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B F Leung

Publications and source records attributed to B F Leung.

8 recordsLinked to original sources
PubMed1988

Serum urate, complement 3 and pre-eclampsia in patients with systemic lupus erythematosus.

Pre-eclampsia (PE) is a frequent complication of pregnancies in women with systemic lupus erythematosus (SLE). The diagnosis of PE is usually based on clinical features such as hypertension and proteinuria, which could also be features of SLE disease exacerbation. As the management of these conditions is different, tests that could confirm the diagnosis of pre-eclampsia would be helpful. Previous studies have shown that serum urate is elevated in PE, while a fall in serum complement 3 occurs in exacerbation of SLE. In this study we looked at the serum urate and complement 3 levels in a group of SLE patients who were in remission before pregnancy. Patients who developed PE had a significantly higher serum urate level while their serum complement 3 level was similar to patients without PE. Our results suggest that measurement of serum urate together with serum complement 3 would help to diagnose PE, and delivery should not be delayed, especially if intra-uterine growth retardation is suspected, in order to avoid intra-uterine death.

Adult↗
PubMed1987

Labour-related eclampsia.

Twenty-four cases of eclampsia managed in a hospital in Hong Kong over a five-year period were reviewed. Four patients had antepartum eclampsia and one had postpartum eclampsia following elective caesarean section. Four of these five patients had severe pregnancy-induced hypertension (PIH) (greater than 160/100 mmHg). The other 19 patients had eclampsia occurring during labour or within six hours of delivery. This group included 10 patients with labour-onset PIH, none of whom developed severe hypertension before their convulsions. In the remaining nine patients, only five had severe hypertension before convulsion. The results suggest that labour-related eclampsia has become more common than antepartum eclampsia, and severe hypertension before convulsion is an infrequent finding and therefore an unreliable sign in these patients.

Adult↗
PubMed1987

Rupture of the gravid uterus.

Seventeen cases of uterine rupture in late pregnancy managed over an eight-year period in one hospital in Hong Kong were analysed. Labour was associated with rupture in 16 cases, including ten with one or more previous caesarean section scars. Rupture occurring in an unscarred uterus was associated with high fetal losses and all required hysterectomy. All of these patients had at least one previous vaginal delivery, in contrast to the patients with a scarred uterus. Labour should be closely monitored in multiparous patients with or without a uterine scar, and oxytocics should be used carefully. Patients with previous sections who are scheduled for repeat elective sections should be delivered before 39 weeks.

Cesarean Section↗
PubMed1987

Is X-ray pelvimetry useful in a trial of labour after caesarean section?

In a trial of labour after caesarean section, X-ray pelvimetry has generally been regarded as an important part in the evaluation of patients before a decision is made. A review of 445 patients with trial of labour has shown that although the measurements of the pelvic inlet were greater in patients who delivered vaginally, the incidence of successful trial was not related to the measurements of the pelvis. Maternal height was also unrelated to the outcome. Only a history of previous vaginal delivery was predictive of a successful trial. The results suggest that X-ray pelvimetry is not necessary in the majority of patients if the past obstetric history and the clinical assessment are in favour of a successful trial. It is only useful when there is doubt and in this case both a lateral and an antero-posterior film are necessary as the obstetric conjugate alone was unreliable in predicting the transverse diameter of the inlet as well as the outcome.

Cesarean Section↗
PubMed1987

Labor induction for planned vaginal delivery in patients with previous cesarean section.

The role of labor induction in patients scheduled for vaginal delivery following a previous lower segment cesarean section has been controversial. In Hong Kong, we have managed these patients by induction when there were obstetric or medical indications. A review of 137 patients who had labor induced for a trial of scar showed that induction of labor was a safe procedure and the rate of repeat caesarean section in these patients (18.2%) was similar to that in other patients with a trial of scar who had spontaneous onset of labor (12.9%). There were no serious maternal or fetal complications. Although the use of oxytocin in addition to amniotomy produced no difference in the outcome, we felt that it was useful in preventing a long induction delivery interval as well as avoiding a high failure rate of induction. We conclude that in patients selected for a trial of scar, planned induction of labor should be attempted when an indication for delivery arises, as a high proportion (more than 80%) of these patients gave birth vaginally. If induction were ruled out, most of these patients would have to be delivered by repeat cesarean section, with its associated morbidity and expense.

Cesarean Section↗