Vitaya Titapant

A novel method to derive amniotic fluid stem cells for therapeutic purposes

BackgroundHuman amniotic fluid stem (hAFS) cells have become an attractive stem cell source for medical therapy due to both their ability to propagate as stem cells and the lack of ethical debate that comes with the use of embryonic stem cells. Although techniques to derive stem cells from amniotic fluid are available, the techniques have limitations for clinical uses, including a requirement of long periods of time for stem cell production, population heterogeneity and xeno-contamination from using animal antibody-coated magnetic beads. Herein we describe a novel isolation method that fits for hAFS derivation for cell-based therapy.Methods and ResultsWith our method, single hAFS cells generate colonies in a primary culture of amniotic fluid cells. Individual hAFS colonies are then expanded by subculturing in order to make a clonal hAFS cell line. This method allows derivation of a substantial amount of a pure stem cell population within a short period of time. Indeed, 108 cells from a clonal hAFS line can be derived in two weeks using our method, while previous techniques require two months. The resultant hAFS cells show a 2-5 times greater proliferative ability than with previous techniques and a population doubling time of 0.8 days. The hAFS cells exhibit typical hAFS cell characteristics including the ability to differentiate into adipogenic-, osteogenic- and neurogenic lineages, expression of specific stem cell markers including Oct4, SSEA4, CD29, CD44, CD73, CD90, CD105 and CD133, and maintenance of a normal karyotype over long culture periods.ConclusionsWe have created a novel hAFS cell derivation method that can produce a vast amount of high quality stem cells within a short period of time. Our technique makes possibility for providing autogenic fetal stem cells and allogeneic cells for future cell-based therapy.

Relation between gestational weight gain and pregnancy outcomes.

The aim of this study was to evaluate the effects of gestational weight gain on pregnancy outcomes in pregnant Thai women with different pre‐pregnancy body mass indexes (BMI).

Psychological effects of fetal diagnoses of non-lethal congenital anomalies on the experience of pregnant women during the remainder of their pregnancy

The aim of this study was to explore the effects of prenatal fetal diagnoses of non‐lethal anomalies on the psychological well‐being of pregnant women throughout their pregnancy.

Reverse Twin-Twin Transfusion Syndrome after Fetoscopic Laser Photocoagulation of Chorionic Anastomoses: A Case Report

A case of severe twin-twin transfusion syndrome (TTTS) which developed at menstrual age of 17 weeks underwent a fetoscopic laser ablation of the anastomosing vessels. The vascular equator of the anastomoses was noticed to be deviated due to marginal cord insertion of the recipient fetus. The procedure was accomplished uneventfully. However, the recipient fetus died 6 h after the procedure. After the pregnancy was terminated, the donor was found to be counterintuitively plethoric, and the recipient was pale. Similar appearances were noted on the placental territories of each fetus. This is consistent with reverse TTTS. Dye injection study and microscopic examination revealed a residual deep vein-vein anastomosis. This subchorionic vascular connection is still a challenge to coagulate with current placental surgery techniques. To the best of our knowledge, this is the first confirmed case of reverse TTTS as a cause of fetal loss following laser photocoagulation. This report also discusses the technical considerations in the complicated case of in utero placental surgery for TTTS.

Functional three-dimensional sonographic study of the postpartum uterus

Abstract Objective: To demonstrate sequential changes of the postpartum uterus using two- and three-dimensional (2D and 3D) ultrasounds and Doppler studies. Methods: Eighty-one women who delivered a singleton at term were recruited for this prospective longitudinal study. Manual and ultrasound examinations of the uterus were performed for seven consecutive weeks. Sequential changes in size of the uterus, endometrial thickness and appearances and Doppler indices of the uterine and arcuate arteries were analyzed. Results: Complete follow ups were achieved in 71 women who had an uncomplicated postpartum course. 2D and 3D ultrasound estimations of uterine volume are highly correlated with each other (r > 0.7), but not manual estimations (r < 0.3). Data generated from 497 3D observations demonstrated rapid involution of the uterus in the first two weeks after delivery. Breastfeeding and parity did not affect uterine involution (r < 0.2). Resistance index (RI) of the uterine artery started to elevate at four weeks after delivery (r > 0.7). RI of the arcuate artery was not significantly changed during the study period (r < 0.2). Uterine involution was independent from progressive thinning of the endometrium and elevation of uterine artery RI. (r < 0.1 and 0.2, respectively). Conclusion: Longitudinal sonographic study showed independent physiologic reversals of uterine volume, endometrium and vascular supply in the first seven weeks following vaginal delivery. Standardization of measurement techniques is essential to apply this information for an early detection of postpartum uterine complications.

Influence of water intake on the waiting time prior to gynecologic transabdominal ultrasound

To investigate the effect of volume of water intake on the length of time before the bladder is sufficiently full prior to undergoing transabdominal ultrasound.

Predicting fetal anemia by using reference centile charts for liver length, spleen perimeter and umbilical vein maximum flow velocity in Thai fetuses throughout gestation

Aim: To create reference centile charts for liver length, spleen perimeter and umbilical vein maximum flow velocity (UVVmax) in Thai fetuses in order to predict fetal anemia in Thai fetuses.

Prevalence and Management of Functional Gastrointestinal Disorders in Infants: An Asian Perspective

Xin Hua Hospital, Shanghai Jia Tong University School of Medicine, Shanghai, China, *Santokba Durlabhji Memorial Hospital, Jaipur, India, Department of Pediatrics, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia,Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, Department of Paediatrics, National University Hospital, Singapore, Siriraj Hospital, Mahidol University, Bangkok, Thailand, Nutricia Research, Utrecht, The Netherlands, **Nutricia Research, Singapore

Retrospective analysis of 113 consecutive cases of placenta accreta spectrum from a single tertiary care center

Abstract Objective: Placenta accreta spectrum (PAS) remains a major cause of maternal morbidity. We sought to assess the characteristics and treatment outcomes of PAS managed at a tertiary care center with high volume of PAS. Study design: Electronic medical records of all patients with diagnosis of PAS from June 2010 to October 2016 were reviewed. Details of obstetric backgrounds, predelivery diagnosis, peripartum management, and outcomes were analyzed. Results: One hundred thirteen women with PAS were identified from 50,448 deliveries during the study period. Vaginal delivery, emergency, and elective cesarean section were accomplished in 41.6, 30.1, and 28.3%, respectively. There was no maternal mortality. Approximately 41.6% of women with PAS had peripartum hysterectomy. There was a fair inverse correlation between intraoperative blood loss and gestational weeks at delivery (r = −0.311; p=.001), but not gestational weeks at diagnosis (p = .249). Cases with predelivery diagnosis (n = 29) had higher intraoperative blood loss than those diagnosed postdelivery (n = 84) (p<.001). Anterior PAS (n = 58) is associated with attachment to previous uterine scar, antepartum bleeding, and intraoperative blood loss compared to posterior PAS (n = 44) (p<.05). The PAS patients with previous uterine surgery had the highest chance of peripartum hysterectomy (p<.001). Conclusions: Contradictory to previous reports, our data suggest a more severe spectrum of PAS in those with predelivery detection earlier gestational weeks at delivery. Peripartum hysterectomy was highest in anterior PAS that attached to the previous uterine scar.

OP32.09: Sequential three-dimensional sonographic studies of postpartum uterine involution

histogram value of uterine cervical anterior lip was significantly associated with the successful induction of labor. ROC curve for anterior lip histogram value in predicting success of induction indicated a significant relationship with successful induction. The best cutoff value was 69.4. Conclusions: Anterior lip histogram value associates significantly with the prediction of success of induction of labor in nulliparous pregnant women. But, Bishop score and other sonographic measurement of the length, volume, and posterior lip histogram of the uterine cervix have no predictive values for successful induction.