Charts of Thai fetal biometries: 3. Femur length.

A cross-sectional study was conducted in order to construct a new reference chart for Thai fetal femur length (FL). A total of 621 normal pregnant women between 12-41 weeks of gestation and their fetuses were enrolled. Measurements were made once at a randomly assigned gestational age specifically for the purpose of this study only. Femur length data were available in 608 measurements due to unfavorable fetal position in some cases. Linear regression technique was used to model separately the mean and standard deviation as functions of gestational age. Reference centiles were constructed from a combination of both models, assuming the data were normally distributed. A new reference centiles chart for FL is presented and compared with previously published data. While our derived centiles were clearly lower than those from Western studies, they were found comparable with those from a Thai study. This demonstrated the important effect of racial differences between populations on fetal biometries and elucidates the need to develop fetal biometries charts specifically for each region.

Percutaneous umbilical cord blood sampling.

Percutaneous umbilical cord blood sampling is a newer, safer, and more convenient technique and can be performed in the second and third trimester of pregnancy by direct puncture of the umbilical vein near its placental insertion, using a needle guided by ultrasound. Between 2-4 ml of pure fetal blood were obtained from 10 pregnancies at between 19 and 39 weeks' gestation. This new procedure offers access to the fetal circulation for diagnosis and therapeutic purposes.

Outcome of pregnancy after threatened abortion.

In a prospective study of 203 pregnancies complicated by threatened abortion, obstetrical and neonatal data were analysed for pregnancy outcome. Comparison was made with a selected group of 496 non-risk pregnancies. There was a high incidence of pre-term birth, low birth weight infants and antepartum haemorrhage. The incidences of perinatal mortality and congenital malformations did not differ significantly from those of the control group. These findings suggest that early gestational virginal bleeding is one predictor of suboptimal pregnancy outcome.

Amniocentesis guided by ultrasound.

Abdominal amniocentesis was performed on 252 pregnant women at Siriraj Hospital during the period from August 1984 to July 1985, 227 cases for fetal lung maturity and 25 cases for genetic study in second trimester. Failure to obtain amniotic fluid encountered in 11 cases (4.36 percent) was directly associated with placental site, fetal position, amount of amniotic fluid and some technical error. Among the complication occurred in 4 cases (1.76 percent).There were premature rupture of membranes, chorioamnionitis, fetal trauma and one case of abortion in second trimester amniocentesis for chromosome study. The results of this study show that failure rate, bloody taped amniotic taped amniotic fluid and major complication can be reduced by using ultrasound guidance.

Chromosome study of partial hydatidiform mole: A case report.

A case of partial hydatidiform mole was admitted with hyperemesis gravidarum, human chorionic gonadotrophine was at high level. Ultrasonographic study showed the empty gestational sac with enlarged placenta which had cystic change in some area. The histologic study showed only hydatidiform mole but chromosome study confirmed classical partial hydatidiform mole which had a triploid (69 XXY) constitution. The clinical findings, ultrasound study and HCG level can emphasize this condition. Histologic and genetic study will confirm the diagnosis.

Partial hydatidiform mole: Report of 1 case.

A case of partial hydatidiform mole admitted with pre-eclampsia delivery of a living baby at 34 weeks was reported. Ultrasonographic study showed foetus with intrauterine growth retardation and cystic change of the placenta. The final diagnosis was made by pathologic histology. We suggested the clinical findings and ultrasonographic findings reminded the physician that some of this foetus has chromosome abnormalities. Correct diagnosis prenatally, will make the opportunity for the physician to manage such cases properly.