Factors Influencing Malaysian Men's Perceptions of Gender Equity in Family Planning.

INTRODUCTION: Various factors influence men's perceptions regarding gender equity in family planning (FP). Identifying these factors can contribute to a deeper understanding of the roles that men play in family planning and ultimately leads to women's reproductive health outcomes. OBJECTIVES: This paper aims to investigate factors influencing Malaysian men's perceptions of gender equity in family planning. To achieve this, the effects of sociodemographic characteristics (age, education, and marital status), masculine traits, and attitudes towards domestic violence are investigated. METHODOLOGY: This is a cross-sectional study undertaken by administrating questionnaires to a sample of 168 men in Malaysia. The data are analyzed by applying partial least squares-structural equation modeling (PLS-SEM) and by using WarpPLS 6.0. RESULTS: The results confirmed the significant effects of masculine traits and attitudes supporting domestic violence on perceived gender equity in family planning. In other words, the results showed that men's masculine traits and attitudes supporting domestic violence negatively influenced gender equity in family planning. The hypothesized effects of sociodemographic characteristics on perceived gender equity in family planning could not be verified. CONCLUSIONS: This study suggests some practical implications for local authorities to implement interventions that take a gender transformative approach to reduce men's masculine traits and improve their attitudes towards domestic violence to enhance gender equity in family planning.

Premature rupture of membranes in nulliparas at term with unfavorable cervices: a double-blind randomized trial of prostaglandin and placebo.

OBJECTIVE: To determine whether the use of a prostaglandin (PG) E2 3-mg pessary followed by a delay of 12 hours before stimulation of labor with oxytocin improves obstetric outcome compared with the use of a placebo pessary. METHODS: One hundred fifty-five nulliparas at term with poor cervical scores (modified Bishop score below 6 of 10) and premature rupture of membranes (PROM) were recruited for this double-blind, placebo-controlled randomized trial. On admission to the study, either a PGE2 pessary or an identical-appearing placebo pessary was inserted into the posterior fornix. If labor did not start in the next 12 hours or if symptoms and signs of infection were evident, labor was induced with oxytocin infusion. Assignment was unblinded at the end of the study, and details of the labor and maternal and neonatal outcome in women who received a PG pessary were compared with those who received a placebo pessary. RESULTS: Women receiving a PG pessary were significantly less likely to require stimulation of labor at the end of 12 hours than were those given a placebo pessary (37 versus 58%, P = .002). The mean time between admission to study and delivery was significantly shorter in the PG group compared with the placebo group (15 versus 19 hours, P = .01). The rate of cesarean delivery was not statistically different in the two groups (13.9% with PG versus 15.8% with placebo). CONCLUSION: In nulliparas with poor cervical scores who present with PROM at term and no evidence of infection or obstetric complications, use of a PGE2 pessary resulted in more women establishing labor earlier, with a resultant reduction in the admission-to-delivery interval, compared with the use of a placebo pessary. The cesarean delivery rates in the two groups were similar, and there were no significant differences in neonatal outcome.

Genital Group B Streptococcus carriage in the antenatal period: its role in prom and preterm labour.

Of 326 high vaginal swabs taken during the antenatal period, Group B Streptococcus (GBS) was isolated from the birth canal in 46 women, giving a carrier rate of 14.1%, which is within the often quoted range of between 5% - 25% in different parts of the world. Carriage rates were similar at different gestations. In a subgroup of 34 women, 2 swabs taken at least 5 weeks apart yielded results which were discordant in over one fifth of the time. This knowledge of the natural history of GBS carriage questions the practice of treating asymptomatic carriers of GBS in the antenatal period to prevent transmission of GBS to the neonate. The group of women with positive swabs in the antenatal period did not have a significantly higher incidence of preterm labour and/or prelabour rupture of membranes (PROM) compared with the group of women with negative swabs. Routine screening of the antenatal population for GBS carrier status prior to 32 weeks gestation may not identify women at high risk of PROM or preterm labour.

Obstetric outcome of pregestational diabetic pregnancies.

This retrospective study examined the obstetric and neonatal outcome in 23 pregestational diabetic pregnancies. The incidence of congenital malformations and mortality in infants of diabetic mothers was increased compared to the control population. Late booking for antenatal care and poor glycaemia control are probably the reasons for this high incidence. There was also a significantly higher preterm delivery and Caesarean section rate in the pregnancies complicated by pregestational diabetes. The neonatal morbidity was also higher than the controls in terms of jaundice, hypoglycaemia, respiratory distress syndrome and admissions to neonatal intensive care unit. Only with preconception counselling and tight glycaemia control in the periconception period and throughout pregnancy can we expect a drop in the complication rates in pregestational diabetic pregnancies.

Prelabour rupture of membranes to delivery interval related to the incidence of maternal and neonatal infection.

OBJECTIVE: To assess the infectious morbidity associated with prelabour rupture of membranes (PROM) to delivery interval, and the incidence of maternal and neonatal infection in a population managed by either immediate stimulation or by overnight conservatism. METHOD: A retrospective study of 117 women admitted with PROM to the labour ward in the National University Hospital, Singapore, in the period between June 1990 and May 1991, and who were managed by immediate stimulation or by stimulation after overnight conservatism. Statistical analysis was performed using Chi-square and Student's t-test. RESULTS: More than one third of infants whose mothers had ruptured membranes for > 48 hrs had signs of neonatal infection, compared with an incidence of 8.8% and 8.9%, respectively for those with an interval of < 12 hrs and 12-24 hrs between PROM to delivery. Group B streptococcal infection was a major cause of neonatal infectious morbidity. Clinical evidence of maternal infection occurred in 3 of the 117 women; these patients had an interval between rupture of membranes and delivery of between 24-76 hrs. CONCLUSIONS: Prolongation of PROM to delivery interval for > 48 hrs increases the incidence of infection. Conservative policy of management of PROM at term should aim to deliver the babies < 48 hrs after PROM. The difference in maternal and neonatal infection rates were not significant in the group treated with a policy of overnight conservatism compared with the group in whom labour was stimulated immediately on admission.

A randomized controlled study of prostaglandin 15-methyl F2 alpha compared with syntometrine for prophylactic use in the third stage of labour.

A randomized controlled study of 112 women with singleton pregnancies at term, and no antenatal complications, admitted in spontaneous labour were randomized to receive either an intramuscular injection of 0.5 mg of Syntometrine or an intramuscular injection of 125 ug of prostaglandin 15-methyl F2 alpha at delivery of the anterior shoulder of the baby. Blood lost in the first 2 hours, and subsequent 22 hours postdelivery were collected separately and measured by colourimetric measurement of haemoglobin content. Other parameters in the third stage were measured, including need for transfusion of blood or blood products, length of the third stage, and change in haemoglobin concentration before and 24 hours after delivery. The incidence of side-effects with administration of either prostaglandin 15-methyl F2 alpha or Syntometrine were documented. The prophylactic use of intramuscular prostaglandin 15-methyl F2 alpha (Carboprost) in the active management of the third stage of labour gave similar results to prophylactic intramuscular Syntometrine in terms of length of the third stage of labour, incidence of postpartum haemorrhage and total blood loss in the first 2 hours and subsequent 22 hours after delivery. However it has the disadvantage of higher cost, as well as statistically significant increase in the incidence of profuse and frequent diarrhoea. Based on these results intramuscular injection of prostaglandin 15-methyl F2 alpha offers no advantage over intramuscular Syntometrine for routine prophylactic use to reduce blood loss in the third stage of labour.