Anuwat Sutantawibul

Relation between gestational weight gain and pregnancy outcomes.

The aim of this study was to evaluate the effects of gestational weight gain on pregnancy outcomes in pregnant Thai women with different pre‐pregnancy body mass indexes (BMI).

Prediction and prevention of pre‐eclampsia in Asian subpopulation

The benefit of the early administration of aspirin to reduce preterm pre‐eclampsia among screened positive European women from multivariate algorithmic approach (ASPRE trial) has opened an intense debate on the feasibility of universal screening. This review aims to assess the new perspectives in the combined screening of pre‐eclampsia in the first trimester of pregnancy and the chances for prevention using low‐dose aspirin with special emphasis on the particularities of the Asian population. PubMed, CENTRAL and Embase databases were searched from inception until 15 November 2017 using combinations of the search terms: preeclampsia, Asian, prenatal screening, early prediction, ultrasonography, pregnancy, biomarker, mean arterial pressure, soluble fms‐like tyrosine kinase‐1, placental growth factor, pregnancy‐associated plasma protein‐A and pulsatility index. This is not a systematic review or meta‐analysis, so the risk of bias of the selected published articles and heterogeneity among the studies need to be considered. The prevalence of pre‐eclampsia and serum levels of biochemical markers in Asian are different from Caucasian women; hence, Asian ethnicity needs to be corrected for in the algorithmic assessment of multiple variables to improve the screening performance. Aspirin prophylaxis may still be viable in Asian women, but resource implication needs to be considered. Asian ethnicity should be taken into account before implementing pre‐eclampsia screening strategies in the region. The variables included can be mixed and matched to achieve an optimal performance that is appropriate for economical restriction in individual countries.

Predicting fetal anemia by using reference centile charts for liver length, spleen perimeter and umbilical vein maximum flow velocity in Thai fetuses throughout gestation

Aim: To create reference centile charts for liver length, spleen perimeter and umbilical vein maximum flow velocity (UVVmax) in Thai fetuses in order to predict fetal anemia in Thai fetuses.

Puerperal Retroperitoneal Abscess Caused by Clostridium difficile: Case Report and Review of the Literature

BACKGROUND Retroperitoneal infection can be lethal. Optimal management is still elusive to describe because of the small number of case reports. We presented here a case of retroperitoneal abscess caused by Clostridium difficile arising in the puerperal period. METHODS Case report and review of recent English-language literature. RESULTS The patient presented with surgical incision dehiscence. A gas-forming fluid collection was discovered in the pelvic retroperitoneal fascia by computed tomography, but the patient did not show marked symptoms of sepsis. Emergency laparotomy drainage and debridement were performed. Clostridium difficile was isolated, and she was treated with a three-week course of vancomycin. The patient recovered without major morbidity. Recent case reports describe variation in the course of the disease and management options for puerperal retroperitoneal infection. CONCLUSION Puerperal retroperitoneal abscess caused by C. difficile can present with minimal symptoms. Prompt recognition, early surgical intervention, and optimal use of antibiotics can reduce morbidity and prevent death.