In total, 333 third trimester pregnant mothers, with age ranged between 17-45 years old had agreed to participate in this study. There are multiracial involvement amongst the respondents consisting of the Malays (n = 263, 79%), and non Malays; Chinese (n = 54, 16.2%), Indians (n = 8, 2,4%) and other races (n = 8, 2.4%). The National Statistics Department had revealed that Malaysia had a population of 25.7 million of which 24 million Malaysians (93.4%) and 1.7 million were non-Malaysians (6.6%). Among the non-Malays, Indians made up 1.8 million (7.5%), Chinese 6.1 million (25.4%), other races 300,000 (1.3%) [12
]. Therefore, the distribution of races in our study might not be exactly the same with the racial distribution in Malaysia, however it is similar in which most of Malaysians are Malays followed by Chinese, Indians and others.
82 pregnant mothers (24.6%) were clinically diagnosed to have CTS where 72 (87%) of them were Malays, and 10 (12%) were non-Malay which comprise of Chinese (n = 9, 11%) and Indians (n = 1, 2.4%). The correlation of the Malay race with CTS in this study was found to be significant (p = 0.024) and the risk for Malay pregnant mothers to get CTS was twice higher than the non-malays (OR = 2.26). Other variables such as gravida, parity, and age have no significant correlation with CTS.
The cases of bilateral CTS in pregnancy (n = 58, 63.4%) were almost two times more than the unilateral cases (n = 30, 36.6%). However, whether it is bilateral or unilateral CTS, there was no significant correlation with the severity of CTS (p = 0.284) or functional (p = 0.906). From the physical examination, 11% had affected 2 point discrimination and 8.5% had weakness of the abductor pollicis brevis muscle.
The most common presenting symptom from the CTS-6 was numbness and tingling during daytime (n = 63, 76.8%), followed by numbness and tingling at night, (n = 59, 72%), relief by shaking (n = 43, 52.4%), waking up due to numbness (n = 27, 32.9%), pain during day and night time (both n = 20, 24.4%), and the least common symptom was waking up due to pain (n = 14, 17.1%). Similarly, the most common complaint from the BCTQ symptom severity scale (Figure ) was also numbness (n = 76, 92.7%), where 45 (54.9%) had mild numbness, 27 (32.9%) moderate numbness and 4 (4.9%) had severe numbness. The other two common complaints were tingling sensation (n = 62, 75%) and numbness at night (n = 53, 64.6%). Even though pain was the least common complaint for CTS in pregnancy it was found that complains of any symptoms related to pain have significant correlation with severity (p = 0.00, OR = 12.23) and function (p = 0.005, OR = 5.01), whereas numbness and tingling did not (Severity, p = 0.843, function, p = 0.632). Among those who complained of pain, numbness or tingling at night, 13 (15.9%) woke up because of pain and 27 (32.9%) woke up because of numbness or tingling sensation. However, both complaint of waking up due to pain or waking up due to numbness had significant correlation with impaired function (p = 0.001, p = 0.000 respectively).
Symptoms severity by each complaints.
As a whole, summation of BCTQ-Symptoms severity scale (Figure ) revealed that, most of the CTS cases in third trimester pregnancy was mild (n = 13, 80.5%), 7 (17.1%) had moderate CTS and only 1 respondent (2.4%) had the severe form of CTS. Whereas, the BCTQ-Functional scores (Figure ) found that 28 (34.1%) of symptomatic pregnant mothers had functional difficulties, where 21 (25.6%) had mild and 7 (8.5%) had moderate functional difficulties. There were no respondents' scores higher than moderate functional score. The function from the BCTQ-functional score according to task is shown in Figure . The task that was commonly affected were carrying grocery bag (n = 18, 23%), followed by doing household chores (n = 17, 20.7%), gripping telephone (n = 15, 18.3%) and writing (n = 15, 18.3%), holding a book (n = 13, 15.9%), opening a jar (n = 12, 14.6%), buttoning clothes (n = 9, 14.6%) and bathing and dressing (n = 7, 9%).
Frequency of symptoms and functional severity according to group totals.
Functional severity by each task.
Despite all this, only 21 (25.6%) of the symptomatic pregnant mothers mentioned their problems to the doctor in which only 2 (9.5%) receive treatments, such as vitamins, painkillers, calcium supplements and advice to drink plenty of milk. There was a significant correlation between the number of pregnant mothers who mention their symptoms to the doctors with the severity (p = 0.013, OR = 4.08) and function (p = 0.041, OR = 2.84). In addition to that, it was also observed that none of the pregnant mothers knew about CTS except for those who work in the clinical health setting such as doctors and nurses. However no objective data were taken to support this. But this fact further strengthens the impression that CTS is still not well known to the community, not even to the high risk group of pregnant mothers.