[show abstract][hide abstract] ABSTRACT: Background
Preterm prelabor rupture of membrane (PPROM) causes maternal and neonatal complications. Prophylactic antiobiotics were used in the management of PPROM. The objectives of this retrospective study were to compare clinical course and outcome of PPROM managed expectantly with prophylactic antibiotics and antenatal corticosteroids with those without prophylactic antibiotics and antenatal corticosteroids.
A total of 170 cases of singleton pregnant women with gestational age between 28–34 weeks suffering from PROM during January 1998 to December 2009 were included; 119 cases received prophylactic antibiotics and antenatal corticosteroids while 51 cases did not received prophylactic antibiotics and antenatal corticosteroids. Median latency period in the study group was significantly longer than in the control group (89.8 vs. 24.3 hours, P < 0.001). The percentage of patients who did not deliver within 48 hours and within 7 days in the study group were also significantly higher than in control group (64.7 vs. 31.4%, P < 0.001 and 29.4 vs. 7.8%, P = 0.002, respectively). Maternal infectious morbidity was comparable between groups (17.6% vs. 13.7%, P = 0.52). Neonatal infectious morbidity was significantly lesser in study group than control group (21% vs. 35.3%, p = 0.04).
Latency period of PPROM after using prophylactic antibiotics and antenatal corticosteroids increased while neonatal infectious morbidity was low. But maternal infectious morbidity was not increased. This retrospective study confirms the benefit of prophylactic antibiotics and antenatal corticosteroids in management of PPROM.
[show abstract][hide abstract] ABSTRACT: The aim of this study was to evaluate operative complications, operative time, postpartum complications and neonatal outcome in repeated cesarean section between previous low midline and previous Pfannenstiel cesarean section.
This was a prospective comparative study conducted at the King Chulalongkorn Memorial Hospital in pregnant women with indication of repeated cesarean section for either low midline or Pfannenstiel incisions.
A total of 320 pregnant women with previous cesarean section were enrolled into two groups: low midline (n = 160) and Pfannenstiel (n = 160) groups. Operative complications, postpartum complications and neonatal outcomes were not statistically different between the groups (P > 0.05). Median times for total operative time (50 vs 50 min, P = 0.833), time from skin incision to the uterus (4 vs 4 min, P = 0.877), and time from uterine incision to fetal delivery (3 vs 2 min, P = 0.871) were comparable between the groups.
Operative complications, operative time, postpartum complications and neonatal outcomes were comparable between low midline and Pfannenstiel groups in repeated cesarean sections irrespective of the previous technique used.
Journal of Obstetrics and Gynaecology Research 07/2013; · 0.84 Impact Factor
[show abstract][hide abstract] ABSTRACT: AIMS: The aim of this study was to identify the differences in risk factors between early and late onset pre-eclampsia. MATERIAL AND METHODS: A case-control study was carried out involving pregnancies with pre-eclampsia (152 early onset and 297 late onset) and 449 controls at King Chulalongkorn Memorial Hospital, Bangkok, Thailand between 1 January 2005 and 31 December 2010. The data were reviewed from antenatal and delivery records. RESULTS: Factors which were significantly associated with increased risk for both early and late onset pre-eclampsia were family history of diabetes mellitus, high pre-pregnancy body mass index ≥ 25 kg/m(2) and weight gain ≥ 0.5 kg per week. History of chronic hypertension (odds ratio 4.4; 95% confidence interval 2.1-9.3) was significantly associated with increased risk for only early onset pre-eclampsia, while family history of chronic hypertension (odds ratio 18; 95% confidence interval 6-54) was significantly associated with increased risk for only late onset pre-eclampsia. CONCLUSIONS: The risk factors that differ between early and late onset of pre-eclampsia were history of chronic hypertension and family history of chronic hypertension. Family history of diabetes mellitus, pre-pregnancy body mass index ≥ 25 kg/m(2) and weight gain ≥ 0.5 kg per week were risk factors of both early and late onset pre-eclampsia. These risk factors are of value to obstetricians in identifying patients at risk for pre-eclampsia and in implementing primary prevention.
Journal of Obstetrics and Gynaecology Research 10/2012; · 0.84 Impact Factor
[show abstract][hide abstract] ABSTRACT: Leg cramps are common in pregnant women. Currently, there is no standard treatment for pregnancy-induced leg cramps. The objective of this study was to evaluate the therapeutic efficacy of oral magnesium in pregnant women with leg cramps. This double-blinded, randomised, placebo-controlled trial included 86 healthy pregnant women, 14-34 weeks of gestation who had leg cramps at least twice per week. The study period was 4 weeks. Eighty women completed the study. Forty-one women were assigned to magnesium bisglycinate chelate (300 mg per day) and 39 women to placebo. Details of leg cramps were recorded before beginning the treatment and the fourth week of study. Outcome measure was the reduction of cramp frequency after treatment and cramp intensity measured by 100-mm visual analogue scale. Fifty per cent reduction of cramp frequency was significantly higher in the magnesium group than the placebo group (86.0% vs. 60.5%, P = 0.007). The 50% reduction of cramp intensity was also significantly higher in the treatment group than in the placebo group (69.8% vs. 48.8%, P = 0.048). There were no significant differences between the two groups in terms of side effects such as nausea and diarrhoea. These results demonstrated that oral magnesium supplement can improve the frequency and intensity of pregnancy-induced leg cramps. Therefore, oral magnesium may be a treatment option for women suffering from pregnancy-induced leg cramps.
Maternal and Child Nutrition 08/2012; · 2.11 Impact Factor
[show abstract][hide abstract] ABSTRACT: Aims: To assess whether terbutaline is able to prolong the latency period in women with preterm premature rupture of membranes (PPROM) and compare maternal and neonatal morbidity and mortality in the terbutaline and nontocolysis groups. Methods: This study retrospectively analyzed data from women with singleton pregnancies (gestational ages between 28 and 34 weeks) suffering from PPROM from January 1998 to December 2009. Results: A total of 163 cases of PPROM were analyzed; there were 61 cases (37.4%) in the terbutaline group and 102 cases (62.6%) in the nontocolysis group. The median latency period was comparable in the two groups (78 vs. 75 h, p = 0.44). The percentage of patients who did not deliver within 48 h was significantly higher in the terbutaline group compared with the nontocolysis group (78.7 vs. 62.7%, p = 0.03). There were no differences in maternal morbidity and mortality, and neonatal mortality between the two groups. Interestingly, neonatal infectious morbidity was significantly higher in the terbutaline group when compared with the nontocolysis group. Conclusions: Terbutaline cannot prolong the latency period in PPROM. There were no differences in maternal morbidity and mortality. However, neonatal infectious morbidity was higher in the terbutaline group.
Gynecologic and Obstetric Investigation 02/2012; 73(2):130-4. · 1.10 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of the present study was to compare the efficacy of placental alpha-microglobulin-1 (PAMG-1) rapid immunoassay with conventional standard methods for the diagnosis of rupture of membranes (ROM).
A prospective observational study was performed in patients with symptoms or signs of premature rupture of membranes (PROM) at the Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University. Conventional standard methods were performed to establish the diagnosis and were compared with PAMG-1 immunoassay results. ROM was diagnosed if visualization of fluid leaking from the cervical os or two of the following three conditions were present: positive nitrazine test, ferning test, and nile blue test. The diagnosis of ROM was confirmed by reviewing the medical records after delivery. ResuLTS: One hundred patients (gestational age 36.5±3.5weeks, range 22-41weeks of gestation) were recruited into the study. Seventy-six percent were preterm and 24% were at term. PAMG-1 immunoassay had a sensitivity of 97.2%, specificity of 69%, positive predictive value (PPV) of 90.8%, negative predictive value (NPV) of 90.9% and an accuracy of 89%. In contrast, conventional combined standard methods had a sensitivity of 88.7%, specificity of 96.6%, PPV of 98.4%, NPV of 77.8%, and accuracy of 91% for the diagnosis of ROM.
PAMG-1 immunoassay is a rapid method for the diagnosis of ROM. PAMG-1 has a higher sensitivity than conventional standard methods for the diagnosis of ROM.
Journal of Obstetrics and Gynaecology Research 11/2011; 38(1):226-30. · 0.84 Impact Factor
[show abstract][hide abstract] ABSTRACT: Prepregnancy obesity is associated with increased risk for adverse pregnancy outcome such as gestational diabetes mellitus (GDM), gestational hypertension, preeclampsia, fetal macrosomia and the need for cesarean delivery. The objectives of this study assessed whether Thai women classified as obese according to WHO's recommended body mass index (BMI) for Asians were at risk for developing gestational diabetes mellitus (GDM) and other complications such as preeclampsia, gestational hypertension and fetal macrosomia.
Two hundred and forty women participated in this study and followed prospectively until delivery. Half of the women (n = 120) were obese (BMI ≥ 27.5 kg/m2) and the other half (n = 120) had normal weight (BMI > 18.5-23 kg/m2). Maternal demographic data, obstetric and neonatal outcomes from both groups were compared to each other. Relative risk and 95% confidence interval (CI) were calculated.
Compared to normal weight women, obese Thai women were not at increased risk for gestational diabetes mellitus (RR = 0.9 [95% CI 0.6-1.4]). Relative risk of preeclampsia and fetal macrosomia in obese women were 0.7 [95% CI 0.2-3.3] and 1.4 [95% CI 0.5-4.3], respectively. Relative risk of gestational hypertension in obese women was 12 [95% CI 1.6-90.8].
When WHO's classification of obesity was used for Asian populations, prepregnancy obesity without metabolic problems did not increase the risk for GDM, preeclampsia and fetal macrosomia in Thai women. But, prepregnancy obesity continued to increase the risk for developing gestational hypertension.
BMC Pregnancy and Childbirth 08/2011; 11:59. · 2.52 Impact Factor
[show abstract][hide abstract] ABSTRACT: To examine the value of combined maternal serum inhibin A and embryonic/fetal heart rate to predict the pregnancy outcome in a first-trimester threatened abortion.
This was a prospective observational study. The authors measured maternal serum inhibin A and the embryonic/fetal heart rate in women with a clinical diagnosis of a threatened abortion and in normal pregnant women. The main outcome measured was ongoing normal pregnancies.
Thirty women with threatened abortions and 30 normal pregnant women were followed. Three women with threatened abortions ended in failed pregnancies. The mean embryonic/fetal heart rate and the median of serum inhibin A in the threatened abortion group were not different from the control group. In women with threatened abortions and failing pregnancies, the embryonic/fetal heart rate (101.7 +/- 20.1 beats/min) was significantly lower than in women with threatened abortions but ongoing pregnancies (163.3 +/- 19.7 beats/min, p = 0.024). Serum inhibin A in women with threatened abortions and failing pregnancies was not different from women with threatened abortions but ongoing pregnancies (median) 274.0 vs. 559.9 pg/mL, p = 0.388). When using serum inhibin A combined with embryonic/fetal heart rate, or only embryonic/fetal heart rate, the sensitivity and specificity for predicting an ongoing pregnancy were 100% and 50% or 100% and 100%, respectively.
Combined maternal serum inhibin A and embryonic/fetal heart rate is not better than embryonic/fetal heart rate for predicting the pregnancy outcome in a first-trimester threatened abortion.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 05/2011; 94(5):529-34.
[show abstract][hide abstract] ABSTRACT: To evaluate and compare effectiveness, side effects and patient acceptability between oral and sublingual 600 µg misoprostol for the treatment of incomplete abortion.
A randomized controlled trial was conducted. Pregnant women of less than 14 weeks gestation, diagnosed with incomplete abortion, were randomly assigned to receive 600 µg misoprostol orally or sublingually. The patients were evaluated at 48 h after drug administration for complete abortion.
A total of 64 women were recruited to the study (32 in the oral group and 32 in the sublingual group). The complete abortion rate was not statistically different between oral and sublingual groups (87.5% versus 84.4%, P > 0.05). There was no statistical difference in side effects and satisfaction rate. Fever/chills were the most common side effects.
Both sublingual and oral 600 µg misoprostol are useful for the management of incomplete abortion. Side effects and satisfaction rates are not different. Thus, these methods may be used as alternative treatments of incomplete abortion.
Journal of Obstetrics and Gynaecology Research 10/2010; 36(5):978-83. · 0.84 Impact Factor
[show abstract][hide abstract] ABSTRACT: From 2005 to 2008, the authors assessed the medical ethics of 779 medical students in the Department of Obstetrics and Gynecology at the Faculty of Medicine, Chulalongkorn University by using the Chula Method. This was conducted through a written examination asking the students to express their opinions about ethical issues. Their answers were rated as either Satisfactory (S) or Unsatisfactory (U). It was found that 750 students (96.3%) earned S while 29 students (3.7%) earned U. The results from this study can not be compared with the results from studies published in medical journals. Thus, knowledge about medical ethics is not complete even though it is intensively taught in medical schools and has been practiced for a long time. The authors would like to propose a new assessment of the medical ethics so that it can be systematically applied.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 09/2010; 93(9):1115-8.
[show abstract][hide abstract] ABSTRACT: Although there are many benefits to breastfeeding, its prevalence and duration in many countries is still lower than the international recommendation for 6-month exclusive breastfeeding. The objective of the present study was to investigate whether a knowledge sharing practices with empowerment strategies (KSPES) program on antenatal education and postnatal support strategies improves the rates of 6-month exclusive breastfeeding during the first six months postpartum compared with a standard knowledge of breastfeeding techniques.
A randomized controlled trial was conducted. Pregnant women of more than 32 weeks' gestation were randomly assigned to receive a routine standard knowledge of breastfeeding techniques alone (control group) or with KSPES on antenatal education and postnatal support strategies (study group). The primary outcome was the rate of exclusive breastfeeding at 6-month postpartum. The secondary outcomes were rates at 7 days, 14 days, 1, 2, 3, 4, and 5 months postpartum.
Rates of exclusive breastfeeding in the study group were significantly higher when compared with those in the control group at 14 days (82.5% vs. 52.6%, p = 0.005), 1 month (77.5% vs. 52.6%, p = 0.021), 2 months (62.5% vs. 368%, p = 0.023), 4 months (35.0% vs. 7.9%, p = 0.008), 5 months (25.0% vs. 2.6%, p = 0.012), and 6 months postpartum (20.0% vs. 0%, p = 0.005).
KSPES on antenatal education and postnatal support strategies significantly improve rates of exclusive breastfeeding at 6-month postpartum. These strategies also significantly improve rates of exclusive breastfeeding at 14 days, 1, 2, 4, 5, and 6 months postpartum.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 09/2010; 93(9):1009-18.
[show abstract][hide abstract] ABSTRACT: To determine the risk factors of preeclampsia in a university hospital.
The authors conducted a case control study involving 309 Thai pregnant women with preeclampsia and 309 controls who delivered at King Chulalongkorn Memorial Hospital, Bangkok, Thailand between June 2008 and May 2009. Information was taken from maternal inquiry, delivery records and antenatal care records.
The risk factors that were significantly associated with increased risk of preeclampsia were maternal age > or = 35 years (ORs 1.7; 95% CI 1.1-2.9), nulliparity (ORs 3.8; 95% CI 2.5-5.7), prepregnancy body mass index > or = 30 kg/m2 (ORs 3.0; 95% CI 1.4-6.3), multifetal pregnancy (ORs 2.8; 95% CI 1.2-7.1), history of preeclampsia in a previous pregnancy (ORs 17.0; 95% CI 3.3-87.6) and chronic hypertension (ORs 19.5; 95% CI 2.4-155.7). Maternal age < 20 years (ORs 0.4, 95% CI 0.2-0.9) and prepregnancy body mass index < 20 kg/m2 (ORs 0.4; 95% CI 0.2-0.6) were significant protective factors against the development of preeclampsia.
Risk factors of preeclampsia were maternal age > or = 35 years, nulliparity, prepregnancy body mass index > or = 30 kg/m2, multifetal pregnancy, history of preeclampsia in previous pregnancy and chronic hypertension. On the other hand, maternal age < 20 years and prepregnancy body mass index < 20 kg/m2 were significant protective factors against the development of preeclampsia. These risk factors should be of value to obstetricians counseling women regarding preeclampsia.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 06/2010; 93(6):661-6.
[show abstract][hide abstract] ABSTRACT: Heterotopic pregnancy is a rare event and management is by either laparotomy or laparoscopic surgery to remove the extrauterine pregnancy. As there has been no report detailing the use of gasless laparoscopy for management of heterotopic pregnancy, the authors herein report a case of heterotopic pregnancy that was successfully managed by gasless laparoscopic surgery. The subsequent antenatal course was unremarkable. The intrauterine pregnancy carried to term with uneventful maternal and fetal outcomes. Thus, gasless laparoscopy can be used as an alternative method for the management of heterotopic pregnancy.
Journal of Obstetrics and Gynaecology Research 06/2010; 36(3):686-9. · 0.84 Impact Factor
[show abstract][hide abstract] ABSTRACT: Sexuality usually decreases during pregnancy.
To evaluate sexual behavior during pregnancy, comparing two groups. One had sexual education and the other had none.
After randomizing two groups of pregnant women, they completed self-administered questionnaires regarding attitudes and sexual behavior before and during pregnancy. Sexual education was provided in one group and a second self-administered questionnaire was completed 12 weeks later. Responses were summarized using descriptive statistics. Comparison of change of sexual behavior between two groups was analyzed using chi-square and student t-tests.
The change in frequency of coitus during pregnancy was compared between the sexual education group and the noneducation group.
There was no statistically difference in changes of sexual behavior between the two groups. There was a reduction in frequency of coitus (90.6% vs. 94.9%, P>0.05) between the nonsexual education group and the sexual education group and no statistically significant change in mean reduction of sexual desire (8.9 vs. 4.4, P>0.05), sexual arousal (14.3 vs. 13.1, P>0.05), satisfaction from coitus (15.4 vs. 7.2, P>0.05), and orgasm from coitus (12.3 vs. 12.3, P>0.05).
The change of sexual behavior during pregnancy in the sexual education group was not different from that in the nonsexual education group.
Journal of Sexual Medicine 02/2010; 7(10):3434-8. · 3.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: To identify pregnancy complications of women with heart disease delivering at a university hospital.
A retrospective study was carried out of 193 pregnant women with heart disease delivered at a university hospital between January 1997 and December 2006.
Rheumatic heart disease (RHD), congenital heart disease (CHD), arrhythmia and cardiomyopathy were observed in 133 (68.9%), 26 (13.5%), 32 (16.6%) and 2 (1%) cases, respectively. Obstetric complication was found in 27 (14%) cases that was composed of preterm delivery (11.4%), gestational diabetes (1%), pregnancy induced hypertension (1%) and postpartum hemorrhage (0.5%). Cardiac complication was observed in 24 (12.4%) cases. Congestive heart failure was the most common cardiac complication which observed in 11 (5.7%) cases. There were four (2.1 %) maternal deaths, three cases in CHD group and one case in RHD group. Preterm infant was observed in 22 (11.4%) cases. Thirteen percent had low birth weight and 8.3% were small for gestational age. There were no perinatal deaths or congenital anomalies.
Form this study, RHD with pregnancy is still predominant. The most common obstetric complication was preterm delivery. The most common cardiac complication was congestive heart failure.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 11/2009; 23(10):1200-4. · 1.36 Impact Factor
[show abstract][hide abstract] ABSTRACT: To compare complete abortion rate, duration of abortion, and side effects between 600 microg powdery sublingual misoprostol and 600 microg sublingual misoprostol tablet for management of embryonic death or anembryonic pregnancy.
Fifty-four pregnant women up to 13 weeks of gestation diagnosed with embryonic death or anembryonic pregnancy were randomized to receive 600 microg powdery sublingual misoprostol or 600 microg sublingual misoprostol tablet. Complete abortion was evaluated by transvaginal ultrasound at 48 h.
Twenty-six patients received 600 microg powdery sublingual misoprostol and 28 patients received 600 microg sublingual misoprostol tablet. Complete abortion rate was 34.6% in powdery sublingual misoprostol group and 32.1% in sublingual misoprostol tablet group (P = 0.847). Duration of abortion in powdery sublingual misoprostol group and sublingual misoprostol tablet group was similar (34.7 +/- 18.8 vs. 36.9 +/- 17.8 h, respectively, P = 0.656). There was no significant difference in the side effects between both groups.
Single dose of 600 microg of powdery sublingual misoprostol does not improve its efficacy for management of embryonic death or anembryonic pregnancy when compared to sublingual misoprostol tablet.
Archives of Gynecology 03/2009; 280(3):431-5. · 0.91 Impact Factor
[show abstract][hide abstract] ABSTRACT: To evaluate the use of third trimester inhibin A levels to assess the severity of preeclampsia.
Blood samples were taken from women diagnosed with mild and severe preeclampsia during the third trimester of pregnancy. Blood samples were collected in plain tubes, centrifuged and stored at -80 degrees C until analyzed. All serum samples were measured for inhibin A levels by enzyme-linked immunosorbent assays.
Inhibin A levels were greater in the severe (1,435.9 +/- 603.2 pg/mL) than in the mild preeclampsia group (1,021.9 +/- 438.8 pg/mL, P = 0.014).
Inhibin A levels rise with increasing severity of disease. However, there is considerable overlap of serum inhibin A levels in women with mild and severe preeclampsia. Inhibin A is therefore not a useful adjunct for the classification of preeclampsia.
Archives of Gynecology 01/2009; 280(2):183-6. · 0.91 Impact Factor
[show abstract][hide abstract] ABSTRACT: To construct nomograms of the size of the fetal orbit and lens and to evaluate the relationships between the gestational age and the biometry of the fetal orbit and lens.
Six hundred two normal pregnant women were evaluated from 15 to 40 weeks of gestation. Fetal orbital and lens measurements were added to routine biometric measurements for normal fetuses.
A total of 595 measurements were used for analyses. A strong linear correlation was observed between gestational age and orbital diameter, orbital circumference, and orbital surface. A linear correlation was also found between gestational age and lens diameter, lens circumference, and lens surface. A linear growth function was observed between biparietal diameter and both the orbital diameter and the lens diameter.
Orbital and lens measurements provide data that correlate with fetal growth and development. These data may also help detect fetal ocular abnormalities.
Journal of Clinical Ultrasound 11/2008; 37(2):69-74. · 0.70 Impact Factor
[show abstract][hide abstract] ABSTRACT: To construct reference ranges of fetal ocular distance (interocular and binocular distance) and to evaluate the relationships between the gestational ages and fetal ocular distance.
Six hundred and two normal pregnant women were evaluated from the 15th to 40th week of gestation. Fetal ocular distance (interocular and binocular distances) was added to routine biometric measurements for normal fetuses. The fetal ocular distance (interocular and binocular distances) was also related to gestational age.
Five hundred and ninety five measurements were used for analyses. A linear regression and correlation were observed between gestational age (GA) and interocular distance (y = 2.304 + 0.510 x GA, R2 = 0.887; p < 0.0001), and binocular distance (y = 2.590 + 1.420 x GA, R2 = 0.953; p < 0.0001). A linear growth function was observed between biparietal diameter (BPD) and both interocular distance (y = 2.854 + 0.203 x BPD, R2 = 0.888; p < 0.0001), and binocular distance (y = 3.893 + 0.568 x BPD, R2 = 0.965; p < 0.0001).
The present study provides normative data of fetal interocular distance and binocular distance. These data may be helpful in detection of fetal hypotelorism or hypertelorism.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 09/2008; 91(9):1318-22.
[show abstract][hide abstract] ABSTRACT: To establish reference ranges for maternal serum inhibin A in normal first trimester pregnant women.
This was a cross-sectional study. We measured maternal serum inhibin A in normal pregnant women gestation age between 6(+0) and 14(+6) weeks using the enzyme-linked immunosorbent assay (ELISA) method. Maternal serum inhibin A was analyzed according to gestational ages (GA).
Serum of 300 pregnancies was analyzed and the outcome demonstrated the median of maternal serum inhibin A according to gestational age. The levels of maternal serum inhibin A during the 6(0)-6(+6) week of gestations are lowest when compared with other gestational age. The levels of maternal serum inhibin A during 9(0)-9(+6) week of gestations are maximal. Maternal serum inhibin A then declined until 14 weeks of gestation.
Serum inhibin A can be measured during the first trimester of pregnancy by using the recent ELISA technique. Our reference ranges might be useful for further studies, such as prediction of adverse pregnancy outcome in threatened abortion.
Archives of Gynecology and Obstetrics 05/2008; 277(4):307-10. · 1.33 Impact Factor