UNIQUE: A significant breakthrough stemming from a research to prevent maternal and infant mortality has been made by a group of fresh medical graduates. The discovery is also said to be the first of its kind. Nuradilla Noorazam gives an insight into their research
A BREAKTHROUGH discovery on preventive medicine for hypertension among pregnant mothers recently could provide the answer to reducing the maternal mortality rate in the country.
The discovery was made by four final year medical students from Universiti Kebangsaan Malaysia (UKM) who have graduated as doctors in April this year.
Dr Noorfaizahtul Hanim Nawawi, Dr Lim Jing Fen, Dr Melissa Luqman and Dr Faizuddin Zolkeplai conducted a 22-month research on first-time mothers who conceived via In Vitro Fetrilisation (IVF).
The research showed that these first-time mothers have a lesser risk of developing hypertension than those who conceived normally.
Gestational hypertension or high-blood pressure in pregnant mothers occurs in the second half of pregnancy and without treatment, they develop a serious condition called preeclampsia.
Preeclampsia is a condition that limits the blood and oxygen flow from a mother's body to her child and can affect her kidney and brain.
Under the guidance of their lecturer and UKM's Deputy Dean of Medical Faculty, Prof Dr Zainul Rashid Mohamad Razi, the four students noticed that mothers who conceived via IVF were supplemented with a progestogen hormone called drygestrone in the first 16 weeks of pregnancy while those who conceived normally did not.
Prof Zainul said that progestogen hormone is a steroid hormone found involved in menstrual cycle, pregnancy and development of embryo to foetus in a woman's body.
"In medicine, progestogen is widely used in Assisted Reproductive Technology (ART), particularly IVF treatment to support the development of pregnancy."
The research concluded that mothers who were supplemented with dydrogestron had a much lesser risk of developing hypertension.
Prof Zainul said dydrogestron was used because it contained natural progesterone and does not have any side effect on a mother or her baby.
He added that the mortality rate among pregnant mothers in the country was 28 deaths out of every 10,000 pregnancies and Hypertensive Disorders in Pregnancy (HDP) accounted for 14.1% of the total mortality rate.
Regarded as the third highest cause for infant and maternal mortality rate in the country, hypertension occurred in between 10 and 15 per cent of pregnancies.
"Pregnant mothers who develop HDP will experience epilepsy and risk having premature births. Those with a high-risk of developing HDP include first-time mothers, obese women who weigh more than 80kg, those with diabetes, women who were pregnant after 35 years of age and those who have had multiple pregnancies or twins, and those who had conceived with a new partner or husband."
Dr Faizuddin said they did not expect to make such a discovery, but were very pleased to know that their research could be used to save many lives.
"We are still surprised over the discovery and will like to see the use of dydrogestron in preventing hypertension and reduce the mortality rate among pregnant women around the world."
The students are now hoping that their research can be published in the Royal College of Obstetricians and Gynaecologists (RCOG) journal, a highly acclaimed medical research journal in the United Kingdom.
Prof Zainul conducted a presentation to members of the press on the current treatment of pregnant women with hypertension. The treatment was only aimed to minimise the damage to mother and foetus by prolonging the pregnancy and allowing foetal maturity.
"The current treatment we have for hypertension does not cure the disease, in fact at times it can cause death to a mother and baby.
"That is why this study is very important because if we can reduce the risk of developing hypertension, there will be no need for further treatments and pregnancy complications later on."
A total of 226 pregnant mothers who participated in the research were divided into two groups namely the control group and study group.
The study group was given dydrogestrone supplement while the control group was not.
After compiling the data, they found that only two mothers who conceived via IVF developed hypertension while 15 who conceived normally developed the disease.
Two of the mothers in the study group weighed more than 98kg and were considered obese -- which led them to conclude that the medicine was not effective on overweight women.
For Prof Zainul, the fight to end maternal mortality does not stop after the significant success.
In fact, Zainul and his new breed of students are already in the midst of conducting a bigger, nationwide research on the use of dydrogestrone to eliminate the risk of hypertension for pregnant mothers.