Biomedical subjects

T B Song

Publications and source records attributed to T B Song.

10 recordsLinked to original sources

PubMed2001

Obstetric prognosis of the gestational thrombocytopenia.

To define clinical outcomes of marked gestational thrombocytopenia (GT) (<100,000/mm3) we identified twenty-nine infants born to 28 pregnancies at 26 women with GT among 8,364 deliveries during the years 1993- 1999. Cordocentesis was performed in 7 mothers with platelet counts less than 75,000/mm3. Cord blood platelet count was checked in all cases at delivery. The most significant decrease of platelet count in pregnancy with GT was less than 50,000/mm3 in 6 pregnancies (21.4%) and between 50,000 and 100,000/mm3 in 22 pregnancies (78.6%). In pregnancies with GT, 2 neonates (6.9%) had mild thrombocytopenia and 1 neonate (3.4%) moderate thrombocytopenia. Severe thrombocytopenia was not observed in any neonate born to mothers with GT. There were no cases of coagulation disturbance at delivery or in the postpartum period. Fourteen cases for which follow-up was carried out recovered platelet counts to more than 100,000/mm3 within one month postpartum. Two patients who became pregnant twice noticed recurrence of GT. In conclusion, GT is not associated with bleeding diathesis in the mother, resolves spontaneously during the postpartum period, and can recur in subsequent gestations, and the association of severe fetal/neonatal thrombocytopenia is very rare. No intervention is necessary during pregnancy or delivery, apart from a careful maternal and fetal surveillance if there is no obstetric indication.

Adult↗

PubMed2000

Delayed interval delivery in multiple gestations.

Two multiple pregnancies with delayed delivery after expulsion of dead fetus are presented. Case 1: A woman with a twin pregnancy and one intrauterine fetal death at 20 weeks' gestation delivered a dead fetus at 27 weeks' gestation. She delivered a healthy male infant weighing 2430 g at 33 weeks' gestation (42 d after the delivery of the first twin). Case 2: A woman with quadruplets pregnancy (2 live fetuses, one empty sac, and one fetocide at 7 weeks' gestation) got a intrauterine fetal death at 21 weeks' gestation at one fetus among 2 live fetuses and delivered a dead fetus at 24 weeks' gestation. She delivered a healthy female infant weighing 2110 g at 33 weeks' gestation (58 d after the delivery of a dead fetus). On the basis of our experience and the review of literature, delayed delivery with careful observation of fetal and maternal condition is recommended for improved survival and decreased morbidity among latter-born siblings.

Adult↗

PubMed2000

Fetal weight prediction by thigh volume measurement with three-dimensional ultrasonography.

OBJECTIVE: To evaluate the usefulness and accuracy of a simple method of predicting fetal weight by measuring fetal thigh volume with three-dimensional ultrasonography. METHODS: In 84 pregnant women, fetuses without structural or chromosomal anomalies were studied prospectively and cross-sectionally. Biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL) were measured by two-dimensional ultrasound. Fetal thigh volume was measured by three-dimensional ultrasound, using three cross-sectional images of femur, from proximal, middle, and distal parts of femur diaphysis. Infants were delivered within 48 hours after ultrasound examinations. RESULTS: Modified thigh volume measurements using three cross-sectional images of femur by three-dimensional ultrasound were correlated strongly with birth weight (R(2) = 0.921, P <.001). Using linear and polynomial regression, we calculated a new best-fit formula: Birth weight (g) = 165.32 + 28.78 x modified thigh volume (mL). The mean and standard deviation of the residual were 121.8 and 110.4, respectively, in three-dimensional formulas, which were significantly smaller than those of two-dimensional formulas. CONCLUSION: Thigh volume measurement using three cross-sectional images of femur by three-dimensional ultrasound was simple, and there was better accuracy with this method than with two-dimensional ultrasound methods for predicting fetal weight during the third trimester of pregnancy.

Adult↗

PubMed2000

Prenatal diagnosis of severe tricuspid insufficiency in Ebstein's anomaly with pulmonary atresia and intact ventricular septum: a case report.

Pulmonary atresia with intact ventricular septum is an uncommon congenital cardiac anomaly which very often present varying degrees of downward displacement and dysplasia of the tricuspid valve. A 23-year-old woman was referred at 23 weeks' gestation because of fetal cardiomegaly detected by routine ultrasonography. Ebstein's anomaly with pulmonary atresia was diagnosed by fetal echocardiography. On pulsed Doppler examination, a severe tricuspid regurgitation was detected. Pulmonary atresia was suspected, as forward flow was not detected into pulmonary artery. The fetus was terminated at 25 weeks. At the postmorterm examination Ebstein's anomaly with pulmonary atresia and intact ventricular septum were confirmed. The finding of right atrial enlargement on an early sonogram should prompt the search for tricuspid valve abnormalities with tricuspid regurgitation and the presence or development of pulmonary atresia or stenosis. With the information provided, early detection of tricuspid valve disease should be possible so that the option of therapeutic abortion can be offered.

Abortion, Induced↗

PubMed2000

Red blood cell life span in the ovine fetus.

Red cell life span within the fetal circulation has not been reported, although erythrocyte life span has been studied in the adult and newborn. The present study quantified red cell life span in 12 chronically catheterized fetal sheep at 97-136 days gestation (term = 150 days) with the use of autologous red cells labeled with [(14)C]cyanate. Cyanate forms a permanent covalent bond with hemoglobin and acts as a permanent red cell label. In the fetuses, blood (14)C activity decreased in a curvilinear fashion with time and reached 50% of the initial activity at 16.4 +/- 1.6 (SE) days. In contrast, (14)C activity of autologous red cells in two adult ewes decreased linearly with time as expected, reached 50% of the initial (14)C activity in 59 days, and yielded life spans of 117 and 121 days. Computer modeling and parameter optimization taking into account growth and skewed life span distribution were used to analyze the (14)C disappearance curve in each fetus. The mean life span of all red cells in the fetal circulation was 63.6 +/- 5.8 days. Mean red cell life span increased linearly from 35 to 107 days as fetal age increased from 97 to 136 days (r = 0.83, P < 0.001). Life span of cells produced at the time of labeling was significantly greater than the mean life span. Fetal growth rate estimated from parameter optimization was 3.28 +/- 0.72%/day; this compared well with the rate of 3.40 +/- 0.14%/day calculated from fetal weights at autopsy. Mean corpuscular volume decreased as a function of gestational age, but the decrease was small compared with the large increase in red cell life span. We conclude the following: 1) red cell life span in the fetal circulation is short compared with the adult; 2) red cells in younger fetuses have shorter life spans than in near-term fetuses; 3) the curvilinear disappearance of labeled red cells in the fetus appears to be due primarily to an expanding blood volume with fetal growth; and 4) red blood cell life span in a growing organism will be significantly underestimated unless the expansion of blood volume with growth is taken into account.

Animals↗

PubMed1996

A study on fetal urinary tract anomaly: antenatal ultrasonographic diagnosis and postnatal follow-up.

OBJECTIVE: To evaluate the incidence, associated anomalies, and the type of congenital urinary tract anomaly and to know the cause of congenital hydronephrosis. METHODS: In 4.5 years, 5,442 fetuses had ultrasonography and 48 cases of fetal urinary tract anomaly were detected. Ultrasonogram was done after delivery with further examination as necessary. RESULTS: The incidence of all types of anomaly was 4.3% (236/5,442) and the incidence of urinary tract anomaly was 0.9% (48/5,442, 8.8/1,000 births) of all babies born and 20.3% (48/236) of entire anomaly. Types of urinary tract anomaly were as follows; hydronephrosis (37 cases), multicystic dysplastic kidney (5 cases), polycystic kidney disease (2 cases), renal agenesis (2 cases), ectopic kidney (1 case) and hypoplastic kidney (1 case). Associated anomalies were found in 8 cases (16.7%) among 48. Causes of hydronephrosis were ureteropelvic obstruction in 13 cases, ureterovesical obstruction in 4 cases, vesicoureteral reflux in 2 cases, proximal ureteral obstruction in 2 cases, and no specific causes in 16 cases. CONCLUSIONS: Antenatal ultrasonography is a very useful diagnostic tool in the detection of urinary tract anomaly and a careful search for other anomalies is indicated when urinary tract anomaly is found.

Female↗

PubMed1994

Prenatal ultrasonographic diagnosis of congenital kyphosis due to anterior segmentation failure.

A few cases of congenital scoliosis due to segmentation failure have so far reported and the antenatal detection of pure congenital kyphosis without scoliosis due to segmentation failure has not been reported. We report the first prenatal identification using ultrasound of a fetus affected with pure congenital kyphosis due to anterior segmentation failure of the vertebral body between the second and third lumbar spine which was associated with ventriculomegaly, cleft palate, and hydramnios.

Adult↗

PubMed1993

Treatment failure in malignant gestational trophoblastic disease.

One hundred and thirty-three patients with malignant gestational trophoblastic disease (GTD) were admitted. All patients (86/86) of the nonmetastatic and metastatic low-risk groups and 89.4% (42/47) of the metastatic high-risk group showed remission. The overall remission rate was 96.2%. Among 5 patients with brain metastases, however, only one (20%) survived. We arrived at two main conclusions. First, brain metastatic lesions did not successfully respond to therapy utilizing conventional chemotherapeutic regimens. Second, the key factors for successful outcome in brain metastases were early diagnosis and aggressive initial therapy. Therefore, early detection of brain metastases should be made with: (1) fine computerized tomography (CT) or magnetic resonance imaging (MRI), (2) measurement of the ratio of serum to cerebrospinal fluid hCG concentration, and (3) early recognition of their clinical features.

Adult↗

PubMed1993

[Transplantation of free medial leg skin flap to bridge over electric burns at wrist].

Twelve wrists (in 11 patients) with electric burns were covered by the transplantation of free medial leg skin flaps. It was successful in 10 but failed in 2. Our experience is summarized as following: 1. The skin flaps can serve as bridge to allow blood to go through as well as good coverage for the wound. When the ulnar artery and the radial artery are injured, we can obtain a long segment of the posterior tibial artery, and portions of it can be used to repair these arteries. In this series two hands were saved with good function in three years follow-up. 2. The sites of the skin flaps are concealed. Harvesting of the flaps does not impaired the function of the donor site. Thickness of the flaps is adequate. The flaps are not excessively bulky. The anatomical site of the posterior tibial artery is constant. The calibre of the posterior tibial artery is similar to that of the radial arteries. The rate of success of the operation is high.

Adult↗

PubMedDate not supplied

Low neonatal risk of thrombocytopenia in pregnancy associated with immune thrombocytopenic purpura.

OBJECTIVE: To estimate the risk of neonatal thrombocytopenia in infants born to mothers with immune thrombocytopenic purpura (ITP). METHODS: During the years 1993-1997, there were 6,082 deliveries. There were 32 infants born to 31 mothers with ITP. Cordocentesis was performed between 34 and 41 weeks of gestation in 16 mothers with ITP. The cord blood platelet count was checked in all cases at delivery. RESULTS: In mothers with ITP, 5 neonates (15.6%) had mild thrombocytopenia and 7 neonates (21.9%) moderate thrombocytopenia. Severe thrombocytopenia was not observed in any neonate born to mothers with ITP. CONCLUSIONS: The means of delivery in pregnant women with ITP can be determined solely on the basis of obstetric indications because the incidence of severe fetal and neonatal thrombocytopenia is very rare, neonatal intracranial hemorrhage is unlikely to be related to the mode of delivery and percutaneous umbilical blood sampling is technically difficult with a risk of fetal death.

Cordocentesis↗