Biomedical subjects

S F Lai

Publications and source records attributed to S F Lai.

5 recordsLinked to original sources

PubMed1995

Uterine perforation during elective first trimester abortions: a 13-year review.

OBJECTIVE: The purpose of this study was to determine the incidence, presentation, management and outcome of uterine perforation during elective first trimester abortions. METHODS: We conducted a retrospective study of 40 patients, including 2 transferred patients, who sustained uterine perforation during elective abortions from January 1980 to December 1992. RESULTS: The incidence of uterine perforation was 0.8 per 1,000 procedures (0.08%). There were 8 (20%) nulliparae and 3 (7.5%) grand multigravidae. 82.5% of the cases occurred when the abortion was performed by medical officers or junior registrars under training. The commonest perforating instrument was the suction cannula (25%) followed by the uterine sound (22.5%) and the dilator (20%). Three (7.5%) cases were treated conservatively, 33 (82.5%) cases underwent emergency operation, 2 (5%) cases were discovered during subsequent sterilisation, and 2 (5%) cases suffered undiagnosed perforation and were re-admitted for emergency surgery. Morbidity included post operative fever (12.5%), bowel injury (7.5%), retained conceptus (5%) and wound breakdown (2.5%). There was no mortality. CONCLUSION: A careful assessment of the uterine size and position, vigilance in the use of uterine sound and dilators, greater care in the use of suction cannula, and experience in vacuum aspiration will decrease the incidence of uterine perforation during elective abortions. A high degree of suspicion, early diagnosis and treatment will prevent the potential complications that may arise from uterine perforation.

Abortion, Induced↗

PubMed1994

Primary ovarian pregnancy: current diagnosis and management.

We reviewed five cases of ovarian pregnancy that were diagnosed at the Kandang Kerbau Hospital Histopathology Laboratory over three years. The clinical presentation, diagnosis and management of these patients are discussed in detail. This condition usually occurs in parous fertile women as evidenced by three of the five patients studied. It is probably an accidental event with no predisposing features as compared to the tubal pregnancy patient. The diagnosis has been aided by the recent advances in human chorionic gonadotrophin determination and ultrasound. Ultrasound, especially transvaginal ultrasound scanning has proven to be an invaluable tool in the diagnosis of this condition. Fertility after conservative surgical procedures does not appear to be affected and ovarian wedge resection or ovarian cystectomy is the treatment of choice.

Adult↗

PubMed1993

Primary unruptured ovarian pregnancy--a case report.

A rare case of an unruptured ovarian ectopic pregnancy is reported. This patient had a dilatation and curettage for an incomplete abortion and no products of conception were revealed in the histology specimen. A repeat ultrasound scan detected an ectopic pregnancy. Laparotomy confirmed the diagnosis of an unruptured ovarian pregnancy. The problems with the diagnosis and the management of this case are discussed.

Adult↗

PubMed1993

Delivery after a lower segment caesarean section.

A retrospective study on the outcome of 130 consecutive patients with a previous lower segment Caesarean section who delivered in Kandang Kerbau Hospital, Singapore from January to June 1989 was performed. Seventy-six percent of these patients were selected for a trial of labour and 24% of the patients had a repeat (elective) Caesarean section. Vaginal delivery was achieved in 65% of patients chosen to undergo a trial of labour. A trial of labour was found to be relatively safe with only a 0.7% incidence of uterine dehiscence and a perinatal mortality of 10.1 per 1,000 births with no maternal mortality. Cephalopelvic disproportion in the previous pregnancy and cervical dilatation during the previous Caesarean section were not important prognostic factor for the subsequent pregnancy outcome. A previous vaginal delivery in patients who had a previous Caesarean section was a good prognostic factor for a subsequent successful vaginal delivery (p < 0.05) in the trial of labour. More vaginal deliveries (p < 0.05) were achieved when oxytocic infusion was used in selected cases during the trial of labour. Maternal morbidities were higher in patients who had a failed trial of labour (57%) and repeat elective Caesarean section (20%) than those who had a successful trial of labout (10%). Management of patients with a previous lower segment Caesarean section may present a dilemma, but if properly conducted, the outcome can be favourable.

Cesarean Section, Repeat↗

PubMed1993

Benign teratoma of the fallopian tube: a case report.

A benign teratoma of the fallopian tube in a 33-year-old woman with primary subfertility is reported. This is the first case reported in Singapore. The features of benign teratoma of the fallopian tube is discussed.

Adipose Tissue↗