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Biomedical subjects

B Chanrachakul

Publications and source records attributed to B Chanrachakul.

23 records · Page 2Linked to original sources

Umbilical artery blood gas and lactate in healthy newborns.

This study aimed to establish the normal range of umbilical artery pH, pCO2, base deficit and lactate in normal term and preterm newborn. Umbilical artery pH, pCO2, base deficit and lactate was measured in 637 newborn babies. The study included 555 babies at term with Apgar score equal to or more than 7 at 5 minutes, not requiring assisted ventilation and not admitted to the neonatal unit (NNU), as well as 47 preterm babies with Apgar score equal to or more than 7 at 5 minutes who were admitted to the NNU for observation only because of prematurity. Data was presented as mean and SD. Statistical analysis was done by t-test and simple linear regression analysis. In the newborn at term mean umbilical artery blood gas and lactate were as follows; pH = 7.25 (+/- 0.08), pCO2 = 45.66 (+/- 1.88) mmHg, base deficit = 7.69 (+/- 3.88) mEq/L, lactate = 2.96 (+/- 1.8) mMol/L. In preterm newborn the values were; pH = 7.25 (+/- 0.04), pCO2 = 51.78 (+/- 13.00) mmHg, base deficit = 5.29 (+/- 1.87) mEq/L, lactate = 2.55 (+/- 1.87) mMol/L. The range of umbilical artery blood gas and lactate parameters in term and preterm fetuses with good neonatal outcome were derived. There was a statistically significant difference in pCO2 and base deficit between term and preterm newborn. There was no linear correlation between lactate, pH, pCO2, base deficit and fetal glucose respectively in term or preterm infants.

Acid-Base Equilibrium↗

The epidemiology of cervical incompetence in Ramathibodi Hospital between 1982-1997.

Cervical incompetence is an important cause of midtrimester abortion. However, the etiology and diagnostic method have still not been established. This retrospective study was aimed to review epidemiology, management and outcome of cervical incompetence in Ramathibodi Hospital, Mahidol University, Thailand, from 1982 to 1997. Fifty seven patients were diagnosed as having cervical incompetence during this period. Fifty patients had elective cerclage. Seven patients had emergency cerclage. Success rate in this study was 94.6 per cent. Only 7 per cent of patients had complications such as chorioamnionitis and suture displacement. There was no other serious complication after treatment. Nowadays, there is still no established method to diagnose cervical incompetence in pregnancy. Treatment is usually based on past obstetric history. Cervical cerclage is an established treatment for this problem. Emergency cerclage is still controversial. The prevention is to avoid any procedure which can cause cervical trauma leading to cervical incompetence.

Abortion, Spontaneous↗

Emergency cervical cerclage: Ramathibodi Hospital experience.

This retrospective study is to evaluate the outcome of pregnancy after emergency cervical cerclage. Records of patients, who were treated with emergency cervical cerclage in Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, from 1982 to 1997, were reviewed. Maternal age, gravida, parity, past obstetric history, gestational age at cerclage, latency period, complication and outcome were noted. Only one of 7 patients who had this operation performed, aborted. The others continued pregnancy and all the babies were born alive. There was no serious maternal complication. This operation has a favorable outcome in selected cases.

Adult↗

Malignant ovarian germ cell tumours: experience in the National University Hospital of Singapore.

Management of thirteen cases of malignant ovarian germ cell tumours was reported. Of these, 5 (38%) were immature teratoma, 3 (23%) were endodermal sinus tumour, 1 (8%) was dysgerminoma and 4 (31%) were mixed germ cell tumour. Eight (61%) had stage I, 1 (8%) had stage II and 4 (31%) had stage III diseases. Six had unilateral salpingo-oophorectomy, 6 had total abdominal hysterectomy and bilateral salpingo-oophorectomy and 1 had bilateral oophorectomy. Ten (77%) had adjuvant chemotherapy predominantly with bleomycin/etoposide/cisplatin combination. All patients with stage I and stage II tumours were alive with no evidence of disease at 1/2 year to 5 years followup. Of the 4 patients with stage IIIC diseases, 2 with optimal debulking surgery were alive and disease free at 4 and 7 years after surgery. The other 2 patients with stage IIIC tumours had multiple bulky residual tumours. One of them with a combination of endodermal sinus tumour and embryonal carcinoma died of progressive disease despite chemotherapy 6 months after surgery and the other with mixed endodermal sinus tumour and dysgerminoma was alive with disease at 6 months. Alpha-fetoprotein levels were raised in all 6 patients with endodermal sinus tumour, either pure or combined with other tumours. Regression of alpha-fetoprotein levels was of important prognostic significance in endodermal sinus tumour.

Adult↗

Cesarean and postpartum hysterectomy.

OBJECTIVE: To review the cases of cesarean and postpartum hysterectomy. METHOD: A retrospective study of all cases of cesarean and postpartum hysterectomy during 1985-1994. Maternal characteristics, method of delivery, indications for hysterectomy and complications were reviewed. RESULTS: The rate of cesarean and postpartum hysterectomy was 1:1667 deliveries. Half of these cases were delivered by cesarean section. The main indications for hysterectomy were massive bleeding due to uterine atony, abnormal placental adhesions or uterine rupture. Maternal morbidity was high and there was one maternal death. CONCLUSION: Cesarean and postpartum hysterectomy is a necessary life-saving operation. Although maternal mortality is rare, morbidity remains high. Prevention of complications that give rise to hysterectomy and optimally timed surgery should decrease maternal morbidity and mortality.

Adult↗