects were divided into test group women with adverse pregnancy outcome, control group women with successful pregnancy. Four ml of unstimulated whole saliva were collected. The concentrations of cotinine and cortisol were evaluated using commercially available ELISA kit.

    RESULTS: Pregnancies in which the average standardized cortisol during history of previous miscarriage(s) which occurred within 6th-27th week or/and history of preterm labor which occurred within 28th-36th weeks of gestation, demonstrated higher cortisol level (1.0201 ± 0.1855 ng/ml) compared to control group 0.9757 ± 0.2860 ng/ml (P = 0.323); statistical analysis showed no significant differences. Women of control group were more likely to be environmental tobacco smoke exposed (1.2714 ± 1.7639 ng/ml) than women with miscarriage and preterm births (0.9889 ± 0.5498 ng/ml).

    CONCLUSION: The results from this primarily study demonstrated no association between cotinine, cortisol, miscarriage and preterm births.

  8. Grace Ng YH, Aminuddin AA, Tan TL, Kuppusamy R, Tagore S, Yeo GSH
    Arch Gynecol Obstet, 2021 May 11.
    PMID: 33973051 DOI: 10.1007/s00404-021-06090-y
    OBJECTIVE: To evaluate the safety in the first 12 h, efficacy and maternal satisfaction of a double balloon catheter (DBC) with vaginal prostaglandin (PGE) for induction of labour (IOL).

    METHODS: We conducted a multicentre randomised controlled study of 420 patients from 1st January 2016 to 31st December 2017 to evaluate the use of DBC in IOL in an Asian population looking at the adverse effects in the first 12 h after insertion. Women were assigned randomly to cervical ripening with either a DBC or a prostaglandin pessary. The adverse events in the 12 h after DBC or first prostaglandin inserted, the efficacy of a DBC to a prostaglandin in labour induction and maternal satisfaction were evaluated.

    RESULTS: There were significantly less women with uterine hyperstimulation in the DBC (2 vs 24, p ≤ 0.0001) compared to the prostaglandin group. There were no women with uterine hyperstimulation and non-reassuring foetal status in the DBC while there were 5 women with uterine hyperstimulation and foetal distress in the prostaglandin group. Use of entonox was significantly less in the DBC group (p = 0.009). There were no significant differences in both groups in caesarean section, vaginal deliveries and time to delivery, although significant less time was needed to achieve cervical os dilation more than 4 cm in the DBC group (p ≤ 0.0001). Neonatal birth outcomes were similar. Women's pain scores were similar for both methods. 80.1% of women allocated the DBC and 76.8% of women allocated the PGE were keen to recommend their method of induction.

    CONCLUSION: Double balloon catheter remains a good alternative method for inducing women in view of a good safety profile with low risk of hyperstimulation and high maternal satisfaction.

    CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02620215.

  9. Sukarna N, Tan PC, Hong JGS, Sulaiman S, Omar SZ
    Arch Gynecol Obstet, 2021 08;304(2):345-353.
    PMID: 33452923 DOI: 10.1007/s00404-020-05950-3
    PURPOSE: To compare 3 consecutive days of hyperglycemic response following antenatal dexamethasone regimens of 12-mg or 6-mg doses 12 hourly in diet-controlled gestational diabetes.

    METHODS: A randomized controlled trial was carried out in a university hospital in Malaysia. Women with lifestyle-controlled gestational diabetes scheduled to receive clinically indicated antenatal corticosteroids (dexamethasone) were randomized to 12-mg 12 hourly for one day (2 × 12-mg) or 6-mg 12-hourly for two days (4 × 6-mg). 6-point (pre and 2-h postprandial) daily self-monitoring of capillary blood sugar profile for up to 3 consecutive days was started after the first dexamethasone injection. Hyperglycemia is defined as blood glucose pre-meal ≥ 5.3 or 2 h postprandial ≥ 6.7 mmol/L. The primary outcome was a number of hyperglycemic episodes in Day-1 (first 6 BSP points). A sample size of 30 per group (N = 60) was planned.

    RESULTS: Median [interquartile range] hyperglycemic episodes 4 [2.5-5] vs. 4 [3-5] p = 0.3 in the first day, 3 [2-4] vs. 1 [0-3] p = 0.01 on the second day, 0 [0-1] vs. 0 [0-1] p = 0.6 on the third day and over the entire 3 trial days 7 [6-9] vs. 6 [4-8] p = 0.17 for 6-mg vs. 12-mg arms, respectively. 2/30 (7%) in each arm received an anti-glycemic agent during the 3-day trial period (capillary glucose exceeded 11 mmol/L). Mean birth weight (2.89 vs. 2.49 kg p 

  10. Vallikkannu N, Laboh N, Tan PC, Hong JGS, Hamdan M, Lim BK
    Arch Gynecol Obstet, 2022 Jan 09.
    PMID: 34999923 DOI: 10.1007/s00404-021-06383-2
    PURPOSE: To evaluate Foley catheter and controlled release dinoprostone insert compared to foley catheter alone on induction to delivery interval and maternal satisfaction.

    METHODS: A randomized trial was conducted in a university hospital in Malaysia from December 2018 to May 2019. Term nulliparas with unfavorable cervix (Bishop score ≤ 5) scheduled for labor induction were randomized to Foley catheter and controlled release dinoprostone insert simultaneously or Foley catheter alone. Primary outcomes were induction to delivery interval (hours) and maternal satisfaction on birth experience (assessed by 11-point Visual Numerical Rating Scale VNRS 0-10, higher score more satisfied).

    RESULTS: Induction to vaginal delivery intervals was mean ± standard deviation 22.5 ± 10.4 vs. 35.1 ± 14.9 h, P =  

  11. Mosavat M, Omar SZ, Tan PC, Razif MFM, Sthaneshwar P
    Arch Gynecol Obstet, 2018 03;297(3):797-803.
    PMID: 29270728 DOI: 10.1007/s00404-017-4617-0
    PURPOSE: To assess the association of serum leptin and its receptor (SLeptinR) with the risk of gestational diabetes mellitus (GDM) and to evaluate the longitudinal circulation of these peptides in pregnancy.

    METHODS: This study consisted of 53 subjects diagnosed with GDM and 43 normal glucose tolerance (NGT) pregnant women. Serum leptin and SLeptinR were measured at 24-28 weeks, prior and after delivery, and post-puerperium.

    RESULTS: Lower levels of leptin and SLeptinR were observed in GDM compared to NGT. Leptin [OR 0.97 (95% CI 0.94-1.0)] and SLeptinR [OR 0.86 (95% CI 0.79-0.93]) were inversely associated with GDM. Participants in the lowest tertile for leptin and SLeptinR had a 2.8-fold (95% CI 1.0-7.6) and a 5.7-fold (95% CI 1.9-17.3) higher risk of developing GDM compared with the highest tertile, respectively. These relationships were attenuated after adjustment for covariates. In both the groups, peak leptin was observed at 24-28 weeks, decreasing continuously during pregnancy (p > 0.05) and after delivery (p 

  12. Saraluck A, Aimjirakul K, Jiet NJ, Chinthakanan O, Mangmeesri P, Manonai J
    Arch Gynecol Obstet, 2024 Mar 05.
    PMID: 38441602 DOI: 10.1007/s00404-024-07426-0
    OBJECTIVE: To investigate the prevalence of DD and AI with POP symptoms in females attending a urogynecology clinic, and to identify factors associated with DD and AI in POP symptoms patients.

    METHODS: Computer-based medical records of women with POP symptoms attending a urogynecology clinic in a referral tertiary center between January 2016 and December 2020 were reviewed. Demographic data were collected. Selected defecatory dysfunction (DD) and anal incontinence (AI) were recorded. The associations between patient characteristics, site and severity of prolapse, and DD and AI symptoms in POP patients were investigated for identified associated factors.

    RESULTS: The mean age of the 754 participants was 65.77 ± 9.44 years. Seven hundred and fifteen (94.83%) were menopause. The prevalence of DD and AI in patients with POP symptoms was 44.03% (332/754) and 42.04% (317/754) according to the PFBQ and medical history records, respectively. Advanced posterior wall prolapse (OR 1.59, 95% CI 1.10-2.30) and wider GH (OR1.23, 95% CI 1.05-1.43) were identified as risk factors for DD by multivariate analysis. Additionally, single-compartment prolapse (OR 0.4, 95% CI 0.21-0.76) and a stronger pelvic floor muscle assessed with brink score (OR 0.94, 95% CI 0.88-0.98) are protective factors for AI.

    CONCLUSION: DD and AI are prevalent among women with POP symptoms who visit a urogynecology clinic. DD should be evaluated in women with POP symptoms especially in women with increased genital hiatus and point Ap beyond the hymen. To prevent AI, women with POP should be encouraged to perform pelvic floor muscle training in order to increase pelvic floor muscle strength.

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