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Vorapong Phupong

Publications and source records attributed to Vorapong Phupong.

At least 19 recordsLinked to original sources
PubMed2006

Awareness of the benefits of folic acid and prevalence of the use of folic acid supplements to prevent neural tube defects among Thai women.

OBJECTIVE: To determine the level of knowledge about the usefulness of periconceptional folic acid supplementation among pregnant women. MATERIALS AND METHODS: An anonymous questionnaire was completed by selected subjects to assess folic acid awareness. The questionnaire was administered to pregnant women who were seeking antenatal care at King Chulalongkorn Memorial Hospital May to December 2005. The questions covered their knowledge and use of folic acid supplements, pregnancy intention, and demographic and socioeconomic characteristics. RESULTS: Out of 401 women surveyed, 76.1% of them reported that they had heard of folate. Of these, only 24.4% of the total subjects knew that folate was something important. Overall, 9.7% of the total women took folic acid during periconceptional period. The most common information sources on folate were the media. Logistic regression analysis showed that education of mother was the strongest predictor of having taken folic acid during the correct period. CONCLUSION: Although some pregnant women are aware of the need to take folic acid, the actual impact of the present recommendations is almost negligible. Information to specifically inform patients about the need to take folic acid to prevent neural tube defects by medias and healthcare personnel seem to improve the final intake of folic acid during the protective period.

Adult↗
PubMed2006

Spontaneous resolution of cystic hygroma in 47,XYY fetus.

INTRODUCTION: 47,XYY karyotype occurs in 1 out of 1,000 male births. Physical phenotype is normal, with tall stature by adolescence. Prenatal diagnosis of the 47,XYY syndrome is usually fortuitous. Some cases are being diagnosed when prenatal karyotyping is done for the detection of Down syndrome and other major aneuploidies. Some cases are diagnosed when prenatal ultrasonographic findings of fetal abnormalities are found. Herein, we report a case of 47,XYY after prenatal finding of fetal cystic hygroma with spontaneous resolution. CASE REPORT: A 19-year-old primigravid woman presented for antenatal care at the 13th week of pregnancy. She used oral isotretinoin, being unaware of pregnancy, for a treatment of acne during the first 4 weeks of gestation. Ultrasonogram was performed due to first trimester screening and the history of isotretinoin exposure. The result revealed a single viable fetus compatible with a 13-week pregnancy and a posterior cervical cystic hygroma. No other structural anomalies were noted. An amniocentesis was performed for prenatal chromosome analysis and a 47,XYY karyotype was found. Repeated ultrasonogram at 23-week gestation showed that the cystic hygroma had spontaneously disappeared. She delivered a normal appearing male infant by spontaneous vaginal delivery at 40 weeks. The maternal and neonatal outcomes were uneventful. CONCLUSION: Fetal cystic hygroma can be associated with abnormal karyotype, such as 47,XYY. Without hydrops fetalis, this may be ended with a normal outcome. Therefore, an antenatal karyotype determination should be offered to any woman whose fetus has cystic hygroma, even to those with spontaneous resolution.

Adult↗
PubMed2006

Efficacy of Yasmin in premenstrual symptoms.

OBJECTIVE: To evaluate the effect of oral contraception formulation with drospirenone (Yasmin) on premenstrual symptoms. MATERIALS AND METHODS: An open-label non-comparative clinical trial was conducted. One hundred women who desired oral contraception for at least 6 months were recruited. The subjects received a blister pack which contained 21 tablets of 3 mg drospirenone/30 microg ethinyl estradiol for the first four cycles (1 cycle = 28 days). Cycle-5 and -6 blister packs were dispensed during the next visit in cycle 4. The subjects were evaluated on menstruation-related symptoms by using the women's health assessment questionnaire (WHAQ) at baseline and at each follow-up visit for three phases of their menstrual cycle. The measured outcome was the mean score changes from baseline to cycle 6 of WHAQ categories. RESULTS: Of the total 100 subjects, 92 (92%) completed the study. At the premenstrual phase, a significant decrease was seen from baseline to cycle 6 in the mean WHAQ scores for impaired concentration, water retention, negative effect, increased appetite, feeling of well-being and undesirable hair change. At the menstrual phase, a significant decrease was seen from baseline to cycle 6 regarding the mean WHAQ scores for impaired concentration, negative effect, feeling of well-being, and undesirable hair change. At the postmenstrual phase, significant changes were consistently observed regarding the feeling of well-being and undesirable hair change. CONCLUSIONS: Oral contraception formulation with drospirenone (Yasmin) has an ameliorating effect on premenstrual symptoms. This oral contraception may have a role in women who are looking forward to use contraception and also suffer from premenstrual symptoms.

Adult↗
PubMed2006

Prenatal exclusion of subtelomeric deletion 1p by fluorescent in situ hybridization.

BACKGROUND: Subtelomeric deletion 1p is difficult to detect from banded karyotypes. Recent developments in the field of molecular cytogenetics have made it possible for submicroscopic rearrangements within chromosomes to be detected using fluorescence in situ hybridization (FISH) techniques. MATERIALS AND METHODS: We describe prenatal FISH testing of subtelomeric 1p deletion in a fetus of a mother whose previous child had subtelomeric 1p deletion. RESULTS: Fluorescent in situ hybridization from fetal cells demonstrated normal 1p, thus predicting a very high likelihood of an unaffected fetus. The study was confirmed by the birth of a normal neonate. CONCLUSIONS: We report the use of molecular genetic testing to exclude subtelomeric 1p deletion prenatally. Prenatal diagnostic testing for a known deletion is a reasonable option for couples at risk for having a child with subtelomeric 1p deletion. Molecular testing is more accurate and reliable than ultrasonography and provides families with reassurance.

Adult↗
PubMed2006

Kikuchi disease during pregnancy.

BACKGROUND: Kikuchi disease is a rare but distinctive type of necrotizing lymphadenitis. It has a self-limiting clinical course and usually affects the cervical lymph nodes in young women. Although Kikuchi disease occurs most often in young women, it is rare during pregnancy. CASE: A 28-year-old woman, primigravida, 8 weeks pregnancy, presented initially for antenatal care. Last 4 years, she had chronic cough, weight loss and enlarged left supraclavicular lymph node. The diagnosis was for Kikuchi disease and she received prednisolone for 4 months and had no symptom. She had an enlarged left supraclavicular node again at her first antenatal care. She received no treatment for Kikuchi disease during pregnancy and remained symptom free. The antenatal care course was unremarkable. The maternal outcome was complicated with immediate postpartum hemorrhage; however, the baby was healthy. CONCLUSION: This is the fourth reported case of Kikuchi disease developing during pregnancy. When Kikuchi disease occurs in a pregnant woman, there is neither any effect of disease on the pregnant woman nor the fetus.

Adult↗
PubMed2006

First trimester embryonic/fetal heart rate in normal pregnant women.

OBJECTIVE: To establish reference ranges for first trimester embryonic/fetal heart rate in normal pregnant women. MATERIALS AND METHODS: This was a cross-sectional study. We performed ultrasonogram in 319 normal pregnant women, gestation age between 6(+0) and 14(+6) weeks and measured embryonic/fetal heart rates using M-mode. The embryonic/fetal heart rates were analyzed according to gestational ages (GA). RESULTS: Data of 319 pregnancies were analyzed and the outcome revealed the mean of fetal heart rate according to gestational age. The mean embryonic heart rates during the 6th-7th week of gestation are lower when compared with the other gestational ages. At the 8th week of gestation, the embryonic heart rate is maximum. Then the embryonic/fetal heart rate gradually decreased to 161 beats/min at the 14th week of gestation. The regression equation for embryonic/fetal heart rate (beat/min) [y] according to GA (day) [x] was y = -53.124 + 6.1333x + (-0.0407)x ( 2 )(r (2) = 0.525; P < 0.001). CONCLUSION: Embryonic/fetal heart rates during the 6(+0) and 14(+6) week of gestation are related to GA. Our reference ranges may be useful for further studies such as for prediction of adverse pregnancy outcome in threatened abortion.

Adult↗
PubMed2006

An increase of the cardiothoracic ratio leads to a diagnosis of Bart's hydrops.

BACKGROUND: Thalassemia is a common single gene disorder in Southeast Asia. a-thalassemia is a group of syndrome characterized by deficient production of the alpha-globin chain. Individuals with heterozygous alpha-thalassemia-1 are at risk of having a fetus that has Hemoglobin Bart's hydrops fetalis (Hb Bart's). Usually, when the hemoglobin electrophoresis in heterozygous alpha-thalassemia-1 is normal, the Mean Corpuscular Volume (MCV) is lowered. We report a case of increased cardiothoracic ratio that led to a diagnosis of Hb Bart's in a couple who had normal hemoglobin electrophoresis and low MCV. CASE REPORT: A 23-year-old woman, gravida 2, Para 0-0-1-0, initially presented for antenatal care at 13 weeks pregnancy. Her MCV was 67 fentolitre, DiChlorophenol-IndolPhenol (DCIP) test was negative and hemoglobin electrophoresis was normal. Her husbands MCV was 67 fentolitre, and hemoglobin electrophoresis was normal. Cardiomegaly (an increased of the cardiothoracic ratio) was detected by ultrasonogram at 25 weeks of gestation. She and her husband were comprehensively counseled after an Hb Bart's was suspected. A cordocentesis was performed and the fetal blood was tested for hemoglobin electrophoresis. The result was later known and confirmed as Hb Bart's. The couple decided to terminate the pregnancy. The induced abortion was successful and the patient was discharged on the second day after the abortion. She was well at the 4-week follow-up. CONCLUSION: A prenatal ultrasonographic screening should be conducted in couples who are suspected of being alpha-thalassemia-1 carriers when DNA study of alpha-globin gene cannot be performed. The increase of cardiothoracic ratio will help detect an early stage of Hb Bart's.

Adult↗
PubMed2006

Spontaneous reseal of ruptured membranes after genetic amniocentesis.

BACKGROUND: Rupture of membranes is an uncommon complication of genetic amniocentesis. The risk of ruptured membranes is reported as 1-1.2%. CASE: Genetic amniocentesis complicated by ruptured membranes was diagnosed in a 31-year-old woman. The membranes resealed after 48 hours with conservative management and the pregnancy ended with a favorable outcome. CONCLUSION: Spontaneous reseal of ruptured membranes after genetic amniocentesis can occur with conservative management and end with a favorable pregnancy outcome.

Adult↗
PubMed2005

The effect of tranexamic acid for treatment of irregular uterine bleeding secondary to Norplant use.

OBJECTIVE: The purpose of this study is to evaluate the effects of tranexamic acid and placebo on controlling irregular uterine bleeding secondary to Norplant use. MATERIALS AND METHODS: A prospective randomized, double-blind, placebo-controlled trial was conducted. Sixty-eight Norplant users who had irregular bleeding were randomly allocated into two groups. A total of 34 users received tranexamic acid 500 mg twice a day for 5 days; the placebo was given to the other 34 users in the same manner. The total number of days of bleeding and spotting and the percentage of women whose irregular uterine bleeding was stopped was analyzed at the end of weeks 1 and 4. RESULTS: In the follow-up period (4 weeks after the initial treatment), a bleeding-free interval of > 20 days was found in 58.8% of the subjects treated with tranexamic acid and in 76.5% treated with placebo (p = .12). The percentage of subjects whose irregular uterine bleeding stopped during week 1 after the initial treatment was significantly higher in the tranexamic acid group than those in the placebo group (64.7% vs. 35.3%, p = .015). The mean number of bleeding/spotting days was not significantly different between the groups (15.4 vs. 12.7 days, p = .182). CONCLUSIONS: Tranexamic acid for 5 days appears to be an effective treatment for irregular uterine bleeding associated with Norplant use only while it is being used. However, treatment for 5 days does not seem to provide long-term benefit.

Adult↗
PubMed2005

Serum calcium and serum magnesium in normal and preeclamptic pregnancy.

OBJECTIVE: The aims of this study were to measure serum levels of calcium and magnesium in preeclamptic pregnancies and to compare them with those in normal pregnancies. MATERIALS AND METHODS: We collected venous serum samples from 40 preeclamptic pregnant women and 40 normal pregnant women. The blood samples were analyzed for calcium and magnesium, using a colorimetric analyzer. The data were analyzed using the Student's t-test, chi2-test or Fisher exact tests when appropriate. RESULTS: The serum calcium concentration in preeclamptic pregnant women is significantly lower than that in normal pregnant women (9.0 +/- 0.4 mg/dl vs. 9.7 +/- 0.7 mg/dl, p < 0.0001). Like serum calcium, serum magnesium concentration in preeclamptic women is significantly lower than that in normal pregnant women (0.77 +/- 0.08 mmol/l vs. 0.85 +/- 0.09 mmol/l, p = 0.001). CONCLUSION: This study shows that both serum calcium and serum magnesium levels in preeclamptic pregnant women are lower than in normal pregnant women. These findings support the hypothesis that hypocalcemia and hypomagnesemia are possible etiologies of preeclampsia.

Adult↗
PubMed2005

Disseminated gonococcal infection during pregnancy.

BACKGROUND: Disseminated gonococcal infection in pregnancy is rare with the incidence of 0.04-0.09% in pregnant women. Its most common manifestation is arthritis. CASE: A 38-year-old woman, G1P0, 36+ weeks pregnancy came to hospital with decreased fetal movement. She had purulent vaginal discharge and history of self treatment 1 month earlier. She had a fever with arthritis for 3 days. Purulent joint fluid from arthrocentesis of her right wrist demonstrated intracellular Gram negative diplococcal bacteria. The diagnosis was disseminated gonococcal infection. She was successfully treated with parenteral ceftriaxone followed by oral cefixime. Cesarean section was performed due to preterm premature rupture of the membranes. The maternal and neonatal outcomes were uneventful. CONCLUSION: Disseminated gonococcal infections are not rare, however, disseminated gonococcal infection in pregnancy is a rare condition. Clinicians should be suspicious of the disease when a pregnant patient presents with arthritic symptoms.

Adult↗
PubMed2005

Prospective randomized, double-blinded, placebo-controlled trial of preoperative rofecoxib for pain relief in uterine curettage.

OBJECTIVE: To evaluate the analgesic efficacy of preoperative rofecoxib in patients who underwent uterine curettage. MATERIALS AND METHODS: This double-blinded, randomized, placebo-controlled trial included 80 women who underwent uterine curettage. Forty women were randomly assigned to rofecoxib 50 mg and 40 women to the placebo. The main outcome measure was the intensity of pain measured by the visual analog scale and categorical pain scores during and after the procedure. Chi-squared, Fisher exact, Student t test, and Mann-Whitney U tests were used for statistical analysis. RESULTS: The intensity of pain was not found to be different between groups over the course of procedure (P>0.05). There were no serious adverse effects in this study. CONCLUSION: The preoperative administration of rofecoxib was not effective in reducing pain in uterine curettage.

Adult↗
PubMed2005

First trimester diagnosis of partial mole.

BACKGROUND: Partial mole is one of the two distinctive subtypes of hydatidiform mole. It is usually paternally derived triploid conceptions in which embryonal development occurs in association with trophoblastic hyperplasia. The definite diagnosis is confirmed by pathological and cytogenetic studies. Ultrasound might be helpful to diagnose partial mole in the first trimester. CASE: A 25-year-old woman, gravida 2, para 0-0-1-0, was initially seen for antenatal care at 6 weeks' pregnant. Ultrasound was undertaken at 13 weeks' pregnancy due to her first fetal anomaly, which demonstrated partial mole and embryonic death. The serum beta hCG was 190,900 mIU/ml. Suction curettage was performed without complication. Histopathological study confirmed partial mole and cytogenetic study of the placenta revealed an uncommon karyotype, mosaicism of triploid (69,XXX/69,XXY). Serum beta hCG was declined and negative at 8 weeks. The patient was well and serum beta hCG remained normal throughout 6 months of follow-up. CONCLUSION: Although the majority of partial mole pregnancies cannot be detected by routine first trimester ultrasound examination, first trimester ultrasound can be helpful in some cases, such as this one. If partial mole is sonographically suspected, it should be confirmed with histopathology and cytogenetic studies. The management is similar to complete mole including prompt evacuation and careful monitoring of beta hCG.

Adult↗
PubMed2005

Primary ovarian pregnancy.

BACKGROUND: Primary ovarian pregnancy is a relatively rare form of ectopic pregnancy with an incidence of 1/6000 - 1/40000 pregnancies. CASE REPORT: A 25-year-old woman, gravida 1, parity 0, presented with vaginal bleeding after 8 weeks of amenorrhea. Pelvic examination revealed a left adnexal mass and transvaginal ultrasound confirmed a left adnexal echocomplex mass with free fluid in the cul-de-sac. Serum beta hCG was 3441 mIU/mL. Emergency exploratory laparotomy was performed with a preoperative diagnosis of left ectopic pregnancy, suspected of ovarian pregnancy. Ruptured left ovarian pregnancy was intraoperatively diagnosed. Left salpingo-oophorectomy was performed. The histopathology confirmed ovarian pregnancy. She was well at discharge and throughout a 4-week period of follow-up. CONCLUSION: Although primary ovarian pregnancy is rare and difficult to diagnose clinically and even intraoperatively, it can be detected early with the use of combined transvaginal ultrasonography and serum beta hCG The standard of care is conservative treatment in order to preserve the patient's fertility.

Adult↗