1
|
Nor Azlin MI, Maisarah AS, Rahana AR, Shafiee MN, Aqmar Suraya S, Abdul Karim AK, Jamil MA. Pregnancy outcomes with a primary complaint of perception of reduced fetal movements. J OBSTET GYNAECOL 2014; 35:13-5. [PMID: 24987985 DOI: 10.3109/01443615.2014.930108] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Reduced fetal movement is a worrisome common complaint, not only for mothers but also for the attending medical personnel. The aim of this study was to analyse the pregnancy outcomes of women who presented primarily with reduced fetal movements (RFM). A retrospective study was performed based on patients' perception alone. Obstetric, past medical history, current presentation and outcomes of pregnancy were analysed. A total of 230 case notes were reviewed, with the majority being primigravidae. Less than half (48.7%) of the women had spontaneous labour, 45.7% had induction and 5.6% had elective caesarean section. There were no maternal complications in 97.4% (n = 224) of them. About 0.9% (n = 2) and 1.7% (n = 4) had primary postpartum haemorrhage and extended perineal tear, respectively. Although there was no major neonatal mortality and morbidity, until a randomised trial with a significant sample is conducted in the management of RFM, careful selections for elective delivery or conservative management would prevent untoward complications.
Collapse
Affiliation(s)
- M I Nor Azlin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia
| | | | | | | | | | | | | |
Collapse
|
2
|
Nor Azlin MI, Bakin YD, Mustafa N, Wahab NA, Johari MJM, Kamarudin NA, Jamil MA. Thyroid autoantibodies and associated complications during pregnancy. J OBSTET GYNAECOL 2011; 30:675-8. [PMID: 20925608 DOI: 10.3109/01443615.2010.503908] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study was undertaken to determine the presence of thyroid autoantibodies and associated pregnancy complications from 49 pregnant women with thyroid disease. There were 31 (63%) women with Graves' disease (GD) and 18 (37%) with primary hypothyroidism (PHT). A total of 26 (53.1%) women, 19 (61%) with GD and seven (39%) with PHT, had positive antibodies. Six had thyroid peroxidase antibodies (TPO), one with thyroglobulin antibody (TG) and eight had TSH receptor antibodies (TR). Two had a mixture of antibodies involving TG/TPO (one GD vs one PHT), four with TG/TPO/TR (all had GD) and five with TPO/TR (four with GD vs one with PHT). There were associations in women with positive thyroid antibodies and pre-eclampsia (15.4%), abruptio placenta (4%), caesarean deliveries (31%), postpartum thyroiditis (19.2%) and abnormal neonatal thyroid function (15.4%). Women with positive thyroid antibodies in pregnancy need close care during and after pregnancy, as they can develop complications affecting both mother and fetus.
Collapse
Affiliation(s)
- M I Nor Azlin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | | | | | | | | | | | | |
Collapse
|
3
|
Azlin MIN, Maryasalwati I, Norzilawati MN, Mahdy ZA, Jamil MA, Rashid MRZ. The efficacy of etoricoxib vs mefenamic acid in the treatment of primary dysmenorrhoea: A randomised comparative trial. J OBSTET GYNAECOL 2009; 28:424-6. [DOI: 10.1080/01443610802150051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
4
|
Nor Azlin MI, Abdullah HSNA, Zainul Rashid MR, Jamil MA. Misoprostol (alone) in second trimester terminations of pregnancy: as effective as Gemeprost? J OBSTET GYNAECOL 2007; 26:546-9. [PMID: 17000504 DOI: 10.1080/01443610600811383] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Gemeprost (Cervagem) has been used widely compared with Misoprostol (Cytotec) alone in second trimester pregnancy termination. This prospective randomised trial was to evaluate the efficacy of intravaginal Misoprostol (alone) and Gemeprost in second trimester termination of pregnancy. A total of 54 women with 27 on each arm were involved. A total of 25 patients (92.6%) in the Misoprostol group and 22 patients (81.5%) in the Gemeprost group delivered within 48 h. The Misoprostol group delivered earlier, although average number of tablets required were similar. The side-effects were not significant between the two groups in fact, but there was more pyrexia in the Gemeprost group (p = 0.004). Misoprostol in second trimester termination of pregnancy is clinically as effective and less costly than the standard regimen of Gemeprost.
Collapse
Affiliation(s)
- M I Nor Azlin
- Department of Obstetrics and Gynaecology, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | | | | | | |
Collapse
|
5
|
Ng SP, Jamil MA, Nurshaireen A, Zainul MR. The empty follicle syndrome. Med J Malaysia 2006; 61:499-500. [PMID: 17243533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The empty follicle syndrome (EFS) is a rare complication of in vitro fertilization (IVF) treatment, leading to cycle cancellation. Low human chorionic gonadotropin (hCG) bioavailability and ovarian dysfunction have been implicated with this condition. This case report illustrates a typical case of EFS and several strategies suggested to overcome this problem.
Collapse
Affiliation(s)
- S P Ng
- Department of Obstetric & Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur
| | | | | | | |
Collapse
|
6
|
Ng SP, Leong CF, Nurismah MI, Shahila T, Jamil MA. Primary Burkitt lymphoma of the ovary. Med J Malaysia 2006; 61:363-5. [PMID: 17240592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
A 20 year-old woman presented with features of a twisted ovarian cyst and had an emergency laparotomy Intraoperative findings revealed bilateral, solid ovarian tumors and a left oophorectomy with biopsy of the contralateral ovary performed. Histopathology report confirmed Burkitt lymphoma of ovary. There was no other evidence of lymphoma elsewhere. The primary Burkitt lymphoma of the ovaries was successfully managed with six courses of highly toxic chemotherapy (Berlin-Frankfurt- Munster 1986 protocol). The patient has remained disease free for the last 36 months.
Collapse
Affiliation(s)
- S P Ng
- Department of O and G, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Kuala Lumpur
| | | | | | | | | |
Collapse
|
7
|
Zarina AL, Jamil MA, Ng SP, Rohana J, Yong SC, Salwati S, Boo NY. Unbalanced chromosomal translocation: a cause of recurrent spontaneous abortion. Med J Malaysia 2006; 61:260-2. [PMID: 16898328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Recurrent spontaneous abortion, defined as three consecutive abortions, occurs in approximately 1% to 2% of couples. Although the cause is unknown in up to 50% of cases, about 5% of these couples are found to be a balanced translocation carrier. We report a case in which the mother was identified to be a translocation carrier following the birth of a baby with multiple congenital abnormalities.
Collapse
Affiliation(s)
- A L Zarina
- Department of Paediatrics, Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur
| | | | | | | | | | | | | |
Collapse
|
8
|
Abstract
OBJECTIVE To determine whether therapy with dydrogesterone in threatened abortion during the first trimester of pregnancy will improve pregnancy outcome. DESIGN Prospective open study. SUBJECTS Pregnant women presenting to the obstetric and gynaecology clinic admitting center with vaginal bleeding before 13 weeks gestation were evaluated for entry into the study. Women were excluded if they had a history of recurrent miscarriage. METHOD Eligible subjects were randomized to receive either dydrogesterone 40 mg stat dose followed by 10 mg twice a day for one week or conservative therapy. RESULTS One hundred and 54 women were recruited. There was no statistically significant differences between the two groups with regard to pre-treatment status. The continuing pregnancy success rate was significantly (p=0.037) higher in women treated with dydrogesterone (95.9%) compared with women who received conservative treatment (86.3%). The odds ratio of the success rate between dydrogesterone treatment and non-treatment was 3.773 (95% confidence interval: 1.009-14.108). CONCLUSION Corpus luteal support with dydrogesterone has been shown to reduce the incidence of pregnancy loss in threatened abortion during the first trimester in women without a history of recurrent abortion.
Collapse
Affiliation(s)
- M H Omar
- Department of Obstetrics and Gynaecology, University Kebangsaan, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
| | | | | | | |
Collapse
|
9
|
Khairil OA, Zulfiqar A, Thambidorai CR, Nizam JM, Ahmad JT, Jamil MA. Ultrasound measurement of corporeal (penile) length in newborns. Med J Malaysia 2005; 60:469-74. [PMID: 16570709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
In the initial clinical examination of a child with ambiguous genitalia an accurate measurement of the corporeal length is needed. Most often the corporeal length is measured with a ruler from the symphysis pubis to the tip of the glans of a stretched penis. More recently, ultrasound has been successfully used to measure corporeal length. This study aimed to (i) establish normal values for corporeal length in normal male newborns using ultrasound measurement, (ii) compare these measurements to stretched corporeal measurements, (iii) compare the corporeal length of newborns of different races, and (iv) determine the relationship between corporeal length and birth weight, birth length and head circumference. This was a prospective study of 141 newborns. Ultrasound imaging was done in an oblique parasagittal plane such that the corpus could be included in a single image and measured, Stretched corporeal length was measured with the penis stretched alongside a wooden spatula and the length from the pubic bone to the tip of the glans was marked on the spatula and measured. By ultrasound measurement the mean corporeal length of the normal newborn was 3.18 +/- 0.56cm. There was no significant difference in the mean corporeal length when determined by ultrasound and by stretched corporeal measurement. There was no significant difference in the mean corporeal length of the different races when the length was determined by either ultrasound or stretched corporeal measurement. There was a positive correlation between ultrasound length and birth weight and birth length. However, there was no correlation between ultrasound length and head circumference. There was no significant correlation between the stretched length and either birth weight, birth length or head circumference.
Collapse
Affiliation(s)
- O A Khairil
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur
| | | | | | | | | | | |
Collapse
|
10
|
Nor Azlin MI, Haliza H, Mahdy ZA, Anson I, Fahya MN, Jamil MA. Tocolysis in term breech external cephalic version. Int J Gynaecol Obstet 2004; 88:5-8. [PMID: 15617697 DOI: 10.1016/j.ijgo.2004.09.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2004] [Revised: 08/31/2004] [Accepted: 09/07/2004] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the effect of ritodrine tocolysis on the success of external cephalic version (ECV) and to assess the role of ECV in breech presentation at our centre. MATERIAL AND METHODS A prospective randomized double-blind-controlled trial comparing ritodrine and placebo in ECV of singleton term breech pregnancy at a tertiary hospital. RESULTS Among the 60 patients who were recruited, there was a success rate of 36.7%. Ritodrine tocolysis significantly improved the success rate of ECV (50% vs. 23%; P=0.032). There was a marked effect of ritodrine tocolysis on the ECV success in nulliparae (36.4% vs. 13.0%) and multiparae (87.5% vs. 57.1%). External cephalic version has shown to reduce the rate of cesarean section for breech presentation by 33.5% in our unit. CONCLUSION External cephalic version significantly reduced the rate of cesarean section in breech presentation, and ritodrine tocolysis improved the success of ECV and should be offered to both nulliparous and parous women in the case of term breech presentation.
Collapse
Affiliation(s)
- M I Nor Azlin
- Department of Obstetric and Gynaecology, Hospital Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, 56000 Kuala Lumpur, Malaysia.
| | | | | | | | | | | |
Collapse
|
11
|
Mohammad M, Mahdy ZA, Omar J, Maan N, Jamil MA. Laboratory aspects of asymptomatic bacteriuria in pregnancy. Southeast Asian J Trop Med Public Health 2002; 33:575-80. [PMID: 12693594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
A total of 1,661 pregnant women aged between 13 and 45 years were screened for bacteriuria by urine culture. Of the 1,661 culture results, 615 (37%) yielded no growth; 728 (43.8%) yielded no significant growth (presence of <10(5) organisms/ml urine of one or more types of bacteria); 286 (17.2%) yielded mixed growth (presence of >10(5) organisms/ml urine of more than one type of bacteria) and only 32 (1.9%) showed significant growth (presence of >10(5) organisms/ml urine of a single bacterium). Urine microscopy was also conducted. Two hundred and twenty-four (13.5%) specimens had >10 white blood cells/ml urine, of which 66 had >100 white blood cells; 13 were from the significant growth group. Three hundred and seventy-four (22.5%) specimens showed the presence of bacteria, 42 (2.5%) had red blood cells, 370 (22.3%) had epithelial cells, 58 (3.5%) had crystals, and 14 (0.8%) had yeasts. The most common bacterium isolated was Escherichia coli (12; 40%); the others included group B Streptococcus (5; 15%), Klebsiella spp (5; 15%), Diphtheroids (2), and Candida albicans (2). Fifty-two percent of tested strains were sensitive to ampicillin; 24 of 28 strains (85.7%) were sensitive to ciprofloxacin; all 7 strains tested were sensitive to nitrofurantoin and all 20 strains tested were sensitive to cotrimoxazole; 14/20 (70%) and 16/17 (94.1%) were sensitive to cephalexin and cefuroxime respectively. This study shows that asymptomatic bacteriuria does occur in pregnant women, albeit at a very low rate in an urban setting like Cheras. Urine microscopy is not specific and only serves as a guide to bacteriuria. The commonest causative organisms are those from the gastrointestinal tract and vagina. The antibiogram showed that cefuroxime and cephalexin are likely to be effective in treating bacteriuria: ampicillin must be reserved for Gram-negative organisms. For Gram-positive organisms, of which Group B Streptococcus is important, ampicillin is still effective in vitro. Nitrofurantion and cotrimoxazole have excellent activity in vitro and should be considered for therapy. 17.2% of the urine culture yielded mixed growth: likely to indicate that contamination of urine specimens still happens despite the strict instructions given to patients about the collection of a midstream urine specimen. Proper collection, appropriate transport, and the early processing of urine specimens remain essential.
Collapse
Affiliation(s)
- Marlyn Mohammad
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
| | | | | | | | | |
Collapse
|
12
|
Fadilah SA, Hatta AZ, Keng CS, Jamil MA, Singh S. Successful treatment of acute promyelocytic leukemia in pregnancy with all-trans retinoic acid. Leukemia 2001; 15:1665-6. [PMID: 11587228 DOI: 10.1038/sj.leu.2402250] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
13
|
Abstract
OBJECTIVES To assess the prevalence and association of frequently used screening risk factors for gestational diabetes mellitus (GDM) and to compare the validity and cost of universal screening with risk factor screening. METHOD A cross-sectional survey of 768 pregnant women at > or = 24 weeks' gestation who were attending the antenatal clinic at the Hospital Universiti Kebangsaan Malaysia (HUKM) was made. Risk factors were determined using a questionnaire. An abnormal oral glucose tolerance test was defined as a 2-h post-prandial blood sugar level of > or = 7.8 mmol/l. RESULTS A total of 191 pregnant mothers (24.9%) had GDM. The most commonly identified screening factors were positive family history of diabetes mellitus (31.4%), history of spontaneous abortion (17.8%), vaginal discharge and pruritus vulvae in current pregnancy (16.0%), and maternal age greater than 35 years (14.7%). Five hundred and thirteen mothers (66.8%) had at least one risk factor. All screening risk factors, except past history of diabetes mellitus in previous pregnancy and maternal age, were not significantly associated with abnormal glucose tolerance (GT). Risk factor screening gave a sensitivity of 72.2% and a specificity of 35.0%. Universal screening would cost RM 12.06 while traditional risk factor screening would cost RM 11.15 per identified case and will have missed 53 of the 191 cases. CONCLUSIONS Risk factor screening scored poorly in predicting GDM. Cost analysis of universal compared with traditional risk factor screening showed a negligible difference. Thus universal screening appears to be the most reliable method of diagnosing GDM.
Collapse
Affiliation(s)
- K Shamsuddin
- Department of Community Health, Medical Faculty, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
| | | | | | | | | |
Collapse
|
14
|
Masir N, Tamby MR, Jamil MA. A cervical ectopic masquerading as a molar pregnancy. Med J Malaysia 2000; 55:138-40. [PMID: 11072500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We report a case of cervical pregnancy complicated by life threatening hemorrhage. An initial diagnosis of molar pregnancy was made preoperatively. During uterine evacuation she developed profuse hemorrhage which required an emergency hysterectomy for uncontrolled bleeding. Histopathological examination confirmed a cervical pregnancy. The clinical and pathological criteria for the diagnosis and the etiology of cervical pregnancy are discussed.
Collapse
Affiliation(s)
- N Masir
- Department of Pathology, Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur
| | | | | |
Collapse
|