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Biomedical subjects

W Phuapradit

Publications and source records attributed to W Phuapradit.

At least 37 records · Page 2Linked to original sources
PubMed1997

Association of contraceptives and HIV-1 infection in Thai female commercial sex workers.

We conducted a case-control study to evaluate the association between contraceptive methods and HIV infection among Thai female commercial sex workers in Khon Kaen and Lumpang provinces, Thailand; 118 cases of HIV-1 infected sex workers were eligible for inclusion and 258 HIV-1 negative women were recruited as controls during the period of October 1, 1993 to December 31, 1994. Cases and controls were matched by age, education, parity, age at first exposure to commercial sex, number of clients per night, duration of work and sexual practice during menstruation. The ratio of case per control was 1:2. Both cases and controls were interviewed and underwent blood testing by a team of investigators. The study revealed no significant association between oral pill, injection, other contraceptives and HIV-1 infection. However, condom usage showed a significant protective effect. It is suggested that these contraceptives in this high-risk group of women do not increase the risk of HIV infection. In contrast, the use of condoms could reduce the risk of HIV infection.

Adult↗
PubMed1997

Effect of zidovudine treatment in late pregnancy on HIV-1 in utero transmission.

In Thailand, the prevalence of paediatric HIV-1 infection has increased rapidly through vertical transmission. According to the ACTG 076 trial regimen, zidovudine treatment in HIV-infected pregnancy can reduce vertical transmission. However, this treatment is complex and costly. It is not applicable for developing countries. We conducted a study to evaluate the effect of zidovudine treatment in late pregnancy on HIV-1 in utero transmission. Fifty cases of asymptomatic HIV-1 infected-women were voluntarily enrolled to the study. Zidovudine 250 mg orally twice a day was given to these patients from gestational age 36 weeks until labour. The newborns were evaluated at birth by a neonatologist and peripheral blood was tested for HIV genome by PCR technique within 48 hours of birth. The study revealed that no HIV genome was detected from the peripheral blood of newborns. It is suggested that zidovudine treatment in late pregnancy could reduce HIV-1 in utero transmission.

AIDS Serodiagnosis↗
PubMed1996

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↗
PubMed1996

Serum vitamin A and beta-carotene levels in pregnant women infected with human immunodeficiency virus-1.

OBJECTIVE: To determine if low levels of serum vitamin A and beta-carotene are present in pregnant women with human immunodeficiency virus-1 (HIV-1) infection. METHODS: Serum concentrations of vitamin A and beta-carotene were measured in 74 pregnant women seropositive for HIV-1 infection (17 with CD4 count below 200 cells/microliter) and in 148 pregnant seronegative controls in the first trimester. Comparisons were made between groups stratified by CD4 count. RESULTS: Compared with controls, women with HIV-1 infection and CD4 count below 200 cells/microliter exhibited 37% lower mean serum vitamin A levels (0.820 versus 1.308 micromol/L, P < .001) and 37% lower mean serum beta-carotene levels (1.486 versus 2.362 micromol/L, P < .001). Mean maternal age, parity, gestational age, hemoglobin levels, and body mass index at entry into the study did not differ significantly between the control and HIV-1 infection groups. In addition, serum vitamin A levels correlated significantly with the percentage of CD4 lymphocytes (r = 0.589, P < .001), CD4 count (r = 0.772, P < .001), and CD4 to CD8 ratio (r = 0.593, P < .001). Serum beta-carotene levels correlated with the percentage of CD4 lymphocytes (r = 0.407, P < .001), CD4 count (r = 0.614, P < .001), and CD4 to CD8 ratio (r = 0.434, P < .001). CONCLUSION: Compared with levels in uninfected women, serum vitamin A and beta-carotene are decreased in HIV-1-infected pregnant women in the first trimester with CD4 counts lower than 200 cells/microliter. These micronutrient concentrations also correlate with CD4 count.

Adult↗
PubMed1996

Serum ferritin levels in normal and HIV-1 infected pregnant women.

Between May, 1994 and May, 1995 serum ferritin concentrations were measured in 74 pregnant women who were HIV-1 positive (17 with CD4 cell counts below 200 cells/uL) and in 148 HIV-1 negative pregnant controls in first trimester of gestation to determine if a high level of serum ferritin is present in pregnant women with HIV-1 infection. Comparisons were made between groups stratified by CD4 cell counts. Pregnant women with HIV-1 infection had 92% higher mean serum ferritin levels (112.8 versus 58.8 ug/L, p < 0.005) compared to controls, whereas the mean maternal age, parity, gestational age, haemoglobin levels and body mass index at entry into the study did not differ significantly between the control and HIV-1 infection groups. The serum ferritin levels inversely correlated with the percentage of CD4 lymphocytes, CD4 cell counts and the CD4/CD8 ratio. This study suggests that serum ferritin levels can also be used as an immunological marker in HIV-1 infected pregnant women.

Biomarkers↗
PubMed1996

[Letters].

Explore the source record for details and available documents.

Female↗
PubMed1995

Routine voluntary antenatal anti-HIV screening in Bangkok, Thailand.

The following recommendations are made as a result of this study. 1. Routine voluntary screening for HIV infection in all pregnant women is feasible and worthwhile. 2. Every seropositive result should be repeated for confirmation before coming to a definitive conclusion to avoid a misdiagnosis. 3. Routine screening of seronegative pregnant women should be repeated during the third trimester to detect seroconversion since this offers a chance for AZT administration to the seroconverted pregnant women for reduction of perinatal transmission. 4. There should be available the appropriate back up services for seropositive pregnant women such as: (i) C--Choice. Having been appropriately counselled the pregnant women should be able to terminate or continue with the pregnancy. (ii) H--High-risk pregnancy concept. The pregnant women should be treated as high-risk cases. Throughout their pregnancy and delivery only experienced personnel should manage them. (iii) I--Integrated services. From our experience it would be reasonable to integrate the care of seropositive pregnant women with any other high-risk cases. Special or anonymous clinics may create an atmosphere of uneasy feelings among the women who could be made to feel alienated and discriminated against. (iv) P--Provision of care. Comprehensive services must be available. These include an experienced counselling team, adequate laboratory services, services for safe first and second trimester therapeutic abortions, appropriate facility in the delivery suite (including Caesarean section) for infected cases, and dedicated paediatricians.

Adolescent↗
PubMed1995

Vertical transmission of HIV-1 in mid-trimester gestation.

Between July, 1994 and March, 1995, 23 heart blood samples from fresh abortuses of HIV-1 seropositive pregnant women after elective termination of pregnancy between 18 and 25 weeks of gestation by prostaglandin E1 analogue vaginal administration were examined for polymerase chain reaction (PCR) of HIV-1 genome and p24 antigen to investigate the transplacental transfer of HIV-1 infection. All samples of fetal heart blood were positive for HIV-1 antibody (ELISA), but negative for PCR and HIV-1 p24 antigen assay. These negative results could be due to the lack of the virus in the peripheral blood or to a viral load low enough to be undetectable by PCR method at mid-trimester gestation and suggest that HIV-1 vertical transmission occurs mostly during the last trimester of pregnancy and/or at delivery.

Adolescent↗
PubMed1994

Maternal and umbilical cord blood lead levels in Ramathibodi Hospital, 1993.

A prospective cross-sectional study of maternal and umbilical cord blood lead levels was conducted in a total of 500 deliveries at Ramathibodi Hospital. The mean concentrations of lead in maternal and cord blood were 6.2 +/- 2.0, 1.6 +/- 0.5 microgram/dl respectively. There was direct relationship between maternal and umbilical cord blood lead level. Maternal occupation and length of stay in Bangkok were related to maternal blood lead levels. There was no association between adverse pregnancy outcomes and maternal blood lead levels. A large scale study and periodic surveillance of blood lead levels in pregnancy is advocated.

Cross-Sectional Studies↗
PubMed1993

Serum level of magnesium attained in magnesium sulfate therapy for severe preeclampsia.

Serum magnesium levels were determined in severe preeclampsia patients who were treated with magnesium sulfate infusion. Forty-four patients with diagnosis of severe preeclampsia between 30-41 weeks gestation, given a conventional 5 g magnesium sulfate intravenous bolus infusion and 1 g/hr continuous infusion and continued 24 hours postpartum, were prospectively studied. The mean pre-treatment magnesium level was 2.3 +/- 0.3 mg/dl which was similar to those reports. The levels measured at 1/2, 1, 2, 4, 12 and 24 hours after initiation of magnesium infusion were 4.8 +/- 0.4, 4.7 +/- 0.4, 4.5 +/- 0.3, 4.7 +/- 0.3, 5.4 +/- 0.3 and 5.9 +/- 0.3 mg/dl respectively. After delivery the levels were measured immediately, 12, and 24 hours and found to be 4.7 +/- 0.4, 4.9 +/- 0.4, and 5.2 +/- 0.3 mg/dl respectively. The serum magnesium levels were also varied with maternal weight, the dose regimen used in our study is appropriate for Asian pregnant women whose body weight usually less than 70 kg.

Adult↗
PubMed1993

Urinary calcium/creatinine ratio in the prediction of preeclampsia.

The prediction of preeclampsia by the urinary calcium/creatinine ratio during the early third trimester was assessed in 190 primigravidas, aged less than 35 years and between 28 and 32 weeks' gestation without pregnancy complications. Preeclampsia developed in 6.8% of the patients. The mean maternal age, gestational age at entry into the study and at delivery, and the average mean arterial blood pressure at entry into the study did not differ significantly between the 13 patients with subsequent preeclampsia and the 177 normotensive patients. The patients with preeclampsia did not have significantly less excretion of calcium than the normotensives.

Adult↗
PubMed1993

Risk factors for neonatal hyperbilirubinemia.

The purpose of this Historical Prospective Study was to analyze factors associated with neonatal hyperbilirubinemia. Data were collected from summary labour records and individual patients' records at Ramathibodi Hospital between January 1, 1988 and December 31, 1988. Of the 7,644 livebirths, neonatal hyperbilirubinemia (> or = 15 mg/100 ml) occurred in 638 cases. There was a statistically significant positive relationship between hyperbilirubinemia and vacuum extraction (RR 2.7), preterm delivery (relative risk, RR 2.1), low birthweight (RR 2.0), antepartum complication (RR 1.7), intrapartum complications (RR 1.5), forceps delivery (RR 1.4), and oxytocin infusion (RR 1.3). No significant relationship emerged between hyperbilirubinemia and fetal sex, cesarean section, breech delivery and the 5 min Apgar score. From 1984 to 1988 there was a pronounced increase in the incidence of neonatal hyperbilirubinemia in Ramathibodi Hospital. This increase was consistent with the increase in use of oxytocin infusion which reflects changes in obstetric practice. Provision of information, education and communication about this adverse effect to obstetricians and auditing their use are suggested solutions.

Female↗
PubMed1993

Diabetic ketoacidosis in pregnancy.

Diabetic ketoacidosis, though uncommon, is a very serious complication in obstetrics. We reported 5 cases, which in retrospect could all have been prevented from occurring. Either a strong family of diabetes mellitus or presence of glycosuria were present in 4 cases. In 3 cases, the use of sympathomimetic and corticosteroid was the predisposing factor. Clinicians should have an index of suspicion in patients at risk and it might be prudent to screen for diabetes where the use of sympathomimetic and corticosteroid.

Adult↗
PubMed1993

Uterine rupture and labor induction with prostaglandins.

Uterine rupture in patients with labor induction with prostaglandin E2 application though uncommon is a very serious complication and preventable in obstetrics. We reported three cases of spontaneous uterine rupture following induction of labor with intracervical PGE2 gel administration in a dosage of 3-6 mg and two in whom labor was augmented with oxytocin infusion. To avoid such a complication, intracervical PGE2 gel administration should be started with a smaller dose and should augmentation with oxytocin be required careful evaluation and monitoring by a specialist is desirable.

Adult↗
PubMed1993

Treatment of atonic postpartum hemorrhage with a prostaglandin E2 analogue.

Atonic postpartum hemorrhage constitutes a dramatic clinical situation, with acute danger to the life of the mother. The present report is a 3 yrs prospective study using a Prostaglandin E2 analogue (Sulprostone) in the management of 22 cases with severe postpartum hemorrhage due to uterine atony unresponsive to conventional therapy. Successful control of hemorrhage in cases of blood loss more than 1,500 ml occurred in 83 per cent. Precipitated labour was the most common predisposing factor encountered in this group of atonic postpartum hemorrhage. Side effects of the prostaglandin therapy was tolerable and self-limited. The use of intramuscular administered Sulprostone appears to be an adjunctive treatment in uncontrollable atonic postpartum hemorrhage.

Adult↗
PubMed1993

Graves' disease complicating pregnancy.

During the 12-yr period from 1981 to 1992, over 85,000 deliveries at Ramathibodi Hospital from 114 pregnancies (prevalence 0.1%) in 110 patients were complicated by Graves' disease. The diagnosis was made following conception in 52 per cent. Medical treatment with propylthiouracil was the main regimen. Maternal and perinatal outcome were related with thyroid status at delivery including thyrotoxic crisis, preeclampsia and preterm deliveries. There was no case of fetal goitre, hyperthyroidism, but fetal hypothyroidism occurred in 12.2 per cent which calls for close monitoring of antithyroid drug dosage and close neonatal-infant follow-up.

Female↗
PubMed1993

Epidemiology of hypertensive disorders of pregnancy and childbirth: population-based study, Thailand.

A geographically population-based epidemiological study was conducted in Thailand under the WHO International Collaborative Study of Hypertensive Disorders of Pregnancy. Prospectively collected data on blood pressure, proteinuria and edema in pregnancy of 4,126 pregnancies were analyzed correlating with pregnancy outcome. The prevalence of mothers with antenatal diastolic pressures equal to or greater than 90 mmHg was approximately 20 per cent. Hypertension with edema or proteinuria was observed in about 6 per cent of pregnancies and these were associated with a significant increase of low birthweight infants, but did not produce a significant increase in perinatal deaths. Although the incidence of eclampsia during the study period was not high, Hypertensive Disorders of Pregnancy remained the second leading cause of maternal mortality.

Adult↗