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Biomedical subjects

Z A Mahdy

Publications and source records attributed to Z A Mahdy.

3 recordsLinked to original sources

Tocolysis in term breech external cephalic version.

OBJECTIVES: To study the effect of ritodrine tocolysis on the success of external cephalic version (ECV) and to assess the role of ECV in breech presentation at our centre. MATERIAL AND METHODS: A prospective randomized double-blind-controlled trial comparing ritodrine and placebo in ECV of singleton term breech pregnancy at a tertiary hospital. RESULTS: Among the 60 patients who were recruited, there was a success rate of 36.7%. Ritodrine tocolysis significantly improved the success rate of ECV (50% vs. 23%; P=0.032). There was a marked effect of ritodrine tocolysis on the ECV success in nulliparae (36.4% vs. 13.0%) and multiparae (87.5% vs. 57.1%). External cephalic version has shown to reduce the rate of cesarean section for breech presentation by 33.5% in our unit. CONCLUSION: External cephalic version significantly reduced the rate of cesarean section in breech presentation, and ritodrine tocolysis improved the success of ECV and should be offered to both nulliparous and parous women in the case of term breech presentation.

Adult↗

Risk factor screening for abnormal glucose tolerance in pregnancy.

OBJECTIVES: To assess the prevalence and association of frequently used screening risk factors for gestational diabetes mellitus (GDM) and to compare the validity and cost of universal screening with risk factor screening. METHOD: A cross-sectional survey of 768 pregnant women at > or = 24 weeks' gestation who were attending the antenatal clinic at the Hospital Universiti Kebangsaan Malaysia (HUKM) was made. Risk factors were determined using a questionnaire. An abnormal oral glucose tolerance test was defined as a 2-h post-prandial blood sugar level of > or = 7.8 mmol/l. RESULTS: A total of 191 pregnant mothers (24.9%) had GDM. The most commonly identified screening factors were positive family history of diabetes mellitus (31.4%), history of spontaneous abortion (17.8%), vaginal discharge and pruritus vulvae in current pregnancy (16.0%), and maternal age greater than 35 years (14.7%). Five hundred and thirteen mothers (66.8%) had at least one risk factor. All screening risk factors, except past history of diabetes mellitus in previous pregnancy and maternal age, were not significantly associated with abnormal glucose tolerance (GT). Risk factor screening gave a sensitivity of 72.2% and a specificity of 35.0%. Universal screening would cost RM 12.06 while traditional risk factor screening would cost RM 11.15 per identified case and will have missed 53 of the 191 cases. CONCLUSIONS: Risk factor screening scored poorly in predicting GDM. Cost analysis of universal compared with traditional risk factor screening showed a negligible difference. Thus universal screening appears to be the most reliable method of diagnosing GDM.

Adult↗

Superficial hand vein responses to NG-monomethyl-L-arginine in post-partum and non-pregnant women.

1. During human pregnancy marked vasodilatation occurs in arterial and venous vascular beds. The mechanisms responsible for this change remain unclear. The contribution of increased nitric oxide activity to vasodilatation associated with pregnancy was determined by examining superficial hand vein responses to NG-monomethyl-L-arginine, an inhibitor of nitric oxide synthase, in post-partum women 24-48 h after delivery when vasodilatation remains at levels present during the third trimester. 2. Seventeen healthy women, 24-48 h post partum, and 13 healthy non-pregnant women were studied. Eight of the post-partum women underwent repeat studies 12-16 weeks after delivery. 3. NG-monomethyl-L-arginine (100 nmol/min) resulted in venoconstriction in non-constricted veins (baseline, 0%; 5 min, 26 +/- 9%; 10 min, 14 +/- 8%; 15 min, 8 +/- 7%; means +/- SEM) and noradrenaline-constricted veins (5 min, 30 +/- 7%; 10 min, 24 +/- 10%; 15 min, 14 +/- 11%). No constrictor response to NG-monomethyl-L-arginine was present in the same women 12 weeks post partum (5 min, 1 +/- 4%; 10 min, 0 +/- 3%; 15 min, 1 +/- 4%) or in the non-pregnant control subjects in non-constricted (5 min, 2 +/- 3%; 10 min, 4 +/- 3%; 15 min, 2 +/- 2%) or noradrenaline-constricted veins (5 min, -2 +/- 7%; 10 min, 1 +/- 9%; 15 min, -5 +/- 7%). 4. These findings indicate that nitric oxide activity is increased in the immediate post-partum period in venous vasculature, and support the hypothesis that increased nitric oxide activity may be responsible for the vasodilatation observed during normal pregnancy.

Adult↗