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Biomedical subjects

A Sau

Publications and source records attributed to A Sau.

6 recordsLinked to original sources
PubMed2006

Vaginal delivery can be considered in monochorionic diamniotic twins.

The outcomes of 60 sets of monochorionic diamniotic (MCDA) twins were compared with 218 sets of dichorionic diamniotic (DCDA) twins. The caesarean section rates for MCDA were similar to those for DCDA twins (56.6 versus 53.6%, P > 0.1). Although the number of babies with 5-minute Apgar score of <7 was significantly higher for vaginally delivered MCDA twins compared with that of DCDA twins (12 versus 3.5%, P < 0.001), the umbilical artery pH of <7.2 was similar (20 versus 13%, P > 0.05). Admission to neonatal intensive care unit (NICU) and neonatal mortality were also similar in both groups. Delivery by caesarean section was associated with increased admission to the NICU and neonatal mortality for MCDA twins when compared with vaginal delivery group. From this retrospective cohort study, we can conclude that vaginal delivery for MCDA twins appeared to be a reasonable management option when similar selection criteria for vaginal delivery of DCDA twins were applied.

Adult↗
PubMed2004

Intraobserver and interobserver variation in the sonographic grading of placental maturity.

OBJECTIVES: The appearance of Grannum Grade III changes in the placenta at around 34-36 weeks is a predictor of adverse perinatal outcome, which may be reduced by reporting to the clinician. This has led to the suggestion that the placental grade should be noted during any third-trimester scan. There are no published data on the reproducibility of sonographic Grannum grading of the placenta; the objective of this study was to evaluate intra- and interobserver variation. METHODS: Fifty-five placental images from normal and complicated pregnancies of several different gestational ages were collected between April and October 2001. Three fetal medicine consultants and three experienced sonographers graded the images as 0, I, II, III or ungradeable. They then regraded the same images, presented in a different order and with different codes, 4-6 weeks later. Observers were blinded to their previous grading and to each others'. Weighted kappa (kappa), with linear weights, was used to look for strength of agreement. RESULTS: There was good agreement between the two observations of each placental image for five observers (kappa = 0.61 to 0.90), and moderate agreement for one observer (kappa = 0.56). However, the kappa-values for comparisons between the 15 pairs of observers ranged from 0.24 to 0.69 with six values below 0.41, indicating only fair agreement. This was confirmed by the overall kappa-value of 0.24 between all six observers. The agreement between the observers for Grade III placenta was poor, with an overall kappa-value of 0.09. CONCLUSIONS: Although intraobserver agreement was generally good, interobserver agreement was only fair for all grades and poor for Grade III placenta. This may be an indication that Grannum grading is not reproducible or it may reflect a need for training in those performing grading. Such variation may limit the effectiveness of reporting Grannum grades in clinical practice.

Female↗
PubMed2001

Spanwise bifurcation in plane-symmetric sudden-expansion flows.

Present computational investigation reports a steady bifurcation phenomenon for three-dimensional flows through a plane-symmetric sudden expansion. When the channel aspect ratio exceeds a critical value, the well-known step height (pitchfork) bifurcation evolves with different symmetry breaking orientations on the left and right sides of the channel and bifurcates in the spanwise direction. For the channel aspect ratio less than the critical value, the originally occurring spanwise bifurcation cannot be stably retained and evolves eventually to a step height bifurcation. Compared to step height bifurcation, the spanwise bifurcation is found to be more difficult to obtain, because the symmetric flow present on the spanwise symmetry plane is unstable in two dimensions. For completeness, an extensive analysis of the observed spanwise bifurcation, covering its transient behavior, dependence on flow Reynolds number, channel aspect ratio, and expansion ratio, is included.

Journal Article↗
PubMed2001

Screening for trisomy 21: the significance of a positive second trimester serum screen in women screen negative after a nuchal translucency scan.

Screening of pregnancies for trisomy 21 is now an accepted part of antenatal care. Measurement of fetal nuchal translucency in the first trimester and analysis of maternal serum biochemistry in the second trimester are both established methods of screening. The performance characteristics of both tests in an unselected population are well described and the choice of test offered is usually determined by local policy and resources. We present data from a screening programme offering women with a low risk result from nuchal translucency measurement a second trimester serum screen. There were eight cases of trisomy 21 in the 2683 women screened, all of which presented with a high-risk nuchal screen result. Serum screening of 1057 women who screened negative by nuchal translucency gave 46 high-risk results, all of which were, therefore, false positive for trisomy 21. Second trimester biochemistry screening following a negative nuchal translucency screen did not increase the detection of trisomy 21.

Journal Article↗