RESUMEN
Schuurs-Hoeijmakers syndrome (SHS) is a rare syndrome involving a de novo variant in the PACS1 gene on chromosome 11q13. There are 36 individuals published in the literature so far, mostly diagnosed postnatally (34/36) after recognizing the typical facial features co-occurring with developmental delay, intellectual disability, and multiple malformations. Herein, we present one prenatal and 15 postnatal cases with the recurrent heterozygous pathogenic variant NM_018026.3:c.607C>T p.(Arg203Trp) in the PACS1 gene detected by exome sequencing. These 16 cases were identified by mining Centogene and the Hong Kong clinical genetic service databases. Collectively, the 49 postnatally diagnosed individuals present with typical facial features and developmental delay, while the three prenatally diagnosed individuals present with multiple congenital anomalies. In the current study, the use of exome sequencing as an unbiased diagnostic tool aided the diagnosis of SHS (pre- and postnatally). The identification of additional cases with SHS add to the current understanding of the clinical phenotype associated with pathogenic PACS1 variants. Databases combining clinical and genetic information are helpful for the study of rare diseases.
Asunto(s)
Anomalías Múltiples/genética , Discapacidades del Desarrollo/genética , Discapacidad Intelectual/genética , Proteínas de Transporte Vesicular/genética , Anomalías Múltiples/diagnóstico , Anomalías Múltiples/patología , Niño , Discapacidades del Desarrollo/diagnóstico , Discapacidades del Desarrollo/patología , Femenino , Heterocigoto , Humanos , Discapacidad Intelectual/diagnóstico , Discapacidad Intelectual/patología , Masculino , Fenotipo , Diagnóstico Prenatal/métodos , Secuenciación del ExomaRESUMEN
Given that the perinatal period is a time of increased risk for pregnant women to manifest mental health problems, the identification of antenatal hypomanic symptoms is particularly important. However, data on antenatal hypomanic symptoms is lacking. The present study was aimed at filling this research gap by investigating the prevalence of hypomanic symptoms, including the "active-elated" and "irritable/risk-taking" sides of hypomanic symptoms at the first trimester, and examining their associations with anxiety and depressive symptoms at the following time points: the first trimester, the second trimester, and up to 6-week postpartum. A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 229 pregnant Chinese women in Hong Kong was assessed. Hypomanic symptoms were assessed with the Hypomania Checklist-32 (HCL-32). Of the sample, 43.6% had elevated levels of hypomanic symptoms in the first trimester. Multiple regression analysis showed that after adjusting for potential confounding factors, irritable/risk-taking symptoms were independently associated with higher anxiety symptoms in the first and second trimesters and in the 6-week postpartum period. Primary healthcare practitioners should be made aware of antenatal hypomanic symptoms in pregnant women to facilitate early identification and intervention for anxiety and depression to improve the well-being of both mothers and infants.
Asunto(s)
Depresión Posparto , Complicaciones del Embarazo , Ansiedad/diagnóstico , Ansiedad/epidemiología , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Humanos , Periodo Posparto , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/epidemiología , Prevalencia , Estudios Prospectivos , Factores de RiesgoRESUMEN
OBJECTIVE: Although eating disorders in pregnancy have been studied extensively, little research attention has been given to disordered eating. The objectives of the present study were to determine the prevalence and levels of disordered eating in the perinatal period, and to identify risk factors and adverse outcomes of disordered eating during pregnancy. METHOD: A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,470 Chinese pregnant women from hospitals in Hong Kong was assessed using standardized instruments at five time points from the first trimester to 6 months postpartum. RESULTS: The levels of disordered eating changed significantly across trimesters. Higher levels of disordered eating in pregnancy were significantly associated with higher levels of disordered eating at 6 weeks and 6 months postpartum, greater anxiety and depressive symptoms, lower 1-min Apgar scores, and abnormal birth weight. DISCUSSION: The present study pointed to the need for more research and clinical attention to antenatal disordered eating given that it is associated with anxiety, depression, postpartum disordered eating and obstetric outcomes.
Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/complicaciones , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Complicaciones del Embarazo/epidemiología , Adulto , Femenino , Humanos , Estudios Longitudinales , Embarazo , Estudios Prospectivos , Factores de RiesgoRESUMEN
OBJECTIVE: Universal screening of vaginal and rectal group B streptococcus (GBS) carriage in pregnant women is now recommended in many countries to identify at-risk pregnancies and reduce the risk of early-onset GBS disease in newborn infants. This study compared self-screening by pregnant women with screening by health care workers in a largely Chinese population. METHODS: A randomized crossover study was conducted in Hong Kong. All women attending the GBS screening visit at 35-37 weeks gestation between May and October 2015 were approached for recruitment. Consenting participants underwent both self-screening and screening by health care workers. Group 1 had health care worker screening swabs first, and group 2 had self-screening first. A positive GBS diagnosis was made if either swab was positive. The sensitivity of each approach was calculated by comparison with this gold standard. Acceptance of GBS self-screening and neonatal outcomes was analyzed (Canadian Task Force Classification I). RESULTS: Of the 672 women approached, 428 (63.7%) consented to the study. The prevalence of GBS was 19.7% (83 of 422). Sensitivities of self-screening and screening by health care workers were 61.4% (51 of 83) and 97.6% (81 of 83), respectively (P < 0.05). Women who used vaginal pessaries and non-Chinese women had a higher positive concordance rate with health care workers (P < 0.05). Neonatal outcomes of GBS-positive mothers were similar in the concordant and discordant groups. CONCLUSION: The sensitivity of self-screening of GBS in Hong Kong was lower than the sensitivity of screening by health care workers. Cultural difference needs to be considered when implementing self-screening in different populations.
Asunto(s)
Portador Sano/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Autocuidado , Manejo de Especímenes/métodos , Infecciones Estreptocócicas/diagnóstico , Streptococcus agalactiae/aislamiento & purificación , Adulto , Canal Anal/microbiología , Estudios Cruzados , Femenino , Hong Kong , Humanos , Aceptación de la Atención de Salud , Embarazo , Diagnóstico Prenatal , Sensibilidad y Especificidad , Vagina/microbiologíaRESUMEN
AIM: According to the published work, pregnancy termination rates due to prenatal diagnosis of fetal sex chromosome aneuploidies (SCA) vary widely. Some potentially modifiable and non-modifiable factors have been reported to be associated with parental decision. This study aimed to evaluate the rate of pregnancy termination for fetal SCA and the factors influencing parents' decisions in Hong Kong. METHODS: This was a 21-year retrospective cohort study of parents' decisions following prenatal diagnosis of SCA. Univariate and multivariate analyses for the association between demographic factors, prenatal factors, or counseling provided and decision-making were conducted. RESULTS: The study included 399 pregnancies with prenatal diagnosis of SCA and the overall termination rate was 55.6% (91.7%, 48.0%, 23.4%, 4.8%, and 22.7% for 45,X, 47,XXY, 47,XXX, 47,XYY, and mosaicism, respectively). Pregnancies with ultrasound abnormalities were associated with higher termination rates than pregnancies with normal ultrasound findings (91.3% vs 28.3%, P < 0.0001). From multivariate regression analysis on 226 pregnancies with normal ultrasound examination, a higher likelihood to terminate was found in pregnancies affected by 45,X and 47,XXY (adjusted odds ratio, 4.72, P < 0.0001). Increased maternal age and history of infertility were associated with lower likelihood to terminate (adjusted odds ratio, 0.9, P = 0.012; and 5.12, P = 0.038, respectively). The pregnancy termination rate declined over time. CONCLUSION: A significant correlation was found between the termination of SCA-affected pregnancy and the presence of fetal sonographic abnormalities, type of SCA, maternal age, and presence of infertility.
Asunto(s)
Aborto Inducido/estadística & datos numéricos , Aneuploidia , Toma de Decisiones , Padres , Diagnóstico Prenatal , Aberraciones Cromosómicas Sexuales , Femenino , Hong Kong , Humanos , Infertilidad/genética , Cariotipificación , Edad Materna , Embarazo , Estudios Retrospectivos , Ultrasonografía PrenatalRESUMEN
PURPOSE: The use of array comparative genomic hybridization (aCGH) has been increasingly widespread. The challenge of integration of this technology into prenatal diagnosis was the interpretation of results and communicating findings of unclear clinical significance. This study assesses the knowledge and acceptance of prenatal aCGH in Hong Kong obstetricians and pregnant women. The aim is to identify the needs and gaps before implementing the replacement of karyotyping with aCGH. Questionnaires with aCGH information in the form of pamphlets were sent by post to obstetrics and gynecology doctors. METHOD: For the pregnant women group, a video presentation, pamphlets on aCGH and a self-administered questionnaire were provided at the antenatal clinic. RESULT: The perception of aCGH between doctors and pregnant women was similar. Doctors not choosing aCGH were more concerned about the difficulty in counseling of variants of unknown significance and adult-onset disease in pregnant women, whereas pregnant women not choosing aCGH were more concerned about the increased waiting time leading to increased anxiety. Prenatal aCGH is perceived as a better test by both doctors and patients. CONCLUSION: Counseling support, training, and better understanding and communication of findings of unclear clinical significance are necessary to improve doctor-patient experience.
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Actitud del Personal de Salud , Hibridación Genómica Comparativa , Conocimientos, Actitudes y Práctica en Salud , Cariotipificación , Médicos/psicología , Mujeres Embarazadas/psicología , Diagnóstico Prenatal/métodos , Adulto , Femenino , Hong Kong , Humanos , Cariotipo , Obstetricia , Embarazo , Mujeres Embarazadas/etnología , Encuestas y CuestionariosRESUMEN
AIM: The diagnostic accuracy of fetal echocardiogram performed by an obstetrician alone and that performed jointly by an obstetrician and pediatric cardiologist for congenital heart disease were compared. MATERIALS AND METHODS: All cases of suspected fetal congenital heart disease (CHD) referred to the Prenatal Diagnostic Clinic at Tsan Yuk Hospital, Hong Kong during 2006-2011 were reviewed. Prenatal fetal echocardiogram findings were compared with postnatal diagnosis. Cases of incorrect prenatal diagnosis with significant difference in prognosis were analyzed qualitatively. RESULTS: One hundred and eleven cases of fetal CHD were analyzed. Complete agreement between prenatal and postnatal diagnosis of CHD was observed in 69.4% of cases by fetal echocardiogram performed by obstetrician and 83.8% by fetal echocardiogram performed during pediatric cardiology consultation (P = 0.001). Collaboration with a pediatric cardiologist also improved detection of ductal-dependent cardiac lesions (77.4% vs. 86%, P = < 0.001). Five cases with an incorrect diagnosis were associated with a different prognosis. Three of the cases involved outflow tract abnormalities with incorrect identification of outflow vessels. CONCLUSION: Collaboration with a pediatric cardiologist can significantly improve the accuracy of prenatal diagnosis of CHD. In particular, joint consultation is associated with significantly better detection of ductal-dependent lesions. Outflow tract abnormalities remain a diagnostic challenge in prenatal diagnosis. Incorrect identification of outflow tract vessels was the major cause of incorrect diagnosis in our series.
Asunto(s)
Ecocardiografía , Enfermedades Fetales/diagnóstico por imagen , Cardiopatías Congénitas/diagnóstico por imagen , Ultrasonografía Prenatal , Adulto , Femenino , Edad Gestacional , Humanos , Recién Nacido , Variaciones Dependientes del Observador , Obstetricia , Pediatría , Embarazo , Reproducibilidad de los ResultadosRESUMEN
OBJECTIVES: To study whether lifestyle intervention can reduce the development of type II diabetes mellitus (DM) and metabolic syndrome (MS) among Chinese women who had gestational diabetes mellitus (GDM). METHODS: A prospective randomized controlled interventional trial of 450 women who had GDM and impaired glucose tolerance (IGT) postpartum. Advice on diet and exercise was given to the intervention group and reinforced in each follow-up visit. Women in both arms were followed for 36 months. Blood pressure and anthropometry were measured at each visit and blood tests were repeated. RESULTS: Fewer women in the intervention group developed DM (15 versus 19 %) but this was not statistically significant, and there was a lower incidence of DM among women over 40 years old. No difference was found in fasting glucose, insulin and homeostasis model assessment (HOMA) index. Both systolic and diastolic blood pressures, and triglyceride level, were lower but the significance was inconsistent among visits. BMI and percentage body fat were also significantly lower in the later visits. There was no difference in waist-hip ratio and basal metabolic rate. CONCLUSIONS: Our results demonstrate a trend towards lower incidence of type II DM within 3 years postpartum in GDM women given lifestyle advice, which also potentially offers protection against development of MS, in terms of lower blood pressure and triglyceride level. Women over 40 years old are more likely to benefit. Future studies should address ways to maximize compliance to lifestyle intervention as its potential benefits can be undermined by challenges of motherhood.
Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Diabetes Gestacional/prevención & control , Estilo de Vida , Síndrome Metabólico/prevención & control , Adulto , Factores de Edad , Antropometría , China/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Gestacional/epidemiología , Femenino , Humanos , Incidencia , Síndrome Metabólico/epidemiología , Periodo Posparto , Embarazo , Estudios Prospectivos , Factores de RiesgoAsunto(s)
Quimioprevención/métodos , Anticuerpos contra la Hepatitis B/administración & dosificación , Vacunas contra Hepatitis B/administración & dosificación , Hepatitis B/prevención & control , Hepatitis B/transmisión , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/virología , ADN Viral/sangre , Femenino , Virus de la Hepatitis B/aislamiento & purificación , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Estudios Prospectivos , Medición de Riesgo , Insuficiencia del Tratamiento , Carga ViralRESUMEN
AIM: The aim of this study was to assess the miscarriage and fetal loss rates of twin pregnancies after amniocentesis. MATERIAL AND METHODS: The outcome of 140 twin pregnancies that had amniocentesis performed from 1997 to 2006 was reviewed. RESULTS: Among 140 twin pregnancies with amniocentesis, 35 were excluded (fetuses with structural anomalies, post-selective feticide, abnormal fetal karyotype, twin-twin transfusion syndrome [TTTS], termination of pregnancy, and unknown outcome). For the remaining 105 twin pregnancies, 102 had live births of all fetuses. One dichorionic twin had silent miscarriage of one fetus at 23 weeks. Another dichorionic twin had intrauterine death of one fetus at unknown gestation. One patient had preterm delivery at 32 weeks with neonatal death of one twin due to severe intrauterine growth restriction. The miscarriage rate (one or both fetuses) for twins before 24 weeks was 0.96% (1/105), the pregnancy loss (one or both fetuses) within 4 weeks of amniocentesis was 0.96% (1/105). The total fetal loss rate was 0.96% (2/210) for twins. CONCLUSION: Our cohort showed a low fetal loss rate after amniocentesis for uncomplicated twin pregnancies.
Asunto(s)
Aborto Espontáneo/epidemiología , Amniocentesis/efectos adversos , Muerte Fetal/epidemiología , Embarazo Gemelar , Adulto , Estudios de Cohortes , Femenino , Humanos , Embarazo , Resultado del EmbarazoRESUMEN
OBJECTIVE: Recessive genetic diseases impose physical and psychological impacts to both newborns and parents who may not be aware of being carriers. Expanded carrier screening (ECS) allows screening for multiple genetic conditions at the same time. Whether or not such non-targeted panethnic approach of genetic carrier screening should replace the conventional targeted approach remains controversial. There is limited data on view and acceptance of ECS in general population, as well as the optimal timing of offering ECS to women. This study assesses views and acceptance of ECS in both pregnant women and non-pregnant women seeking fertility counseling or checkup and their reasons for accepting or declining ECS. MATERIALS AND METHODS: This is a questionnaire survey with ECS information in the form of pamphlets distributed from December 2016 to end of 2018. Women were recruited from the antenatal clinics and the assisted reproductive unit at the Department of Obstetrics and Gynaecology, Queen Mary Hospital and the prepregnancy counseling clinic at the Family Planning Association of Hong Kong. RESULTS: A total of 923 women were recruited: 623 pregnant women and 300 non-pregnant women. There were significantly more non-pregnant women accepting ECS compared to pregnant women (70.7% vs. 61.2%). Eight hundred and sixty-eight (94%) women perceived ECS as at least as effective as or superior to traditional targeted screening. Significantly more pregnant women have heard about ECS compared with non-pregnant women (42.4% vs. 32.3%, P = 0.0197). Majority of women showed lack of understanding about ECS despite reading pamphlets that were given to them prior to filling in the questionnaires. Cost of ECS was a major reason for declining ECS, 28% (n = 256). Significantly more pregnant women worried about anxiety caused by ECS compared with the non-pregnant group (21.1% vs. 7.4%, P = 0.0006). CONCLUSION: Our study demonstrates that expanded carrier screening was perceived as a better screening by most women. Prepregnancy ECS maybe a better approach than ECS during pregnancy, as it allows more reproductive options and may cause less anxiety. Nevertheless, implementation of universal panethnic ECS will need more patient education, ways to reduce anxiety, and consensus on optimal timing in offering ECS.
RESUMEN
BACKGROUND: Pregnancy is a time of increasing vulnerability to the development of body dissatisfaction, anxiety, and depression. The present study aims to examine associations of body dissatisfaction with anxiety and depression at the following points: 6 months before pregnancy (retrospective report); in the first, second, and third trimesters of pregnancy; and up to 6 weeks postpartum. METHODS: A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,371 Chinese pregnant women in Hong Kong was assessed using standardized instruments at four time points. RESULTS: A mixed-effects model with repeated measures revealed that body dissatisfaction and depression symptoms changed across different stages of pregnancy. Hierarchical multiple regressions showed that, after adjusting for the identified risk factors, body dissatisfaction before and during pregnancy were positively associated with antenatal anxiety and depression symptoms. Concurrent body dissatisfaction was positively associated with postpartum depression symptoms. LIMITATIONS: There was a high attrition rate in the follow-up assessments. Antenatal anxiety symptoms were assessed using the scale for general anxiety, which may not adequately capture the experience of anxiety among pregnant women. CONCLUSIONS: Primary healthcare practitioners should be made aware of body dissatisfaction among pregnant women in order to facilitate early intervention for anxiety and depression, because untreated psychological disturbance during pregnancy may persist into the postpartum period.
Asunto(s)
Depresión Posparto , Complicaciones del Embarazo , Ansiedad/epidemiología , Insatisfacción Corporal , Depresión/epidemiología , Depresión Posparto/epidemiología , Femenino , Hong Kong/epidemiología , Humanos , Estudios Longitudinales , Periodo Posparto , Embarazo , Complicaciones del Embarazo/epidemiología , Estudios Prospectivos , Estudios Retrospectivos , Factores de RiesgoRESUMEN
OBJECTIVE: To evaluate the effect of rupture of membranes and labour on the risk of hepatitis B virus (HBV) vertical transmission. STUDY DESIGN: A prospective multicentre observational study was carried out in Hong Kong between 2014-2016. Pregnant HBV carriers were recruited. The duration of rupture of membranes, labour and mode of delivery were collected prospectively. HBV DNA was examined at 28-30 weeks of gestation. All newborns received standard HBV vaccination and immunoglobulin. Hepatitis B surface antigen of infants was tested at 9-12 months of age. RESULTS: 641 pregnancies were recruited and analyzed. No statistically significant difference was found in gravida, parity, gestational age at delivery, mode of delivery, duration of rupture of membranes, duration of labour, preterm delivery, preterm rupture of membranes or birth weight (p > 0.05). Subgroup analysis in viral load > 7log10IU/ml and 8log10IU/ml also did not find a significant association between duration of rupture of membranes and labour with immunoprophylaxis failure. CONCLUSIONS: Duration of rupture of membranes and labour would not affect the risk of HBV vertical transmission in infants following standard HBV vaccination and hepatitis B immunoglobulin administration.
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Parto Obstétrico , Hepatitis B/transmisión , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Trabajo de Parto , Complicaciones Infecciosas del Embarazo/virología , Adulto , Femenino , Hepatitis B/prevención & control , Humanos , Recién Nacido , Embarazo , Estudios Prospectivos , Factores de Riesgo , Carga ViralRESUMEN
This study supports training in genetic counseling for obstetricians and adoption of a multidisciplinary approach in the counseling process following prenatal diagnosis of sex chromosome aneuploidy.
Asunto(s)
Consejo/educación , Asesoramiento Genético/métodos , Obstetricia/educación , Trastornos de los Cromosomas Sexuales/diagnóstico , Aneuploidia , Femenino , Hong Kong , Humanos , Masculino , Embarazo , Diagnóstico Prenatal , Estudios Retrospectivos , Trastornos de los Cromosomas Sexuales/psicología , Cromosomas SexualesRESUMEN
OBJECTIVE: It was the aim of our study to investigate the association between culture time and weight of villi obtained by transabdominal chorionic villus sampling (CVS). METHODS: We analyzed 1,442 villus samples. RESULTS: The gestational age at sampling ranged from 10 to 14 weeks. The weight of villi in these samples ranged from 1 to 80 mg (median 10 mg, interquatile range 7-12 mg). The culture time ranged from 5 to 24 days. Culture time was significantly and inversely correlated with the weight of villi obtained (r = -0.258, p < 0.01). Time was significantly longer when 5 mg or less of villi was obtained but the difference was only up to 2 days. CONCLUSIONS: Because the difference in culture time for different groups of villus samples was within 1-2 days, this relationship is statistically significant but has no clinical significance.
Asunto(s)
Técnicas de Cultivo de Célula/métodos , Muestra de la Vellosidad Coriónica/métodos , Vellosidades Coriónicas , Enfermedades Fetales/diagnóstico , Células Cultivadas , Femenino , Enfermedades Fetales/genética , Pruebas Genéticas , Edad Gestacional , Humanos , Cariotipificación , Tamaño de los Órganos , Embarazo , Estudios Retrospectivos , Factores de TiempoRESUMEN
OBJECTIVE: Maternal serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) have been used effectively in the screening of Down syndrome in the first trimester. In this study, we aim to measure the value of first-trimester maternal serum free beta-hCG and PAPP-A as predictors of homozygous alpha0-thalassemia-affected pregnancies. METHODS: Free beta-hCG and PAPP-A concentrations were measured in stored maternal serum samples obtained at 12 weeks of gestation from 22 women with fetuses affected by homozygous alpha0-thalassemia and from 436 controls matched for maternal age, ethnicity, and weight, as well as gestation at blood sampling. RESULTS: Maternal serum concentration of free beta-hCG was significantly increased in women with pregnancies affected by homozygous alpha0-thalassemia than in controls (P = .001). Concentrations of PAPP-A did not differ between the cases affected by homozygous alpha0-thalassemia and the controls (P = .652). CONCLUSION: Pregnancies affected by homozygous alpha0-thalassemia are associated with increased maternal serum free beta-hCG at 11-14 weeks of gestation. This serum analyte alone may not be clinically useful as a predictor of pregnancies affected by homozygous alpha0-thalassemia. However, the absence of ultrasound features of fetal anemia and hydropic changes, together with normal maternal serum free beta-hCG and PAPP-A in the first trimester, will be reassuring signs of normality for fetuses at risk of homozygous alpha0-thalassemia and, hence, enable women to avoid invasive tests in unaffected pregnancies.
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Gonadotropina Coriónica Humana de Subunidad beta/sangre , Enfermedades Fetales/diagnóstico , Complicaciones Hematológicas del Embarazo/diagnóstico , Proteína Plasmática A Asociada al Embarazo/análisis , Diagnóstico Prenatal/métodos , Talasemia alfa/diagnóstico , Adulto , Biomarcadores/análisis , Biomarcadores/sangre , Estudios de Casos y Controles , Gonadotropina Coriónica Humana de Subunidad beta/análisis , Reacciones Falso Positivas , Femenino , Enfermedades Fetales/sangre , Enfermedades Fetales/genética , Homocigoto , Humanos , Valor Predictivo de las Pruebas , Embarazo , Complicaciones Hematológicas del Embarazo/sangre , Primer Trimestre del Embarazo/sangre , Sensibilidad y Especificidad , Talasemia alfa/sangre , Talasemia alfa/genéticaRESUMEN
BACKGROUND: Group B Streptococcus (GBS) is a leading cause of neonatal morbidity and mortality. In an effort to reduce the impact of this serious affliction, universal screening for GBS has been adopted in many countries. The objective of this study was to examine the acceptability of self-collected GBS swabs in a local population in Hong Kong. METHODS: This study is a cross-sectional questionnaire survey conducted in a tertiary teaching hospital. A total of 327 pregnant women who attended the antenatal clinic for GBS screening from April 2012 to May 2012 were included in our study. The acceptability of GBS self-screening and its associated factors were analyzed. RESULTS: Of these women, 200/320 (62.5%) participants preferred screening by healthcare workers, whereas only 18/320 (5.6%) preferred self-screening. The most common reasons why some participants preferred to be screened by clinicians were that professionals had greater knowledge, and the added worry about the accuracy of self-screening. 22/320 (69.4%) and 195/320 (60.9%) women believed that they felt comfortable enough to self-perform the vaginal swab and rectal swab respectively. Previous use of tampons was associated with higher perceived capability of self-performing the vaginal swab. Perceived capability to self-perform the rectovaginal swabs was associated with a willingness to self-perform the swabs (p < 0.001). The majority of women, 303/320 (94.7%), found the current practice of an additional clinic visit for GBS screening acceptable. However, 218/320 (68.1%) participants would like to undertake self-screening if they were given the chance to do so in the next pregnancy, and 187/320 (58.4%) would recommend others have self-screening for GBS as well. CONCLUSION: Most women in the local population still preferred physician-collected samples for GBS screening, but they welcomed the option of self-screening in future pregnancies. Improved health education about the importance of GBS screening may improve the willingness of women to perform self-screening.
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Complicaciones Infecciosas del Embarazo/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Streptococcus agalactiae , Adulto , Estudios Transversales , Femenino , Humanos , Embarazo , Manejo de Especímenes , Encuestas y CuestionariosRESUMEN
BACKGROUND: Severe acute respiratory syndrome (SARS) epidemics have affected populations in many countries, including Hong Kong. This disease is infectious, especially in hospital settings. Health care workers have expressed great concern, including those working in obstetrics wards, defined as high-risk areas. METHOD: Four weeks after implementation of universal precautionary measures at a teaching hospital in Hong Kong, a survey of the health care staff was conducted to identify their feelings and opinions. RESULTS: In spite of general knowledge about SARS epidemics and related mortality, most respondents stated that universal precautionary measures were not very necessary, especially in the obstetrics ward. In addition, respondents were generally dissatisfied with the measures, as most items imposed extra work, inconvenience, and burdens on the staff. CONCLUSION: Our findings reported the views and satisfaction levels of the front-line staff of an obstetric unit concerning precautionary measures against SARS. The importance of individualized design and implementation of infection control measures is highlighted and discussed.
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Actitud del Personal de Salud , Infección Hospitalaria/prevención & control , Servicio de Ginecología y Obstetricia en Hospital/normas , Personal de Hospital/psicología , Síndrome Respiratorio Agudo Grave/prevención & control , Precauciones Universales , Adulto , Infección Hospitalaria/epidemiología , Femenino , Hong Kong/epidemiología , Hospitales de Enseñanza , Humanos , Masculino , Personal de Hospital/estadística & datos numéricos , Embarazo , Ropa de Protección , Factores de Riesgo , Síndrome Respiratorio Agudo Grave/epidemiología , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To investigate the outcome of fetuses with cystic hygroma (CH) diagnosed at the first trimester from a general population in Hong Kong. METHOD: This was a prospective study of 30 fetal cystic hygroma detected at 11 to 13 + 6 weeks' gestation in 8835 sequential unselected pregnancies. Fetal cystic hygroma was categorized as isolated cystic hygroma (ICH) or associated cystic hygroma (ACH) according to the presence of associated multiple congenital structural abnormalities (MCA). RESULTS: There were 10 cases of ICH and 20 cases of ACH. The karyotypes were obtained in 29 cases. In the ICH, 30% (3/10) were associated with chromosomal abnormalities. In the ACH, 65% (13/20) were associated with major chromosomal abnormalities. CONCLUSION: This study suggests that the prognosis of cystic hygroma detected in the first trimester is guarded, with high incidence of MCA (66.7%, 20/30) and chromosomal abnormalities (53.3%, 16/30). The findings support detailed ultrasound examination and invasive prenatal diagnosis for cystic hygroma.