Ann Acad Med Singap
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Ann Acad Med Singap · May 2002
Outcome of pregnancy in Asian women with systemic lupus erythematosus: experience of a single perinatal centre in Singapore.
To study maternal and fetal outcomes in women with systemic lupus erythematosus (SLE). ⋯ Good pregnancy outcomes can be expected in women with SLE in remission. Pre-pregnancy counselling is crucial to achieve this. All pregnancies should still be considered high risk and be managed jointly between the obstetricians, the perinatologists and the physicians. In particular, those with renal impairment are at increased risk of IUGR, superimposed pre-eclampsia and preterm births. Co-existing APS augurs a poorer prognosis for pregnancy outcome, and may present atypically as autoimmune haemolytic anaemia in the postpartum period.
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Ann Acad Med Singap · May 2002
Pregnancy after renal transplantation: experience in Singapore General Hospital.
Renal transplantation offers the best hope for those women with end-stage renal disease who wish to have children. However, pregnancy after renal transplantation is associated with increased maternal and fetal morbidity. The aim of this retrospective study was to review the outcome of pregnancy in renal transplant patients in Singapore General Hospital. ⋯ Successful pregnancy is possible in women after renal transplantation. Such pregnancy is often associated with increased maternal and fetal complications and should be managed by a multidisciplinary approach in a tertiary centre. The function and survival of renal allograft was not adversely affected by pregnancy.
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Ann Acad Med Singap · Mar 2002
Two-year outcome of normal-birth-weight infants admitted to a Singapore neonatal intensive care unit.
To describe the characteristics, the immediate and short-term outcome and predictors of mortality in normal-birth-weight (NBW) infants admitted to a tertiary neonatal intensive care unit (NICU) in Singapore. ⋯ Despite their short hospital stay (compared to very-low-birth-weight infants), the high volume of NBW admissions make the care of this population an important area for review to enhance advances in and hence, reduce the cost of NICU care. With improved antenatal diagnostic techniques (allowing earlier and more accurate diagnosis of congenital malformations) and better antenatal and perinatal care (allowing better management of at-risk pregnancies), it is anticipated that there should be a reduction in such admissions with better outcomes. Close follow-up of this high-risk group of infants is also important in order to offer early intervention to those who may possibly have perinatally-related developmental difficulties.
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Ann Acad Med Singap · Mar 2002
Cosmesis in neurosurgery: is the bald head necessary to avoid postoperative infection?
The aims of this study were to prospectively investigate the incidence of postoperative wound infection following elective cranial surgery, when scalp hair removal was limited to the line of the incision, and to see if there was an increased risk of infection. ⋯ In a review of earlier studies and a search into the history of aseptic surgery, no scientific ground for the practice of shaving was found. We suggest that there is no advantage in shaving patients in terms of reducing wound infection rates.
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The upper airway can obstruct due to soft tissues, blood, secretions and infections. In patients who are sedated, anaesthetised or unconscious, the commonest cause is due to loss of airway muscle tone. The usual site of obstruction is the soft palate followed by the epiglottis and occasionally the tongue. ⋯ Oral and nasal airways are useful adjuncts to improve airway patency. In patients who are unconscious or adequately anaesthetised, the laryngeal mask or Combitube could be used especially in the difficult airway situation. As there is a significant decline in performance with time, it is important to maintain airway skills through regular practice and evaluation.