Vaginal colonization with Group B streptococcus (GBS) or Streptococcus agalactiae can potentially... more Vaginal colonization with Group B streptococcus (GBS) or Streptococcus agalactiae can potentially cause ascending intrauterine infection among pregnant women, and hence it is known as one of the risk factors for preterm delivery. Ascending intrauterine infection may also cause the transmission of GBS to the fetus in utero and the newborn during delivery, leading to the development of early onset of neonatal infection. GBS are β-hemolytic, gram-positive bacteria that are opportunistic commensal of the gastrointestinal and urogenital tract of approximately 18% of pregnant women globally. Intrapartum antibiotic prophylaxis (IAP) only reduces the rate of early onset neonatal infection, but not the late onset neonatal infection. Thus, the development of GBS vaccine is thought to be important to decrease the rate of preterm delivery and neonatal infections particularly in low-and-middle income countries where IAP program is not feasible. Vaccination can also be cost-effective for the heal...
INTRODUCTION: Obesity has reached pandemic level with higher prevalence among women. Obese pregna... more INTRODUCTION: Obesity has reached pandemic level with higher prevalence among women. Obese pregnant women have higher risk of comorbidities, maternal and fetal complications. This study aimed to determine the prevalence of vaginal delivery and pregnancy outcomes of obese primigravida presented with spontaneous labour at term. MATERIALS AND METHODS: This prospective cohort study was conducted in a tertiary hospital in Perak involving 250 obese primigravida (BMI ≥27.5kg/m2) and 250 non-obese primigravida. Data collected from August 2020 till January 2021 and analyzed using descriptive statistics, independent T-test and Mann-Whitney U test by SPSS version 23.0. RESULTS: Our study found that there were no significant differences in the proportion of vaginal delivery and caesarean delivery between obese and non-obese primigravida [72.0% vs. 78% (vaginal delivery) and 28% vs. 22% (caesarean delivery)] with spontaneous onset of labour at term. No difference in complications of labour such ...
Objective: To assess the social-demographic characteristic and the maternal risk factors for pre ... more Objective: To assess the social-demographic characteristic and the maternal risk factors for pre eclampsia (PE) especially maternal fasting serum lipids (FSL) between trimesters. It was also to find out the association between FSL with fetal birth weight at a primary maternal child health center (KKIA). Materials and methods: A prospective cohort study was designed for recruiting pregnant women who were in their 1st trimester at KKIA at Jalan Gambut Kuantan Pahang. The study involved taking fasting serum lipids (FSL), blood pressure (BP) measuring and urine albumin in every trimester. The data was analyzed using (SPSS) version 17.0 and p value of < 0.05 was considered as statistically significant. Results: Triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and total cholesterol (TC) were increased as the gestational age increased. The mean of TC surged from 5 mmol/L in 1st trimester to 7.4 mmol/L in 3rd trimester (p0.05). Meanwhile serum triglyceride level was double (4.5mmol/L) in one patient who developed eclampsia at 25 weeks gestation. Conclusion: Serum lipid increase in parallel to increase in gestational age, however it does not influenced the maternal blood pressure and birth weight. .
Introduction: The modified Viennese manual perineal protection (VMPP) is a modified method based ... more Introduction: The modified Viennese manual perineal protection (VMPP) is a modified method based on an experimental study on a computerized biomechanical model of the perineum by Jansova and colleagues. It determines the exact placement of fingers on the perineum that has less perineal tension with the minimal perineal injury. Aim: To evaluate the effectiveness of modified VMPP in protecting the perineal injury and need of episiotomy compared to conventional method. The associated risk factors for perineal injury were also identified. Methodology: A randomize case control study on laboring women without previous vaginal delivery at the tertiary hospital. The modified VMPP was based on a method described by Jansova et al., (2014). The sanitary pad was used to support and protect perineum in the control group. Result: A total of 158 women were recruited and divided into modified VMPP group (n=71) and control group (n=78). Nine cases were excluded due to instrumental deliveries. Thirty two (21.5%) women had intact perineum mainly in modified VMPP group (p=0.022).There were 81 (54.4%) cases of first degree perineal tear, 16 (10.7%) second degree tear and 26 (18.7%) required episiotomy which is more in the control group (p=0.548). None of the participants suffered third or fourth degree perineal tears. The more advanced maternal age, the higher BMI and larger infant’s head circumference, the higher risk of perineal injury. Conclusion: Modified VMPP is effective in minimizing perineal injury and less need for an episiotomy. The risk of perineal injury is higher with increasing maternal age, BMI and fetal head circumference
27/ Indonesian lady G1P0 @ 38w Twin Pregnancy- MCDA Booking @15w, date confirmed, Both FH seen. N... more 27/ Indonesian lady G1P0 @ 38w Twin Pregnancy- MCDA Booking @15w, date confirmed, Both FH seen. No family h/o twin. No h/o taking ovulation induction dugs(married 1year). No underlying medical problem nor family history of congenital anomaly. Antenatally otherwise uneventful. 19w at district clinic: Dx twin pregnancy with 1 fetal demise. She was monitored for fetal growth. Referred to tertiary center at 30w Transabdominal ultrasound – MCDA- 1 st twin-Breech,microcephaly (BPD= 26w), Bilateral CTEV otherwise other structures normal, 2 nd twin- compressed to side wall of uterus. USG show cystic brain changes of survivor.(Figure 1) Amniocentesis - normal chromosomal study Fetal MRI (Figure 2) – Lissencephaly with dilated ventricles and minimal brain tissue seen. This would be compatible with life but very severe mental retardation. Aimed for vaginal delivery in view of poor prognosis of the baby of the living twin. Presented with prelabour rupture of membranes at 38 weeks. Clinically ut...
Human milk is the perfect food for human infants. The World Health Organisation (WHO) recommends ... more Human milk is the perfect food for human infants. The World Health Organisation (WHO) recommends exclusive breastfeeding for 6 months and continuation of breastfeeding for 2 years and beyond after the introduction of complementary food. Full exclusive breastfeeding provides almost all of the nutrition required by healthy full-term infants and also protection against illness. In Islam, it is the right of every infant to receive the best source of nutrition for their development, a feature that can be found in mother’s milk. However, some mothers are unable to breastfeed their infants due to various unavoidable reasons. In Malaysia, cases such as premature birth, babies born from HIV positive mothers, multiple births are becoming more prevalent. Research evidence shows that infant receiving breastmilk in the early days have low risk of developing critical illness. This creates a need for the establishment of the human milk bank in Malaysia. Unfortunately, there are hurdles in setting ...
Introduction Gestational diabetes is diagnosed by using different criteria. Basically O`Sallivan ... more Introduction Gestational diabetes is diagnosed by using different criteria. Basically O`Sallivan and Mahan implemented the used of 2 standard deviation from the mean in pregnant women in their late 2nd and early 3rd trimester. The result for the fasting and postprandial were 5 and 8.05 mmol/l respectively. The blood samples taken were whole blood. By 1982; Carpenter made a new work using the plasma to analyse blood glucose by the enzymatic method that is still in use. He found higher level for fasting and 2 hours postprandial, it was 5.3 and 8.6 mmol/l. The latest study regarding criteria for diagnosing GDM was the HAPO study using the postnatal outcome as an indicator; it recommended 5.1 mmol for fasting and 8.5 for 2h after 75g oral glucose. The Malaysian guideline diagnostic criteria for GDM is 5.6/7.8 mmol for the fasting and the 2h post 75g sugar.
This book reports a study involving Malay mothers who have had an ongoing breastfeeding experienc... more This book reports a study involving Malay mothers who have had an ongoing breastfeeding experience. The motivation of this book was derived from two main considerations. First, it was driven by the need to explore the influences of religious affiliation experience on breastfeeding practices. Second, mothers’ perception and experience throughout their breastfeeding journey need to be understood in establishing health promotion and education within communities with different context of culture. Our attention on breastfeeding issues is rooted from our life experience as a mother who breastfeeds. The exposures as a health care providers working in Obstetrics Ward allowed us to observe the discrepancy between the religious recommendation and sociocultural perspective within the breastfeeding promotion and education program within the society. Islam recommends breastfeeding since human milk is the most nutritious and best first food for infants. Mother’s preference of infant feeding pract...
In year 2016, we managed three cases of monochorionic monoamniotic (MCMA) and all were found to h... more In year 2016, we managed three cases of monochorionic monoamniotic (MCMA) and all were found to have cord entanglements. The diagnosis was made at 17-21 weeks of gestations. The management includes: fortnightly Doppler ultrasound of the umbilical arteries and middle cerebral arteries till 28 weeks. All were routinely admitted at 29 weeks of gestation for daily cardiotocograph (CTG) with weekly biophysical profile and Doppler ultrasound. A course of dexamethasone was given between 29-32 weeks. Elective caesareans after 34 weeks were planned. Results: One case had elective caesarean at 34+5 weeks and the other two had emergency caesareans at 32+5 and 30+2 weeks for abnormal CTG. The babies are healthy with normal developmental growth. Conclusion: Prenatal diagnosis of cord entanglement is not difficult that helps triage for fetal surveillance. This is to achieve a timely optimal gestational age at delivery thus reduce the neonatal morbidity and mortality.
Vaginal colonization with Group B streptococcus (GBS) or Streptococcus agalactiae can potentially... more Vaginal colonization with Group B streptococcus (GBS) or Streptococcus agalactiae can potentially cause ascending intrauterine infection among pregnant women, and hence it is known as one of the risk factors for preterm delivery. Ascending intrauterine infection may also cause the transmission of GBS to the fetus in utero and the newborn during delivery, leading to the development of early onset of neonatal infection. GBS are β-hemolytic, gram-positive bacteria that are opportunistic commensal of the gastrointestinal and urogenital tract of approximately 18% of pregnant women globally. Intrapartum antibiotic prophylaxis (IAP) only reduces the rate of early onset neonatal infection, but not the late onset neonatal infection. Thus, the development of GBS vaccine is thought to be important to decrease the rate of preterm delivery and neonatal infections particularly in low-and-middle income countries where IAP program is not feasible. Vaccination can also be cost-effective for the heal...
INTRODUCTION: Obesity has reached pandemic level with higher prevalence among women. Obese pregna... more INTRODUCTION: Obesity has reached pandemic level with higher prevalence among women. Obese pregnant women have higher risk of comorbidities, maternal and fetal complications. This study aimed to determine the prevalence of vaginal delivery and pregnancy outcomes of obese primigravida presented with spontaneous labour at term. MATERIALS AND METHODS: This prospective cohort study was conducted in a tertiary hospital in Perak involving 250 obese primigravida (BMI ≥27.5kg/m2) and 250 non-obese primigravida. Data collected from August 2020 till January 2021 and analyzed using descriptive statistics, independent T-test and Mann-Whitney U test by SPSS version 23.0. RESULTS: Our study found that there were no significant differences in the proportion of vaginal delivery and caesarean delivery between obese and non-obese primigravida [72.0% vs. 78% (vaginal delivery) and 28% vs. 22% (caesarean delivery)] with spontaneous onset of labour at term. No difference in complications of labour such ...
Objective: To assess the social-demographic characteristic and the maternal risk factors for pre ... more Objective: To assess the social-demographic characteristic and the maternal risk factors for pre eclampsia (PE) especially maternal fasting serum lipids (FSL) between trimesters. It was also to find out the association between FSL with fetal birth weight at a primary maternal child health center (KKIA). Materials and methods: A prospective cohort study was designed for recruiting pregnant women who were in their 1st trimester at KKIA at Jalan Gambut Kuantan Pahang. The study involved taking fasting serum lipids (FSL), blood pressure (BP) measuring and urine albumin in every trimester. The data was analyzed using (SPSS) version 17.0 and p value of < 0.05 was considered as statistically significant. Results: Triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and total cholesterol (TC) were increased as the gestational age increased. The mean of TC surged from 5 mmol/L in 1st trimester to 7.4 mmol/L in 3rd trimester (p0.05). Meanwhile serum triglyceride level was double (4.5mmol/L) in one patient who developed eclampsia at 25 weeks gestation. Conclusion: Serum lipid increase in parallel to increase in gestational age, however it does not influenced the maternal blood pressure and birth weight. .
Introduction: The modified Viennese manual perineal protection (VMPP) is a modified method based ... more Introduction: The modified Viennese manual perineal protection (VMPP) is a modified method based on an experimental study on a computerized biomechanical model of the perineum by Jansova and colleagues. It determines the exact placement of fingers on the perineum that has less perineal tension with the minimal perineal injury. Aim: To evaluate the effectiveness of modified VMPP in protecting the perineal injury and need of episiotomy compared to conventional method. The associated risk factors for perineal injury were also identified. Methodology: A randomize case control study on laboring women without previous vaginal delivery at the tertiary hospital. The modified VMPP was based on a method described by Jansova et al., (2014). The sanitary pad was used to support and protect perineum in the control group. Result: A total of 158 women were recruited and divided into modified VMPP group (n=71) and control group (n=78). Nine cases were excluded due to instrumental deliveries. Thirty two (21.5%) women had intact perineum mainly in modified VMPP group (p=0.022).There were 81 (54.4%) cases of first degree perineal tear, 16 (10.7%) second degree tear and 26 (18.7%) required episiotomy which is more in the control group (p=0.548). None of the participants suffered third or fourth degree perineal tears. The more advanced maternal age, the higher BMI and larger infant’s head circumference, the higher risk of perineal injury. Conclusion: Modified VMPP is effective in minimizing perineal injury and less need for an episiotomy. The risk of perineal injury is higher with increasing maternal age, BMI and fetal head circumference
27/ Indonesian lady G1P0 @ 38w Twin Pregnancy- MCDA Booking @15w, date confirmed, Both FH seen. N... more 27/ Indonesian lady G1P0 @ 38w Twin Pregnancy- MCDA Booking @15w, date confirmed, Both FH seen. No family h/o twin. No h/o taking ovulation induction dugs(married 1year). No underlying medical problem nor family history of congenital anomaly. Antenatally otherwise uneventful. 19w at district clinic: Dx twin pregnancy with 1 fetal demise. She was monitored for fetal growth. Referred to tertiary center at 30w Transabdominal ultrasound – MCDA- 1 st twin-Breech,microcephaly (BPD= 26w), Bilateral CTEV otherwise other structures normal, 2 nd twin- compressed to side wall of uterus. USG show cystic brain changes of survivor.(Figure 1) Amniocentesis - normal chromosomal study Fetal MRI (Figure 2) – Lissencephaly with dilated ventricles and minimal brain tissue seen. This would be compatible with life but very severe mental retardation. Aimed for vaginal delivery in view of poor prognosis of the baby of the living twin. Presented with prelabour rupture of membranes at 38 weeks. Clinically ut...
Human milk is the perfect food for human infants. The World Health Organisation (WHO) recommends ... more Human milk is the perfect food for human infants. The World Health Organisation (WHO) recommends exclusive breastfeeding for 6 months and continuation of breastfeeding for 2 years and beyond after the introduction of complementary food. Full exclusive breastfeeding provides almost all of the nutrition required by healthy full-term infants and also protection against illness. In Islam, it is the right of every infant to receive the best source of nutrition for their development, a feature that can be found in mother’s milk. However, some mothers are unable to breastfeed their infants due to various unavoidable reasons. In Malaysia, cases such as premature birth, babies born from HIV positive mothers, multiple births are becoming more prevalent. Research evidence shows that infant receiving breastmilk in the early days have low risk of developing critical illness. This creates a need for the establishment of the human milk bank in Malaysia. Unfortunately, there are hurdles in setting ...
Introduction Gestational diabetes is diagnosed by using different criteria. Basically O`Sallivan ... more Introduction Gestational diabetes is diagnosed by using different criteria. Basically O`Sallivan and Mahan implemented the used of 2 standard deviation from the mean in pregnant women in their late 2nd and early 3rd trimester. The result for the fasting and postprandial were 5 and 8.05 mmol/l respectively. The blood samples taken were whole blood. By 1982; Carpenter made a new work using the plasma to analyse blood glucose by the enzymatic method that is still in use. He found higher level for fasting and 2 hours postprandial, it was 5.3 and 8.6 mmol/l. The latest study regarding criteria for diagnosing GDM was the HAPO study using the postnatal outcome as an indicator; it recommended 5.1 mmol for fasting and 8.5 for 2h after 75g oral glucose. The Malaysian guideline diagnostic criteria for GDM is 5.6/7.8 mmol for the fasting and the 2h post 75g sugar.
This book reports a study involving Malay mothers who have had an ongoing breastfeeding experienc... more This book reports a study involving Malay mothers who have had an ongoing breastfeeding experience. The motivation of this book was derived from two main considerations. First, it was driven by the need to explore the influences of religious affiliation experience on breastfeeding practices. Second, mothers’ perception and experience throughout their breastfeeding journey need to be understood in establishing health promotion and education within communities with different context of culture. Our attention on breastfeeding issues is rooted from our life experience as a mother who breastfeeds. The exposures as a health care providers working in Obstetrics Ward allowed us to observe the discrepancy between the religious recommendation and sociocultural perspective within the breastfeeding promotion and education program within the society. Islam recommends breastfeeding since human milk is the most nutritious and best first food for infants. Mother’s preference of infant feeding pract...
In year 2016, we managed three cases of monochorionic monoamniotic (MCMA) and all were found to h... more In year 2016, we managed three cases of monochorionic monoamniotic (MCMA) and all were found to have cord entanglements. The diagnosis was made at 17-21 weeks of gestations. The management includes: fortnightly Doppler ultrasound of the umbilical arteries and middle cerebral arteries till 28 weeks. All were routinely admitted at 29 weeks of gestation for daily cardiotocograph (CTG) with weekly biophysical profile and Doppler ultrasound. A course of dexamethasone was given between 29-32 weeks. Elective caesareans after 34 weeks were planned. Results: One case had elective caesarean at 34+5 weeks and the other two had emergency caesareans at 32+5 and 30+2 weeks for abnormal CTG. The babies are healthy with normal developmental growth. Conclusion: Prenatal diagnosis of cord entanglement is not difficult that helps triage for fetal surveillance. This is to achieve a timely optimal gestational age at delivery thus reduce the neonatal morbidity and mortality.
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