How can we reduce neonatal sepsis after universal group B streptococcus screening?

Background: Group B Streptococcus (GBS) infection remains a leading cause of newborn morbidity and mortality. The study aimed to determine the adherence rate to the universal screening policy a decade after its introduction. Secondly, whether the timing of antibiotics given in GBS carriers reduces the incidence of neonatal sepsis.

A randomized controlled trial of auricular transcutaneous electrical nerve stimulation for managing posthysterectomy pain.

Background. A patient- and assessor-blinded randomized controlled trial was conducted to examine the effectiveness of auricular transcutaneous electrical nerve stimulation (TENS) in relieving posthysterectomy pain. Method.

Scan the fetal heart by real-time three-dimensional echocardiography with live xPlane imaging.

Objective: To describe the methodology of live xPlane imaging in the visualization of the fetal heart in detail.

Methods: Fifty-one consecutive pregnant women with singleton pregnancies were imaged to display four screening sections of the fetal heart, the four-chamber view, the left outflow tract view (LVOT), the right outflow tract view (RVOT), and the three-vessel and trachea view (3VT), using live xPlane imaging. The methodology of how to visualize the screening planes was described in detail.

Placental site in the second trimester of pregnancy and its association with subsequent obstetric outcome.

Objective: To determine if placental location in the second trimester of pregnancy is associated with adverse pregnancy outcomes.

Methods: We performed a retrospective study on 16 236 patients having ultrasound examination at 14 to 23 weeks of gestation between 2000 and 2007. The placental location was classified into one of four groups: 'central', 'fundal', 'lateral' and 'covering Os'.

Assessment of sonographer nuchal translucency measurement performance--central tendency and dispersion.

Objective: To assess center and sonographer nuchal translucency (NT) measurements that were performed as part of routine prenatal screening for Down syndrome.

Methods: Sonographers were assessed for measures of central tendency and dispersion by comparing them with expected population median and dispersion parameters. NT measurements were converted to multiples of the expected NT values according to CRL (NTMoM) and transformed to their log(10) equivalent (log(10) NTMoM).

The use of three-dimensional ultrasound does not improve training in fetal biometric measurements.

Objective: To investigate whether three-dimensional (3D) technology offers any advantage over two-dimensional (2D) ultrasound in fetal biometric measurement training.

Methods: Ten midwives with no hands-on experience in ultrasound were randomized to receive training on 2D or 3D ultrasound fetal biometry assessment. Midwives were taught how to obtain fetal biometric measurements (biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL)) by a trainer.

Nausea and vomiting in health-related quality of life among Chinese pregnant women.

Background: Nausea and vomiting in pregnancy (NVP) is the most common pregnancy complication affecting women during the first trimester of pregnancy. The cause of NVP remains unknown and factors associated with the occurrence of NVP are contradictory. There is currently little information on its effects of NVP in general and specifically in the Chinese population.

Massive subchorionic thrombohematoma: a series of 10 cases.

A retrospective audit identified 10 cases of massive idiopathic subchorionic thrombohematoma. The incidence was 1:3,133. Only six of these pregnancies resulted in a livebirth and only two reached term.

Outcome of induction of labour using maternal characteristics, ultrasound assessment and biochemical state of the cervix.

Objective: To assess pre-induction sonographic, digital examination and biochemical changes in the cervix to predict induction outcome.

Methods: Transvaginal and abdominal scans were performed in 460 women at 37-41 weeks of gestation to determine cervical length (CL), posterior cervical angle (PCA) and foetal occipital position. The Bishop Score (BS) and the absence/presence of phosphorylated form of insulin-like growth factor-binding protein-1 (phIGFBP-1) in cervical secretions were assessed.

Study on the applicability of frontomaxillary facial angle in the first-trimester trisomy 21 fetuses in Chinese population.

Objective: To evaluate the measurement of frontomaxillary facial (FMF) angle at 11 weeks to 13 weeks, 6 days in a Chinese population and its applicability in the screening for fetal trisomy 21.

Method: In a retrospective study, the stored images for the measurement of fetal nuchal translucency (NT) thickness in a Chinese population from August 2003 to March 2007 were reviewed for the comparison of the FMF angle between 22 trisomy 21 fetuses (study group) with 220 randomly selected normal fetuses with satisfactory images (control group).

Results: No association between FMF angle and NT, nasal bone length, or fetal heart rate was shown (P > 0.

Gastroschisis associated with an intra-abdominal umbilical vein varix: a report of 2 cases.

We describe 2 cases of gastroschisis which were found to be associated with an intra-abdominal umbilical vein varix.

First trimester measurements of nasal bone length using three-dimensional ultrasound.

Objectives: To investigate the feasibility and reproducibility of measurements of nasal bone length using a three-dimensional (3D) ultrasound in the first trimester.

Methods: In a prospective study, 118 consecutive pregnant women attending for Down syndrome screening at 11-13 + 6 weeks were recruited. They had successful fetal nasal bone measurement by two-dimensional (2D) ultrasound by four operators.

Ultrasound screening for fetal structural abnormalities performed by trained midwives in the second trimester in a low-risk population--an appraisal.

Objective: To determine the performance of trained midwives in second trimester ultrasound screening for fetal structural abnormalities in a low-risk population.

Design: Retrospective study.

Setting: University Department of Obstetrics and Gynecology.

First trimester combined screening for Trisomy 21 in Hong Kong: outcome of the first 10,000 cases.

Objective: To examine the effectiveness of first trimester fetal Trisomy 21 (T21) screening using a combination of maternal age, nuchal translucency, maternal serum levels of free beta-hCG and PAPP-A in a predominantly Chinese population in Hong Kong.

Methods: Consecutive women who underwent the combined screening for T21 between 11 and 13 + 6 weeks of gestation between 2003 and 2007 were recruited. Risk of T21 was calculated using Fetal Medicine Foundation algorithm and karyotyping was advised when the risk was 1:300 or above.

Fetal nasal bone status in Chinese women undergoing first-trimester screening for trisomy 21.

Objective: The objective of the study was to determine the likelihood ratio for trisomy 21 in Chinese fetuses with absent nasal bone (NB) at 11-14 weeks of gestation.

Study Design: The NB was classified as present or absent in 8101 chromosomally/phenotypically normal or trisomy 21 pregnancies. The effect of crown rump length (CRL), nuchal translucency (NT), maternal age, and fetal karyotype on the incidence of absent NB was examined using logistic regression.

Expectation and knowledge of pregnant women undergoing first and second trimester ultrasound examination in a Chinese population.

Objective: To evaluate expectation and knowledge on obstetric ultrasound examination in the first and second trimester in a Chinese population.

Method: A cross-sectional survey was conducted in a university obstetric clinic in Hong Kong. Chinese pregnant women who underwent the first trimester early scan sessions, or the second trimester anomaly scan sessions were invited to complete a self-administered questionnaire, which contained items on their knowledge, expectation, and sociodemographic characteristics.

Seasonal variation in pre-eclamptic rate and its association with the ambient temperature and humidity in early pregnancy.

Aims: To determine any relationship between ambient temperatures adjusted for humidity at conception and the occurrence of pre-eclampsia.

Methods: The subjects were singleton primiparae delivered in a Teaching Hospital between 1995 and 2002. We studied the odds of developing pre-eclampsia across months and investigated the association between the pre-eclamptic rates based on the months of conception and the mean monthly heat index.

Cervicovaginal fistula secondary to embedded fetal bones: a case report.

Background: Embedded fetal bone after surgical termination of midtrimester pregnancy is a recognized complication. Most cases occur in the uterine cavity; however, this case demonstrates that a cervicovaginal fistula can be caused by embedment of bone in the cervical canal.

Case: A 19-year-old girl presented with persistent smelly vaginal discharge 4 years after surgical pregnancy termination.

Fetal parvovirus B19 infection in a twin pregnancy with 1 twin presenting with hydrops fetalis and the other asymptomatic: a case report.

Background: Parvovirus B19 infection during pregnancy is a known cause of nonimmune hydrops, while about one third of maternal infection is asymptomatic. Spontaneous abortion, hydrops fetalis, intrauterine growth retardation and meconium peritonitis are possible manifestations of fetal infection, but the infection can also be asymptomatic.

Case: Both fetuses in a dichorionic, diamniotic twin pregnancy were infected with parvovirus B19 infection, but only 1 fetus presented with hydrops fetalis.

Ex utero intrapartum treatment (EXIT) for congenital giant ranula.

Unlabelled: Congenital giant ranula causing life-threatening upper airway obstruction is a rare condition. A well-planned ex utero intrapartum treatment (EXIT) procedure for aspiration and decompression of the cystic lesion is simple, efficacious and effective in securing a patent airway before the fetus is completely delivered, and may prevent lifelong neurodevelopmental complications associated with perinatal asphyxia in such cases.

Conclusion: EXIT could be a life-saving procedure for congenital giant ranula.

Dextrocardia in pregnancy: 20 years' experience.

Objective: To identify all pregnancies complicated by maternal dextrocardia and report the obstetric performance in these patients.

Study Design: A retrospective review of all deliveries between May 1984 and December 2004 at Prince of Wales Hospital, Chinese University of Hong Kong. Maternal demographic data as well as information on the antenatal course and delivery outcome were abstracted from the maternal records.

Risk factors for procedure-related fetal losses after mid-trimester genetic amniocentesis.

Background: The objective of this study was to determine the institutional pregnancy loss rate following second-trimester genetic amniocentesis and to ascertain whether factors exist which would identify pregnancies at increased risk of having a procedure-related fetal loss.

Setting: University Teaching Hospital

Methods: Details of the procedure and pregnancy outcome of all patients who had amniocentesis planned or performed between 15-22 gestational weeks between January 1997 and June 2004 were extracted from our clinical audit database. The procedure-related fetal loss rate, defined as all unintended abortions, stillbirths and neonatal deaths without major fetal abnormalities or obvious obstetric causes, was determined and compared to a presumed background fetal loss rate of 0.

The utility assessment of Chinese pregnant women towards the birth of a baby with Down syndrome compared to a procedure-related miscarriage.

Objective: This study was performed to investigate the preferences of Chinese pregnant women for Down syndrome-affected birth compared to invasive test-related miscarriage, using the standard gamble approach, and to investigate whether there is a difference in Utility Score between general obstetric patients and those who request prenatal screening.

Methods: An interviewer-administered survey was conducted on 67 women who presented to the General Obstetric Clinic for booking visits and 69 women who presented to the first-trimester Combined Screening Clinic for fetal Down syndrome in a University Obstetric Unit. Preferences for Down syndrome-affected birth compared to invasive test-related miscarriage were assessed using the standard gamble approach.

Higher median levels of free beta-hCG and PAPP-A in the first trimester of pregnancy in a Chinese ethnic group. Implication for first trimester combined screening for Down's syndrome in the Chinese population.

Objective: To study the effect of ethnic Chinese on the medians of free beta-hCG and PAPP-A in the first trimester of pregnancy.

Methods: The data of 943 women undergoing first trimester combined screening for fetal Down syndrome were analysed to derive the Chinese-specific medians. The calculated risk of Down syndrome based on these Chinese-specific medians was compared with that based on the original algorithm of the Fetal Medicine Foundation (FMF).

Expectation and knowledge of women undergoing first-trimester combined screening for Down syndrome in a Chinese population.

Objectives: To study the preference of pregnant women regarding the time taken to report the results of first-trimester combined screening for Down syndrome and their knowledge about it.

Methods: A questionnaire survey was conducted on a cohort of 325 pregnant participants who attended our first-trimester combined nuchal translucency and biochemical screening programme for fetal Down syndrome. This service was operated in a one-stop setting and the result of the screening test was available within 1 to 2 h after the collection of blood sample.