Displaying publications 1 - 20 of 29 in total

  1. Siva Achanna K
    Med. J. Malaysia, 2011 Mar;66(1):1-3.
    PMID: 23765133
    Matched MeSH terms: Postpartum Hemorrhage*
  2. Achanna S, Mohamed Z, Krishnan M
    J. Obstet. Gynaecol. Res., 2006 Jun;32(3):341-5.
    PMID: 16764627
    Acute puerperal uterine inversion is a life-threatening and unpredictable obstetric emergency. If overlooked, it could lead to a maternal death. Although the precise cause is unknown, it is postulated to be caused by the mismanagement of the third stage of labor with premature traction of the umbilical cord and fundal pressure before placental separation. At the Ipoh General Hospital in Malaysia there were 31 394 deliveries and four acute uterine inversions occurring from 1 January 2002 to 30 June 2005. The four patients were between 25 and 36 years of age and their parities were between two and three. When manual repositioning of the uterus failed, successful correction was accomplished by the O'Sullivan's hydrostatic method. One case had to undergo subtotal hysterectomy after repositioning because of massive hemorrhage secondary to placenta accreta. Early diagnosis, immediate treatment of shock, and replacement are essential.
    Matched MeSH terms: Postpartum Hemorrhage/pathology; Postpartum Hemorrhage/therapy*
  3. MENG LY
    Med J Malaya, 1958 Sep;13(1):74-9.
    PMID: 13589374
    Matched MeSH terms: Postpartum Hemorrhage*
  4. Sinnathuray TA
    Med J Malaya, 1972 Sep;27(1):57-62.
    PMID: 4264827
    Matched MeSH terms: Postpartum Hemorrhage/epidemiology*
  5. Rashid Z, Hamidah NH, Othman A, Cheong SK, Fairuz AK, Adeeb N
    J Obstet Gynaecol (Tokyo 1995), 1995 Jun;21(3):221-5.
    PMID: 8590357
    A young primigravida presented with postpartum haemorrhage with no apparent cause following a low forceps delivery. She was extremely pale with gross hepatosplenomegaly. Hysterectomy was performed following three episodes of disseminated intravascular coagulation. Investigations revealed an extremely high platelet count with poor aggregatory function. A diagnosis of primary thrombocythaemia was made.
    Matched MeSH terms: Postpartum Hemorrhage/etiology*
  6. Ping WW, Sinnathuray TA
    Med J Malaya, 1970 Sep;25(1):54-7.
    PMID: 4249498
    Matched MeSH terms: Postpartum Hemorrhage/etiology
    Med. J. Malaysia, 1964 Mar;18:212-4.
    PMID: 14157188
    Matched MeSH terms: Postpartum Hemorrhage*
  8. Japaraj RP, Raman S
    Med. J. Malaysia, 2003 Oct;58(4):604-7.
    PMID: 15190639
    Massive postpartum haemorrhage after Cesarean section for placenta previa is a common occurrence. The bleeding is usually from the placental bed at the lower uterine segment. Uterine tamponade has a role in the management of such patients especially when fertility is desired. We describe here a case of massive postpartum haemorrhage, which was managed, with the use of a Sengstaken-Blakemore tube. This allowed us to avoid a hysterectomy for a young primiparous patient.
    Matched MeSH terms: Postpartum Hemorrhage/etiology; Postpartum Hemorrhage/therapy*
  9. Voon HY, Suharjono HN, Shafie AA, Bujang MA
    Taiwan J Obstet Gynecol, 2018 Jun;57(3):332-339.
    PMID: 29880160 DOI: 10.1016/j.tjog.2018.04.002
    OBJECTIVE: Postpartum hemorrhage remains the leading cause of maternal mortality in developing countries and a significant proportion of these cases are attributable to uterine atony. In contrast to the advances made in the treatment of postpartum hemorrhage, there has been few novel prophylactic agents. This study was undertaken to analyze the effectiveness of carbetocin compared to oxytocin for the prevention of postpartum hemorrhage, in the context of cesarean deliveries.

    MATERIALS AND METHODS: Major electronic databases were searched for randomized-controlled trials comparing carbetocin with oxytocin. Only trials involving cesarean deliveries were included. Non-randomized trials, non-cesarean deliveries, studies which did not directly compare carbetocin to oxytocin and studies which did not analyze the intended outcomes were excluded. Outcomes analysed were postpartum hemorrhage, additional use of uterotonic and transfusion requirement.

    RESULTS: Seven studies involving 2012 patients were included in the meta-analysis. There was a significant reduction in the rates of postpartum hemorrhage (RR 0.79; 95% CI 0.66 to 0.94; p = 0.009), use of additional uterotonics (RR 0.57; 95% CI 0.49 to 0.65; p postpartum hemorrhage and transfusion when used during cesarean deliveries. However, despite the potential benefits illustrated in this meta-analysis, the disparity between the cost of carbetocin and oxytocin suggests that locoregional cost-effectiveness analysis should be performed before any decision is made to adopt it for routine prophylaxis.

    Matched MeSH terms: Postpartum Hemorrhage/drug therapy; Postpartum Hemorrhage/prevention & control*
  10. Hashim H, Nawawi O
    Malays J Med Sci, 2013 Mar;20(2):76-80.
    PMID: 23983582 MyJurnal
    Uterine arteriovenous malformation (AVM) is a rare condition, with fewer than 100 cases reported in the literature. Despite it being rare, it is a potentially life-threatening condition. This case report describes a 33-year-old woman who presented with secondary post-partum hemorrhage. Transabdominal ultrasound (US) of the pelvis showed increased vascularity with multidirectional flow of the uterus and a prominent vessel, located on the left lateral wall. She also had retained product of conception, which complicated the diagnosis. A uterine artery angiogram confirmed an AVM in the fundal region with an early draining vein. Embolisation of the AVM was performed successfully.
    Matched MeSH terms: Postpartum Hemorrhage
  11. Subramaniam S, Nadarajan C, Aziz ME
    Cureus, 2018 Feb 23;10(2):e2220.
    PMID: 29692958 DOI: 10.7759/cureus.2220
    Uterine artery pseudoaneurysm is an uncommon cause of secondary postpartum hemorrhage, although it carries a high mortality rate. The etiology includes vascular trauma during cesarean section, vaginal delivery, curettage or hysterotomy. We present a post-cesarean female who developed delayed hemorrhage and was diagnosed with left uterine artery pseudoaneurysm. Selective transcatheter arterial embolization was performed and the pseudoaneurysm was successfully obliterated. Angiographic embolization is a safe and efficient method of treatment of postpartum hemorrhage due to pseudoaneurysm in hemodynamically stable patients. Thus, it should be considered as a treatment option before opting for surgery in favorable cases.
    Matched MeSH terms: Postpartum Hemorrhage
  12. Thiruselvi Subramaniam, Ann Jee Tan
    Background: House-officers and medical officers are at
    the forefront during medical emergencies in the ward
    and casualty which impose cognitive, communication,
    social and system challenges and yet, training in this
    area is commonly lacking. A workshop was conducted
    using simulation to provide training on some acute
    medical emergencies like cord prolapse, post- partum
    haemorrhage with collapse, poly-trauma and acute
    exacerbation of asthma.

    Objective: To determine the effectiveness of simulation
    in developing competency in managing selected clinical

    Methodology: There were 22 participants consisting
    of house-officers, junior medical officers and nursing
    clinical instructors. Only doctors were included in
    the study. Four medical emergencies were chosen viz.:
    Cord prolapse; post- partum haemorrhage with collapse;
    poly-trauma and acute exacerbation of asthma. The
    simulated sessions were conducted using high fidelity
    manikins and simulated patients. Simulated patients
    were trained and moulage was applied accordingly. The
    skills stations were on airway equipment and techniques
    of application, latest cardiac life support algorithm and
    hands on chest compression using manikins.

    Results: A 5 point Likert scale used to rate the
    sessions. The skills station had 65% (n=13) rating as
    excellent and 35% (n=7) good. The skills simulation
    was rated excellent by 75% (n=15) and good by 25%
    (n=5) of participants. Verbal feedback was that it was
    very refreshing, informative, and helpful in terms of
    improving their skills.

    Conclusion: The simulated skills training for the junior
    doctors was very well received and maybe beneficial for
    work preparedness and in the long run address patient
    Matched MeSH terms: Postpartum Hemorrhage
  13. 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.
    Matched MeSH terms: Postpartum Hemorrhage/prevention & control
  14. 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.

    Matched MeSH terms: Postpartum Hemorrhage/epidemiology
  15. Nirmala K, Zainuddin AA, Ghani NA, Zulkifli S, Jamil MA
    J. Obstet. Gynaecol. Res., 2009 Feb;35(1):48-54.
    PMID: 19215547 DOI: 10.1111/j.1447-0756.2008.00829.x
    To compare the efficacy of a single dose of 100 microg intramuscular carbetocin to a single dose of intramuscular syntometrine (0.5 mg ergometrine and 5IU oxytocin), in preventing post-partum hemorrhage (PPH) in high risk patients following vaginal delivery.
    Matched MeSH terms: Postpartum Hemorrhage/prevention & control*
  16. Suleiman AB, Mathews A, Jegasothy R, Ali R, Kandiah N
    Bull. World Health Organ., 1999;77(2):190-3.
    PMID: 10083722
    A confidential system of enquiry into maternal mortality was introduced in Malaysia in 1991. The methods used and the findings obtained up to 1994 are reported below and an outline is given of the resulting recommendations and actions.
    PIP: This is a report on the methods, findings, resulting recommendations and actions of a study on maternal mortality in Malaysia during the period 1991-94. Maternal death was defined as the death of a woman while pregnant or within 42 days following termination of pregnancy from any cause related to the pregnancy or its management but not from accidental causes. Between 1991 and 1994 there were 1066 reported maternal deaths, and the maternal mortality ratios for the successive years were respectively 44, 48, 46 and 39 per 100,000 live births. The primary causes of maternal death were postpartum hemorrhage (24%), hypertensive disorders of pregnancy (16%), obstetric pulmonary embolism (13%), and associated medical conditions (7%). Analysis of the 375 deaths from 1992 - 1993 showed that the maternal mortality ratio was 53/100,000 live births for deliveries performed at home, 36/100,000 in government hospitals, and 21/100,000 in private institutions. Shortcomings among health personnel were detected in several cases; these involved failure to diagnose, failure to appreciate the severity of a patient's condition, inadequate therapy, and inappropriate, delayed or failed adherence to protocols. The high proportion of maternal mortality associated with substandard care demonstrates that it is important to make the standard of care more widely available. Reports have been circulated to institutions and organizations providing maternal care and to medical schools. Articles and case histories have been published, and many new protocols and procedures have been developed. Furthermore, seminars have been organized and training modules have been distributed to all involved in the provision of maternity care.
    Matched MeSH terms: Postpartum Hemorrhage/mortality
  17. White JC, Chan LK, Lau KS, Sen DK
    J Trop Med Hyg, 1976 Jun;79(6):132-6.
    PMID: 1084931
    Five patients illustrate various aspects of obstetrical defibrination in West Malaysia, resulting from exaggeration of changes in fibrinolytic-coagulation equilibrium that occur at delivery. Hypofibrinogenaemia and fibrinolysis may occur in association or either feature predominate. These patients are from a population in which a variety of genetic and environmental factors may interact, e.g. abnormal haemoglobins, cold agglutinins, viral and other infections, introducing additional complications.
    Matched MeSH terms: Postpartum Hemorrhage/blood
    Med. J. Malaysia, 1963 Jun;17:306-15.
    PMID: 14060509
    Matched MeSH terms: Postpartum Hemorrhage*
  19. Rachagan SP, Sivanesaratnam V
    PMID: 6608460
    Caesarean hysterectomy is a useful surgical procedure. However, the increased blood supply to the pelvis during pregnancy, distortion of the anatomy caused by the enlarged uterus, fragility of oedematous pelvic tissues and adhesions from prior caesarean sections predispose to poor haemostasis and urinary tract injuries. In this series all the cases were done as an emergency procedure and, despite the multiple obstetric complications, there was no maternal mortality and the incidence of post-operative morbidity was low.
    Matched MeSH terms: Postpartum Hemorrhage/surgery
  20. Tan PC, Ling LP, Omar SZ
    Int J Gynaecol Obstet, 2009 Apr;105(1):50-5.
    PMID: 19154997 DOI: 10.1016/j.ijgo.2008.11.038
    To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM).

    GCT was positive if the 1-hour plasma glucose level was >or=7.2 mmol/L. GDM was diagnosed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive, and 168 had GDM. Pregnancy outcomes were extracted from hospital records. Multivariable logistic regression analysis was performed with GCT negative women as the reference group.

    GCT false-positive status was associated with preterm birth (adjusted odds ratio [AOR] 2.1; 95% CI, 1.2-3.7) and postpartum hemorrhage (AOR 1.7; 95% CI, 1.0-2.7). GDM was associated with labor induction (AOR 5.0; 95% CI, 3.3-7.5), cesarean delivery (AOR 2.2; 95% CI, 1.6-3.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.2-3.7), and neonatal macrosomia (AOR 2.5; 95% CI, 1.0-6.0).

    GCT false-positive women had an increased likelihood of an adverse pregnancy outcome. The role and threshold of the GCT needs re-evaluation.
    Matched MeSH terms: Postpartum Hemorrhage/etiology; Postpartum Hemorrhage/epidemiology
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