Background: Increased maternal anxiety level has been reported to have detrimental effects on the physical outcome of pregnancies such as not achieving vaginal births. This study thus aims to determine the level and factors affecting mental preparedness among mothers with normal pregnancies and its correlation with birth outcomes. Methods: Three hundred healthy mothers above 37 weeks of gestation in the early stage of labour were assessed for their level of mental preparation before birth process and outcomes after births which include general feeling (euphoria), ability to withstand labour pain and bonding with the new born. The successfulness of vaginal birth and other data on factors affecting mental preparation were also collected. Results: The level of mental preparedness was found good in 78% of the mothers, mainly determined by their socioeconomic status, family support and personal ability to adjust to changes. Age (p= 0.048), parity (0.00) and income (0.01) were found to influence mental preparedness significantly. Race, occupation, education level and marital status are however not significantly related. Poor mental preparedness is associated with greater pain during labour. A correlation analysis also found a positive relationship between the level of mental preparation and mental outcomes following birth in these mothers but it did not significantly influence the mode of delivery. Conclusion: Mental preparation before birth seems to have an effect on mental outcomes of mothers following birth process. It is vital that mothers of the younger age group with no previous obstetric experience be given more attention in preparing them mentally before they face the painful birth process.

Subcutaneous emphysema, a known complication of tracheobronchial injury (TBI), is usually a self-limiting condition, but occasionally, a massive one can become life-threatening. We present a patient with TBI who developed massive subcutaneous emphysema with bilateral pneumothorax causing hemodynamic instability. Upon arrival to the hospital, the patient required emergent intubation for impending respiratory collapse. Bilateral thoracostomy tubes were inserted, resulting in hemodynamic improvement. Emergent CT thorax showed a tracheal-oesophageal injury just distal to the cuff of the endotracheal tube (ETT) at the level of the third thoracic vertebra (T3). Despite surgical repair and intensive care, the patient succumbed after a week in ICU due to ventilatory failure. This case report highlights the importance of the initial management of TBI requiring rapid identification and airway management.