Browsing by Author "Tannirandorn, Y"
Now showing 1 - 20 of 51
Results Per Page
Sort Options
Item About the death penalty in Thailand.(2000-12-20) Wilde, H; Pruksapong, C; Phaosavasdi, S; Tannirandorn, Y; Taneepanichskul, S; Chulsiriwong, TItem Accuracy of ultrasonographic criteria for the prenatal diagnosis of placental amnionicity and chorionicity in twin gestations.(1993-04-01) Tannirandorn, Y; Phaosavasdi, SA total of 31 twin pregnancies were studied antenatally with ultrasound, followed up clinically, and the placentas examined to determine if, solely on the basis of prenatal sonography, an accurate assessment of amnionicity and chorionicity could be made. Sonographic features noted included number of placental sites, fetal gender, qualitative and quantitative evaluation of the dividing membrane. Documentation of two placental sites or different fetal gender confirms the presence of a dichorionic-diamniotic pregnancy. When only one placental site or similar fetal gender is demonstrated, examination of the membrane is helpful for distinguishing between dichorionic and monochorionic diamniotic gestations. A thick membrane separating the fetuses was seen in all dichorionic diamniotic pregnancies. A thin membrane was visible in 94.4 per cent of monochorionic-diamniotic pregnancies. The predictive value of a thick membrane with regard to a dichorionic-diamniotic pregnancy was 92.3 per cent and the predictive value of a thin membrane with regard to a monochorionic-diamniotic pregnancy was 100 per cent. The thickness of the membrane was measured in 13 cases. With a thickness of 2 mm used as a cutoff point, the accuracy in predicting monochorionic or dichorionic twinning was 100 per cent for both. Lack of visualization of a separating membrane suggests a monochorionic-monoamniotic pregnancy.Item Are we really managing this HIV patient?(2001-07-05) Phaosavasdi, S; Taneepanichskul, S; Tannirandorn, Y; Wilde, H; Pruksapong, CItem Biparietal diameter/femur length ratio and actual femur length/expected femur length ratio: a sonographic screening method for Down's syndrome.(1992-08-01) Sukcharoen, N; Tannirandorn, Y; Suwajanakorn, S; Paosawadi, SSeveral ultrasonographic signs have been described in second-trimester Down's syndrome fetuses. Previously published reports have shown that fetuses affected with Down's syndrome have normal biparietal diameter (BPD), high BPD-to-femur length (FL) ratio, and low actual FL-to-expected FL ratio. A retrospective comparison of the BPD-to-FL ratio and actual FL-to-expected FL ratio was made between 3 fetuses with Down's syndrome diagnosed prenatally by second-trimester amniocentesis and 189 normal fetuses with gestational age varying from 13-25 weeks who were seen in the Ultrasound Unit of Department of Obstetrics & Gynaecology, Chulalongkorn Hospital between January 1, 1989 and May 31, 1990. The sensitivity of BPD-to-FL ratio and actual FL-to-expected FL ratio as a screening technique for Down's syndrome in this study was 66.7 and 100 per cent, with a specificity of 93.4 and 89.2 per cent respectively. These sonographic parameters appear to be a useful screening method for Down's syndrome.Item A comparative study of membrane stripping and nonstripping for induction of labor in uncomplicated term pregnancy.(1999-03-20) Tannirandorn, Y; Jumrustanasan, TA prospective, randomized controlled trial was undertaken at the Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn Hospital to determine whether stripping of the fetal membranes is a safe and effective method for induction of labor in uncomplicated term pregnancy. Ninety-six women were included in this study; 16 were excluded; 41 were randomized to a study group and 39 to a control group. Both groups had pelvic examination performed under sterile technique and a Bishop score was assessed. In the study group, membrane stripping was performed. Gentle pelvic examination for Bishop scoring was continued weekly in both groups. Thirty five of 41 women (85.4%) in the study group delivered within 7 days as compared to 22 of 39 women (56.4%) in the control group, a statistically significant difference (P = 0.004). A statistically significant difference was also observed with respect to the mean number of days to delivery (5.3 +/- 4.9 versus 9.5 +/- 5.9 days, respectively; P = 0.002). No statistically significant differences were observed in both maternal and fetal complications. In conclusion, membrane stripping is a safe and effective method for induction of labor in uncomplicated term pregnancy.Item Controversial issues in obstetrics.(1998-11-06) Phaosavasdi, S; Wilde, H; Pruksapong, C; Tannirandorn, Y; Taneepanichskul, SItem DNA diagnosis for clinical and prenatal diagnosis of spinal muscular atrophy in Thai patients.(1996-12-01) Mutirangura, A; Norapucsunton, T; Tannirandorn, Y; Jongpiputvanich, SItem Doctor in the 30 baht era: ethics vs policy.(2001-04-20) Phaosavasdi, S; Taneepanichskul, S; Tannirandorn, Y; Pruksapong, CItem Doppler umbilical artery flow velocity waveforms in pregnancies complicated by major fetal malformations.(1993-09-01) Tannirandorn, Y; Witoonpanich, P; Phaosavasdi, SA pulse-wave Doppler ultrasound was used to identify fetal umbilical cord and to obtain flow-velocity waveforms. The umbilical artery Doppler indices were determined in 34 fetuses with major congenital malformations between 20 and 38 wks' gestation. Reference ranges of fetal umbilical artery systolic and diastolic (S/D) ratio, pulsatility index (PI) and resistance index (RI) with gestation were constructed from a cross-sectional study of 331 appropriate for gestation age fetuses of 16 to 41 wks' gestation. The records were reviewed to determine the changes associated with fetal malformation. Twenty five of 34 patients with major congenital anomalies showed high S/D ratio, PI and RI in waveforms taken from the umbilical artery. All fetuses with chromosomal aneuploidy (10 cases) had high umbilical artery S/D ratio, PI and RI. It appears that a fetal mechanism may determine the changes in the umbilical placental circulation resulting in an umbilical artery pattern of high flow resistance in fetuses with congenital anomalies.Item Elevation of depressed skull fracture in the neonate by obstetrical vacuum extractor.(1993-12-01) Tannirandorn, Y; Thaithumyanon, P; Aroonrasmeruang, TIn this article, three cases of neonatal depressed skull fracture were successfully elevated by means of an obstetrical vacuum extractor. No complications from the procedure were observed. Neonatal depressed skull fractures which are not associated with neurological signs may be safely elevated without surgery by using the obstetrical vacuum extractor. This simple, atraumatic procedure should be considered first for the management of uncomplicated depressed skull fracture in the newborn.Item Ethical birth control.(2000-05-23) Phaosavasdi, S; Taneepanichskul, S; Tannirandorn, YItem Ethics and care of the terminally ill.(1998-06-24) Phaosavasdi, S; Wilde, H; Pruksapong, C; Tannirandorn, YItem Ethics of a leader.(2003-07-02) Phaosavasdi, S; Taneepanichskul, S; Tannirandorn, Y; Pruksapong, C; Kullavanijaya, P; Karnjanapitak, AItem Ethics of using controls and placebo in clinical trials.(1999-06-12) Wilde, H; Phaosavasdi, S; Pruksapong, C; Tannirandorn, Y; Taneepanichskul, SItem Etiquette of medical consultations.(1998-10-06) Phaosavasdi, S; Wilde, H; Pruksapong, C; Tannirandorn, Y; Taneepanichskul, SItem Evaluation of current antepartum fetal tests.(1995-01-01) Tannirandorn, Y; Uerpairojkit, B; Phaosavasdi, SThree hundred high-risk pregnancies of at least 28 weeks' gestation were included in this prospective descriptive study. Fetal movement count was performed daily. Maternal perception of sound provoked fetal movement (MPSPFM), fetal acoustic stimulation test (FAST), amniotic fluid index (AFI) and doppler umbilical artery pulsatility index were tested weekly until delivery. All fetal testing performed within a week of delivery was compared with fetal outcome. Fetal outcome was considered poor when there was perinatal death, intrapartum fetal distress, a five minute Apgar score of less than 7, thick meconium-stained amniotic fluid or admission to the neonatal intensive care unit. Seventeen pregnancies were considered poor outcome (prevalence of 5.7%). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Kappa index (KI) of each test to predict poor fetal outcome were evaluated. A combination of FAST and AFI is the most reliable antepartum fetal test. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Kappa index of the combination of FAST and AFI were 70.0%, 99.6% 87.5%, 98.8%, 98.5% and 0.77%, respectively.Item Fetal acoustic stimulation for rapid intrapartum assessment of fetal well-being.(1993-11-01) Tannirandorn, Y; Wacharaprechanont, T; Phaosavasdi, SFetal heart rate reactions to the fetal acoustic stimulation test (FAST) were prospectively studied in 140 women in early labor. Overall 45 of 140 patients (32%) had one or more complications of pregnancy. All were in the latent phase of labor with a singleton, vertex-presenting fetus. Gestational age ranged from 37-43 wks. The women were screened with a 15-20 min fetal heart rate recording (FHR admission test) before the acoustic stimulation was applied. Results of the FHR admission test and the FAST in women were compared with fetal outcome; which was considered poor when there was perinatal death, a 5 min Apgar score less than 7, fetal distress requiring cesarean section, thick meconium stained amniotic fluid or admission to the neonatal intensive care unit. FAST had better sensitivity (71.4% vs 42.8%), specificity (99.2% vs 97.7%), positive predictive value (83.3% vs 50.0%) and negative predictive value (98.5% vs 97.0%) for poor fetal outcome than the FHR admission test. Fetal acoustic stimulation test in the early intrapartum period may be used as a noninvasive screening method for rapid intrapartum assessment of fetal wellbeing. It may discriminate the compromised from the noncompromised fetus. This clinical application can be helpful in a busy labor room when rapid assessment of fetal health is required.Item Fetal complete heart block: an expectant management.(1998-12-23) Uerpairojkit, B; Charoenvidhya, D; Chottivittayatanakorn, P; Tannirandorn, Y; Benjachollamas, W; Phaosavasdi, SFetal complete heart block is a rare cardiac arrhythmia occurring in prenatal life. The diagnosis usually requires a multimodality approach of imaging technology especially M-mode and Doppler ultrasound. The management guideline is not conclusive. We presented 2 cases of fetal complete heart block diagnosed prenatally. The fetuses were closely monitored conservatively and delivered at term. Permanent cardiac pacemakers were performed neonatally with satisfactory outcomes.Item Fetal hematology.(1999-06-12) Tannirandorn, Y; Uerpairojkit, B; Manotaya, S; Tanawattanacharoen, S; Danthamrongkul, V; Charoenvidhya, DThe objective of this study was to establish normal fetal hematological parameters throughout gestation. Samples of pure fetal blood from 35 fetuses of 21-38 weeks' gestation were obtained by fetal blood sampling under continuous ultrasound guidance. The hematological parameters were determined with automated cell counter within 30 minutes after the procedures. Fetal red blood cell and granulocyte counts rose significantly with advancing gestation, whereas, the mean corpuscular volume fell. There were no significant changes in fetal hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width, total white blood cell count, lymphocyte count, mid-cell count, platelet count, mean platelet volume, and platelet distribution width with increasing gestation. The growing application of fetal blood sampling to the prenatal diagnosis renders mandatory a knowledge of normal fetal blood values. These results may provide useful reference values for prenatal diagnoses of hematological disorders.Item Fetal metabolism.(1999-04-20) Tannirandorn, Y; Phaosavasdi, S; Numchaisrika, P; Wongwathanavikrom, R; Leepipathpaiboon, SNormal reference ranges for apolipoprotein A-I, apolipoprotein A-II, apolipoprotein B, total triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol + chylomicron, plasma glucose, total protein, albumin and globulin were determined from 25 fetal plasma samples between 21-39 weeks' gestation. Pure fetal blood was obtained by cordocentesis under continuous ultrasound guidance. They were referred to us for advanced maternal age and a previous chromosomal aneuploidy baby. All these biochemical parameters excepts total protein and albumin showed no change with gestational age. These normal values of fetal metabolism will improve our knowledge of physiology and help to determine the specific values of a test in fetal pathology.
- «
- 1 (current)
- 2
- 3
- »