ABSTRACT
Background : Prevalence of births with neural tube defect varies geographically. There is no information about this issue in Srinagarind HospitalObjective : To determine trends in birth prevalence of neural tube defects at Srinagarind Hospital during 19881996 and clinical characteristics of affected pregnancies.Design : A retrospective descriptive study.Setting : Department of Obstetrics and Gynecology, Faculty of medicine, Srinagarind Hospital, Khon Kaen University.Subjects : All 44 births affected by neural tube defects from 45,350 total in 1988-1996.Main outcome measures : birth prevalence of individual and all nural tube defects.Results : Among 44 cases of neural tube defects, there were 38 cases of anencephaly, 4 cases of cephalocele and 2 cases of spina bifida. Birth prevalence of neural tube defects was 0.97/1,000 total births with no upward or down ward trend. Birth prevalence of anencephaly, cephalocele and spina bifida were 0.84, 0.09 and 0.04/1,000 total births respectively. Mean gestatinal age at delivery was 38 weeks and 22.7% of all neural tube defects were undiagnosed prenatally.Conclusion : Birth prevalence of neural tube defects at Srinagarind hospital remained relatively stable. To enhance the fall in birth prevalence, the prenatal screening program for neural tube defects such as routine second trimester ultrasonographic screening should be established in the future.Key words : neural tube defects, birth prevalence
ABSTRACT
Background : The prenatal diagnosis of duodenal obstruction enables clinicians to plan proper obstetric management and early postnatal surgical correction.Objective: To present an case report.Results: We report the case of a 38-year-old woman obstetric ultrasound examination at 31 weeks’ gestation because of the large size of her uterus. The examination revealed a single live fetus left whose size was consistent with 31 weeks’ gestation. The fetus had polyhydramnios and the double-bubble sit in its abdomen. Cordocentesis was performed. Chromosomal examination of the fetal blood revealed trisomy 21. Preterm delivery occurred at 34 weeks’ gestation and a baby girl weighing 2,460 grams was delivered vaginally. Surgical correction of the duodenal obstruction was carried out. The cause of the obstruction was an annular pancreas. The baby died on the fifth postoperative day because of sepsis.Conclusion: Ultrasound was show to be a useful diagnostic toll for the prenatal diagnosis of duodenal obstruction. It enabled further management to be properly planed.
ABSTRACT
Background: Severe pre-eclampsia is not an uncommon obstetric complication. The incidence or risk factors for this complication in Srinagarind Hospital has not previously been studied.Objectives : 1. To analysel the ratio of severe pre-eclampsia to total number of deliveries in Sringarind hosptialj ; 2. The risk factors for severe pre-eclampsia; and 3. The modes of delivery and the condition of the infant born to mothers with severe pre-eclampsia.Design: A descriptive case-controlled study.Setting: Department of Obstetrics and Gynecology, Srinagarind hosptial. Faculty of Medicine, Khon Kaen University, Thailand.Subjects: 10, 580 women who has delivered at Srinagarind Hospital between January 1, 1992 and December 31, 1993.Main outcome measures: Ratio of cases of Sever pre-eclampsia to total number of deliveries, and risk factors analysed by multiple logistic regression.Results: The incidence of severe pre-eclampsia was 0.96 per 100 deliveries. Thei risk factors were primigravida status (adjusted OR:2.4,95%CI: 1.3-4.3); base history of pre-eclampsia (adjusted OR:0,95%CI: 2.7-18.8); gestational diabetes (adjusted OR:4.6,95%CI: 1.3-16.6); and body mass index of more than 20 kg/m2 prior to the pregancy (adjusted OR:3.3,05%CI: 1.3-8.2). The most common mode of delivery was cesarean section, while normal vaginal birth was the most common mode of delivery in the case and control groups were 2599.7 grams (SD. = 699.4) and 3095.7 grams (SD. = 420.7), respectively. The percentrage of infacnts with a low birth weight (less than 2500 grams) in the pre-eclampsia group was 40.6% compared with 5.9% in the control group. Severe birth asphyxia occurred in 9.9 % of the pre-eclampsia group compared with 1.8% in the control group.Conclusion: Severe pre-eclampsia is not uncommon in Srinagarind Hospital. It was found in 0.96 per 100 deliveries. The risk factors are primigravida status, past history of pre-eclampsia, grestational diabetes, and body mass index of more than 30 kg.m2 prior to the pregnancy. Themost common mode of delivery was the most common in the controls group. The gestational age, birth weight and apgar score of infants in the pre-eclampsia than the control group.
ABSTRACT
No abstract