Intrauterine management of fetal supraventricular tachycardia (SVT) with cardiac failure.

Fetal arrhythmias are not uncommon in pregnancy. The diagnosis can be established on routine ultrasound scan. Fetal supraventricular tachycardia (SVT) is the most common cause of fetal tachycardia.

Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia.

Introduction: Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics.

Methods: A cross-sectional survey design was used.

Influence of a targeted educational intervention on evidence-based practice in two Malaysian maternity units: the SEA ORCHID project in Malaysia.

We conducted a before and after study to determine whether an educational intervention to build capacity in the understanding and implementation of evidence could result in improved outcomes for mothers and babies in obstetric and neonatal units of two Malaysian hospitals. Twelve practices and thirteen associated outcomes were selected based on clear evidence from the Cochrane Library. There were significant improvements in most practices with little change in outcomes.

Influence of training in the use and generation of evidence on episiotomy practice and perineal trauma.

Objective: To examine episiotomy practices before and after a multi-component intervention designed to support the use and generation of research evidence in maternal and neonatal health care.

Methods: Set in 9 centers across 4 Southeast Asian countries, a retrospective survey was performed for 12 recommended pregnancy/childbirth practices and 13 outcomes of women in each center before and after intervention. Qualitative interviews were conducted to assess staff awareness and experience in evidence-based practice.

Is there a place for selective vaginal breech delivery in Malaysian hospitals: experiences from the Ipoh Hospital.

Background: The 'Term Breech Trial' (TBT) results of 2001 have impacted on the mode of delivery of breech with a low threshold for caesarean delivery (CD) worldwide.

Aims: The trends in mode of delivery in developing countries have also changed. The aims of this retrospective analysis of all breech presentation was to see if similar trends are seen in Ipoh Hospital in Malaysia and if perinatal outcome is affected by mode of delivery.

Antenatal diagnosis of placenta previa accreta in patients with previous cesarean scar.

Aim: To determine the accuracy of transabdominal and transvaginal gray-scale and color Doppler in diagnosing placenta previa accreta in patients with previous cesarean sections.

Methods: Twenty-one patients who had undergone previous cesarean sections and were confirmed to have partial or total placenta previa in the current pregnancy were subjected to ultrasound examinations after the 28th week of gestation. Specific ultrasound features were looked for on gray-scale ultrasound and color Doppler examination of the placenta and its interphase with the uterus and the bladder.

Sengstaken-Blakemore tube to control massive postpartum haemorrhage.

Massive postpartum haemorrhage after Cesarean section for placenta previa is a common occurrence. The bleeding is usually from the placental bed at the lower uterine segment. Uterine tamponade has a role in the management of such patients especially when fertility is desired.

Gastroschisis: can prenatal sonography predict neonatal outcome?

Objective: Gastroschisis is associated with significant neonatal morbidity, and occasionally mortality. Previous studies looking at ways to prognosticate this condition by antenatal ultrasound have shown conflicting results. The aim of this study was to evaluate the usefulness of prenatal sonographic parameters to predict neonatal outcome of gastroschisis.

The prevalence of HIV positive antenatal mothers in a routine screening programme in two states.

This is a retrospective study of the prevalence of Human Immunodeficiency Virus (HIV) positive mothers in two states in Malaysia i.e., Perak and Negeri Sembilan since the introduction of the HIV screening programme in antenatal mothers.

Complete hydatidiform mole and surviving coexistent twin--a case report.

Hydatidiform mole with a coexistent fetus is a rare occurrence with an incidence of I per 22,000-100,000 pregnancies. It is associated with persistent gestational trophoblastic tumour. Hence an early and correct diagnosis is imperative to plan subsequent management of such patients.