Effect of ethnicity on first trimester biomarkers for combined trisomy 21 screening: results from a multicenter study in six Asian countries.

Objective: To assess differences between first trimester trisomy 21 screening markers free beta chain of the human chorionic gonadotrophin (βhCG) and pregnancy-associated plasma protein A (PAPP-A) in pregnant women of six different Asian countries (China, Indonesia, Korea, Taiwan, Thailand, and Vietnam) and compare serum levels with those in women of European countries.

Methods: Median and multiple of median (MoM) values of free βhCG and PAPP-A were determined in more than 3000 pregnant women from the Asian countries during their first trimester of pregnancy. Differences in MoM values between a European reference group from a previous multicenter evaluation and the Asian population were evaluated.

Magnesium sulfate maintenance infusion in women with preeclampsia: a randomized comparison between 2 gram per hour and 1 gram per hour.

Objective: To compare the percentages of pregnant women with preeclampsia who reached the therapeutic serum magnesium levels between those who received maintenance magnesium sulfate infusion of 2 g/hour versus I g/hour

Material And Method: Sixty women diagnosed of preeclampsia and magnesium sulfate that were considered for seizure prophylaxis were randomized into two groups. A loading dose of 5 g magnesium sulfate was given intravenously over 20 minutes to both groups. Maintenance doses of magnesium sulfate of 2 g/hour and 1 g/hour were given to the study and control groups, respectively.

Cystic malformation of lower female genital tract resulting in hydrops fetalis: a case report.

Genitourinary tract malformations causing hydrops fetalis are rare. The authors report a case of a female delivered at 32 weeks gestational age following a prenatal diagnosis of an abdominopelvic cystic mass with hydrops fetalis. The neonate was persistently hypoxic with unstable cardiovascular status and survived only 7 days.

Are the cardiac dimensions spared in growth-restricted fetuses resulting from uteroplacental insufficiency?

Aim: The aim of this study was to investigate the effect of intrauterine growth restriction (IUGR), specifically from uteroplacental insufficiency, on fetal cardiac dimensions.

Material And Methods: Cardiac circumference (CC) and cardiac area (CA) were measured in four-chamber view in 143 normal fetuses between 18 and 40 weeks of gestation. A study group comprised a homogeneous group of 49 IUGR fetuses with abnormal umbilical artery impedance.

Sensitivity and specificity of modified 100-g oral glucose tolerance tests for diagnosis of gestational diabetes mellitus.

Objective: To study the sensitivity and specificity of the modified 100-g oral glucose tolerance test for diagnosis of gestational diabetes mellitus (GDM).

Material And Method: Medical records of pregnant women attending the antenatal clinic of King Chulalongkorn Memorial Hospital, Thailand, who underwent a 100-g oral glucose tolerance test (OGTT) during March 2004 to September 2009, were retrospectively reviewed. Three modified criteria were proposed for diagnosis of GDM.

Fetal facial sonographic markers for second trimester Down syndrome screening in a Thai population.

Objective: To assess the efficacy of using facial sonographic markers for screening fetuses in the second trimester for Down syndrome (DS) in a high-risk Thai population.

Method: Frontomaxillary facial angle (FMF) and nasal bone length (NBL) were measured prospectively in pregnant women at high-risk for DS who were undergoing genetic amniocentesis from November 2008 to October 2009. The receiver operator characteristic (ROC) curves were constructed to assess the screening efficacy of FMF angle and NBL.

Placental cord drainage and the effect on the duration of third stage labour, a randomized controlled trial.

Objective: To assess the effect of placental cord drainage on the duration of third stage labor, and to clarify the safety of this method regarding to postpartum hemorrhage, retained placenta, incidence of manual removal of placenta, and the need for blood transfusion.

Design: Randomized controlled trial.

Setting: King Chulalongkorn Memorial Hospital.

Maternal periodontal disease and risk of preeclampsia: a case-control study.

Background: We examined whether pregnant women with periodontal disease have an increased risk of preeclampsia, and we empirically evaluated the extent to which associations between periodontal disease and preeclampsia are dependent upon diagnostic criteria used to define periodontal disease operationally.

Methods: One hundred and fifty preeclampsia cases and one-fifty normotensive controls who delivered a singleton infant at term were enrolled. Periodontal examinations were performed within 48 h after delivery.

Is maternal periodontal disease a risk factor for preterm delivery?

Several studies have suggested an association between maternal periodontal disease and preterm delivery, but this has not been a consistent finding. In 2006-2007, the authors examined the relation between maternal periodontal disease and preterm delivery among 467 pregnant Thai women who delivered a preterm singleton infant (<37 weeks' gestation) and 467 controls who delivered a singleton infant at term (> or =37 weeks' gestation). Periodontal examinations were performed within 48 hours after delivery.

Excursion index of the septum primum as a parameter for diastolic function assessment of Thai fetuses: at 32 to 35 weeks' gestation.

Objective: To establish the normal value of fetal diastolic function by the measurement of the excursion index of the septum primum (EISP) from 32 to 35 weeks' gestation in Thai fetuses.

Material And Method: Fetuses of normal Thai pregnant women were recruited for 2-dimensional echocardiographic measurements of the EISP (the ratio between the linear displacement of the flap valve and the left atrial diameter) from 32 to 35 weeks' gestation. All had a confirmed gestational age, normal structural scanning, and negative diabetic screening at 24 to 28 weeks' gestation.

Nasal bone hypoplasia in trisomy 21 at 15 to 24 weeks' gestation in A high risk Thai population.

Objective: To assess the utility of nasal bone hypoplasia in the detection of fetuses with trisomy 21 in the second trimester in a high risk Thai population.

Material And Method: A prospective study involving pregnant women undergoing amniocentesis due to increased risk of aneuploidy from January 2005 to December 2005. Fetal biometry and nasal bone measurements were obtained at the time of amniocentesis.

Interventricular septal thickness of Thai fetuses: at 32 to 35 weeks' gestation.

Objective: To establish the normal value of fetal InterVentricular Septal Thickness (IVST) from 32 to 35 weeks' gestation in Thai fetuses.

Material And Method: Thai pregnant women with normal fetuses were recruited for prenatal 2-dimensional M-mode echocardiographic measurements of fetal IVST at 32 to 35 weeks' gestation. All had a confirmed gestational age, normal structural scanning and negative diabetic screening at 24 to 28 weeks 'gestation.

The management of acardiac twins at King Chulalongkorn Memorial Hospital: case series.

Acardiac twin is a rare event with high perinatal mortality rate and the management strategies remain controversial. The authors report 4 cases of twin pregnancies associated with one acardiac twin diagnosed at King Chulalongkorn Memorial Hospital during the period 1993 to 2002. Two cases were expectantly managed and intrauterine interventions were performed in order to occlude umbilical artery of the acardiac twin in 2 cases, by using Guglielmi detachable coil (GDC) embolization and absolute alcohol injection.

Intrauterine therapy for fetal supraventricular tachycardia in a twin pregnancy.

A case of a twin pregnancy in which one fetus developed hydrops secondary to supraventricular tachycardia was detected at 21 weeks' gestation. Transplacental digoxin therapy successfully converted the supraventricular tachycardia to a normal sinus rhythm without evidence of maternal or fetal side-effects. The pregnancy proceeded to term and elective cesarean section was carried out at 37 weeks' gestation.

Predicting the risk of preeclampsia and small for gestational age infants by uterine artery Doppler in low-risk women.

The objective was to assess the value of uterine artery notching as a screening test for preeclampsia and fetal growth restriction in a low-risk population of healthy pregnant women. Color Doppler ultrasound was used to examine both uterine arteries in 322 healthy pregnant women at 24.9 +/- 1.

Serum beta-hCG regression after laparoscopic salpingostomy in the treatment of ectopic pregnancy in Thai women.

This is a descriptive study which reviewed the regression pattern of serum beta hCG in Thai women with ectopic pregnancy after laparoscopic salpingostomy. The study group included the medical records of 21 patients who underwent laparoscopic salpingostomy between January 1991 and August 2001. The results revealed that the regression of serum beta hCG in patients with ectopic pregnancy after laparoscopic salpingostomy was about 10, 100, 1,000 times at day 6, 20 and 35 after operation.

Value of humerus length shortening for prenatal detection of Down syndrome in a Thai population.

Objective: To assess the value of humerus length shortening for prenatal detection of Down syndrome in a Thai population.

Methods: A prospective study was performed on 3053 women undergoing second-trimester amniocentesis, between 16 and 24 weeks gestation, for the indications of advanced maternal age and a past history of chromosomal abnormality. Biparietal diameter (BPD) and humerus length measurements were obtained before the procedures.

Evaluation of a culture system for enrichment of CD34+ hematopoietic progenitor cells present in maternal blood.

Background: Clonogenic expansion of fetal cells in maternal blood is one approach to overcome the very low number of target cells available for prenatal genetic analysis. However, efficient methods of enrichment, culturing conditions and subsequent analysis of fetal cells are lacking. Optimization of this technique requires more detailed evaluation of the composition and distribution of fetal cells that cross the placenta into the maternal circulation.