Chia, Yee Tien
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Publication Obstetric outcome of pregestational diabetic pregnancies.(1995-10) Chia, Y.T.; Chua, S.; Thai, A.C.; Yeoh, S.C.; Kek, L.P.; Selamat, N.; Ratnam, S.S.; MEDICINE; OBSTETRICS & GYNAECOLOGYThis retrospective study examined the obstetric and neonatal outcome in 23 pregestational diabetic pregnancies. The incidence of congenital malformations and mortality in infants of diabetic mothers was increased compared to the control population. Late booking for antenatal care and poor glycaemia control are probably the reasons for this high incidence. There was also a significantly higher preterm delivery and Caesarean section rate in the pregnancies complicated by pregestational diabetes. The neonatal morbidity was also higher than the controls in terms of jaundice, hypoglycaemia, respiratory distress syndrome and admissions to neonatal intensive care unit. Only with preconception counselling and tight glycaemia control in the periconception period and throughout pregnancy can we expect a drop in the complication rates in pregestational diabetic pregnancies.Publication Induction of labour: Does internal tocography result in better obstetric outcome than external tocography(1993) Chia, Y.T.; Arulkumaran, S.; Soon, S.B.; Norshida, S.; Ratnam, S.S.; OBSTETRICS & GYNAECOLOGYA prospective randomized study was undertaken to evaluate the benefit of intrauterine catheters in induced labour. Two hundred and thirty nine women who had induced labour were studied. The patients in one group had intrauterine catheters inserted and oxytocin was titrated to achieve the 75th percentile of uterine activity observed in spontaneous normal labour according to parity. Contractions were assessed by external tocography in the other group and oxytocin was titrated to achieve 6 to 7 contractions per 15 minutes each lasting > 40 seconds. Mean maximum dose of oxytocin, mode of delivery, Apgar score < 7 at 5 minutes, cord arterial blood pH < 7.15 and admission to neonatal intensive care unit did not differ significantly in the 2 groups. In conclusion, women who had intrauterine catheters did not have a shorter duration of labour, lower dose of oxytocin, fewer operative deliveries or fewer babies in poor condition at birth compared with those who had external tocography in induced labour.Publication Evaluation of new catheter systems for intrauterine pressure measurement(1995) Chia, Y.T.; Arulkumaran, S.; Yang, M.; Ratnam, S.S.; OBSTETRICS & GYNAECOLOGYPublication Pregnancy outcome and mitral valve prolapse(1994) Chia, Y.T.; Yeoh, S.C.; Lim, M.C.L.; Viegas, O.A.; Ratnam, S.S.; OBSTETRICS & GYNAECOLOGYMitral valve prolapse (MVP) comprises a large proportion of obstetric cardiac problems and has a general prevalence of 4%. We examined the obstetric outcome of patients with MVP delivered between 1988-1991 at the National University Hospital, Singapore. During this interval, deliveries totalled 16,755 of which 85 (0.51%) had maternal cardiac disease. Of these, 28 (32.9%) had echocardiographic evidence of non-myxomatous MVP. Ten patients (37.5%) had demonstrable mitral regurgitation and 4 (14.3%) had benign ventricular ectopics. All patients remained well throughout pregnancy. Gestation at delivery and use of analgesia did not differ significantly from non-cardiac patients. However, the labour induction rate was twice the department average at 17.9%. Twenty-four (85.7%) patients achieved vaginal delivery and 4 (14.3%) patients were delivered abdominally. All babies were liveborn. Eight patients (28.6%) did not receive antibiotic prophylaxis during labour and postpartum period and remained afebrile. The role of antibiotics in this category of patients is discussed. Patients with MVP without myxomatous valve changes may expect excellent pregnancy outcome.Publication Ethnicity and obstetric performance in Singapore(1995) Viegas, O.A.C.; Leong, W.P.; Chia, Y.T.; Yeoh, S.C.; Ratnam, S.S.; OBSTETRICS & GYNAECOLOGYPublication Gestational diabetes : Obstetric and neonatal outcome in 411 cases(1996-12) Chia, Y.T.; Chua, S.; Thai, A.C.; Kek, L.P.; Ratnam, S.S.; OBSTETRICS & GYNAECOLOGYAim: To study the obstetric and neonatal outcome of women with gestational diabetes mellitus. Methods: Four hundred and eleven (411) women with gestational diabetes mellitus were studied retrospectively. The control group was 3,391 non-diabetic women delivered in the same period. Results: Women with gestational diabetes mellitus had a significantly higher incidence of pregnancy-induced hypertension, and more were likely to present with malpresentation in labour. They had a higher incidence of surgical induction and an increased incidence of elective and emergency Caesarean section rate compared to controls. The neonatal outcome was excellent. The perinatal morbidity and mortality were similar to the non-diabetic controls. Conclusion: The excellent outcome of the women with gestational diabetes mellitus in this study is attributed to tight control of blood glucose level and close attention given to this group of patients.Publication Necrotising Fasciitis Originating from a Vulval Abscess - A Case Report(1998-05) Razvi, K.; Ong, C.L.; Chua, S.; Chia, Y.T.; Ratnam, S.S.; Arulkumaran, S.; OBSTETRICS & GYNAECOLOGYThis article reports a rare case of necrotising fasciitis starting out as a vulval abscess with rapid progression to a potentially lethal condition. Elderly people with medical conditions such as diabetes are especially prone to it. A high index of suspicion and an early surgical consult are essential in improving outcome in this condition. Once diagnosed, agressive surgical debridement with antibiotic cover is crucial. This is followed up with meticulous nursing care of the large wound till it heals. The various diagnostic points and treatment modalities are also discussed.