Kuntharee Traisrisilp

Pregnancy outcomes among chronic carriers of hepatitis B virus

To compare pregnancy outcomes of women with chronic HBV infection with those of HBV‐negative women.

Prenatal diagnosis of choledochal cyst: a case report.

Choledochal cyst is one of the intra‐abdominal abnormalities of the biliary ducts that present as a cystic mass in the right upper quadrant abdomen. Prenatal diagnosis has been achieved by the demonstration of a connection between a dilated common bile duct and a cystic lesion. In this report, we describe a pregnant woman in whom routine fetal anomaly scan strongly suggested a choledochal cyst at 29 weeks of gestation by demonstrating a round cystic mass in the right upper quadrant of the abdomen, completely separated from the stomach, bowel loops, and gall bladder, and which showed a connection with the dilated common bile duct.

Prenatal sonographic diagnosis of congenital varicella syndrome

Congenital varicella syndrome is a rare disorder occurring in less than 1% of maternal varicella during early pregnancy but is associated with high fetal morbidity and mortality. This case report aimed to describe the sonographic features of congenital varicella syndrome following maternal varicella. Well‐documented maternal chicken pox was made at 12 weeks of gestation and prenatal ultrasound was performed at 16 weeks. Striking sonographic features included hydropic changes and disseminated calcifications in multiple organs, especially liver and myocardium. Elective termination of pregnancy was done at 17 weeks. The presence of disseminated calcifications could suggest the diagnosis of congenital varicella syndrome.

Reference ranges for the fetal cardiac circumference derived by cardio-spatiotemporal image correlation from 14 to 40 weeks' gestation

The purpose of this study was to construct reference ranges for the fetal cardiac circumference derived from volume data sets obtained by cardio–spatiotemporal image correlation.

Associations between maternal serum free beta human chorionic gonadotropin (β-hCG) levels and adverse pregnancy outcomes.

The objective was to determine the strength of relationship between maternal free beta human chorionic gonadotropin (β-hCG) concentrations and rates of adverse pregnancy outcomes. Consecutive records of the database of our Down screening project were assessed for free β-hCG levels and pregnancy outcomes. Pregnancies with foetal chromosomal or structural anomalies and those with underlying disease were excluded. Free β-hCG levels of < 0.5, > 0.5 and < 2.0, and ≥ 2.0 MoM were categorised as low, normal and high, respectively. Of 17,082 screened women, 13,620 were available for analysis. In the first trimester (n = 8150), low β-hCG levels significantly increased risk for intrauterine growth restriction (IUGR), preterm birth, low birth weight (LBW) and low Apgar score with relative risk of 1.66, 1.43, 1.83 and 2.89; whereas high β-hCG group had a significant decreased risk of preterm birth and GDM with relative risk of 0.73 and 0.62. In the second trimester (n = 5470), both low and high β-hCG groups had significant increased risks of the most common adverse outcomes, i.e. spontaneous abortion, IUGR and preterm birth. In conclusion, abnormally low (< 0.5MoM) or high (> 2.0 MoM) free β-hCG levels are generally associated with an increased risk of adverse pregnancy outcomes. Nevertheless, high free β-hCG levels in the first trimester may possibly decrease risk of preterm delivery and GDM.

Median levels of serum biomarkers of fetal Down syndrome detected during the first trimester among pregnant Thai women

To develop Thai‐specific medians of serum pregnancy‐associated plasma protein A (PAPP‐A) and free β‐human chorionic gonadotropin (hCG) levels during the first trimester of pregnancy and to compare these values to a Caucasian‐specific model for the detection of fetal Down syndrome.

Maternal iodine insufficiency and adverse pregnancy outcomes.

This study aimed to assess the iodine status of pregnant women in each trimester and to compare the pregnancy outcomes between groups with iodine insufficiency and iodine sufficiency. Longitudinal study on urinary iodine concentration (UIC) in each trimester as well as comparison between women with iodine insufficiency (<150 mcg L(-1) ) and iodine sufficiency was conducted. Pregnant women without thyroid diseases who had not received iodine supplementation were recruited for UIC measurements in each trimester and were followed up for pregnancy outcomes. In the analysis of 384, 325 and 221 samples in the first, second and third trimester, the medians of UICs were 147.39, 157.01 and 153.07 mcg L(-1) , respectively. Of 399 women, 174 (43.6%) had a UIC less than 150 mcg L(-1) (suggesting iodine insufficiency) and 225 (56.4%) had a UIC greater than or equal to 150 mcg L(-1) (suggesting iodine sufficiency). Of 390 women with availability of the final outcomes, 171 and 219 in the insufficiency and sufficiency group, respectively, the rates of preterm birth and low birthweight were significantly higher in the insufficiency group, 17.5% vs. 10.0% (P = 0.031) and 19.9% vs. 12.3% (P = 0.042), respectively. Logistic regression analysis showed that iodine status was an independent risk of preterm birth and low birthweight. Finally, women with a UIC <100 mcg L(-1) had a significantly higher rate of fetal growth restriction, 13/68 vs. 30/322 (P = 0.031). In northern Thailand, a great number of pregnant women had a median UIC less than 150 mcg L(-1) and they had a higher risk of preterm birth and low birthweight. Finally, those with a median UIC of less than 100 mcg L(-1) had a higher risk of fetal growth restriction.

Pregnancy outcomes among mothers aged 15 years or less

The aim of this study was to determine pregnancy outcomes among early adolescent women (aged ≤ 15 years) compared with those in late adolescence (16–19 years) and adults aged 20–30 years.

Different median levels of serum triple markers in the second trimester of pregnancy in a Thai Ethnic Group

Aim:  The aim of the present study was to establish Thai‐specific reference ranges of triple markers for fetal Down syndrome as a function of gestational age as well as weight correction models and to compare the false positive rates when using Thai‐specific model relative to Caucasian‐specific model.

Association between isolated abnormal levels of maternal serum unconjugated estriol in the second trimester and adverse pregnancy outcomes.

Abstract Objective: To determine the association between maternal serum unconjugated estriol (uE3) levels in the second trimester and adverse pregnancy outcomes. Patients and methods: The prospective database of our fetal Down screening program was assessed and reviewed for maternal serum uE3 levels. Pregnancies with medical diseases, abnormal levels of beta-human chorionic gonadotropin, alpha-fetoprotein and fetal chromosomal or structural abnormalities were excluded. The recruited women were categorized into three groups: high (>95th percentile), normal (5–95th percentile) and low (<5th percentile) uE3 levels. Results: Of 14 212 screened women, 9183 (high; 455, normal; 8271 and low; 457) levels group, were available for outcome analysis. The rates of most adverse outcomes, including preterm birth, low Apgar scores, fetal death, placental abruption, preeclampsia and gestational diabetes mellitus, of the high and normal groups were comparable. Nevertheless, low uE3 levels increased risk of fetal growth restriction (FGR) (RR: 2.36, 95% CI: 1.79–3.10) and low birth weight (LBW) (RR: 1.87, 95% CI: 1.45–2.39), but not preterm birth. Logistic regression analysis indicated that low uE3 level was an independent risk factor for FGR and LBW. Conclusions: High uE3 levels in the second trimester are not associated with poor outcomes, whereas low levels significantly increase risk of FGR and LBW but not other adverse outcomes.