Spontaneous carotid cavernous fistula complicating pregnancy.

Carotid cavernous fistula is a well-documented but rare condition in pregnancy, about which there are a limited number of reports in the literature. We report such a case in a 41-year-old woman presenting with right-sided headache, proptosis, and diplopia at 37 weeks of gestation. She was subsequently diagnosed to have carotid cavernous fistula based on angiography. Embolisation was performed in the postpartum period. Carotid cavernous fistula has the potential of serious morbidity including visual loss and intracranial haemorrhage. It can be treated effectively by endovascular embolisation, which confers a good prognosis. Although headache is a common complaint during pregnancy, obstetrician should be aware of this condition if the clinical presentation is suspicious.

Intrapleural injection of OK-432 as the primary in-utero treatment for fetal chylothorax.

Chylothorax is a rare congenital condition associated with significant perinatal mortality and morbidity. Previous treatments with repeated thoracocentesis or thoracoamniotic shunting were technically demanding, and associated with significant procedure-related complications and neonatal complications. Here we report the first successful case in Hong Kong treated by a simple and effective intervention, namely pleurodesis with OK-432, in a fetus presenting at 20 weeks of gestation with bilateral pleural effusion.

Deficient knowledge on hepatitis B infection in pregnant women and prevalence of hepatitis B surface antigen carriage in an endemic area: a review.

Hepatitis B infection is a major global health problem. Vertical transmission is the commonest route of spreading hepatitis B virus (HBV) in many endemic areas. In order to control such transmission in Hong Kong, neonatal immunization programme was implemented for more than two decades. A declining prevalence of HBV infection was expected. However, the prevalence remained unabated at around 10% in recent studies. We suspect that one of the explanations of this persistent high prevalence is deficient knowledge on infection with the HBV and its prevention. Our paper gives an overview of the knowledge on HBV infection among Chinese population in both high and low endemic areas and discusses the potential factors that influenced the knowledge on as well as the implication of the sources of information for HBV infection, which was not addressed in previous studies.

The impact of fetal gender on preterm birth in a southern Chinese population.

OBJECTIVE: This study was conducted to determine whether carrying a singleton male fetus increases the risk of preterm birth (PTB) in Chinese women. METHODS: A retrospective cohort study was conducted on women with singleton pregnancies and delivered in our hospital. Maternal characteristics, pregnancy outcome, and incidence of PTB, were compared between women carrying a male versus a female fetus. The independent effect of a male fetus on PTB was examined with multiple logistic regression analysis adjusting for the other confounding factors identified. RESULTS: There were significant differences in maternal and infant characteristics between women with a male versus a female fetus. Despite similar or lower incidences of complications and labor induction, women with a male fetus had increased birth <37 weeks (7.0% versus 6.2%, p

Knowledge on hepatitis B infection among pregnant women in a high endemicity area.

OBJECTIVE: To assess the knowledge on hepatitis B virus (HBV) infection and associated factors among expectant mothers in an endemic region. METHODS: A questionnaire was administered to pregnant Chinese women (n=1623) attending the antenatal clinic to examine their knowledge on HBV infection, and correlating this with socio-demographic, medical and obstetric factors. RESULTS: Independent factors associated with insufficient reduced HBV knowledge include women outside the healthcare sector, lower education level, and no previous HBV testing. The majority of respondents could provide correct responses about the common aspects of HBV infection, including screening, blood-borne and perinatal transmissions, prevention by vaccination, and sequelae of HBV infection, but 47.1% did not know that HBV is transmissible by sexual intercourse. Over 75% respondents misunderstood the fact that HBV cannot be transmitted through food, or prevented by a balanced life style and nutrition. CONCLUSIONS: Misconceptions about HBV transmission are still common among the obstetric population, and the provision of appropriate and correct information is warranted to improve further the control of HBV infection to the target group. PRACTICE IMPLICATIONS: Appropriate emphasis should be given to educating the general population about horizontal transmission of HBV.

Universal rubella vaccination programme and maternal rubella immune status: a tale of two systems.

Maternal rubella status was compared between local residents with non-residents who delivered in our hospital during 1998-2008. Among the 60,822 women, non-immunity was more common in the non-residents (19.9% versus 8.1%, P<0.001). Significant difference and positive correlation with age and parity were found for both groups, but a significant inverse correlation with year-of-birth was found only in the residents. Regression analysis confirmed that birth after 1970 was associated with reduced odds of non-immunity, which indicated that the rubella vaccination programme, introduced since 1978, has succeeded in reducing the incidence of non-immunity to <5% in the youngest generation.