Phaosavasdi S

Female sterilization by electrocoagulation of tubal ostia using hysteroscopy.

Abstract Forty-four women were treated by hysteroscopically directed electrocoagulation of the tubal ostia to produce permanent sterilization. Thirty-four of these had a mesh inserted in the wounded area. Eighty-four per cent of those treated had bilateral tubal closure as determined by hysterosalpingography.

Cut‐off criteria for second‐trimester nuchal skinfold thickness for prenatal detection of Down syndrome in a Thai population

Objective: To evaluate the use of progressive cut‐offs for nuchal skinfold thickness with advancing gestational age and the commonly applied cut‐off method (≥6 mm) for prenatal detection of Down syndrome in a Thai population. Method: A prospective study was performed by experienced perinatologists on 2150 women undergoing second‐trimester amniocentesis for the indications of advanced maternal age and past history of chromosomal abnormality. Reference ranges were established for nuchal skinfold thickness from the 16th to the 24th week, using either gestational‐specific centiles or the parametric method. Assaying different cut‐off criteria for both centile and the parametric methods were calculated and then compared with the commonly applied cut‐off level (≥6 mm.). Results: There were 2114 chromosomally normal pregnancies, 19 fetuses with Down syndrome (1:113), and 17 other chromosome abnormalities. In fetuses with normal karyotype the nuchal skinfold thickness increased with advancing gestational age [NF (mm)=−0.502+0.212 GA (week), r=0.36, P<0.001]. The sensitivities of an abnormal nuchal skinfold thickness using different cut‐off criteria for detecting Down syndrome were low (5.3–26.3%) with the false positive rates ranging from 2.5 to 16.5%. Conclusions: In this study, measurement of second‐trimester nuchal skinfold thickness was a poor and unreliable screening test for fetal Down syndrome in a Thai population.

Prenatal Diagnosis of Pulmonary Atresia by Fetal Echocardiography

With an improvement in cardiac imaging during the past 20 years, fetal echocardiography has progressively altered the practice of obstetricians and become a principle armamentarium for the diagnosis of fetal heart diseases. We presented a case of pulmonary atresia with intact ventricular septum diagnosed prenatally using fetal echocardiography.