Chadakarn Phaloprakarn

Risk assessment for preeclampsia in women with gestational diabetes mellitus.

Abstract Aim: To develop a clinical model to assess the risk of preeclampsia in women with gestational diabetes mellitus (GDM). Methods: We studied clinical characteristics of 813 consecutive women who had GDM between January 2003 and February 2008 at our institution. The clinical features which were significantly associated with preeclampsia by multiple logistic regression analysis were integrated into a risk model. The diagnostic performance of this model was then evaluated from a receiver-operating characteristic (ROC) curve analysis. Results: A total of 78 women with GDM (9.6%) developed preeclampsia. In a multivariable analysis, first-trimester BMI ≥27 kg/m2 (P<0.001), GDM diagnosed within 20 weeks of gestation (P<0.001), and poor glycemic control (P<0.001) were associated with preeclampsia. These three factors were incorporated into a risk-scoring model which ranged from 0 to 3 points. At the optimal cut-off score of ≥2, the sensitivity, specificity, and area under the curve (AUC) for preeclampsia were high at 76.9% [95% confidence interval (CI) 69.0–85.2], 92.8% (95% CI 85.9–98.1), and 0.849 (95% CI 0.792–0.905), respectively. Conclusion: A model based on clinical data yielded predicted the development of preeclampsia in women with GDM.

Risk score comprising maternal and obstetric factors to identify late preterm infants at risk for neonatal intensive care unit admission

The aim of this study was to develop and validate an antepartum risk score based on maternal and obstetric characteristics to predict the requirement for neonatal intensive care unit (NICU) admission among late preterm infants.

Inappropriate gestational weight gain among teenage pregnancies: prevalence and pregnancy outcomes

Objective To study the prevalence and pregnancy outcomes of inappropriate gestational weight gain (GWG) among teenage pregnant women. Methods A retrospective descriptive study was conducted on 2,165 teenage pregnant women who attended our antenatal clinic between January 2007 and August 2015. Adverse pregnancy outcomes, including maternal and neonatal outcomes of women with inappropriate GWG, including underweight and overweight, were studied and compared with those of women with appropriate GWG. Results Complete data of 1,943 women were obtained. Among these women, the mean age was 17.4±1.4 years and mean body mass index at first visit was 19.1±3.0 kg/m2. The prevalence of inappropriate GWG was 61.7%. Underweight women were more likely to experience anemia and preterm delivery, whereas overweight women required more cesarean sections because of cephalopelvic disproportion and preeclampsia, compared to women with appropriate weight gain (all P<0.001). The rates of gestational diabetes mellitus among women who were underweight, overweight, or appropriate weight were not significantly different. Conclusion More than 60% of teenage pregnancies showed inappropriate GWG. GWG had a significant impact on pregnancy outcomes.

Timing of elective cesarean delivery at term and its impact on maternal and neonatal outcomes among Thai and other Southeast Asian pregnant women.

The impact of timing of elective cesarean delivery (CD) at term on maternal and neonatal outcomes among Thai and other Southeast Asian pregnancies was investigated. The rate of spontaneous labor before the scheduled CD, as well as maternal characteristics predicting spontaneous labor, was also evaluated.

Comparison of tissue adequacy for histologic examination from Ipas MVA plus and Wallach Endocell in women with abnormal uterine bleeding

The aim of this study was to compare endometrial tissue adequacy sampling by Wallach Endocell and manual vacuum aspiration (Ipas MVA plus) in women with abnormal uterine bleeding. Pain and immediate complications from each method were also compared.