Background : Miscarriage is a common problem in pregnancy which can occur during early, mid or late pregnancy. Incomplete miscarriage can be treated expectantly, medically or surgically. The most preferred method used in UKMMC is using sharp curettage.
Methodology : This study is conducted in the UKMMC from 1st January 2010 to 30th March 2010. The purpose of this study is to analyze the cost of treating incomplete miscarriage using metal sharp curettage from the provider’s perspective per patient-day.
Result : A total of 17 samples were eligible for analysis from 46 patients who fulfilled the inclusion and exclusion criteria. The cost is derived from cost calculation on capital and recurrent costs. Results showed that the average cost for treating incomplete miscarriage using sharp curettage per day is RM252.56. Recurrent costs contributed 83.3% of the total treatment with overhead cost was the biggest percentage (51.6%). Discussion The treatment cost for incomplete miscarriage using sharp curettage is found to be higher as compared to medical approach according to literatures. The higher cost of surgical approach was mainly attributed to the recurrent cost which is included in the calculation.
Conclusion : Effective usage of the operation theatre and all resources should be managed and utilized well in order to achieve optimum outcome.
The objective of this study was to determine the seroprevalence of cytomegalovirus (CMV) infections through antenatal screening data and the association of this virus with obstetric complications. Serum samples from 125 apparently healthy pregnant women sent for antenatal screening from various hospitals in Malaysia between January 2007 and December 2008, were examined for CMV specific IgM and IgG antibodies using an enzyme-linked immunosorbent assay method. Of the 125 pregnant women tested, anti-CMV IgG antibody was found in 105 (84%) of the cases and anti-CMV IgM in 9 cases (7.2%). Both CMV IgM and IgG were also found in another 37 women whose serum samples were sent for investigation of various obstetric complications: 17 cases of spontaneous abortions, 15 cases of fetal anomalies detected during ultrasound examination, 1 case of incomplete abortion, 3 cases with premature delivery of infant with congenital anomalies and 1 case of infertility. Our preliminary data which only represented a small study group has shown the prevalence of CMV infection among the local population and the association of CMV in obstetric complications.
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.