Ounjai Kor-Anantakul

Prince of Songkla University · Faculty of Medicine

Objective To evaluate the efficacy of the quadruple test for potential use as a Thai national policy for Down syndrome (DS) screening and establish an accurate equation for risk estimation of Down syndrome based on gestational age, weight and the ethnic-specific reference range of our population. Methods A prospective study was conducted on single...

Background: Spontaneous preterm delivery (sPTD) is one of the most common global problems causing perinatal morbidity and mortality. However, there is no effective universal screening method for predicting sPTD. Therefore, we want to evaluate the extra benefit of quadruple maternal serum biomarkers for Down syndrome (DS) screening to predict sPTD....

Objective To perform a cross-sectional observational study of calcium consumption among pregnant women from multicenter tertiary care hospitals in the middle-income country in Southeast Asia. Study Design A cross-sectional observational study. Setting The study was conducted in four geographical regions (northern, northeastern, southern, and cent...

Objective To evaluate the ability of second trimester uterocervical angle (UCA) to predict spontaneous preterm birth (sPTB) in low-risk singleton pregnant women. Study design Transvaginal sonographies were performed in the second trimester of 450 singleton pregnant women with no history of sPTB and no history of second trimester miscarriage with n...

The uterocervical angle (UCA) has recently been studied as a parameter to identify women at risk for spontaneous preterm birth (sPTB). This study aimed to investigate the distribution of UCA values by transvaginal sonography (TVS) in the second trimester of women at low risk for sPTB. TVS was performed in 450 low-risk pregnant women at gestational...

Objective: To compare the reliability between uterocervical angle (UCA) and cervical length (CL) measurements by various experienced operators. Methods: Transvaginal ultrasonographies (TVS) were performed in 102 pregnant women between 160/7-240/7 gestational weeks by different levels of experienced operators. For both CL and UCA measurements, intra...

Purpose To compare the accuracies of transabdominal sonography (TAS) and transvaginal sonography (TVS) in the diagnosis of placenta previa. Methods A prospective, cross‐sectional study was conducted at a university hospital. Both TAS and TVS were performed on 81 pregnant women with a suspicion of placenta previa in the third trimester. The final d...

Objectives: The aims of this study were to construct reference ranges for the time interval parameters of the ductus venosus during the early second trimester of pregnancy and to demonstrate the clinical utility in various fetal disorders. Methods: The ductus venosus Doppler measurements of 331 healthy fetuses between 15 and 22 weeks' gestation...

Objective To establish normative weight-adjusted models for the median levels of first trimester serum biomarkers for trisomy 21 screening in southern Thai women, and to compare these reference levels with Caucasian-specific and northern Thai models. Methods A cross-sectional study was conducted in 1,150 normal singleton pregnancy women to determi...

Analysis file for this research. (XLSX)

A prospective study was conducted in centre in Southern Thailand, to evaluate agreement in EFM interpretation among various physicians in order to find out the most practical system for daily use. We found strong agreement of very normal FHR tracings among the FIGO, NICHD 3-tier and 5-tier systems. The NICHD 3-tier was more compatible with the FIGO...

Multiple gestation consisting of complete hydatidiform mole with co-existing fetus (CHMCF) is unusual. From our institution, we reported two cases with unfavorable obstetric consequences. The recommendation for antenatal management is still not distinctly determined. Therefore, the aim of this article was to review the literature according to the p...

Objective: To evaluate whether music listening decreased pain perception during second trimester genetic amniocentesis. Material and method: We conducted a prospective randomized study to compare the pain perception using a visual analogue scale (VAS), pain rating, future decision to repeat the procedure, and pain perception compared to a venipu...

Background: Down syndrome (DS) is the most common chromosomal disorder that causes mental retardation. In 2009, a population-based birth defects study was implemented in three provinces in southern Thailand. This study aimed to determine the prevalence of DS in the studied regions, and the proportion of DS fetuses detected by prenatal screening....

Objective: To evaluate the accuracy of fetal sex determination using ultrasonography performed by Thai Maternal Fetal Medicine fellowships during second trimester genetic amniocentesis and also identify the possible factors of inaccurate determination. Material and method: A prospective non-random study was conducted to evaluate the accuracy of...

Background Acute infection of pregnant women with Toxoplasma gondii can result in fetal transmission. When clinical abnormalities are evident by ultrasonography in late gestation, medical treatment may be attempted, but the data on outcomes are limited. Objectives To present a case of congenital fetal toxoplasmosis from Thailand and review the lit...

This prospective study aimed to present the reference range of amniotic fluid glucose (AFglu) among second trimester pregnant women in southern Thailand, to evaluate the possibility of predicting subsequent gestational diabetes mellitus (GDM) using AFglu, and to estimate AFglu cut-off levels for identifying pregnancies at high or low risk for subse...

Objective: To establish reference ranges for ductus venosus (DV) blood flow velocities and indices during the early second trimester. Methods: A cross-sectional DV Doppler study of fetuses at 15-22 weeks of gestation was conducted at Songklanagarind Hospital, Songkhla, Thailand, during 2013-2014. The peak forward velocities were recorded and the...

A prospective study was conducted for comparing the incidence of fetal bradycardia and level of fetal heart rate change following a second-trimester genetic amniocentesis with and without placental injury. A total of 257 and 495 participants in injured and non-injured groups were analysed. The incidence of fetal bradycardia following amniocentesis...

Objective: To evaluate the benefit of aromatic therapy using menthol for decrease pain perception during amniocentesis. Material and method: A prospective randomized study was conducted to compare pain level between groups ofpregnant women who underwent amniocentesis with and without aromatic therapy using menthol. Visual analogue scale (VAS) wa...

Frontomaxillary facial (FMF) angle is the angle between upper part of the anterior end of the maxillary bone and the line along the frontal bone in the midfacial profile view. Based on several previous studies, FMF angle can be useful in screening Down syndrome foetuses, in which FMF angle is significantly larger than that in euploid foetuses. Howe...

Background Fetal hemodynamics can be assessed by Doppler ultrasonography, but the normal Doppler waveform pattern and reference range of fetal renal artery blood flow indices in normal Thai fetuses during the second trimester have not been studied. Objectives To study the pattern and establish the normal reference range of fetal renal artery blood...

Introduction Down syndrome (DS) is the most common chromosomal disorder that causes mental retardation. In Thailand, studies on DS from 1969–1978 and 1988–1999, both hospital-based, found prevalences of DS of 0.89 and 1.07 per 1,000 live births. Objective To determine the prevalence of DS in the population-based birth defect registries in 3 provinc...

Objective: To establish reference ranges for ductus venosus (DV) blood flow assessment obtained transabdominally at 11-13(+6) weeks of gestation. Methods: A cross-sectional study was conducted on singleton pregnancies with a crown-rump length (CRL) ranging from 45 to 84 mm, normal fetus, and subsequent newborn birth weight appropriate for gestat...

Neural tube defects (NTDs) are a group of congenital malformation of the central nervous system that leads to permanent physical disability and requires lifelong treatment. In Thailand, there have been three published articles on NTDs, all hospital-based studies, which found prevalence of NTDs of 4.8-6.7 per 10,000 live births. It was our purpose w...

To compare the effectiveness of counseling methods before second trimester genetic amniocentesis. A randomized controlled study comparing the improvement in patients' knowledge satisfaction anxiety and perceived pain between computer-assisted instruction (CAI) and leaflet self-reading (LSR) and subsequent individual counseling among pregnant women...

Objective: To evaluate the accuracy of the 5 sonographic morphology scoring (SMS) systems (Sassone, DePriest, Lerner, Vera and Kawai and Valentin) for prediction of malignant ovarian tumors. Methods: A diagnostic study was conducted at Songklanagarind Hospital during November 2008 to June 2009. All of the patients scheduled for elective surgery...

To survey the knowledge and attitudes towards Down syndrome screening in the final year of training of Thai obstetrics and gynaecology residents. A self-administered structured questionnaire of knowledge and attitudes towards Down syndrome screening was developed One hundred thirty six residents were asked to respond to the questionnaire on their l...

Objective To compare the pregnancy outcome between pregnancies affected and not affected by thalassemia trait. Methods A retrospective case–control cohort study was conducted on singleton pregnant women who attended antenatal care and delivered at Songklanagarind Hospital. All of the participating thalassemia trait pregnant women were diagnosed ba...

Objective: The aim of the research was to determine effectiveness of the model for prenatal control in reducing new cases of severe thalassemia. Methods: Pregnant women at six tertiary centers were recruited to follow the model, consisting of (1) carrier screening using mean corpuscular volume (for alpha-thal-1 and beta-thal) and CMU-E screen (f...

Objective: To compare intra-/inter-operator reliability of manual and semi-automated NT measurement by experienced operators. Methods: Images of 103 fetuses at 11 to 13+6weeks were selected. Two operators performed NT measurement independently 3 times each using both manual and semi-automated methods. Intraoperator reliability of the methods was...

Nasal bone assessment has been incorporated into Down syndrome screening in first trimester. Several studies have established the normal reference values for fetal nasal bone length in the first trimester, which were found to be varied by population. However, the study on reliability of nasal bone length measurement was limited with contradictory r...

To evaluate the effectiveness of cryoanalgesia in decreasing the degree of pain sensation during second trimester genetic amniocentesis. We performed a prospective randomized study comparing the anticipated and actual pain before and after second trimester genetic amniocentesis between pregnant women who received and did not receive cryoanalgesia....

The purpose of this study was to establish a Thai reference for normal fetal nasal bone length (NBL) at 11-13(+6) weeks gestation. The fetal nasal bone was measured by sonography in pregnant women at 11-13(+6) weeks gestation. All neonates who showed normal karyotypes were examined after delivery to confirm the absence of congenital abnormalities....

To evaluate the outcome of genetic amniocentesis in singleton gestation at Songklanagarind Hospital. This was a descriptive study that included all singleton pregnant women who had a second trimester amniocentesis for chromosome studies at the Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Songklanagarind Hospital between Ja...

To establish the normative data distribution of nuchal translucency (NT) thickness in Thai fetuses. A cross-sectional multicenter study was conducted among 6,455 women with singleton pregnancies and gestational age between 10 and 14 weeks. For each case, the fetal crown-rump length (CRL) and NT were measured by transabdominal ultrasound. Transvagin...

To compare the mortality, morbidity of emergency and elective cesarean section with vaginal delivery among Asian teaching hospitals. Hospital based prospective study at 12 centers of 9 countries. 12 591 vaginal deliveries, 3062 elective and 4328 emergency cesarean section were followed up to 5 days postpartum. Maternal deaths (95% CI) per 1000 birt...

To determine the knowledge and attitudes of pregnant Thai women towards Down syndrome screening. A total of 714 pregnant women were recruited attending antenatal clinics in Songklanagarind Hospital from February through June 2007. Their knowledge and attitudes concerning Down syndrome screening were evaluated through self-administered questionnaire...

The purpose of this study was to establish a Thai reference for normal fetal nasal bone length at 15 to 23 weeks' gestation. The fetal nasal bone was measured by sonography in 295 pregnant women at 15 to 23 weeks' gestation from May to August 2005. One of the first 4 authors performed 3 measurements for each woman when the fetus was in the midsagit...

To evaluate the outcome of genetic amniocentesis in twin gestations at Songklanagarind Hospital. This was a descriptive study that included all women with twin pregnancies who had a second trimester amniocentesis for chromosome study at the Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Songklanagarind Hospital from January...

A hospital-based, prospective cohort study was conducted at the tertiary care university hospital in southern Thailand, between 1 November 2001 and 31 December 2003. The purpose of this study was to compare the various complications found in vaginal and caesarean deliveries based on the original elected intended mode of delivery. There were a total...

To determine the incidence, etiology and outcome of treatment in obstetric patients complicated by overt disseminated intravascular coagulation (DIC). Medical records of 25 obstetric patients with a diagnosis of DIC in Songklanagarind University Hospital from January 1993 to December 2005 were reviewed The incidence of overt DIC was I per 1,355 del...

To determine the outcomes of multifetal pregnancies and to compare maternal and neonatal complications between spontaneously conceived and assisted reproductive therapy. A retrospective analysis was conducted of the information from medical records relating to all multifetal pregnancies. The outcomes were analyzed and used for a comparison between...

To quantify placental weight and its ratio to birth weight in normal pregnancy; and to determine whether abnormal placental weight and its ratio are associated with poor pregnancy outcomes. Prospective, cross-sectional study. From January 1st, 2004, to December 31st, 2004, placentae were obtained from 238 normal pregnancies, between the 36th-40th g...

Complete trisomy 9 is a very rare chromosome aneuploidy, associated with specific patterns of multisystem dysmorphism and a wide spectrum of congenital anomalies. We present a case of complete trisomy 9 with prenatal sonographic findings in the second trimester. The combination of sonography and karyotyping from cordocentesis enabled us to establis...

To evaluate intra- and inter-observer variations of nuchal translucency (NT) measurements and study the duration of measurements. One hundred and forty-seven singleton pregnant women with 10-14 weeks of gestation who had attended antenatal clinic during January 1st, 2000-August 31st, 2001 were included. Crown-rump length and NT were measured three...

To study the etiology and outcome of non-immune hydrops fetalis in southern Thailand. The medical records and videotape recordings of all pregnant women diagnosed with non-immune fetal hydrops, from January 1993 to December 2002 were reviewed. Non-immune hydrops fetalis was documented in 71 cases. The causes of fetal hydrops were identified in 87.3...

A thalassemia screening program for pregnant women has been established in Songklanagarind Hospital since 1992. After genetic counseling, a total of 5078 pregnant women accepted entry into a screening program for thalassemia. Couples at risk who should receive prenatal diagnosis were 2.8%. Total cases who accepted prenatal diagnosis were 135. Total...

Heavy maternal workloads are considered to be hazardous to the fetus. The effects of physical activity during pregnancy on low birth weight (LBW), small for gestational age (SGA), and prematurity were assessed from a sample of 1797 women in a follow-up study at the antenatal clinic of two hospitals in southern Thailand. The women were interviewed t...

To estimate the effect of long working hours and shift work on time to pregnancy. Cross sectional samples with retrospective data collection from two 700 bed hospitals at secondary to tertiary care level in Hatyai district, Songkhla Province, Thailand. The study was conducted from March 1995 to November 1995 among 1496 pregnant women attending the...