Biomedical subjects

S Weerakiet

Publications and source records attributed to S Weerakiet.

10 recordsLinked to original sources

PubMed2004

Prevalence of gestational diabetes mellitus and pregnancy outcomes in Asian women with polycystic ovary syndrome.

The aim of this study was to determine the prevalence of gestational diabetes mellitus (GDM) and the pregnancy outcomes in Asian women with polycystic ovary syndrome (PCOS). The retrospective cohort study was performed to compare pregnancy outcomes of 47 pregnancies in 41 PCOS women with 264 pregnancies in 222 women with normal menstruation. Logistic regression was used to assess the risk of PCOS on GDM, hypertensive disorder in pregnancy (HDP) and premature delivery. The mean age of both groups was 31 years. The mean body mass index (BMI) and proportion of BMI of > 25 kg/m2 were significantly higher in the PCOS than in the control group. There was no difference in the prevalence of GDM between the PCOS women and the high-risk group of the controls. The prevalence of HDP and premature delivery was significantly greater in PCOS women (21.3 and 13.3%) than in the controls (6.4 and 5.4%), respectively. PCOS was demonstrated as a risk factor for GDM and HDP with borderline statistical significance, but not for premature birth. The Cesarean section rate was higher in the PCOS than in the control group. In conclusion, the prevalence of GDM in Asian women with PCOS is high and comparable to those of a high-risk group.

Adult↗

PubMed2004

Efficacy of metformin on ovulation induction in Asian women with polycystic ovary syndrome.

The aim of this study was to assess the efficacy of metformin on induction of ovulation in Asian women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). Twenty PCOS women who did not respond to CC were enrolled in the study. All received 500-1500 mg/day of metformin for 4 weeks. If no dominant follicle was observed with monitoring by transvaginal ultrasound, 50-150 mg of CC per day for 5 days were added. Timing of sexual intercourse was determined or intrauterine insemination was carried out 36 h after administration of human chorionic gonadotropin. A total of six cycles, pregnancy or anovulation despite taking 150 mg of CC were considered as completion of the study. Blood samples were obtained before and at the end of the 4th week of treatment for hormonal assay. Ovulation was observed in 68 (89.5%) of 76 cycles, of which 34 (44.7%) occurred with metformin alone. Twelve women conceived; therefore, the pregnancy rate was 17.6% per ovulated cycle and 60% per woman. One (8.3%) had an abortion. Four women had minimal adverse effect, but one experienced a severe gastrointestinal effect during the fourth cycle. Insulin and androstenedione levels were significantly decreased after 4 weeks of treatment. In conclusion, these series demonstrated the excellent efficacy of metformin on induction of ovulation and pregnancy in Asian women with CC-resistant PCOS.

Adult↗

PubMed2001

Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in Asian women with polycystic ovary syndrome.

OBJECTIVES: To determine the prevalence of abnormalities of glucose metabolism in Asian women with polycystic ovary syndrome (PCOS) and to assess the different impacts of the 1985 and 1999 WHO consultations and the ADA criteria for the diagnosis of type 2 diabetes mellitus (DM). METHODS: Eighty-five women with PCOS were consecutively included in the study at the Reproductive Endocrinology Unit, Department of Ob-Gyn, Ramathibodi Hospital, Mahidol University. All women underwent a standard oral glucose tolerance test (OGTT). Fasting insulin and testosterone levels were also measured. RESULTS: Seventy-nine women consented to the OGTT. The prevalence of impaired glucose tolerance (IGT) and type 2 DM was 22.8 and 15.2% with the 1985 WHO criteria, and 20.3 and 17.7% according to the 1999 WHO consultation criteria, respectively. The recommendation of the ADA using the fasting glucose levels could only determine a prevalence of 6.3% for type 2 DM. The fasting insulin and testosterone levels were significantly higher in DM than IGT and normal glucose tolerance (NGT) subgroups. The PCOS women with abnormalities of glucose metabolism had a greater body mass index (BMI), higher fasting glucose and 2-h post-load glucose levels than those with NGT. The prevalence of glucose intolerance significantly increased with BMI. CONCLUSIONS: Similar to other ethnic populations, Asian women with PCOS are at risk of developing IGT and type 2 DM especially if obese. The recommendation of the ADA is not appropriate for the diagnosis of type 2 DM in PCOS women.

Adult↗

PubMed2000

Transvaginal ultrasonography combined with pelvic examination in the diagnosis of ovarian endometrioma.

The aim of this retrospective study was to evaluate the efficacy of TVS and TVS combined with pelvic examination for the diagnosis of ovarian endometrioma. Three hundred and five ovarian masses of 244 patients with either pre-operative or post-operative diagnosis of ovarian tumor and received TVS between January 1, 1996 and December 31, 1998 were included in the study. Of 305 masses, 221 endometriomas of 164 patients were diagnosed histologically. The efficacy of TVS was 84.9 per cent with a sensitivity of 92.3 per cent and specificity of 70.2 per cent. LR+ and LR- were 3.1 and 0.1 respectively. The combination of TVS and pelvic examination with either positive test had a higher sensitivity (98.8%) but lower specificity (26.6%). This combination dramatically improved NPV (97.5%) and LR- (0.05), whereas, the combination with both positive tests had a sensitivity of 78.1 per cent, and specificity of 81.5 per cent. LR+ and LR- were not different from those using TVS alone. In conclusion, the study has shown the role of TVS in the diagnosis of ovarian endometrioma. The combination of TVS and pelvic examination may be useful in ruling out the disease. However, a further prospective study should be performed to confirm the efficacy of the combination.

Adult↗

PubMed2000

Laparoscopic hysterectomy using laparosonic coagulating shears: experience of 15 cases.

In conventional laparoscopic hysterectomy, adequate hemostasis is provided by bipolar coagulation, staple, and suture. The Laparosonic Coagulating Shears (LCS) have been proven to give both hemostasis and cutting. The objective of this study was to evaluate the efficacy of the LCS for laparoscopic hysterectomy. Fifteen patients indicated for hysterectomy were enrolled for laparoscopic hysterectomy using LCS. Each procedure was performed under general endotracheal anesthesia. The LCS were operated at power level 1 though 5. All pedicles, blood vessels, and tissues were coagulated and cut by LCS. The cardinal ligaments were cut and ligated transvaginally. The uterus was removed through the vagina. The operative finding, uterine volume and weight, operative time, CO2 volume, blood loss and hospital stay were recorded. Among the 15 cases, the indications were myoma uteri (7 cases), adenomyosis (6 cases) and adenomyosis with endometriomas (2 cases). The mean volume of the uterus was 226.8 cm3 (range 77-399 cm3) and mean weight was 188.8 g (range 85-320 g). Mean operative time was 171.6 min (range 114-210 min) and CO2 loss was 313.8 liters (range 120-650 liters). Blood loss was 366.7 ml (range 100-1,500 ml). LCS can be used for coagulation and cutting simultaneously. Minimal charring and smoke was observed during operation. In general, the hospital stay was 3 days (range 2-4 days), except for one case of recto-sigmoid injury and 2 cases of ureteric injury when the hospital stay was 7, 10, and 12 days, respectively. The injuries occurred in cases with anatomic distortion, profuse bleeding, and dense adhesion. LCS can be used as an alternative instrument for coagulation and dissection. According to our experience, it produces less charring and smoke compared to electrocoagulation. However, a high rate of complications were still encountered.

Adult↗

PubMed1999

Female genital tuberculosis: clinical features and trend.

A retrospective study of genital tuberculosis in women attending the Department of Obstetrics and Gynecology between January 1986 and December 1997 revealed 11 patients with a mean age of 38 years (range 23-77). Two patients had genital tuberculosis and tuberculous peritonitis. The incidence was 0.01 per cent of outpatients and 0.05 per cent of inpatients. Eight cases occurred during the last six years. Although the incidence was quite low, a rising trend was observed. Of the clinical features, infertility was the commonest initial symptom (3 cases). The most common site of infection was the endometrium (5 cases) followed by fallopian tube and ovary (3 cases). Chest X-ray of all patients showed no lung infiltration while AFB staining and PCR for tuberculosis were positive in two out of five and one out of two respectively. Six patients received medical treatment only, and three were treated with antituberculous drugs after surgery; all with good results. Tubal reconstructive surgery was performed in two patients without medical treatment. Gynecologists should be aware of this disease to facilitate early diagnosis and treatment.

Adult↗

PubMed1999

Efficacy of laparoscopic ovulation induction in polycystic ovary syndrome.

This prospective study was aimed to evaluate the efficacy of laparoscopic ovarian electrocoagulation in women with PCOS. Twenty-three PCOS women who had refractory to clomiphene citrate attending the Reproductive Endocrinology Unit, Ramathibodi Hospital between March 1995 and June 1998 were enrolled in the study. In all patients, electrocoagulation on the ovarian surface of both ovaries was performed through laparoscope under general anesthesia. Two patients were lost to follow-up for unknown reasons. The remaining 21 women had a mean age of 30.3 +/- 3.9 years (range 21-39) and mean duration of infertility of 4.1 +/- 2.8 years (range 1-11). There was no intra-operative and post-operative complication. After surgery, ovulation was documented in 16 out of 18 (88.9%) patients. Fifteen (71.4%) patients became pregnant. Fourteen pregnancies (93.3%) occurred within 9 months after surgery. Twelve women (80%) became pregnant in spontaneous cycles without any treatment. The outcomes of pregnancies were 10 live births, 3 ongoing pregnancies and 2 abortions. This study reveals the high efficacy of ovarian electrocoagulation in infertile women with PCOS. High pregnancy and low abortion rates are convincing. This surgical technique should be the treatment of choice for women with CC-resistant PCOS.

Adult↗

PubMed1996

Spontaneous abortion rate.

OBJECTIVE: To study the incidence of spontaneous abortion and relationship between incidence and maternal age profession, education level and income. STUDY DESIGN: Prospective cohort study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand. SUBJECTS: 999 patients registered at antenatal care unit, Department of Obstetrics and Gynecology from July 1, 1992. MAIN OUTCOME: Number of spontaneous abortion measures. RESULTS: From 999 patients, 69 were excluded from the study (8 had induced abortion, 61 could not be contacted). Most of patients aged 20-34 (85.5%) with the mean of 27 years. Spontaneous abortion occurred in 64 patients, incidence of 6.9 per cent. The analysis of data showed no relationship between the incidence of spontaneous abortion and age, profession, education level and income. CONCLUSION: Compared with previous studies, the incidence of spontaneous abortion is this study was quite low. With regard to the relationship of socioeconomic, further study with larger population should be performed to draw suitable conclusion.

Abortion, Spontaneous↗

PubMed1995

Determinants of multiple pregnancies in in vitro fertilization other than number of transferred embryos.

The aim of this study is to assess the many different parameters involved in the incidence of multiple pregnancies, such as maternal age, stimulation, endometrium, receptivity and the quality of the transferred embryos. During a 3.5 year period, 86 pregnancies were recorded in our IVF unit. A single gestational sac was identified by early ultrasonography in 67 patients, while in 19 others, multiple sacs were noted. Patient characteristics, treatment cycles and embryology results were similar in the two groups. When the number of transferred embryos was kept similar in both groups, EIR was found to be a valuable prognostic determinant for multiple pregnancies in IVF.

Abortion, Spontaneous↗

PubMed1995

Outcome of pregnancy in IVF-ET cycle at Ramathibodi Hospital.

As assisted reproductive technology is being developed, in vitro fertilization and embryo transfer (IVF-ET) are the treatments of choice for many infertility problems. The outcome of pregnancies achieved by IVF-ET is different from that of spontaneous pregnancies. In this retrospective study, the outcome of pregnancies from 400 IVF treatment cycles performed from October 1991 to October 1994 were reported. There were 80 pregnancies (20% per oocyte retrieval, 21.9% per embryo transfer) with an increased rate of abortion (30%), multiple pregnancy (20%), ectopic pregnancy (6.25%), heterotopic pregnancy (1.25%), preterm delivery (11.8%), low birth weight (35.8%) and cesarean section (62.7%). This study shows that the complication rate of pregnancies from IVF-ET cycles was higher than that found in spontaneous pregnancies. Some complications such as multiple pregnancies may be prevented by limiting the number of transferred embryos. From this study, all IVF-ET pregnancy should be considered as high risk pregnancies.

Adult↗