Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.

Objective: To evaluate the efficacy of the quadruple test for potential use as a Thai national policy for Down syndrome (DS) screening and establish an accurate equation for risk estimation of Down syndrome based on gestational age, weight and the ethnic-specific reference range of our population.

Methods: A prospective study was conducted on singleton pregnancies at 14 to 21 weeks of gestation to evaluate the efficacy of quadruple DS screening using the automatically calculated Western European descent factor (WF) in our population and the impact of screening using a specific Thai ethnic factor as well as to establish an equation for the risk estimation of DS based on gestational age, weight and a local Thai ethnic factor to correct for the impact of ethnic factor on the screening efficacy.

Results: Of a total of 5,515 women, 12 cases of DS and 8 cases of other aneuploidies were found.

Calcium Consumption During Pregnancy: A Multicenter Study in a Middle-Income Country in Southeast Asia.

Objective: To perform a cross-sectional observational study of calcium consumption among pregnant women from multicenter tertiary care hospitals in the middle-income country in Southeast Asia.

Study Design: A cross-sectional observational study.

Setting: The study was conducted in four geographical regions (northern, northeastern, southern, and central) of Thailand.

Uterocervical angle measurement for preterm birth prediction in singleton pregnant women with no history of preterm birth and normal cervical length: A prospective cohort study.

Objective: To evaluate the ability of second trimester uterocervical angle (UCA) to predict spontaneous preterm birth (sPTB) in low-risk singleton pregnant women.

Study Design: Transvaginal sonographies were performed in the second trimester of 450 singleton pregnant women with no history of sPTB and no history of second trimester miscarriage with normal cervical length (CL) who attended antenatal care at Songklanagarind Hospital, a tertiary teaching hospital in southern Thailand. Gestational ages at delivery were recorded then the UCA values were evaluated according to sPTB occurrence.

Distribution of uterocervical angles in the second trimester of pregnant women at low risk for preterm delivery.

The uterocervical angle (UCA) has recently been studied as a parameter to identify women at risk for spontaneous preterm birth (sPTB). This study aimed to investigate the distribution of UCA values by transvaginal sonography (TVS) in the second trimester of women at low risk for sPTB. TVS was performed in 450 low-risk pregnant women at gestational age (GA) 16-24weeks.

Comparison of reliability between uterocervical angle and cervical length measurements by various experienced operators using transvaginal ultrasound.

To compare the reliability between uterocervical angle (UCA) and cervical length (CL) measurements by various experienced operators. Transvaginal ultrasonographies (TVS) were performed in 102 pregnant women between 16°-24° gestational weeks by different levels of experienced operators. For both CL and UCA measurements, intraobserver variability was assessed for each operator by examining the range between maximum and minimum measurements in each participant, compared to the mean of all three measurements.

Comparison of transabdominal and transvaginal sonography in the diagnosis of placenta previa.

Purpose: To compare the accuracies of transabdominal sonography (TAS) and transvaginal sonography (TVS) in the diagnosis of placenta previa.

Methods: A prospective, cross-sectional study was conducted at a university hospital. Both TAS and TVS were performed on 81 pregnant women with a suspicion of placenta previa in the third trimester.

Time Interval Measurements of the Ductus Venosus During the Early Second Trimester of Pregnancy: Reference Ranges and Clinical Application.

Objectives: The aims of this study were to construct reference ranges for the time interval parameters of the ductus venosus during the early second trimester of pregnancy and to demonstrate the clinical utility in various fetal disorders.

Methods: The ductus venosus Doppler measurements of 331 healthy fetuses between 15 and 22 weeks' gestation were analyzed. The systolic time and diastolic time were subdivided into the systolic acceleration time, systolic deceleration time, diastolic acceleration time, and diastolic deceleration time.

Normative weight-adjusted models for the median levels of first trimester serum biomarkers for trisomy 21 screening in a specific ethnicity.

Objective: To establish normative weight-adjusted models for the median levels of first trimester serum biomarkers for trisomy 21 screening in southern Thai women, and to compare these reference levels with Caucasian-specific and northern Thai models.

Methods: A cross-sectional study was conducted in 1,150 normal singleton pregnancy women to determine serum pregnancy-associated plasma protein-A (PAPP-A) and free β-human chorionic gonadotropin (β-hCG) concentrations in women from southern Thailand. The predicted median values were compared with published equations for Caucasians and northern Thai women.

Agreement of three interpretation systems of intrapartum foetal heart rate monitoring by different levels of physicians.

A prospective study was conducted in centre in Southern Thailand, to evaluate agreement in EFM interpretation among various physicians in order to find out the most practical system for daily use. We found strong agreement of very normal FHR tracings among the FIGO, NICHD 3-tier and 5-tier systems. The NICHD 3-tier was more compatible with the FIGO system than 5-tier system.

Complete hydatidiform mole with co-existing fetus: Predictors of live birth.

Multiple gestation consisting of complete hydatidiform mole with co-existing fetus (CHMCF) is unusual. From our institution, we reported two cases with unfavorable obstetric consequences. The recommendation for antenatal management is still not distinctly determined.

Music Listening to Decrease Pain during Second Trimester Genetic Amniocentesis: A Randomized Trial.

Objective: To evaluate whether music listening decreased pain perception during second trimester genetic amniocentesis.

Material And Method: We conducted a prospective randomized study to compare the pain perception using a visual analogue scale (VAS), pain rating, future decision to repeat the procedure, and pain perception compared to a venipuncture before and after the second trimester genetic amniocentesis between groups of pregnant women who underwent amniocentesis with and without music listening.

Results: Three hundred thirty two pregnant women were enrolled; 161 listened and 171 did not listen to the music.

A population-based study of prevalence of Down syndrome in Southern Thailand.

Background: Down syndrome (DS) is the most common chromosomal disorder that causes mental retardation. In 2009, a population-based birth defects study was implemented in three provinces in southern Thailand. This study aimed to determine the prevalence of DS in the studied regions, and the proportion of DS fetuses detected by prenatal screening.

Accuracy of Ultrasonography Performed by Thai Maternal Fetal Medicine Fellowship at Songklanagarind Hospital for Fetal Sex Determination during Second Trimester Genetic Amniocentesis.

Objective: To evaluate the accuracy of fetal sex determination using ultrasonography performed by Thai Maternal Fetal Medicine fellowships during second trimester genetic amniocentesis and also identify the possible factors of inaccurate determination.

Material And Method: A prospective non-random study was conducted to evaluate the accuracy of fetal sex determination using ultrasonography performed by Thai Maternal Fetal Medicine fellows at Songklanagarind Hospital during second trimester genetic amniocentesis and also identify the possible factors of inaccurate determination.

Results: Five hundred and sixty singleton pregnant women were enrolled.

Subsequent gestational diabetes mellitus prediction in advanced maternal age using amniotic fluid glucose concentration during second trimester genetic amniocentesis.

This prospective study aimed to present the reference range of amniotic fluid glucose (AFglu) among second trimester pregnant women in southern Thailand, to evaluate the possibility of predicting subsequent gestational diabetes mellitus (GDM) using AFglu, and to estimate AFglu cut-off levels for identifying pregnancies at high or low risk for subsequent GDM in singleton pregnancies undergoing genetic amniocentesis due to advanced maternal age. A total of 438 eligible pregnant women were analysed, among whom 58 were subsequently diagnosed as having GDM. The reference range that included the central 95% of AFglu values at 16, 17 and 18 weeks of gestation in women not subsequently developing GDM was determined from a linear regression model.

Ductus venosus blood flow velocity waveforms during the early second trimester of pregnancy in a Thai population.

Objective: To establish reference ranges for ductus venosus (DV) blood flow velocities and indices during the early second trimester.

Methods: A cross-sectional DV Doppler study of fetuses at 15-22 weeks of gestation was conducted at Songklanagarind Hospital, Songkhla, Thailand, during 2013-2014. The peak forward velocities were recorded and the DV indices were calculated.

Reducing Pain and Anxiety during Second Trimester Genetic Amniocentesis Using Aromatic Therapy: A Randomized Trial.

Objective: To evaluate the benefit of aromatic therapy using menthol for decrease pain perception during amniocentesis.

Material And Method: A prospective randomized study was conducted to compare pain level between groups ofpregnant women who underwent amniocentesis with and without aromatic therapy using menthol. Visual analogue scale (VAS) was usedfor pain assessment.

A reference for ductus venosus blood flow at 11-13+6 weeks of gestation.

Objective: To establish reference ranges for ductus venosus (DV) blood flow assessment obtained transabdominally at 11-13(+6) weeks of gestation.

Methods: A cross-sectional study was conducted on singleton pregnancies with a crown-rump length (CRL) ranging from 45 to 84 mm, normal fetus, and subsequent newborn birth weight appropriate for gestational age. Measurements of DV Doppler variables were performed by experienced sonographers: peak velocity during ventricular systole (S-wave) and diastole (D-wave), nadir during atrial contraction (A-wave), time-averaged maximum velocity (TAmax), pulsatility index for veins (PIV), and peak velocity index for veins (PVIV).

Prevalence of neural tube defect in southern Thailand: a population-based survey during 2009-2012.

Background: Neural tube defects (NTDs) are a group of congenital malformation of the central nervous system that leads to permanent physical disability and requires lifelong treatment. In Thailand, there have been three published articles on NTDs, all hospital-based studies, which found prevalence of NTDs of 4.8-6.

Comparison of the effectiveness of different counseling methods before second trimester genetic amniocentesis in Thailand.

Objective: The objective of this study is to compare the effectiveness of counseling methods before second trimester genetic amniocentesis.

Study Design: The design of this study is a randomized controlled study comparing the improvement in patients' knowledge satisfaction anxiety and perceived pain between computer-assisted instruction (CAI) and leaflet self-reading (LSR) and subsequent individual counseling among pregnant women scheduled for second trimester genetic amniocentesis in a developing country.

Results: There were 164 and 157 participants in the LSR and CAI groups, respectively.

The knowledge and attitudes of Thai obstetrics and gynaecology residents towards Down syndrome screening.

Objective: To survey the knowledge and attitudes towards Down syndrome screening in the final year of training of Thai obstetrics and gynaecology residents.

Material And Method: A self-administered structured questionnaire of knowledge and attitudes towards Down syndrome screening was developed One hundred thirty six residents were asked to respond to the questionnaire on their last day of the Thai board examination in the year 2006 and 2007. The data was analyzed using SPSS for windows version 15.

Pregnancy outcomes amongst thalassemia traits.

Objective: To compare the pregnancy outcome between pregnancies affected and not affected by thalassemia trait.

Methods: A retrospective case-control cohort study was conducted on singleton pregnant women who attended antenatal care and delivered at Songklanagarind Hospital. All of the participating thalassemia trait pregnant women were diagnosed based on hemoglobin typing and/or DNA analysis.

Effectiveness of the model for prenatal control of severe thalassemia.

Objective: The aim of the research was to determine effectiveness of the model for prenatal control in reducing new cases of severe thalassemia.

Methods: Pregnant women at six tertiary centers were recruited to follow the model, consisting of (1) carrier screening using mean corpuscular volume (for alpha-thal-1 and beta-thal) and CMU-E screen (for HbE trait), (2) carrier diagnosis, (3) the couples at risk were counseled and offered prenatal diagnosis, and (4) termination of affected pregnancy. All neonates were evaluated for thalassemia.

Reliability of manual and semi-automated measurements of nuchal translucency by experienced operators.

Objective: To compare intra-/inter-operator reliability of manual and semi-automated NT measurement by experienced operators.

Methods: Images of 103 fetuses at 11 to 13+6weeks were selected. Two operators performed NT measurement independently 3 times each using both manual and semi-automated methods.