Lin Wai Chan

Trends in maternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinese women.

Objective  To assess the effect of increasing body mass index (BMI) on pregnancy outcome in a population of Chinese women.

Secondary findings from non‐invasive prenatal testing for common fetal aneuploidies by whole genome sequencing as a clinical service

To report secondary or additional findings arising from introduction of non‐invasive prenatal testing (NIPT) for aneuploidy by whole genome sequencing as a clinical service.

Prediction of birth weight by fetal crown-rump length and maternal serum levels of pregnancy-associated plasma protein-A in the first trimester

To determine whether the first trimester crown–rump length (CRL), maternal serum levels of pregnancy‐associated plasma protein A (PAPP‐A) and free beta‐human chorionic gonadotropin (fβ‐hCG) are independent predictors of birth weight.

Which ultrasound or biochemical markers are independent predictors of small-for-gestational age?

To investigate which ultrasound or biochemical markers in both the first and the second trimesters are the best predictors for fetal growth and small‐for‐gestational age (SGA).

High incidence of obstetric interventions after successful external cephalic version

Objective To investigate the delivery outcome after successful external cephalic version (ECV).

First-trimester combined screening for trisomy 21 in a predominantly Chinese population

To examine the effectiveness of first‐trimester fetal trisomy 21 screening using a combination of maternal age, nuchal translucency thickness (NT) and maternal serum free beta‐human chorionic gonadotropin (β‐hCG) and pregnancy‐associated plasma protein‐A (PAPP‐A) levels in a predominantly Chinese population in Hong Kong.

First trimester combined screening for Trisomy 21 in Hong Kong: outcome of the first 10,000 cases

Objective. To examine the effectiveness of first trimester fetal Trisomy 21 (T21) screening using a combination of maternal age, nuchal translucency, maternal serum levels of free β-hCG and PAPP-A in a predominantly Chinese population in Hong Kong. Methods. Consecutive women who underwent the combined screening for T21 between 11 and 13 + 6 weeks of gestation between 2003 and 2007 were recruited. Risk of T21 was calculated using Fetal Medicine Foundation algorithm and karyotyping was advised when the risk was 1:300 or above. All women were followed up for pregnancy and fetal outcome. Results. 10,363 fetuses underwent screening. 99% of the women were Chinese and 27.4% were at or above 35 years old. 618 fetuses were screened positive (5.9%), which included 31 cases of T21, 14 cases of T18, 7 cases of T13, 10 cases of 45XO and 7 cases of other chromosomal abnormalities. Among the 9745 screened negative fetuses all but 50 (0.5%) had a known outcome, which included three T21 and four other chromosomal abnormalities. All were subsequently identified at the morphology scan except for one case of T21. The detection rate and false positive rates for T21 were 91.2% and 5.4%, respectively and the positive predictive value for all chromosomal abnormalities was 1 in 9. Conclusions. Combined screening for T21 is highly effective among Chinese women. Training, quality control, regular auditing and follow up are essential to maintain screening standards.

Volumetric (3D) imaging reduces inter‐ and intraobserver variation of fetal biometry measurements

To compare the inter‐ and intraobserver variation of fetal biometric measurements utilizing two‐dimensional (2D) and three‐dimensional (3D) ultrasound imaging.

Maternal experience of pain during external cephalic version at term

Background.  This study was designed to investigate maternal pain perception during external cephalic version (ECV).

One-year urodynamic outcome and quality of life in patients with concomitant tension-free vaginal tape during pelvic floor reconstruction surgery for genitourinary prolapse and urodynamic stress incontinence

The aim of the study was to examine the 1-year urodynamic outcome and quality of life in patients who have had concomitant tension-free vaginal tape insertion during pelvic floor reconstruction surgery. The medical notes of a retrospective cohort of 45 patients who had undergone tension-free vaginal tape together with pelvic floor reconstruction surgery were reviewed. The operative information, the results of the urodynamic studies and the change in the quality-of-life scores 1 year after surgery were examined. The quality of life was assessed with both general and disease-specific quality-of-life questionnaires (General Health Questionnaire (GHQ-12), Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7)). Patient satisfaction was assessed with the validated Chinese version of the Client Satisfaction Questionnaire (CSQ). Forty-five patients underwent tension-free vaginal tape insertion together with pelvic floor reconstruction surgery. The overall objective cure rate was 43%. There was a significant improvement in the disease specific quality-of-life assessment (UDI-6 score 38.3–15.5; P<0.01) and (IIQ-7 score 15.0–4.0; P<0.01). The patients who had a concomitant cystocele repair had a worse objective cure rate than patients without concomitant cystocele repair (38% vs 67%; P=0.19).