Particulate Matter 2.5 and Obstetric Complications

Particulate matter (PM) is microscopic solid or liquid matter suspended in the atmosphere of Earth. The sources of PM can be natural or anthropogenic. The most common used for classification of PM is the size of PM. PM 2.5 influences general health problems. Inhalation of PM 2.5 also causes obstetric complications such as low birth weight, preterm delivery and stillbirth. Thus, pregnant women should avoid the exposure to PM 2.5 for prevention of these obstetric complications

Zika virus infection in pregnancy

Zika virus is a mosquito-borne virus. It is transmitted to humans by infected Aedes spp. mosquitoes. Non-vector-borne transmission routes of Zika virus include blood transfusion-related transmission, sexual transmission, transplacental transmission, and perinatal transmission. Zika virus infection is asymptomatic in most cases. If symptoms occur, symptoms are generally mild and self-limited. Signs and symptoms, diagnosis and treatment of Zika virus infection in pregnant women are similar to non-pregnant women. Zika virus infection in pregnancy is associated with fetal structural brain abnormalities and microcephaly. The treatments are symptomatic and supportive. Prevention from mosquito bites is the best way to prevent Zika virus infection. Treatment of Zika virus infection in pregnant women is similar to non-pregnant women. However, obstetricians should be aware of congenital Zika virus infection when pregnant women infected with Zika virus especially in the first trimester

Dengue fever in pregnancy: a case report

<p>Abstract</p> <p>Background</p> <p>Dengue, a mosquito-borne flavivirus infection, is endemic in Southeast Asia. Currently, the incidence has been increasing among adults.</p> <p>Case presentation</p> <p>A 26-year-old Thai woman, G₁P₀ 31 weeks pregnancy, presented with epigastric pain for 1 day. She also had a high-grade fever for 4 days. The physical examination, complete blood counts as well as serology confirmed dengue fever. The patient was under conservative treatment despite severe thrombocytopenia. She was well at the 3^rd day of discharge and 1-week follow-up. The pregnancy continued until term without any complication and she delivered vaginally a healthy female baby.</p> <p>Conclusions</p> <p>More cases of dengue infection in pregnancy can be found due to the increasing incidence during adulthood. It should be suspected when a pregnant woman presents with symptoms and signs like in a non-pregnant. Conservative treatment should be conducted unless there are any complications.</p

Twisted fallopian tube in pregnancy: a case report

BACKGROUND: Isolated twisted fallopian tube is an uncommon event, isolated twisted fallopian tube in pregnancy is also very rare. The diagnosis is often difficult and established during the operation. The right fallopian tube is most common affected. CASE PRESENTATION: We report an uncommon twisted left fallopian tube in pregnancy. A 34-year-old G(3)P(2) 28 weeks pregnant woman presented with acute left lower abdominal pain. The clinical and ultrasonographic findings led to diagnosis of twisted left ovarian cyst. Emergency exploratory laparotomy was performed. A twisted left fallopian tube and paratubal cyst was noted and left salpingectomy was performed. The postoperative course was uneventful and the pregnancy continued until term without complication. CONCLUSIONS: Although isolated twisted fallopian tube during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity and may allow preservation of the fallopian tube

Editorial

This fourth issue of Thai Journal of Obstetrics and Gynaecology (TJOG) contains many interesting articles. The special article in this issue is “Serum squamous cell carcinoma antigen and its application in cervical cancer patients”. We already announced the best paper award of TJOG 2016 at RTCOG Annual Meeting 2017 at Khao Yai Convention Center, Nakornraschasima. The best paper for obstetric was “Prevention of Postpartum Hemorrhage with Oxytocin versus Ergometrine plus Oxytocin in the Third Stage of Labor”, and the best paper for gynaecology was “Gum Chewing for Stimulating Early Recovery of Bowel Function after Postoperative Benign Gynecologic Surgery: A Randomized Controlled Trial”. Editor in Chief and managing staff already attended the Thai Journal Citation Index meeting: “The 4th Editors’ Workshop” under the TCI-TRF-Scopus Collaboration Project on 10 November 2017 at Sapphire Room, Century Park Hotel, Ratchaprarop Rd, Bangkok. Editorial Board of TJOG look forward to continuously raising the quality of the TJOG and prepare journal for submission to be index in Scopus index. For the coming New Year 2018, we would like to extend our warmest wishes to RTCOG members, reviewers, authors and families. We thank to all the authors, readers, reviewers, and editors for your contributions to TJOG this past year and look forward to receiving your valuable contributions in 2018

First trimester 3D ultrasound placental volume for predicting preeclampsia and/or intrauterine growth restriction

The objective of the study was to determine the sensitivity of the placental volume for predicting preeclampsia and/or intrauterine growth restriction (IUGR) in the first trimester. A prospective observational study was conducted in pregnant women with a gestational age of 11 to 13+6 weeks. A 3 D transabdominal placental volume measurement was performed at the time of first-trimester aneuploidy screening. The predictive values of this test were calculated. The data from 360 pregnant women was analysed. Seventeen cases developed preeclampsia and/or IUGR. The 10th percentile of placental volume was used as the cut-off level. The sensitivity, specificity, positive predictive value and negative predictive value of placental volume less than the 10th percentile for prediction of preeclampsia and/or IUGR were 23.5%, 90.7%, 11.1% and 96%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value for prediction of early onset preeclampsia were 50%, 90.7%, 3.0% and 99.7%, respectively. This study demonstrated that the placental volume was lower in the cases with preeclampsia and/or IUGR. It was not an effective screening tool for preeclampsia and/or IUGR in the first trimester.IMPACT STATEMENT What is already known on this subject? Placental volume may reflect trophoblast invasion, but much earlier, in the first trimester. The estimation of a smaller early placental volume has been shown to be significantly associated with preeclampsia and IUGR. What do the results of this study add? The placental volume was lower in the cases with preeclampsia and/or IUGR. It was not an effective screening tool for preeclampsia and/or IUGR in the first trimester. But it might be used for predicting early onset preeclampsia. What are the implications of these findings for clinical practice and/or further research? Further research of placental volume in the first trimester for predicting an early onset preeclampsia should be conducted

Comparison of transabdominal and transvaginal ultrasonography for the assessment of cervical length at 16–23 weeks of gestation

The aim of this study was to assess the relationship between transabdominal and transvaginal ultrasonography for the cervical length assessment and to evaluate the predictive value of the transabdominal ultrasonography cervical length assessment for predicting preterm birth. A prospective cohort study was conducted. Transabdominal and transvaginal ultrasonography cervical length assessments were performed in 160 pregnant women between 16 and 23 + 6 weeks of gestation. Transabdominal ultrasonography cervical length assessment was positively correlated with the transvaginal ultrasonography cervical length assessment. Mean ± standard deviation of the cervical length was significantly different between transabdominal and transvaginal ultrasonography (36.4 ± 5.4 vs. 41.2 ± 5.4 mm, p < .001). Transabdominal cervical length was shorter than the transvaginal cervical length with a mean difference of 4.8 mm. The sensitivity, specificity, positive predictive value and negative predictive value for predicting preterm birth when the transabdominal cervical length was ≤35 mm, were 50%, 52.1%, 9.1%, and 91.6%, respectively. In conclusion, transabdominal ultrasonography cervical length assessment is positively correlated with the transvaginal ultrasonography cervical length assessment. Transabdominal cervical length assessment was not a good predictor of preterm birth

Combination of three-dimensional ultrasound measurement of foetal adrenal gland enlargement and placental alpha microglobulin-1 for the prediction of the timing of delivery within seven days in women with threatened preterm labour and preterm labour

The aim of this study was to predict the timing of delivery within seven days in singleton pregnant women with threatened preterm labour and preterm labour by using a three-dimensional (3D) ultrasound measurement of foetal adrenal gland volume enlargement, a foetal zone enlargement and cervicovaginal placental alpha microglobulin-1 (PAMG-1) test. This prospective cohort study included singleton pregnant women at 22–36+6 weeks of gestation who presented with threatened preterm labour and with preterm labour. Transabdominal 3D ultrasound measurement of the whole foetal adrenal gland and of the foetal adrenal zone were performed. Qualitative cervicovaginal PAMG-1 detection was performed at the same time. One hundred and fifty-four pregnant women were included into the study. Eighty-four pregnant women had threatened preterm labour and seventy pregnant women had preterm labour. Twenty-nine pregnant women (18%) delivered within seven days. Use of foetal adrenal gland volume enlargement, foetal zone enlargement and the PAMG-1 test in combination increased sensitivity; if one parameter was positive, the sensitivity, specificity, positive predictive value and negative predictive value were 82.8%, 27.2%, 20.9% and 87.2%, respectively, in the prediction of the timing of delivery within seven days. The combination of foetal adrenal gland enlargement and PAMG-1 increased sensitivity for the prediction of the timing of delivery within seven days in pregnant women presenting with threatened preterm labour and preterm labour.Impact Statement What is already known on this subject? An increased foetal adrenal gland volume is significantly correlated with the risk of preterm birth. What do the results of this study add? The combination of a foetal adrenal gland enlargement and a placental alpha microglobulin-1 increased sensitivity for the prediction of the timing of delivery within seven days in pregnant women presenting with threatened preterm labour and preterm labour. What are the implications of these findings for clinical practice and/or further research? The combination of a foetal adrenal gland enlargement and placental alpha microglobulin-1 may be used for the prediction of the timing of delivery within seven days in pregnant women presenting with threatened preterm labour and with preterm labour