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Biomedical subjects

Jin-Chung Shih

Publications and source records attributed to Jin-Chung Shih.

21 records · Page 2Linked to original sources

Prenatal three-dimensional/four-dimensional sonographic demonstration of facial dysmorphisms associated with holoprosencephaly.

In this report, we describe the prenatal use of 3-dimensional 4-dimensional (3D/4D) sonography to visualize the facial dysmorphisms associated with holoprosencephaly in 6 fetuses (2 with cyclopia, 1 with cebocephaly, and 3 with holoprosencephaly-premaxillary agenesis). Ultrafast MRI was also used. The 3D/4D sonographic images allowed easy, rapid, and precise prenatal evaluation of the facial dysmorphisms associated with holoprosencephaly; the MRI scans provided little additional information. The 3D/4D sonograms helped the parents visualize the abnormalities and facilitated their acceptance of perinatal genetic counseling.

Abnormalities, Multiple↗

Correlation of prenatal ultrasound and postnatal outcome in meconium peritonitis.

OBJECTIVES: To study the relationship between prenatal ultrasound features and postnatal course of meconium peritonitis. METHODS: Meconium peritonitis was diagnosed by prenatal ultrasound. Fetuses were treated by intrauterine paracentesis of ascites when indicated, and symptomatic newborns received surgery. RESULTS: Totally 17 cases were enrolled. Prenatal ultrasound findings include abdominal calcification (16/17), fetal ascites (12/17), hydramnios (9/17), pseudocyst (7/17) and dilated bowel loop (6/17). Persistent ascites, pseudocyst or dilated bowel loop are most sensitive (92%) to predict postnatal surgery (p = 0.022). The survivors have a higher gestational age at birth (36.4 vs. 33.3 weeks, p = 0.008). Persistent ascites and postnatal persistent pulmonary hypertension of the newborns significantly correlate with neonatal mortality (p = 0.029 and 0.022). CONCLUSION: Prenatal ultrasound can predict the neonatal outcome in meconium peritonitis.

Adult↗

Antenatal treatment of chylothorax and cystic hygroma with OK-432 in nonimmune hydrops fetalis.

OBJECTIVES: To present our experience of using OK-432 in treating fetal cystic hygroma and chylothorax complicated with nonimmune hydrops fetalis. METHODS: OK-432 (Picibanil) was injected into the fetal pleural cavity or fetal cystic hygroma. RESULTS: Patient 1: A 23-year-old, gravida 2, para 1, was found to have a recurrent fetal chylothorax at GA 29 weeks. Serial amnioreduction and thoracocentesis was performed at GA 31, 32, 33, and 34 weeks. Intrapleural OK-432 injection was performed twice at GA 33 and 34 weeks. Cyanosis and respiratory distress were noted immediately after birth (GA 34 weeks). The baby expired despite of aggressive neonatal resuscitation. Patient 2: A 26-year-old, gravida 2, para 1, was found to have a cystic hygroma of her fetus at GA 17 weeks. Karyotype of the cystic fluid and the amniocytes were 46, XY. Fetal ascites developed at GA 22 weeks. OK-432 injection into the tumour was performed at GA 23 weeks. Stabilization of the cystic hygroma was noted throughout the pregnancy (about 3.5 cm in diameter). Serial fetal paracentesis and/or amnioreduction were performed. Karyotype of the ascites was again 46, XY. Maternal dietary modification with medium chain triglyceride was also prescribed. Chylothorax developed and the baby was born by cesareans at GA 32 weeks. Resolution of pleural effusion, ascites, and regression of cystic hygroma were noted since the 2nd day after birth. The baby had survived beyond 4 months of age at submission. CONCLUSION: Combination of antenatal OK-432 injection, maternal dietary modification, serial thoracocentesis plus paracentesis, together with amnioreduction and tocolysis, appeared to contribute to the success of antenatal treatment. Fetal pulmonary expansion may determine the immediate neonatal survival.

Adult↗