Tongta Nanthakomon

Maternal vitamin D status, its associated factors and the course of pregnancy in Thai women

There are limited data on the prevalence of vitamin D inadequacy in pregnant women living in Southeast Asia and changes in their vitamin D status during pregnancy.

Quality of Life in Cervical Cancer Survivors and Healthy Women: Thai Urban Population Study

Background : To determine a baseline quality of life (QoL) in cervical cancer survivors compared to that of healthy subjects in the tertiary Thammasat University Hospital, Thailand. Materials and Methods: The investigation was conducted at the outpatient gynecological department of Thammasat University Hospital between January and June 2016. A total of 192 women were entered into the study (97 cervical cancer survivors; 37 after radical hysterectomy (RH), 43 with concurrent chemoradiation (CRT), and 17 featuring both RH and CRT; and 95 control subjects from the same outpatient department with no history of malignancy). Participant QoL was assessed using a Thai version of the EORTC-QLQ-C30 (European Organization for Research Treatment of Cancer Quality-of-Life) and a general survey for the assessment of sociodemographic data was also conducted. Results: There were significant differences in physical, role, emotional and social functions between cervical cancer survivor and control groups. Global health, fatigue, pain, appetite loss, and financial difficulties also demonstrated statistically significant variation. Cervical cancer survivors treated by RH had higher scores for emotional and social function and global health than the control group. Moreover, they had less appetite loss, fatigue and financial difficulties. However, patients treated with CRT experienced more pain than the control group. All cervical cancer survivors had lower physical function scores than the control group. Conclusion: Quality of life in cervical cancer survivors is better than in healthy peers in some domains. Cervical cancer survivors treated with RH may have a better QoL than healthy peers. Early detection for early stage cervical cancer remains most important because treatment in early stages does not cause lowering of the QoL.

P01.05: The value of middle cerebral artery‐umbilical artery pulsatility index ratio in prediction of severe fetal growth restriction

There were classified patients into 2 groups, group 1 with normal MCA/UA PI ratio (MCA/UA PI > 1.08) and group 2 with abnormal MCA/UA PI ratio. Adverse perinatal outcome as neonatal intensive care unit admission, Apgar score at 1 min < 7, need for ventilators, respiratory distress syndrome and need for blood transfusion were compared between 2 groups. Results: Of the 54 pregnancies in this study, 37 patients (68.5%) were classified into group 1 and 17 patients (31.5%) into group 2. There were significantly higher adverse perinatal outcome in group 2 (P values < 0.05). Conclusions: IUGR fetuses with abnormal MCA/UA PI ratio suffered more morbidity than with normal MCA/UA PI ratio. The MCA/UA ratio is a good predictor of adverse perinatal outcome.

P01.04: Cerebroplacental pulsatility ratio predicts perinatal outcome in IUGR fetuses

Objectives: To investigate the relationship between unexplained elevated MSAFP and adverse pregnancy outcomes in our population. Methods: A retrospective cohort study was conducted by reviewing all triple test results that were positive for neural tube screening. Results: We identified 53 women with raised mid trimester MSAFP > 2.5 multiples of median (MoM) between July 2007 to December 2009. Of these, 12 cases were excluded from the study because of presence of structural fetal abnormalities and 3 cases were lost to follow-up. Of the remaining 38 pregnancies with unexplained raised MSAFP, 10 (26%) cases were associated with poor fetal outcome. These included spontaneous second trimester miscarriage (n = 2), preterm rupture of membranes (n = 2), intrauterine fetal growth restriction (n = 5), and stillbirth (n = 1). Maternal complications included recurrent antepartum bleed (n = 1) and severe preeclampsia (n = 1). Conclusions: Our findings reiterate that unexplained raised MSAFP is associated with significantly high rate of adverse pregnancy outcome and warrants close monitoring with regular antenatal checks and serial growth scans.

P24.08: Correlation of fetal Doppler flow and perinatal outcomes in patient with preeclampsia

Objectives: The Umbilical Vein (UV) has a non pulsating and even pattern in normal fetuses. Pulsation of UV has been describedin severely growth restricted fetuses with chronic hypoxia. We wanted to see whether UV pulsation could also be seen in fetuses with heart deceleration during labor, as an adjunctive measure to assess the intrapartum hypoxia. Methods: In a prospective study Doppler examination was performed on 34 fetuses with normal cardiotocography (CTG) and 26 fetuses with abnormal CTGs (GA > 37 w and cervical dilatation > 3 cm). Perinatal outcome was assessed according to presence or absence of UV pulsations. Results: The 2 groups were comparable. (GA, cervical dilatation, Umbilical artery PH, S/D ratio, PI and RI) Intraabdominal UV pulsation were present in 6 (23.1%) of abnormal CTG and none of normal CTG group. (P = 0.005) Five of 6 (83.3%) fetuses with UV pulsation under went cesarean delivery. The rate of cesarean delivery was 90% in abnormal CTG group without pulsation and 14.7% in normal CTG group. The frequency of Apgar score < 7 was more in fetuses with UV pulsations (16.7% vs. 5%) although not significant. NICU admission was considerably more in UV pulsation group. (33% vs. 5%, P = 0.123) After exclusion of LBW fetuses the UV pulsation was present in 4(19%) of abnormal CTG group, who 3 of them under went cesarean section. Neither umbilical artery PH < 7 nor Apgar score < 7 or NICU admission were seen in these 4 neonates. Conclusions: Pulsation in UV was seen in 23% of fetuses with abnormal CTG during intrapartum period. Cesarean delivery and NICU admission was increased in fetuses with UV pulsations, although not statisticly significant. When LBW fetuses were excluded no case of U/A PH < 7, Apgar score < 7 or NICU admission were seen.