Background:Maternal red blood cell (RBC) alloimmunization may lead to production of harmful antibodies that result in hemolytic disease of fetus and newborn (HDFN). There is insufficient data on the prevalence of HDFN due to RBC alloantibodies in the Malay neonatal population.Aim:The aim of this study was to determine the incidence of HDFN in the Malay neonatal population due to clinically significant RBC alloantibodies.Subjects and Methods:A cross sectional study was conducted in Transfusion Medicine Unit, Hospital Universitiy Sains Malaysia over one year period from January to December 2009. A total of 5163 Malay pregnant women who attended labor room for delivery were collected and analyzed prospectively. The blood samples were subjected to the standard immunohematological procedure for RBC antibody screening and identification using reagents of Diamed-ID Gel microtyping system. All the newborns with RBC alloantibody were investigated for the evidence of HDFN.Results:Thirty (0.58%) women were found to have clinically significant RBC alloantibodies. Most of the alloantibodies belonged to Rhesus (Rh) system (56.7%) where anti-E (33.3%) was the most common followed by anti-D (10.0%). Rh antibodies were the main cause of HDFN in fourteen (0.27%) neonates. Anti-D and anti-c were identified to cause moderate to very severe HDFN.Conclusions:With the low prevalence of clinically significant RBC alloantibodies and HDFN, routine antenatal antibody screening practice may not be advised as a routine practice at present, preferably reserved for those women of RhD negative or with history of HDFN, significantly of those attributed to anti-c.

Background: First-time mothers may experience postnatal depression and a lack of social support, affecting their life satisfaction. However, there is a lack of studies investigating the application of guided antenatal education support programs to deal with such issues.Purpose: The study aimed to evaluate the effects of guided antenatal education support programs on postnatal depression, social support, and life satisfaction among first-time mothers.Methods: This quasi-experimental study involved a total of 72 first-time mothers. Convenience sampling was applied for participant selection, and no randomization was used. The participants were equally divided into the intervention group and the control group. A self-administrated questionnaire was used for data collection during the antenatal period (pretest) and six weeks postpartum (posttest). The risk of postnatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). In addition, the Multidimensional Scale of Perceived Social Support (MSPSS) and the Satisfaction with Life Scale (SWLS) were used to assess social support, and life satisfaction, respectively. The intervention group received a guided antenatal education support program, consisting of antenatal education sessions plus an extra 15-minute discussion and a support guidebook. The data were analyzed using a paired t-test and an independent t-test.Results: There was a significant reduction in the risk of postnatal depression score in the intervention group (p<0.05) after receiving the guided antenatal education compared to the control group. Also, there was a significant increment of life satisfaction score (p<0.05) and social support score (p<0.05) after receiving guided antenatal education in the intervention group.Conclusion: The guided antenatal education support is beneficial to reduce postnatal depression and increase life satisfaction and social support. Nurses and midwives should provide an integration of psychoeducation for first-time mothers, especially during pregnancy.

Introduction: Obstetric anal sphincter injury (OASIS) is an uncommon complication that may occur during vaginal delivery and increases the risk of pelvic floor dysfunction following delivery. This 10-year review is aimed to determine the occurrence of OASIS at a tertiary teaching hospital. Methods: A retrospective review of records of women who had their newborns delivered at Hospital Universiti Sains Malaysia between 2007-2016 was conducted. OASIS was classified according to the classification proposed by Sultan AH in 1999. Women who delivered on the same day with the index delivery but without OASIS acted as the control group (n = 154). Results: There were 61,049 vaginal deliveries over the ten years. A total of 154 women were recorded to have vaginal delivery complicated with OASIS, with a cumulative prevalence of 0.25% per year. Of these, 86% (n = 133) sustained a third-degree, and the remaining 14% (n = 21) had a fourth-degree perineal tear. Three independent risk factors for OASIS were identified using multivariable analysis: primiparity, greater gestational age, and higher infant birth weight. Conclusion: Nulliparous, primiparous, and a higher infant birth weight > 3500 g pose a higher possibility of developing OASIS during vaginal delivery among women who delivered at a tertiary teaching hospital on the east coast of Malaysia.