1.Antenatal Iron Deficiency in an Urban Malaysian Population
Mahdy Za ; Jumaida Ab ; Muhammad Za’im Sh ; Rahana Ar ; Mukudan K ; Zaleha Mi
Medicine and Health 2017;12(1):27-33
Iron deficiency anemia is the most common form of anemia in pregnancy. The
present study was carried out to determine the prevalence of antenatal anemia
and iron deficiency in the Malaysian population and its correlation with sociodemographic
and obstetric profile. It was a cross-sectional study conducted at
an urban health clinic over a period of six months. A single blood sample was
drawn from apparently healthy pregnant mothers at antenatal booking and sent
for laboratory assessment of full blood count and serum ferritin as screening tools
for anemia and iron status. SPSS version 19.0 was used for statistical analyses.
The results showed that out of 250 subjects, 43.6% had anemia and 31.6% had
iron deficiency. Whilst 47.7% of subjects with anemia were iron deficient, 19.1%
of subjects without anemia were also iron deficient. Serum ferritin correlated
negatively with period of gestation at booking (p<0.001), with 77.6% of these
women not having prior iron supplements. Serum ferritin was also significantly
lower among grandmultiparae (p=0.01). Iron deficiency was significantly (p=0.024)
more common among Indians (42.5%) compared to Malays (33.5%) and Chinese
(13.0%). In conclusion, continuation of the current practice of routine antenatal
iron supplementation is still warranted and justifiable in Malaysia as there is high
prevalence of iron deficiency in pregnancy not only in the presence of anemia but
also in the presence of normal hemoglobin values.
Anemia, Iron-Deficiency
;
Pregnancy
2.Early Versus Late ECV In Primigravidae With Breech Presentation: A Pilot Study
Nor Azlin MI ; Norliza H ; Norzilawati MN ; Mahdy ZA ; Shuhaila A ; Jamil MA
Malaysian Journal of Public Health Medicine 2013;13(1):20-27
This was a pilot study comparing the success between early versus late external cephalic version (ECV) involving primigravidae with singleton breech pregnancy. They were randomised into early (34–36 weeks) and late (37-40 weeks) ECV groups. A total of 44 women were initially randomised into 22 women for each group. The overall ECV success rate was acceptable in both groups although insignificantly higher in the late ECV group (55.6% versus 46.7%, p= 0.732.) Caesarean section in the early ECV group was higher (80% versus 72.2%). Early ECV group had women with higher BMI (29.5 versus 26.8 kg/m2, p=0.107), anterior placentation (60% versus 38.9%) and extended breech presentation (55.6% versus 44.4%; p= 0.296). In conclusion, early ECV in primigravidae showed no better success rate than late ECV. Maternal obesity, anterior placentation and extended breech presentation should alert to failure risk.
3.Congenital Peritoneal Band Causing Bowel Ischaemia Post Caesarean Section: A Rare Occurrence
Phon SE ; Ng BK ; Ng WYL ; Rahman RA ; Zainuddin AA ; Mahdy ZA
Journal of Surgical Academia 2017;7(2):28-31
Congenital peritoneal band is an extremely rare condition, but may induce small bowel obstruction (SBO) at any age,
predominantly in childhood and rarely in adults. We report a case of extensive bowel ischaemia following caesarean
section, due to trapping of an intestinal loop between a congenital peritoneal band and the mesentery. A 42-year-old,
Gravida 2 Para 1, who has no history of prior abdominal surgery or trauma, presented in spontaneous labour and
underwent an uncomplicated emergency lower segment caesarean section, for fetal distress. Postoperatively, she had
worsening abdominal distension and pain, followed by vomiting. Computed Tomography Scan of the abdomen
showed gross fluid retention with marked small bowel dilatation and fluid filled bowel loops. An emergency
exploratory laparotomy was performed which revealed a congenital band, extending between the right fimbrial end
and the small bowel mesentery, looping over the small bowel, causing extensive small bowel ischemia. Postoperative
course was uneventful. In conclusion, congenital peritoneal band causing small bowel obstruction,
although rare, should be considered in the differential, especially for patients with virgin abdomen.