Displaying publications 1 - 20 of 66 in total

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  1. Tumian NR, Wong M, Wong CL
    J Obstet Gynaecol Res, 2015 Jun;41(6):967-70.
    PMID: 25510540 DOI: 10.1111/jog.12648
    α°-thalassemia is a well-known cause of hydrops fetalis in South-East Asia and can be detected in utero. We report a very rare case of thyrotoxic cardiomyopathy associated with hyperplacentosis secondary to α°-thalassemia-associated hydrops fetalis. A 22-year-old primigravida with microcytic anemia presented at 27 weeks' gestation with pre-eclampsia, hyperthyroidism and cardiac failure. Serum β-human chorionic gonadotrophin was markedly elevated and abdominal ultrasound revealed severe hydropic features and enlarged placenta. Serum β-human chorionic gonadotrophin, cardiac function and thyroid function tests normalized after she delivered a macerated stillbirth. Histopathology of the placenta showed hyperplacentosis. Blood DNA analysis revealed that both patient and husband have the α°-thalassemia trait. This case illustrates a very atypical presentation of α°-thalassemia-associated hydrops fetalis and the importance of early prenatal diagnosis of α-thalassemia in women of relevant ethnic origin with microcytic anemia so that appropriate genetic counseling can be provided to reduce maternal morbidity and the incidence of hydrops fetalis.
  2. Fernandez AR, Husain R
    J Obstet Gynaecol Res, 2015 Feb;41(2):277-82.
    PMID: 25255906 DOI: 10.1111/jog.12511
    During preeclampsia (PE), the excessive circulation of soluble fms-like tyrosine kinase 1 (sFLT1) hinders the vasodilatory effect of vascular endothelial growth factor (VEGF). This effect has been proven in vitro in the renal artery of rats. The endothelium of the blood vessels is also said to be dysfunctional in PE. Genistein has shown the ability to antagonize the vascular contractions caused by a wide range of contractile agents. We conducted vascular reactivity studies to demonstrate the effect of: (i) sFLT1 on the vasodilatory effect of VEGF; and (ii) genistein on the vasodilatory effect of VEGF and its effects on denuded blood vessels (dysfunctional endothelium).
  3. Lim SS, Yu CW, Aw LD
    J Obstet Gynaecol Res, 2015 Feb;41(2):238-47.
    PMID: 25256125 DOI: 10.1111/jog.12523
    The prevalence of hemorrhoids among pregnant women is high in late pregnancy. This study was to evaluate the efficacy between drug treatment with Procort (topical hydrocortisone cream 1%) and mechanical treatment with a Hai's Perianal Support (HPS) toilet seat device in managing symptomatic hemorrhoids during the third trimester of pregnancy.
  4. Tan YL, Naidu A
    J Obstet Gynaecol Res, 2014 May;40(5):1423-5.
    PMID: 24689652 DOI: 10.1111/jog.12334
    Spontaneous rupture of uterine fibroid is rarely encountered. We present a case of a 31-year-old who presented with acute abdominal pain at 9 weeks postpartum. On examination, the abdomen had diffuse tenderness, with rebound tenderness in the suprapubic area and in both iliac fossae. On ultrasonography, a 12.7 × 8.6 × 8.9-cm sized hyperechoic mass was visible on the posterior wall of the uterus. A large amount of fluid was visible in the paracolic gutters and the Pouch of Douglas (POD). The patient underwent an exploratory laparotomy. A ruptured, cystic degenerated uterine fibroid with active bleeding was found, as well as approximately half a liter of free, bloodstained peritoneal fluid and pus. Myomectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, preoperative diagnosis of a perforated, uterine fibroid with spontaneous intra-abdominal hemorrhage is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.
  5. Ee TX, Allen JC, Malhotra R, Koh H, Østbye T, Tan TC
    J Obstet Gynaecol Res, 2014 Apr;40(4):1002-8.
    PMID: 24611987 DOI: 10.1111/jog.12307
    To define the optimal gestational weight gain (GWG) for the multiethnic Singaporean population.
  6. Mahdy ZA, Basri H, Md Isa Z, Ahmad S, Shamsuddin K, Mohd Amin R
    J Obstet Gynaecol Res, 2014 Apr;40(4):983-7.
    PMID: 24320794 DOI: 10.1111/jog.12277
    To determine the adequacy of antenatal calcium intake in Malaysia, and the influencing factors.
  7. Pue LB, Lo TS, Wu PY, Tan YL
    J Obstet Gynaecol Res, 2014 Feb;40(2):611-3.
    PMID: 24245849 DOI: 10.1111/jog.12174
    Abdominal sacrocolpopexy is a well-established procedure for the reconstruction of apical support in pelvic organ prolapse. Its long-term efficacy is well known; however, it is also associated with higher perioperative morbidity when compared with the less invasive transvaginal approach. Long-term risk of bowel-related complication from abdominal sacrocolpopexy is rare, but can be significant as it is often serious and requires major surgical intervention. Here we highlight an unusual case of strangulated small bowel (in this instance complicated with sepsis secondary to peritonitis), 14 years after an abdominal sacrocolpopexy procedure. This example amplifies the need for proper preoperative counseling; also, life-long follow-up is necessary for patients undergoing this procedure.
  8. Yadav H, Lee N
    J Obstet Gynaecol Res, 2014 Feb;40(2):439-44.
    PMID: 24147966 DOI: 10.1111/jog.12209
    To identify the risk factors influencing the development of macrosomia among pregnant women and to develop a regression model to predict macrosomia.
  9. Wahid FS, Nasaruddin MZ, Idris MR, Tusimin M, Tumian NR, Mahdy ZA
    J Obstet Gynaecol Res, 2012 Mar;38(3):490-7.
    PMID: 22381102 DOI: 10.1111/j.1447-0756.2011.01740.x
    To compare the numbers of cord blood CD34(+) hematopoietic stem cells (HSC) between preeclampsia (PE) and control (non-PE) subjects and to determine the factors that may influence this observation.
  10. Wong LP, Arumugam K
    J Obstet Gynaecol Res, 2012 Aug;38(8):1095-105.
    PMID: 22540215 DOI: 10.1111/j.1447-0756.2011.01836.x
    The postoperative effects on Asian women after hysterectomy have not been fully explored. This study was undertaken to investigate the physical, psychological and sexual functioning effects in multi-ethnic Malaysian women who have undergone hysterectomy.
  11. Tan PC, King AS, Omar SZ
    J Obstet Gynaecol Res, 2012 Jan;38(1):145-53.
    PMID: 21955280 DOI: 10.1111/j.1447-0756.2011.01652.x
    AIM: The aim of this study was to evaluate urine microscopy, dipstick analysis and urinary symptoms in screening for urinary tract infection (UTI) in hyperemesis gravidarum (HG).
    MATERIALS AND METHODS:   A prospective cross-sectional study was performed on women at first hospitalization for HG. A clean-catch mid-stream urine sample from each recruit was sent for microscopy (for bacteria, leucocytes and erythrocytes), dipstick analysis (for leukocyte esterase, nitrites, protein and hemoglobin) and microbiological culture. The presence of current urinary symptoms was elicited by questionnaire. UTI is defined as at least 10(5) colony-forming units/mL of a single uropathogen on culture. Screening test parameters were analyzed against UTI.
    RESULTS: UTI was diagnosed in 15/292 subjects (5.1%). Receiver-operator characteristic curve analysis of microscopic urine leucocytes revealed area under the curve=0.64, 95% confidence interval (CI) 0.5-0.79, P=0.063 and erythrocytes area under the curve=0.53, 95%CI 0.39-0.67, P=0.67 for UTI indicating the limited screening utility of these parameters. Microscopic bacteriuria (likelihood ratio [LR] 1.1, 95%CI 0.7-1.5) and urine dipstick leukocyte esterase (LR 1.4, 95%CI 1.1-1.8), nitrites (LR 2.3, 95%CI 0.3-17.2), protein (LR 1.0, 95%CI 0.7-1.6) and hemoglobin (LR 0.8, 95%CI 0.4-1.5) were not useful screening tests for UTI in HG. Elicited symptoms were also not predictive of UTI.
    CONCLUSION: Urine microscopy, dipstick analysis and urinary symptoms were not useful in screening for UTI in HG. UTI should be established by urine culture in HG before starting antibiotic treatment.
  12. Nor Azlin MI, Adam R, Sufian SS, Wahab NA, Mustafa N, Kamaruddin NA, et al.
    J Obstet Gynaecol Res, 2011 Feb;37(2):132-7.
    PMID: 21159037 DOI: 10.1111/j.1447-0756.2010.01330.x
    AIM: To evaluate the safety and tolerability of once or twice daily neutral protamine hagedorn (NPH) insulin in fasting pregnant diabetics during Ramadan.
    METHODS: This was a prospective cohort study conducted during Ramadan 2006 and 2007. Twenty four pregnant diabetic women were given NPH insulin once at 5 pm or twice daily at 5 pm and 5 am. Demographic data, blood glucose control, insulin requirement, days of fasting and hypoglycemic episodes were analyzed.
    RESULTS: Most women were parity 1 (37.5%) in their second trimester (54.2%) and worked during the daytime (87.5%). Fourteen women (58.3%) had gestational diabetes mellitus, nine women (37.5%) had type 2 and one (4.2%) had type 1 diabetes mellitus. There were significant reductions in mean fasting blood glucose (6.16 mmol/L versus 5.34 mmol/L, P = 0.001), glycosylated hemoglobin (HbA1c) (6.70% ± 0.91 versus 6.64% ± 0.96, P = 0.001) and serum fructosamine (232.4 mmol/L ± 24.0 versus 217.0 mmol/L ± 24.3, P = 0.001) after Ramadan compared to before Ramadan. Throughout the four weeks of Ramadan, home blood glucose monitoring showed a reducing trend and was within the acceptable limits. Insulin requirement was increased from the first to the fourth week with a reduction in insulin dose noted after (38.5 U/day) compared to before the start of Ramadan (40 U/day). Most women (79.2%) were able to fast for more than 15 days without any hypoglycemia or fetal demise.
    CONCLUSION: Once or twice daily NPH insulin is a safe and tolerable option for pregnant diabetics who wish to fast during Ramadan.
  13. Naidu A, Nusee Z, Tayib S
    J Obstet Gynaecol Res, 2011 Jun;37(6):633-5.
    PMID: 21349130 DOI: 10.1111/j.1447-0756.2010.01401.x
    A non-puerperal uterine inversion in advanced uterovaginal prolapse is a rare occurrence. Even more unusual is the presence of bladder calculi in these two conditions, which has not been documented before. We report a case of acute urinary retention secondary to severe uterovaginal prolapse associated with uterine inversion and multiple bladder calculi.
  14. Cheah PL, Looi LM, Sivanesaratnam V
    J Obstet Gynaecol Res, 2011 Jun;37(6):489-95.
    PMID: 21349124 DOI: 10.1111/j.1447-0756.2010.01386.x
    With cervical carcinoma remaining the second leading cancer among Malaysian women, it is imperative to clarify the prevalence of human papillomavirus (HPV) in this respect, considering the dearth of local information.
  15. Nadarajah VD, Min RG, Judson JP, Jegasothy R, Ling EH
    J Obstet Gynaecol Res, 2009 Oct;35(5):855-63.
    PMID: 20149032 DOI: 10.1111/j.1447-0756.2009.01037.x
    To establish baseline levels of maternal plasma soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) among normotensive Malaysian mothers and to compare the marker levels between normotensives and mothers with gestational hypertension (GH).
  16. Tan NH, Palmer R, Wang R
    J Obstet Gynaecol Res, 2010 Feb;36(1):19-26.
    PMID: 20178523 DOI: 10.1111/j.1447-0756.2009.01110.x
    Array-based comparative genomic hybridization (array CGH) is a new molecular technique that has the potential to revolutionize cytogenetics. However, use of high resolution array CGH in the clinical setting is plagued by the problem of widespread copy number variations (CNV) in the human genome. Constitutional microarray, containing only clones that interrogate regions of known constitutional syndromes, may circumvent the dilemma of detecting CNV of unknown clinical significance.
  17. Sivanesaratnam V
    J Obstet Gynaecol Res, 2009 Jun;35(3):393-404.
    PMID: 19527374 DOI: 10.1111/j.1447-0756.2009.01049.x
    Ovarian cancer is today the most lethal female cancer with an overall survival of only 49.9%. The currently available screening modalities are disappointing in detecting highly curable early stage ovarian cancer. Natural history of ovarian cancer is unknown; it appears it can develop quickly from normal looking ovaries. Timely referral of women with non-specific symptoms (such as abdominal bloating, pelvic pain) for an ultrasound scan or blood CA125 assessments may help in the early diagnosis. Patients with Stage IA or IB disease with grade 1 tumors have a cure rate of >90%; this is likely to be compromised by laparoscopic surgery. In selected patients fertility preservation with good obstetric outcome is possible. However, the relapse rate in 'high risk' early stage ovarian cancers is 40-45%; adjuvant chemotherapy is needed. Only 20-25% of those with stage III and IV disease are cured. Despite a high primary response (70%) majority (70-75%) will relapse and all are likely to succumb. Optimal debulking surgery followed by adjuvant chemotherapy are needed for stages III and IV disease; the outcome is superior if managed by gynecologic oncologists. Where cost of drugs is an important consideration, an alternative is carboplatin (an affordable and equally effective drug). The role of vaccines needs further study. When relapses occur palliation will be the aim in most instances. Oral contraceptives, breast feeding, tubal sterilization and hysterectomy also have a protective effect. Risk-reducing salpingo-oopherectomy has been suggested in women with BRCA mutations.
  18. Ayadurai T, Muniandy S, Omar SZ
    J Obstet Gynaecol Res, 2009 Dec;35(6):1061-8.
    PMID: 20144172 DOI: 10.1111/j.1447-0756.2009.01067.x
    The status of thrombophilia in Asian women with recurrent pregnancy loss (RPL) is obscure and poorly understood. Numerous studies suggest the non-existence or extreme rarity of the two important thrombophilia markers, factor V Leiden (FVL) and prothrombin G20210A (PTG) mutations, in patients of Asian ancestries. Thus, the consensus that thrombophilia is rare among Asians and laboratory investigations is irrelevant. We therefore investigated Malaysian women with RPL for thrombophilia abnormalities.
  19. Ismail NA, Saharan WS, Zaleha MA, Jaafar R, Muhammad JA, Razi ZR
    J Obstet Gynaecol Res, 2008 Jun;34(3):350-3.
    PMID: 18686348
    AIM: To compare the success, clinical outcomes, and maternal and neonatal complications between the Kiwi Omnicup and the Malmstrom metal cup in vacuum assisted delivery.

    METHODS: This was a prospective randomized comparative trial. Women who required vacuum assisted vaginal delivery were randomized into the Kiwi Omnicup (KO) group and the Malmstrom metal cup (MM) group. The vacuum assisted deliveries were conducted according to hospital protocol. Details of the procedure and delivery outcomes including success and complications were analyzed.

    RESULTS: One hundred and sixty-four women were recruited - 85 were assigned to vacuum assisted delivery using the KO and 79 the MM. One hundred percent delivery success was achieved with no significant differences between the two instruments in terms of maternal morbidity (P = 0.66). Six women in the MM group sustained post delivery complications in comparison to five in the KO group. Three babies were diagnosed with birth asphyxia in each group. More babies in the MM group were admitted to the Neonatal Intensive Care Unit (NICU) (10 babies versus 5 babies) and suffered complications (14 versus 12 babies), compared to the KO group, although the difference was not statistically significant. There were no intrapartum or neonatal deaths and of those admitted to the NICU, all were discharged within a week without any serious consequences.

    CONCLUSION: Kiwi Omnicup is an effective alternative to the currently available Malmstrom metal cup for vacuum assisted delivery with no increase in maternal or neonatal morbidity or mortality.

  20. Omar SZ, Qvist R, Khaing SL, Muniandy S, Bhalla S
    J Obstet Gynaecol Res, 2008 Apr;34(2):174-8.
    PMID: 18412778 DOI: 10.1111/j.1447-0756.2008.00755.x
    The aim of the present study was to determine the existence or prevalence of thrombophilic markers such as Factor V Leiden, prothrombin G20210A, protein S, protein C, activated protein C and anti-thrombin in pre-eclampsia and pregnancy-induced hypertensive patients.
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