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Biomedical subjects

M K Shyu

Publications and source records attributed to M K Shyu.

27 records · Page 2Linked to original sources
PubMed1994

Intrauterine intervention in a case of recurrent meconium peritonitis.

We present a case of recurrent meconium peritonitis detected in the second trimester and treated by intrauterine intervention. Antenatal ultrasound findings included fetal ascites and intra-abdominal calcification. Aspiration of fetal ascites under ultrasound guidance and determination of the bilirubin concentration established the diagnosis of meconium peritonitis. Paracentesis was repeated to remove irritating intestinal contents and to decrease pressure on the fetal thorax. Although the exact cause of the meconium peritonitis remains unknown, the recurrence of the condition suggests a genetic basis. A possibility of cystic fibrosis was not considered because the clinical picture did not suggest it. Intrauterine intervention helped to establish the diagnosis of meconium peritonitis and may have contributed to the good outcome.

Adult↗
PubMed1994

Prenatal diagnosis of congenital rubella infection from maternal rubella in Taiwan.

OBJECTIVE: To determine the frequency of intrauterine rubella infection in Taiwan. METHODS: One hundred three pregnant women with evidence of rubella infection were enrolled. Congenital rubella infection was diagnosed by testing specific immunoglobulin (Ig) M in fetal cord serum obtained from funipuncture or amniotic fluid culture. The fetal outcomes were evaluated by ultrasonic examination, specific antibody detection in cord blood at birth, and complete physical examination during early childhood. RESULTS: Prenatal diagnosis was possible in 95 of 103 fetuses, 93 by funipuncture and two by amniocentesis. Five intrauterine rubella infections were detected prenatally, and another one was diagnosed after birth. The intrauterine infection rates were 10.0, 11.8, 2.9, and 6.5% after maternal infection at 1-10, 11-14, 15-19, and 20-29 gestational weeks, respectively. Among the six fetuses with serologic evidence of congenital infection, one had congenital rubella syndrome with sensorineural deafness, two were terminated during the second trimester, two others were normal, and one was lost to follow-up. With the exception of the infant with clinical congenital rubella syndrome, no evidence of rubella defects was found in the other 81 children who received follow-up to 2-4 years old. CONCLUSION: The risk of congenital rubella infection in seropositive pregnant women is relatively low in Taiwan.

Adult↗
PubMed1993

Methotrexate treatment for cervical pregnancy: experience of four cases.

Although cervical pregnancies account for a very small number of the ectopic pregnancies, they sometimes result in a tragic outcome due to the difficulty of surgical treatment and subsequent intractable hemorrhage. We report our experience with four cases of cervical pregnancy which were treated successfully with methotrexate. All four patients had a history of a previous abortion and two had previously had a cesarean section. High-resolution transabdominal and transvaginal color Doppler ultrasound was used for diagnosis, and the serial beta-human chorionic gonadotropin levels were checked to monitor the therapeutic effect. Hysterectomy was avoided, and the reproductive capability of these patients was preserved. Chemotherapy was well tolerated except for mild stomatitis in one case and a transient elevation of liver enzymes in another case. One patient delivered a healthy female infant two years after treatment. In conclusion, previous curettage and a low segment cesarean section may contribute to the development of a cervical pregnancy. Fortunately, methotrexate therapy offers an effective nonsurgical treatment for this potentially catastrophic condition.

Adolescent↗
PubMed1993

Clinical study of 381 postmenopausal bleeding patients.

In order to evaluate the etiology, incidence of malignancy, clinical risk factors and the interval between menopause and the onset of abnormal vaginal bleeding in postmenopausal women, 381 cases with a complete medical history and available histologic findings were enrolled in this study at the National Taiwan University Hospital from 1989 to 1991. The results showed that 212 (55.6%) of these women had normal histologic findings and 83 (21.9%) had benign pathologic findings, whereas 14 (3.6%) had cervical intraepithelial neoplasia (CIN), 42 (11%) had endometrial hyperplasia, 19 (5%) had cervical cancer and 11 (2.9%) had endometrial cancer. Twenty-nine (7.6%) of the cases suffered from either CIN III or cervical cancer; this number was twice as high as those with endometrial atypical hyperplasia and endometrial cancer (n = 13, 3.4%). In addition, various risk factors, especially obesity, were found to be significantly correlated with malignancy. Fractional curettage should be performed for postmenopausal bleeding patients to ensure accurate diagnosis and correct management.

Endometrial Hyperplasia↗
PubMedDate not supplied

Second trimester maternal serum hCG level in an Asian population: normal reference values by ultrasound dating.

OBJECTIVE: To establish normative data of maternal serum chorionic gonadotropin (hCG) during the second trimester in an Asian population. METHODS: We measured the maternal serum hCG levels in 17,955 normal singleton pregnancies between 15 and 21 weeks of gestation. The gestation age was estimated by measurement of fetal biparietal distance (BPD) in all cases. Median values of hCG at various gestational weeks were calculated and the values of hCG were converted to multiple of median (MoM). The incidences of low MoM value and high MoM value were also calculated. RESULTS: The mean and median values of hCG were 57,153 mIU/ml and 50,120 mIU/ml, respectively, at 15 weeks of gestation and then decreased to 30,898 mIU/ml and 26,226 mIU/ml, respectively, at 21 weeks. We found 8.6% and 9.4% of normal singleton pregnancies have hCG MoM values >2.0 MoM and <0.5 MoM, respectively. CONCLUSIONS: Our report provides a normal reference data of second trimester maternal hCG levels by ultrasound dating in an Asian population.

Chorionic Gonadotropin↗
PubMedDate not supplied

Maternal serum screening for down syndrome by using alpha-fetoprotein and human chorionic gonadotropin in an asian population. a prospective study.

The purpose of the present study is to evaluate the efficacy of second-trimester maternal serum screening program by using alpha-fetoprotein (AFP) and total human chorionic gonadotropin (hCG) in an Asian population. During June 1994 to July 1998, we conducted a prospective study of serum screening protocol for Down syndrome. The cut-off point for a positive result in this analysis was a risk of >/=1/270. A total of 17,742 pregnant women with singleton pregnancy were screened, and 1,153 (6.5%) had positive result. Sixteen of the 17,742 pregnancies had Down syndrome, and 10 of them had positive result. The positive rate and detective rate for Down syndrome were 6.5 and 62.5%, respectively. However, the detective rate will reduce to 47.6% after being adjusted by age-specific risk. It is indicated that the double-marker test using AFP and total hCG is an effective screen strategy for second-trimester detection of Down syndrome in Asian women.

Adult↗
PubMedDate not supplied

Fibronectin levels in normal pregnancy and preeclampsia.

Vascular endothelial damage is reported to be the prime cause of preeclampsia, and elevated levels of fibronectin have been found before clinical signs of preeclampsia were manifested. The total plasma fibronectin concentrations in 212 blood samples from 173 normotensive healthy pregnant women at various gestational ages were measured. Fibronectin levels were also determined for 20 blood samples from 20 preeclamptic patients obtained at the time of clinical manifestation of preeclampsia. Blood samples from 46 non pregnant women of reproductive age were used as controls. The results showed that the total plasma fibronectin concentration during reproductive age was independent of age and the average level during pregnancy decreased with gestational age. Preeclamptic patients had a significantly elevated level of total fibronectin compared with healthy pregnant women. The total fibronectin concentration is a promising biochemical marker for preeclampsia, but a more specific endothelial method of measurement is needed before it is put to clinical use.

Adult↗
PubMedDate not supplied

Hydrops fetalis due to placental chorioangioma: report of one case.

Chorioangioma is the most common tumor of the placenta. However, a large one complicated with hydrops fetalis is rare. We report a patient who had hydrops fetalis associated with placental chorioangioma. The clinical manifestations included generalized edema, coagulopathy, thrombocytopenia, anemia, hypoproteinemia and hepatosplenomegaly. The hospital course was complicated with acute renal failure and repeated pneumonia. The patient died on the 54th day of life due to persistent lung atelectasis and hypovolemic shock. The pathophysiology and management of the complications of hydrops fetalis with chorioangioma are discussed.

Adult↗