Development of nomogram for Malaysian pregnant women
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Date
2009-12
Authors
Ramli, Ramzun Maizan Binti
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Abstract
In this retrospective study, nomograms were developed for Malaysian pregnant women
of singleton pregnancy with minor studies done for twin gestations. A number of 11052
Malaysian pregnant women were involved with 10935 women were singleton and 117 women
were multiple pregnancies. The data collection was done at the Maternity Unit, Hospital Pulau
Pinang. Analyses of data were performed using SPSS software version 11.5. The ANC (except
Hb) and ultrasound (except AFI) parameters were grossly increased throughout the pregnancies.
Highly R! values were noticed for generated models. Greater growth rate of BPD, HC, AC and
FL for second trimester were noticed compared to third trimester but opposite result was found
for EFW. Decrease of AFI values is seen after 28 weeks of GA towards the end of pregnancy.
More factors were seen affecting the ANC values (ethnic, working status, gravida, delivery
method, Apgar score, BL, PW, BW, LB and HCB) but less for ultrasound parameters (affected
only to PW, BW, LB and HCB). The blood groups of the women show no effect for all
parameters in ANC and ultrasound. Diseases such as diabetes mellitus and heart disease were
noticed to have significant impact on ANC and ultrasound parameters during pregnancy.
Comparisons of ultrasound parameters in this study with various studies show more significant
difference results (106 studies; 68.83%) except for CRL. This suggests that every population
should use their own ultrasound biometry assessment except in the first trimester. In this study, as
for twin cases, higher ANC (except Hb), BL, PW; pulse and BP after delivery values were shown
but with lower ultrasound parameters, BW, LB, HCB and TSH were noticed compared to
singleton pregnancies. Most of the parameters studied also show significant differences between
twin and singleton pregnancies. Findings from this study will help the medical practitioner in this
country to predict the outcome of pregnancy earlier thus improving the foetus and mother health
during pregnancy.
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Keywords
Nomogram , Malaysian pregnant women