Dysmenorrhea is a common presentation in women of reproductive age in primary care. It can negati... more Dysmenorrhea is a common presentation in women of reproductive age in primary care. It can negatively affect the quality of life of a woman and restrict her daily activities. Endometriosis is the most common diagnosis for secondary dysmenorrhea. However, cutaneous endometriosis is an uncommon presentation of endometriosis. It requires a thorough history, physical examination and histological findings for definitive diagnosis. This paper reports an interesting case of a 47- year-old woman with primary cutaneous umbilical endometriosis and its management. Her final diagnosis was primary umbilical endometriosis with Stage 3 endometriosis based on the patient's history, clinical and surgical findings. The patient was discharged well on day three of operation and has been well since then with no signs of recurrence.
Pelvic organ prolapse (POP) is a protrusion of pelvic organ into or out of the vagina (ACOG). It ... more Pelvic organ prolapse (POP) is a protrusion of pelvic organ into or out of the vagina (ACOG). It has been on medical record for nearly 4000 years. Worldwide prevalence of POP is around 9% (Vas T et al 2012). It is higher in 3rd world countries estimated closer to 20% (Walker G.J and Gunasekara 2011). Only 30% of women seek medical attention because of embarrassing symptoms
Introduction/Objective: The risk of postpartum urinary retention (PUR) varies between 0.5% and 14... more Introduction/Objective: The risk of postpartum urinary retention (PUR) varies between 0.5% and 14.1% of deliveries. It is higher among the Asian population with prolonged first and second stage of labour, epidural analgesia and previous history of PUR. The objectives were to determine the local incidence of PUR and to evaluate the risk factors and the outcome of PUR. Methods: A cohort study on women who delivered at HTAA from 1st January to 30th December 2011. The subjects were consented women who were stable, not eclamptic, no severe postpartum haemorrhage or medical illnesses that require routine bladder catheterization. Post void residual urine volume (PVRV) was measuredminimum of 6 h post delivery or when subject complaint of inability to pass urine. They were then catagorised into three groups: normal (PVRV 150 mL) or covert (asymptomatic, PVRV > 150 mL). They were managed according to a standardised protocol till discharged. All subjects had a minimum of six months follow up or till the problem resolved. Results: There were 1000 women recruited. This preliminary result is on 414 women who had completed their follow up. The study subjects were mainly aged between 20 and 30 years (56.2%), Malay ethnic group (89.3%), obese (41.3%), low parity (80.9%) and had vaginal delivery (74.8%). There were two cases (0.48%) of overt and 13 cases (3.14%) of covert PUR. Majority of women (96.38%) had PVRV of <150 mL. There was no statistical different of PUR in relation to mode of delivery (P = 0.063), parity (P = 0.224), type of analgesic (P = 0.100), baby weight (P = 0.700) and time of voiding (P = 0.07) except for type of perineal wound (P = 0.01). Episiotomy causes significantly increased in PUR. Regarding covert PUR, 61.5% had urinary tract infection (UTI), 92.30% had an episiotomy wound and 69.23% resolved within 24 h. Both covert and overt PUR resolved spontaneously without complication. Conclusion: Risk of PUR was 3.62% which is compatible with others and had no serious complication. PUR was significantly associated with UTI and episiotomy.
Background: Urinary incontinence (UI) demonstrates major prevalence in women of different populat... more Background: Urinary incontinence (UI) demonstrates major prevalence in women of different population groups. Reduced quality of life (QOL) is observed due to incontinence problems. Urogenital Distress Inventory (UDI-6) and Incontinence Impact Quality of Life (IIQ-7) are useful disease-specific questionnaires evaluating the impact of urinary incontinence on the QOL of women which is accepted internationally. Objective: This study aims to translate and validate UDI-6 and IIQ-7 in Malay language. Methods: A cross sectional study, which recruited 100 participants from two urogynecology clinics. Both questionnaires were initially translated from English to Bahasa Malaysia followed by back translation and final correction done by the professional translators. The participants were requested to maintain a urinary record of the upcoming week for three days that assisted in quantifying the severity of symptoms. None of the subjects were assigned any treatment during the study period. Validity and reliability of the translated questionnaires were determined by checking the internal consistency and also by doing test-retest. Results: The internal consistency levels of the UDI-6 and IIQ-7 Bahasa Malaysia questionnaires were 0.73 and 0.90 respectively with good test-retest (0.86 and 0.95). Incontinence episodes were strongly associated with obstructive, irritative, and stress symptoms. The factor of day time voiding had strong correlation with obstructive and irritative symptoms. Conclusion: UDI-6 and IIQ-7 did not measure similar outcomes; however, both questionnaires have their strengths in clinical settings. Analysis has also revealed that the Malaysian versions of both questionnaires had appropriate test-retest validity and reliability. Thus, it can be said that both of the questionnaires had great importance for screening patients with urinary incontinence in Malaysia.
Objective: To assess the social-demographic characteristic and the maternal risk factors for pre ... more Objective: To assess the social-demographic characteristic and the maternal risk factors for pre eclampsia (PE) especially maternal fasting serum lipids (FSL) between trimesters. It was also to find out the association between FSL with fetal birth weight at a primary maternal child health center (KKIA). Materials and methods: A prospective cohort study was designed for recruiting pregnant women who were in their 1st trimester at KKIA at Jalan Gambut Kuantan Pahang. The study involved taking fasting serum lipids (FSL), blood pressure (BP) measuring and urine albumin in every trimester. The data was analyzed using (SPSS) version 17.0 and p value of < 0.05 was considered as statistically significant. Results: Triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and total cholesterol (TC) were increased as the gestational age increased. The mean of TC surged from 5 mmol/L in 1st trimester to 7.4 mmol/L in 3rd trimester (p0.05). Meanwhile serum triglyceride level was double (4.5mmol/L) in one patient who developed eclampsia at 25 weeks gestation. Conclusion: Serum lipid increase in parallel to increase in gestational age, however it does not influenced the maternal blood pressure and birth weight. .
Objectives: This study aims to identify knowledge, attitude, and practice of pelvic floor muscle ... more Objectives: This study aims to identify knowledge, attitude, and practice of pelvic floor muscle training (PFMT) and to identify the prevalence of urinary incontinence. Materials and methods: The method used was a cross-sectional study. Self-administered knowledge, attitude, and practice questionnaires were distributed among childbearing women attending Maternal & Child Health Clinics in the East Coast region of Malaysia. Results: The findings revealed that most respondents (N = 896) had good or moderate knowledge (80.1%) and attitudes (77.3%) regarding PFMT but most of them (87.2%) still lacked practice. However, there was no association between urinary incontinence and PFMT practice. On the contrary, married women showed a higher risk of urinary incontinence. Conclusions: The practice of pelvic floor muscle training should be recommended and emphasized to childbearing women by healthcare professionals.
Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to th... more Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to the marital institution around the world. The perineal injury may potentially be one of the main risk factors contributing to postpartum female sexual dysfunction (PPFSD). The study aimed to determine the effect of perineal injury and patients’ characteristics on PPFSD. Methodology: This cross-sectional questionnaire study was conducted in six different health clinics in the district of Kuantan from April 2019 to October 2019. Eligible women who came to the family health clinics at 6 months postpartum were recruited as study population. The participants completed their biodata and socio-demographic form and the Malay-validated Female Sexual Function Index (MVFSFI) questionnaire given. A cut-off point of 26.55 and below on MVFSFI scoring system was used as a measure of the primary outcome of sexual dysfunction. Results: Out of 240 women who delivered vaginally, 34 (14%) had intact perineum,...
The most common indications for vaginal (VH) hysterectomy in United State (Whiteman MK, 2018) are... more The most common indications for vaginal (VH) hysterectomy in United State (Whiteman MK, 2018) are symptomatic uterine leiomyomas (51.4%), abnormal uterine bleeding (41.7%), endometriosis (30%) and prolapse (18.2%). The American College of Obstetricians and Gynecologists (ACOG 2017) makes recommendations that VH is the approach of choice whenever feasible. The Cochrane systematic review on 47 studies concluded that VH has the best outcomes compare to abdominal and laparoscopic route. The vaginal approach is the natural route of excellence, which called “natural orifice hysterectomy” or “no scar hysterectomy” which seem to be the current trend for the minimally invasive context. VH is a long-practiced procedure since fourteen century (Berengario de Carpi, 1470–1550), which follow all the criteria of minimally invasive gynecology surgery. However, it is difficult to explain why vaginal hysterectomy, does not hold a preferential place among surgeons. Advantages of the vaginal route incl...
Pelvic organ prolapse (POP) is a protrusion of pelvic organ into or out of the vagina (ACOG). It ... more Pelvic organ prolapse (POP) is a protrusion of pelvic organ into or out of the vagina (ACOG). It has been on medical record for nearly 4000 years. Worldwide prevalence of POP is around 9% (Vas T et al 2012). It is higher in 3rd world countries estimated closer to 20% (Walker G.J and Gunasekara 2011). Only 30% of women seek medical attention because of embarrassing symptoms
Urinary incontinence is one of the common conditions experienced by women all over the world. Alt... more Urinary incontinence is one of the common conditions experienced by women all over the world. Although it is not considered a life-threatening situation, it could affect a woman’s physical, physiological, social, and reduce the quality of their life. Knowing about the disease and getting early treatment has a significant impact on improving the problem. Pelvic floor muscle training, known as conservative therapy, is the first-line treatment for women suffering from urinary incontinence. Therefore, this review aims to identify the understanding of pelvic floor muscle training among childbearing women. Online literature search, including PubMed, ScienceDirect, Medline, SpringerLink, and Scopus, was conducted using Google Scholar and IIUM databases. A total of 20 eligible articles were reviewed. The review revealed that despite most childbearing women being aware of pelvic floor muscle training, it does not influence them to practice it as a routine. Thus, this review will impact Malaysia’s healthcare professional to incorporate pelvic floor muscle training in antenatal class programs
AimsThe aims of this study were primarily to investigate the prevalence, severity and impact on d... more AimsThe aims of this study were primarily to investigate the prevalence, severity and impact on daily life of Lower Urinary Tract Symptoms (LUTS) in a clinical sample of stroke patients and secondly to identify factors associated with LUTS.Materials and MethodsThis was a cross‐sectional, hospital based survey whereby stroke patients were invited by letter to complete The Danish Prostatic Symptom Score (DAN‐PSS‐1) questionnaire at least 1 month following their stroke. Subjects were asked to report the frequency and severity of their symptoms (symptom score) and the impact of each symptom on their daily life (bother score) over the previous fortnight. Of 519 stroke patients invited, 482 subjects were eligible.ResultsThe response rate was 84%. The period prevalence of at least one symptom was 94%; the most frequent symptom was nocturia (76%) followed by urgency (70%) and daytime frequency (59%). The most severe symptom was urgency followed by nocturia and daytime frequency. Among respo...
Introduction Modified VMPP method had been conducted by using a novel biomechanical model of peri... more Introduction Modified VMPP method had been conducted by using a novel biomechanical model of perineum at New Technologies for Information Society, Pilsen, Czech Republic (NTIS). It evaluates the precise placement of the thumbs and index finger during tension of perineal tissue. The most effective modified VMPP method is initial position of fingers 12cm apart (x = + 6cm) on the x-axis, 2cm anteriorly from the posterior fourchette (y = + 2cm) on the y-axis. At the time of pushing till expulsion, the thumb and index finger were then moved 1cm toward midline on the x-axis. There was no movement on the y-axis. It was compared with hands-off delivery techniques. Stress distribution between modified VMPP method showed a wide variation in peak perineal tension from 72% to 102% compared with 100% for the hands-off technique
Introduction: Uterine rupture is a rare obstetrics catastrophic especially if it occurs during ea... more Introduction: Uterine rupture is a rare obstetrics catastrophic especially if it occurs during early pregnancy. We experienced three cases of ruptured uterus in the second trimester that first line doctors and obstetrician could learn lessons from. Objectives: To study the presentations and outcome of uterine rupture in the second trimester. Methodology: A retrospective review of uterine rupture in Hospital Tengku Ampuan Afzan from the 1st of April 2010 to the 1st of April 2011. Data obtained from case records, histopathological and autopsy reports. Result: There were 3 cases of uterine rupture. First case, uterine rupture at 15 weeks post sexual intercourse, undiagnosed until postmortem. Second case: ruptured uterus at 24 week diagnosed at laparotomy with the indication of failed medical termination for fetal anomaly. Third case: ruptured uterus at 21 weeks following abdominal massage with initial diagnosis of acute gastroentritis. The final diagnosis was ruptured uterus secondary ...
Dysmenorrhea is a common presentation in women of reproductive age in primary care. It can negati... more Dysmenorrhea is a common presentation in women of reproductive age in primary care. It can negatively affect the quality of life of a woman and restrict her daily activities. Endometriosis is the most common diagnosis for secondary dysmenorrhea. However, cutaneous endometriosis is an uncommon presentation of endometriosis. It requires a thorough history, physical examination and histological findings for definitive diagnosis. This paper reports an interesting case of a 47- year-old woman with primary cutaneous umbilical endometriosis and its management. Her final diagnosis was primary umbilical endometriosis with Stage 3 endometriosis based on the patient's history, clinical and surgical findings. The patient was discharged well on day three of operation and has been well since then with no signs of recurrence.
Pelvic organ prolapse (POP) is a protrusion of pelvic organ into or out of the vagina (ACOG). It ... more Pelvic organ prolapse (POP) is a protrusion of pelvic organ into or out of the vagina (ACOG). It has been on medical record for nearly 4000 years. Worldwide prevalence of POP is around 9% (Vas T et al 2012). It is higher in 3rd world countries estimated closer to 20% (Walker G.J and Gunasekara 2011). Only 30% of women seek medical attention because of embarrassing symptoms
Introduction/Objective: The risk of postpartum urinary retention (PUR) varies between 0.5% and 14... more Introduction/Objective: The risk of postpartum urinary retention (PUR) varies between 0.5% and 14.1% of deliveries. It is higher among the Asian population with prolonged first and second stage of labour, epidural analgesia and previous history of PUR. The objectives were to determine the local incidence of PUR and to evaluate the risk factors and the outcome of PUR. Methods: A cohort study on women who delivered at HTAA from 1st January to 30th December 2011. The subjects were consented women who were stable, not eclamptic, no severe postpartum haemorrhage or medical illnesses that require routine bladder catheterization. Post void residual urine volume (PVRV) was measuredminimum of 6 h post delivery or when subject complaint of inability to pass urine. They were then catagorised into three groups: normal (PVRV 150 mL) or covert (asymptomatic, PVRV > 150 mL). They were managed according to a standardised protocol till discharged. All subjects had a minimum of six months follow up or till the problem resolved. Results: There were 1000 women recruited. This preliminary result is on 414 women who had completed their follow up. The study subjects were mainly aged between 20 and 30 years (56.2%), Malay ethnic group (89.3%), obese (41.3%), low parity (80.9%) and had vaginal delivery (74.8%). There were two cases (0.48%) of overt and 13 cases (3.14%) of covert PUR. Majority of women (96.38%) had PVRV of <150 mL. There was no statistical different of PUR in relation to mode of delivery (P = 0.063), parity (P = 0.224), type of analgesic (P = 0.100), baby weight (P = 0.700) and time of voiding (P = 0.07) except for type of perineal wound (P = 0.01). Episiotomy causes significantly increased in PUR. Regarding covert PUR, 61.5% had urinary tract infection (UTI), 92.30% had an episiotomy wound and 69.23% resolved within 24 h. Both covert and overt PUR resolved spontaneously without complication. Conclusion: Risk of PUR was 3.62% which is compatible with others and had no serious complication. PUR was significantly associated with UTI and episiotomy.
Background: Urinary incontinence (UI) demonstrates major prevalence in women of different populat... more Background: Urinary incontinence (UI) demonstrates major prevalence in women of different population groups. Reduced quality of life (QOL) is observed due to incontinence problems. Urogenital Distress Inventory (UDI-6) and Incontinence Impact Quality of Life (IIQ-7) are useful disease-specific questionnaires evaluating the impact of urinary incontinence on the QOL of women which is accepted internationally. Objective: This study aims to translate and validate UDI-6 and IIQ-7 in Malay language. Methods: A cross sectional study, which recruited 100 participants from two urogynecology clinics. Both questionnaires were initially translated from English to Bahasa Malaysia followed by back translation and final correction done by the professional translators. The participants were requested to maintain a urinary record of the upcoming week for three days that assisted in quantifying the severity of symptoms. None of the subjects were assigned any treatment during the study period. Validity and reliability of the translated questionnaires were determined by checking the internal consistency and also by doing test-retest. Results: The internal consistency levels of the UDI-6 and IIQ-7 Bahasa Malaysia questionnaires were 0.73 and 0.90 respectively with good test-retest (0.86 and 0.95). Incontinence episodes were strongly associated with obstructive, irritative, and stress symptoms. The factor of day time voiding had strong correlation with obstructive and irritative symptoms. Conclusion: UDI-6 and IIQ-7 did not measure similar outcomes; however, both questionnaires have their strengths in clinical settings. Analysis has also revealed that the Malaysian versions of both questionnaires had appropriate test-retest validity and reliability. Thus, it can be said that both of the questionnaires had great importance for screening patients with urinary incontinence in Malaysia.
Objective: To assess the social-demographic characteristic and the maternal risk factors for pre ... more Objective: To assess the social-demographic characteristic and the maternal risk factors for pre eclampsia (PE) especially maternal fasting serum lipids (FSL) between trimesters. It was also to find out the association between FSL with fetal birth weight at a primary maternal child health center (KKIA). Materials and methods: A prospective cohort study was designed for recruiting pregnant women who were in their 1st trimester at KKIA at Jalan Gambut Kuantan Pahang. The study involved taking fasting serum lipids (FSL), blood pressure (BP) measuring and urine albumin in every trimester. The data was analyzed using (SPSS) version 17.0 and p value of < 0.05 was considered as statistically significant. Results: Triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and total cholesterol (TC) were increased as the gestational age increased. The mean of TC surged from 5 mmol/L in 1st trimester to 7.4 mmol/L in 3rd trimester (p0.05). Meanwhile serum triglyceride level was double (4.5mmol/L) in one patient who developed eclampsia at 25 weeks gestation. Conclusion: Serum lipid increase in parallel to increase in gestational age, however it does not influenced the maternal blood pressure and birth weight. .
Objectives: This study aims to identify knowledge, attitude, and practice of pelvic floor muscle ... more Objectives: This study aims to identify knowledge, attitude, and practice of pelvic floor muscle training (PFMT) and to identify the prevalence of urinary incontinence. Materials and methods: The method used was a cross-sectional study. Self-administered knowledge, attitude, and practice questionnaires were distributed among childbearing women attending Maternal & Child Health Clinics in the East Coast region of Malaysia. Results: The findings revealed that most respondents (N = 896) had good or moderate knowledge (80.1%) and attitudes (77.3%) regarding PFMT but most of them (87.2%) still lacked practice. However, there was no association between urinary incontinence and PFMT practice. On the contrary, married women showed a higher risk of urinary incontinence. Conclusions: The practice of pelvic floor muscle training should be recommended and emphasized to childbearing women by healthcare professionals.
Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to th... more Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to the marital institution around the world. The perineal injury may potentially be one of the main risk factors contributing to postpartum female sexual dysfunction (PPFSD). The study aimed to determine the effect of perineal injury and patients’ characteristics on PPFSD. Methodology: This cross-sectional questionnaire study was conducted in six different health clinics in the district of Kuantan from April 2019 to October 2019. Eligible women who came to the family health clinics at 6 months postpartum were recruited as study population. The participants completed their biodata and socio-demographic form and the Malay-validated Female Sexual Function Index (MVFSFI) questionnaire given. A cut-off point of 26.55 and below on MVFSFI scoring system was used as a measure of the primary outcome of sexual dysfunction. Results: Out of 240 women who delivered vaginally, 34 (14%) had intact perineum,...
The most common indications for vaginal (VH) hysterectomy in United State (Whiteman MK, 2018) are... more The most common indications for vaginal (VH) hysterectomy in United State (Whiteman MK, 2018) are symptomatic uterine leiomyomas (51.4%), abnormal uterine bleeding (41.7%), endometriosis (30%) and prolapse (18.2%). The American College of Obstetricians and Gynecologists (ACOG 2017) makes recommendations that VH is the approach of choice whenever feasible. The Cochrane systematic review on 47 studies concluded that VH has the best outcomes compare to abdominal and laparoscopic route. The vaginal approach is the natural route of excellence, which called “natural orifice hysterectomy” or “no scar hysterectomy” which seem to be the current trend for the minimally invasive context. VH is a long-practiced procedure since fourteen century (Berengario de Carpi, 1470–1550), which follow all the criteria of minimally invasive gynecology surgery. However, it is difficult to explain why vaginal hysterectomy, does not hold a preferential place among surgeons. Advantages of the vaginal route incl...
Pelvic organ prolapse (POP) is a protrusion of pelvic organ into or out of the vagina (ACOG). It ... more Pelvic organ prolapse (POP) is a protrusion of pelvic organ into or out of the vagina (ACOG). It has been on medical record for nearly 4000 years. Worldwide prevalence of POP is around 9% (Vas T et al 2012). It is higher in 3rd world countries estimated closer to 20% (Walker G.J and Gunasekara 2011). Only 30% of women seek medical attention because of embarrassing symptoms
Urinary incontinence is one of the common conditions experienced by women all over the world. Alt... more Urinary incontinence is one of the common conditions experienced by women all over the world. Although it is not considered a life-threatening situation, it could affect a woman’s physical, physiological, social, and reduce the quality of their life. Knowing about the disease and getting early treatment has a significant impact on improving the problem. Pelvic floor muscle training, known as conservative therapy, is the first-line treatment for women suffering from urinary incontinence. Therefore, this review aims to identify the understanding of pelvic floor muscle training among childbearing women. Online literature search, including PubMed, ScienceDirect, Medline, SpringerLink, and Scopus, was conducted using Google Scholar and IIUM databases. A total of 20 eligible articles were reviewed. The review revealed that despite most childbearing women being aware of pelvic floor muscle training, it does not influence them to practice it as a routine. Thus, this review will impact Malaysia’s healthcare professional to incorporate pelvic floor muscle training in antenatal class programs
AimsThe aims of this study were primarily to investigate the prevalence, severity and impact on d... more AimsThe aims of this study were primarily to investigate the prevalence, severity and impact on daily life of Lower Urinary Tract Symptoms (LUTS) in a clinical sample of stroke patients and secondly to identify factors associated with LUTS.Materials and MethodsThis was a cross‐sectional, hospital based survey whereby stroke patients were invited by letter to complete The Danish Prostatic Symptom Score (DAN‐PSS‐1) questionnaire at least 1 month following their stroke. Subjects were asked to report the frequency and severity of their symptoms (symptom score) and the impact of each symptom on their daily life (bother score) over the previous fortnight. Of 519 stroke patients invited, 482 subjects were eligible.ResultsThe response rate was 84%. The period prevalence of at least one symptom was 94%; the most frequent symptom was nocturia (76%) followed by urgency (70%) and daytime frequency (59%). The most severe symptom was urgency followed by nocturia and daytime frequency. Among respo...
Introduction Modified VMPP method had been conducted by using a novel biomechanical model of peri... more Introduction Modified VMPP method had been conducted by using a novel biomechanical model of perineum at New Technologies for Information Society, Pilsen, Czech Republic (NTIS). It evaluates the precise placement of the thumbs and index finger during tension of perineal tissue. The most effective modified VMPP method is initial position of fingers 12cm apart (x = + 6cm) on the x-axis, 2cm anteriorly from the posterior fourchette (y = + 2cm) on the y-axis. At the time of pushing till expulsion, the thumb and index finger were then moved 1cm toward midline on the x-axis. There was no movement on the y-axis. It was compared with hands-off delivery techniques. Stress distribution between modified VMPP method showed a wide variation in peak perineal tension from 72% to 102% compared with 100% for the hands-off technique
Introduction: Uterine rupture is a rare obstetrics catastrophic especially if it occurs during ea... more Introduction: Uterine rupture is a rare obstetrics catastrophic especially if it occurs during early pregnancy. We experienced three cases of ruptured uterus in the second trimester that first line doctors and obstetrician could learn lessons from. Objectives: To study the presentations and outcome of uterine rupture in the second trimester. Methodology: A retrospective review of uterine rupture in Hospital Tengku Ampuan Afzan from the 1st of April 2010 to the 1st of April 2011. Data obtained from case records, histopathological and autopsy reports. Result: There were 3 cases of uterine rupture. First case, uterine rupture at 15 weeks post sexual intercourse, undiagnosed until postmortem. Second case: ruptured uterus at 24 week diagnosed at laparotomy with the indication of failed medical termination for fetal anomaly. Third case: ruptured uterus at 21 weeks following abdominal massage with initial diagnosis of acute gastroentritis. The final diagnosis was ruptured uterus secondary ...
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