Publications by authors named "Angel H W Kwan"
Objective: To determine the correlation, precision, mean percentage difference and agreement between cardiac indices (stroke volume [SV], cardiac output [CO], SV index [SVI], and cardiac index [CI]) measured by noninvasive cardiac output monitor (NICOM, Cheetah Medical, Boston, MA, USA) and 2-dimensional transthoracic echocardiography (2D-TTE) across gestations in Chinese pregnant women.
Methods: This was a prospective longitudinal study performed in women with singleton pregnancy at 11-14 ( = 152), 19-24 ( = 152), 30-34 ( = 141), and 35-37 ( = 103). Cardiac indices, including CO and SV, were obtained by NICOM, which uses thoracic bioreactance, and 2D-TTE.
Cell-free DNA test for fetal chromosomal abnormalities in multiple pregnancies.
Acta Obstet Gynecol Scand
September 2024
Article Synopsis
- The study assessed the effectiveness of cell-free DNA (cfDNA) testing for detecting chromosomal abnormalities in multiple pregnancies, specifically twins, triplets, and cases of vanishing twins.
- Data from 292 pregnancies showed that cfDNA testing was particularly effective for trisomy 21, with a 100% confirmation rate and a 0% false positive rate in twin pregnancies.
- The research concluded that while cfDNA testing is reliable for assessing trisomy 21 in twin pregnancies, its ability to detect other chromosomal abnormalities is limited due to the small number of cases.
Objectives: To investigate the association and the potential value of prelabour fetal heart rate short-term variability (STV) determined by computerised cardiotocography (cCTG) and maternal and fetal Doppler in predicting labour outcomes.
Design: Prospective cohort study.
Setting: The Prince of Wales Hospital, a tertiary maternity unit, in Hong Kong SAR.
Article Synopsis
- Heterozygous variants in the PKD1 gene are linked to adult-onset polycystic kidney disease (ADPKD), while biallelic hypomorphic variants can cause early-onset disease.
- A Chinese family with recurrent fetal polycystic kidneys showed no issues with the PKHD1 gene and revealed two uncertain variants in PKD1 during genetic analysis of an affected fetus.
- The study confirms that these hypomorphic variants are associated with prenatal onset polycystic kidney disease and emphasizes their significance for understanding genetic conditions and aiding reproductive counseling.
Article Synopsis
- The study evaluated how genome-wide cfDNA testing for chromosomal abnormalities performed differently when additional findings were reported versus when they were not, using data from pregnant women between 2015-2019.
- It included 3981 women and found that while the concordance rates for trisomy 21 and 18 were both 100%, there were significant discrepancies in other categories, such as trisomy 13 and sex chromosome aneuploidy.
- The results showed that not reporting extra findings led to a lower false-positive rate (0.17%) compared to reporting them (0.93%), although there was no change in the no-result rates between the two periods.
Background: Various manoeuvres such as McRoberts position, suprapubic pressure, rotational methods, posterior arm extraction and all-four position (HELPERR) have been proposed for relieving shoulder dystocia with variable success. Posterior axillary sling method using a rubber catheter was proposed in 2009 but has not been widely used. We modified this method using ribbon gauzes and a long right-angle forceps and report a successful case.
View Article and Find Full Text PDFUmbilical cord prolapse is an unpredictable obstetrical emergency with an incidence ranging from 1 to 6 per 1000 pregnancies. It is associated with high perinatal mortality, ranging from 23% to 27% in low-income countries to 6% to 10% in high-income countries. In this review, we specifically addressed 3 issues.
View Article and Find Full Text PDFObjectives: To evaluate the feasibility, reliability, and agreement of serial transperineal ultrasound (TPU) assessment of fetal head station (parasagittal angle of progression [psAOP], head-perineum distance [HPD], and head-symphysis distance [HSD]) and sonographic cervical dilatation (SCD), compared to fetal head station and cervical dilatation determined by vaginal examination, respectively.
Methods: This was a prospective longitudinal study in singleton pregnancies undergoing induction of labor at term. Paired assessment of fetal head station and cervical dilatation by vaginal examination, with TPU assessment of psAOP, HPD, HSD, and SCD was made serially.
Objectives: To investigate (i) the association between pre-labor maternal-fetal Dopplers and fetal heart rate short-term variability (FHR STV) with arterial cord blood pH and (ii) the potential value of pre-labor maternal-fetal Dopplers, FHR STV and Dawes-Redman criteria in predicting composite neonatal morbidity at term in a cohort of unselected women.
Method: A prospective study in 218 women with term singleton pregnancy in latent phase of labor or due to undergo induction of labor. Data on maternal characteristics, maternal-fetal Dopplers indices and computerized cardiotocography (CTG) findings of FHR STV and Dawes-Redman criteria were collected.
We describe a case of a 24-year-old overweight woman who presented with hirsutism, secondary amenorrhea, clitoromegaly, and symptoms of diabetes mellitus (DM). While a diagnosis of polycystic ovary syndrome (PCOS) with its associated metabolic disturbances was initially considered, serum total testosterone, androstenedione, and 17-hydroxyprogesterone (17-OHP) measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) were significantly increased. As 17-OHP did not increase upon ACTH (Synacthen) stimulation and the urinary steroid profile (USP) was compatible with an ovarian source of 17-OHP excess rather than adrenal, non classical congenital adrenal hyperplasia (NCCAH) was unlikely and an androgen-secreting tumor was suspected.
View Article and Find Full Text PDFBackground: The diagnosis of labor dystocia generally is determined by the deviation of labor progress, which is assessed by the use of a partogram. Recently, intrapartum transperineal ultrasound for the assessment of fetal head descent has been introduced to assess labor progress in the first stage of labor in a more objective and noninvasive way.
Objective: The objective of the study was to determine the differences in labor progress by the use of serial transperineal ultrasound assessment of fetal head descent between women having vaginal and cesarean delivery.
Objective: To examine (1) the concordance of manual and automated para-symphyseal angle of progression (psAOP) measurements, (2) the repeatability of psAOP, head-symphysis distance, head-perineum distance, and sonographic cervical dilatation, and (3) the value of transperineal ultrasound (TPU) in predicting induction of labor (IOL) outcome.
Methods: We performed a prospective study in 308 women with singleton pregnancies undergoing IOL at term. Logistic regression analysis was used to determine which maternal factors, Bishop score, method of IOL, and TPU parameters were significant predictors of cesarean section (CS) and CS due to no progress (CS-NP).