Advances in antenatal, perinatal, and neonatal care lead to increased survival of preterm infants. As survival rates continued to increase, so did the angst of “intact survival,” or survival without disabilities. A recent meta-analysis revealed that at school-age, cognitive scores of former very low birth weight (VLBW) infants are approximately 10 points lower than those of matched control children1 due to difficulties with attention, behaviour, visual-motor integration, and language performance.2-3
The approach in prenatal diagnosis has been revolutionized by advances in prenatal molecular diagnostics. New algorithms in prenatal diagnosis are evolving and becoming increasingly complicated (Figure 1). The goal is to maximize the prenatal information for pregnant women and the families to make choices for the next generations.
During foetal life, blood flows through the ductus arteriosus (DA) from the pulmonary artery into the aorta, thereby bypassing the lungs. After birth, the DA undergoes active vasoconstriction and eventual closure. A patent ductus arteriosus (PDA) occurs when the DA does not close completely after delivery.
Thalassaemia becomes a global health problem. Most women with thalassaemia trait can be picked up by universal prenatal screening for thalassaemia using mean corpuscular volume/haemoglobin, followed by haemoglobin pattern with or without DNA analysis.
Acute gastroenteritis (AGE) remains a significant contributor to paediatric disease burden across the world in the 21st century. Rehydration remains the mainstay of therapy, while pharmacotherapy may have adjunctive benefits. We seek to review the evolution in management strategies of paediatric AGE, in particular the child with viral AGE.
Advances in health care management of newborn babies have led to an improved survival rate. Improved survival can predispose to chronic health problems and neurodevelopmental disabilities. Hence complex decisions have to be made by the parents and neonatologists about treatment. These decisions might be made at the time of resuscitation at birth, during the continuum of care in the neonatal intensive care unit (NICU), or at the time of replacing intensive care with palliative care.
Yu Tse Ka, Philip Pun Ching Ip, Karen Kar Loen Chan, 20160316034350
Cervical cancer is the fourth most common cancer in women in the world and there were about 528,000 new patients and 266,000 deaths in 2012. In Hong Kong, its crude incidence rate dropped from about 14 per 100,000 women in late 1990s to around 10.5 in early 2010s, and is currently the 9th commonest female cancer. (Table 1a and 1b)1 This phenomenon may be attributed to the implementation of cervical smear screening programme. Nevertheless, it remains as the 8-9th leading cause of female cancer death over the last decade and the crude mortality rate rose from its trough at 3.0 per 100,000 women in 2003 to 4.0 in 2011. From these results it is obvious that cervical cancer still poses a threat to women’s health. This article aims to review the causal relationship between human papillomavirus (HPV) and cervical cancer and discuss existing methods that prevent HPV from leading to cervical cancer.
Ultrasonography has been widely used as a routine component of antenatal care. During the assessment of the foetus and the placenta, an adnexal mass may be discovered at the time of the ultrasound examination. Occasionally, an adnexal mass can also be suspected either on physical examination or as a result of clinical symptoms.
Women with genetically elevated body mass index (BMI) and blood glucose levels are more likely to have higher birth weight infants, while women with genetically elevated systolic blood pressure (SBP) are more likely to have lower birth weight infants, say UK-based researchers.