1.Late-Onset Mirror Syndrome
Erinna Mohamad Zon ; Nik Ahmad Zuky Nik Lah ; Hoo Pek Sung
Malaysian Family Physician 2021;16(1):129-132
Mirror syndrome is a rare clinical condition in pregnancy associated with significant fetal mortality
and maternal morbidity. It is characterized by a triad of complications: fetal hydrops, placenta oedema,
and maternal oedema. We are reporting one case of late-onset Mirror syndrome in which the patient
presented later in the gestation of 36 weeks due to excessive weight gain and clinical sign mimicking
preeclampsia. Awareness of this disease is essential, as a failure of recognition will delay the treatment
and cause higher maternal and perinatal morbidity and mortality
2.Does Epidural During Labour Lead To Chronic Low Backpain? A Malaysian Retrospective Study
Muhamad Rafiqi Hehsan ; Wan Fadzlina Wan Muhd Shukeri ; Shamsul Kamalrujan Hassan ; Hoo Pek Sung
Malaysian Journal of Medicine and Health Sciences 2022;18(No.1):151-155
Introduction: The question as to whether epidural analgesia during labour can cause chronic low backpain has become a concern lately but this association has not been tested locally and remains controversial. This retrospective
study aimed to ascertain the relationship between labour epidural analgesia and development of subsequent chronic
low backpain. Methods: We contacted 200 primiparous women who had delivered by normal vaginal delivery via
telephone at six months after delivery. While 100 of them had previously received epidural analgesia for labour,
the other 100 had not. The women had to quantify their backpain by yes/no responses, numeric rating score, and
impairment of daily function. Both the epidural and the non-epidural groups were compared using independent t-test
and Chi-squared test while logistic regression was used to control for confounding factors. Results: The two groups
had similar baseline characteristics except for body mass index, employment status and labour duration. The women
who received epidural analgesia had significantly higher prevalence of low backpain at six months after delivery
than those who had not (28% versus 9%, P = 0.001). However, the two groups did not show any difference in terms
of numeric rating score or level of impairment of daily function. The low back pain at six months (epidural versus
non-epidural) had an adjusted odds ratio of 8.1 (95% confidence interval 2.7 to 24.0, P <0.001). Conclusion: While
epidural analgesia during labour was shown to be associated with chronic low back pain, this association may not
be causal, suggesting the need for a randomized-controlled study in this area.