Accuracy of O-RADS System in Differentiating Between Benign and Malignant Adnexal Masses Assessed via External Validation by Inexperienced Gynecologists.

To evaluate the accuracy of the O-RADS system in differentiating between benign and malignant adnexal masses, as assessed by inexperienced gynecologists. Ten gynecologic residents attended a 20 h training course on the O-RADS system conducted by experienced examiners. Following the training, the residents performed ultrasound examinations on patients admitted with adnexal masses under supervision, recording the data in a database that included videos and still images.

Implementation of First-Trimester Screening and Prevention of Preeclampsia: A Stepped Wedge Cluster-Randomized Trial in Asia.

Background: This trial aimed to assess the efficacy, acceptability, and safety of a first-trimester screen-and-prevent strategy for preterm preeclampsia in Asia.

Methods: Between August 1, 2019, and February 28, 2022, this multicenter stepped wedge cluster randomized trial included maternity/diagnostic units from 10 regions in Asia. The trial started with a period where all recruiting centers provided routine antenatal care without study-related intervention.

Fetal hemodynamic changes and mitochondrial dysfunction in myocardium and brain tissues in response to anemia: a lesson from hemoglobin Bart's disease.

Objective: Whether or not the effects of anemia in the early phase, while the fetuses attempts to increase cardiac output to meet oxygen requirement in peripheral organs, is detrimental to the fetal developing vital organs is little-known. The objective of this is to compare prenatal cardiovascular changes and post-abortal cellular damages in the myocardium as a pumping organ and the brain as a perfused organ between anemic fetuses (using fetal Hb Bart's disease as a study model) in pre-hydropic phase and non-anemic fetuses.

Methods: Fetuses affected by Hb Bart's disease and non-anemic fetuses at 16-22 weeks were recruited to undergo comprehensive fetal echocardiography.

Maternal Visceral Fat in Prediction of Gestational Diabetes Mellitus.

To determine the diagnostic performance of maternal abdominal visceral adipose tissue thickness, measured by ultrasound, in predicting gestational diabetes mellitus (GDM). A prospective diagnostic study was conducted on low-risk pregnant women attending our antenatal care clinic. All underwent abdominal visceral adipose tissue (VAT) measurement by two-dimension transabdominal ultrasound twice, at late first trimester (gestational age: GA 11-14 weeks) and second trimester (GA 18-22 weeks).

Impacts of β-thalassemia/hemoglobin E disease on pregnancy outcomes.

Objective: To compare obstetric outcomes between women with β-thalassemia/hemoglobin E (β-thal/HbE) disease and those of low-risk pregnancies, and also between the two subgroups, β-thal/HbE and β-thal/HbE disease.

Methods: A retrospective cohort study was undertaken on pregnant women with β-thal/HbE disease and low-risk pregnancies, which were randomly selected with a case-to-control ratio of 1:10.

Results: Pregnancies with β-thal/HbE disease were identified in 0.

Reference-range of arterial stiffness by cardio-ankle vascular index in normal pregnancy.

Objective: To establish the arterial stiffness, represented by the cardio-ankle vascular index (CAVI) at various gestational ages among low-risk pregnant women. The second objective is to construct the reference range of mean arterial pressure and maternal heart rate during pregnancy.

Methods: This cross-sectional study was conducted on low risk pregnant Thai women, meeting the following inclusion criteria: 1) singleton pregnant women aged 18 years old or over; 2) gestational age between 11 and 40 weeks; 3) low-risk pregnancy without any underlying medical diseases; and 4) known final pregnancy outcomes.

Comparison of fetal and neonatal cardiac morphology between the infants of mothers with well-controlled gestational diabetes mellitus and normal controls.

Objective: To compare fetal and neonatal cardiac morphology in fetuses of mothers with gestational diabetes mellitus (GDM) with the controls.

Patients And Methods: Pregnant women at average risk of GDM underwent 100-g, 3-h-OGTT at 24-28 weeks of gestation for diagnosis of GDM. Both GDM group and the control group underwent fetal echocardiography at 32-36 weeks to assess cardiac dimensions.

Trends in the Prevalence of Diabetes Mellitus in Pregnancy during the Past Two Decades in Northern Thailand.

The prevalence of gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PDM) has increased dramatically in the past decade in all ethnic groups. The prevalence also varies markedly among different ethnic groups. Each ethnic group must have its own data about GDM/PDM for improvement in women's health care.

Performance of Serum Quad Test in Screening for Fetal Down Syndrome in a Large-Scale Unselected Population in a Developing Country.

To assess the effectiveness of Quad test in the detection of Down syndrome (DS) in routine practice among a large-scale population and to compare the effectiveness of Quad test based on the Western reference model (WM) and that based on Thai reference model (TM). Quad test was performed on 42,769 pregnancies at 14-21 weeks. The fetal risk of DS derived from Quad test was automatically computed based on WM and used in evaluating the effectiveness.

Placenta-Derived Extracellular Vesicles in Pregnancy Complications and Prospects on a Liquid Biopsy for Hemoglobin Bart's Disease.

Extracellular vesicles (EVs) are nano-scaled vesicles released from all cell types into extracellular fluids and specifically contain signature molecules of the original cells and tissues, including the placenta. Placenta-derived EVs can be detected in maternal circulation at as early as six weeks of gestation, and their release can be triggered by the oxygen level and glucose concentration. Placental-associated complications such as preeclampsia, fetal growth restriction, and gestational diabetes have alterations in placenta-derived EVs in maternal plasma, and this can be used as a liquid biopsy for the diagnosis, prediction, and monitoring of such pregnancy complications.

Convergent Validity of the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire (PHQ-9) in Pregnant and Postpartum Women: Their Construct Correlations with Functional Disability.

This study aimed to evaluate the convergent validity of the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) in Thai pregnant and postpartum women, using the 12-item WHO Disability Assessment Schedule (WHODAS) as the reference standard. Participants completed the EPDS, PHQ-9, and WHODAS during the third trimester of pregnancy (over 28 weeks in gestational age) and six weeks postpartum. The sample included 186 and 136 participants for the antenatal and postpartum data analyses, respectively.

Prenatal Diagnosis of Fetal Heart Failure.

Fetal heart failure (FHF) is a condition of inability of the fetal heart to deliver adequate blood flow for tissue perfusion in various organs, especially the brain, heart, liver and kidneys. FHF is associated with inadequate cardiac output, which is commonly encountered as the final outcome of several disorders and may lead to intrauterine fetal death or severe morbidity. Fetal echocardiography plays an important role in diagnosis of FHF as well as of the underlying causes.

Comparisons of Effectiveness in Differentiating Benign from Malignant Ovarian Masses between Conventional and Modified Risk of Malignancy Index (RMI).

Objective: To compare the predictive performance in differentiating benign from malignant ovarian masses between the modified risk malignancy index (RMI) and the conventional RMI (RMI-1 and RMI-2).

Methods: Women scheduled for elective surgery because of adnexal masses were recruited to undergo pelvic sonography within 24 h before surgery to assess the sonographic characteristics of the masses, focusing on loculi, solid part, ascites, bilateralness, papillary projection, and color flow mapping (CFM). Preoperative CA-125 levels were also measured.

Hydrops Fetalis Associated with Fetal Hemoglobin H-Pakse Disease.

Introduction: Hemoglobin H-Pakse (Hb H-PS) disease is a variant of non-deletional Hb H disease associated with various degrees of anemia. The disorder is rare but commonly seen in Southeast Asia. However, the prenatal course of Hb H-PS disease has never been published.

Serum oxytocin and corticotropin-releasing hormone levels in the third trimester of pregnancy for predicting postpartum depression in Thai women.

Purpose: This prospective observational study aimed to determine whether serum oxytocin (OT) or corticotrophin-releasing hormone (CRH) levels in the third trimester of pregnancy (or late pregnancy) could prospectively predict postpartum depression (PPD) at six weeks after childbirth.

Methods: We measured late pregnancy OT and CRH levels in Thai women, assessed depression using the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire-9 (PHQ-9), and collected mothers, labor, and newborn data. At six weeks postpartum, an EPDS score ≥ 11 or PHQ-9 score ≥ 10 was defined as the presence of PPD.

An Unruptured True Aneurysm of the Uterine Artery during Pregnancy.

The antenatal diagnosis of an unruptured true aneurysm of the uterine artery is extremely rare and has never been reported, whereas pseudoaneurysms associated with previous trauma or cesarean section have been reported several times. True aneurysms occur when the artery or vessel weakens and bulges, sometimes forming a blood-filled sac. Nearly all cases of pelvic true aneurysms involved ovarian arteries which ruptured during the peripartum period.

Fetal Cardiac Inflow Characteristics in Response to Fetal Anemia: Based on Fetal Hemoglobin Bart's Disease at Mid-Pregnancy.

Objectives: To identify the inflow (filling time fraction [FTF] and E/A ratio) characteristics of fetuses with anemia, and to evaluate the performance of the inflow markers in predicting the affected fetuses.

Methods: Fetuses at risk of hemoglobin (Hb) Bart's disease at 17-22 weeks were prospectively recruited to undergo echocardiography before diagnostic cordocentesis. Cardiac Doppler images were digitally stored for off-line blinded measurements of FTF and E/A ratio.

Prenatal Course and Sonographic Features of Congenital Mesoblastic Nephroma.

Congenital mesoblastic nephroma (CMN) is the most common renal tumor among fetuses and infants before the age of 6 months. It usually behaves as a benign tumor. The prenatal features and outcomes of pregnancies with fetal CMN have never been systematically reviewed and analyzed, whereas neonatal or pediatric series have been published several times.

Fetal Atrial Flutter Associated with Atrial Septal Aneurysm.

To provide evidence that fetal atrial flutter (AF) caused by atrial septal aneurysm (ASA) can be completely cured by delivery. Cases series of three fetuses with ASA complicated by AF in late gestation, including hydrops fetalis in one case, were collected and completely followed up. AF in all cases completely disappeared shortly after birth.

The Accelerated Right Ventricular Failure in Fetal Anemia in the Presence of Restrictive Foramen Ovale.

To describe serious hemodynamic changes secondary to anemia in the case of restrictive foramen ovale (FO). A 43-year-old pregnant woman, G4P0030, underwent fetal echocardiography at 35 weeks of gestation and was found to have (1) restrictive FO; (2) poor right ventricular function; (3) unbalanced hemodynamics; (4) fetal anemia (high MCA-PSV and hepatosplenomegaly). Acid-elution test indicated feto-maternal hemorrhage.

Association Between Gut Microbiota and Insulin Therapy in Women With Gestational Diabetes Mellitus.

Objectives: At the time of diagnosis, the blood glucose of women with gestational diabetes mellitus (GDM) who require subsequent insulin treatment does not differ from that of women with adequate diet control. Hence, in this study, we aimed to determine the role of maternal gut microbiota as a marker of insulin necessity in GDM and to identify the effect of insulin therapy on gut microbiota composition in mothers with GDM and their newborns.

Methods: Seventy-one pregnant women were enrolled into the study, including 38 GDM and 33 non-GDM participants.

Outcomes of pregnancies complicated by haemoglobin H-constant spring and deletional haemoglobin H disease: A retrospective cohort study.

The objective of the study was to compare the maternal and foetal outcomes of pregnancies complicated by Hb H-constant spring (HbH-CS) disease/deletional HbH (HbH-del) disease and low-risk pregnancies. A retrospective cohort research was undertaken on singleton pregnancies with Hb H-CS and Hb H-del diseases. The controls were randomly selected with a control-to-case ratio of 10:1.

Fetal heart rate tracing interpretation in cases of fetal heart block: A case series.

Simple assessment of FHR baseline variability can differentiate second-degree heart block (SHB) from complete heart block (CHB). In cases of SHB, antepartum NST can be reliably used for fetal surveillance. Intrapartum assessment of FHR variability and accelerations is useful to select cases for safe vaginal delivery.

Effectiveness of ultrasound algorithm in prenatal diagnosis of hemoglobin Bart's disease among pregnancies at risk.

Objective: To evaluate the effectiveness of ultrasound algorithm in diagnosis of fetal Hb Bart's disease among pregnancies at risk.

Methods: Pregnancies at risk underwent ultrasound for the first time at 12-14 weeks of gestation and serial ultrasound every 2-4 weeks until 24 weeks to identify pre-hydropic signs. The invasive procedure was omitted in case of no pre-hydropic signs.