The relationship of fetal heart rate at 10-14 weeks and birthweight at term.

The purpose of this study was to examine the correlation between the fetal heart rate at 10-14 weeks and birthweight at term. At the fetal medicine unit, Ramathibodi Hospital, the screening for Down's syndrome at 10-14 weeks' gestation by ultrasound has been ongoing since January 1997. Transabdominal ultrasound examination is routinely performed for the crown-rump length, nuchal translucency thickness and fetal heart rate. The fetal heart rate is measured over four to six cardiac cycles by using the pulsed Doppler technique. One thousand and fourteen term singleton pregnancies that resulted in phenotypically normal live births were studied. The study was done was carried out at 10-14 weeks of gestation (mean 12.27 weeks) from January 1997 to November 1997. The mean patient age was 26.78 years old. The mean gestational age and birthweight were 38.83 weeks and 3,097.83 grams respectively. The incidence of low birthweight (less than 2,500 grams) was 14.2 per cent. Regression analysis demonstrated no significant relation between fetal heart rate at 10-14 weeks and birthweight at term. In conclusion, the result of this study revealed that there was no correlation of the fetal heart rate at 10-14 weeks' gestation and birthweight at term.

Primary carcinoma of the fallopian tube: a 20-year review at Ramathibodi Hospital.

Four cases of primary carcinoma of the fallopian tube treated at the Department of Obstetrics and Gynaecology, Ramathibodi Hospital, Mahidol University during a 20-year period were reviewed. The mean age was 54 years. The most common presenting symptoms were watery vaginal discharge, abnormal uterine bleeding and abdominal pain. A palpable abdominal or pelvic mass was also a common physical finding. The preoperative diagnosis was correct in three patients. The possibility of getting an early and correct preoperative diagnosis of this disease is also discussed. All of the patients in this report were in stage I & II. The initial treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy with postoperative radiotherapy or chemotherapy.

Diagnosis of placenta previa by ultrasonography: a review at Ramathibodi Hospital.

From 1,000 ultrasonographic examinations reviewed there were 80 (8%) done for the exclusion of placenta previa. Only 83.6 per cent of these had complete medical records and were the subjects of this study. The most common reason for requesting ultrasonography was antepartum hemorrhage (79.1%). False-positive and false-negative of the report were 16.7 per cent and at least 4.2 per cent respectively. Based on the theory of placental migration it can be recommended that a minor degree of placenta previa diagnosed in the early stage of pregnancy does not need follow-up scanning while the diagnosis of placenta previa totalis follow-up scanning is imperative. A judicious decision in the combined usage of ultrasonography and double-set-up technique can reduce the risk of brisk bleeding and unnecessary cesarean section.

Efficiency of modified medium for direct chromosome preparation of the chorionic villi.

The direct chromosome preparation from the CV is a reliable method for diagnosis of the gross chromosomal anomalies and could be completed in the shortest possible time. However, direct villi preparation does not always provide sufficient or good quality metaphases. The culture medium plays an important role in achieving a good success rate. We report the efficacy of our modified medium and compared it with Chang's. The modified medium showed slightly higher successful karyotyping (68.4%) than the Chang medium (65.4%). This success rate showed no statistically significant difference. The success rate enhanced up to 92.3 per cent using our modified medium when the CV was of good quality. The higher amount of CV did not lead to a higher success rate. Any amount more than 5 mg of the CV was sufficient for direct chromosome preparation.