Hung Vuong Hospital

New York City, NY, United States

Hung Vuong Hospital

New York City, NY, United States

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Hirst J.E.,University of Sydney | Hirst J.E.,Royal North Shore Hospital | Tran T.S.,University of Adelaide | Do M.A.T.,Hung Vuong Hospital | And 4 more authors.
PLoS Medicine | Year: 2012

Background: Gestational diabetes mellitus (GDM) is increasing and is a risk for type 2 diabetes. Evidence supporting screening comes mostly from high-income countries. We aimed to determine prevalence and outcomes in urban Viet Nam. We compared the proposed International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criterion, requiring one positive value on the 75-g glucose tolerance test, to the 2010 American Diabetes Association (ADA) criterion, requiring two positive values. Methods and Findings: We conducted a prospective cohort study in Ho Chi Minh City, Viet Nam. Study participants were 2,772 women undergoing routine prenatal care who underwent a 75-g glucose tolerance test and interview around 28 (range 24-32) wk. GDM diagnosed by the ADA criterion was treated by local protocol. Women with GDM by the IADPSG criterion but not the ADA criterion were termed "borderline" and received standard care. 2,702 women (97.5% of cohort) were followed until discharge after delivery. GDM was diagnosed in 164 participants (6.1%) by the ADA criterion, 550 (20.3%) by the IADPSG criterion. Mean body mass index was 20.45 kg/m2 in women with out GDM, 21.10 in women with borderline GDM, and 21.81 in women with GDM, p<0.001. Women with GDM and borderline GDM were more likely to deliver preterm, with adjusted odds ratios (aORs) of 1.49 (95% CI 1.16-1.91) and 1.52 (1.03-2.24), respectively. They were more likely to have clinical neonatal hypoglycaemia, aORs of 4.94 (3.41-7.14) and 3.34 (1.41-7.89), respectively. For large for gestational age, the aORs were 1.16 (0.93-1.45) and 1.31 (0.96-1.79), respectively. There was no significant difference in large for gestational age, death, severe birth trauma, or maternal morbidity between the groups. Women with GDM underwent more labour inductions, aOR 1.51 (1.08-2.11). Conclusions: Choice of criterion greatly affects GDM prevalence in Viet Nam. Women with GDM by the IADPSG criterion were at risk of preterm delivery and neonatal hypoglycaemia, although this criterion resulted in 20% of pregnant women being positive for GDM. The ability to cope with such a large number of cases and prevent associated adverse outcomes needs to be demonstrated before recommending widespread screening. Please see later in the article for the Editors' Summary. © 2012 Hirst et al.


Tran T.S.,University of Adelaide | Tran T.S.,Hung Vuong Hospital | Hirst J.E.,University of Sydney | Hirst J.E.,Royal North Shore Hospital | And 5 more authors.
Diabetes Care | Year: 2013

OBJECTIVEdWe aimed to compare the discriminative power of prognostic models for early prediction of women at risk for the development of gestational diabetes mellitus (GDM) using four currently recommended diagnostic criteria based on the 75-g oral glucose tolerance test (OGTT).We also described the potential effect of application of the models into clinical practice. RESEARCH DESIGN AND METHODSdA prospective cross-sectional study of 2,772 pregnant women was conducted at a referral maternity center in Vietnam. GDM was determined by the American Diabetes Association (ADA), International Association of the Diabetes and Pregnancy Study Groups (IADPSG), Australasian Diabetes in Pregnancy Society (ADIPS), and World Health Organization (WHO) criteria. Prognostic models were developed using the Bayesian model averaging approach, and discriminative power was assessed by area under the curve. Different thresholds of predicted risk of developing GDM were applied to describe the clinical impact of the diagnostic criteria. RESULTSdThe magnitude of GDM varied substantially by the diagnostic criteria: 5.9% (ADA), 20.4%(IADPSG), 20.8%(ADIPS), and 24.3%(WHO). The ADAprognosticmodel, consisting of age and BMI at booking, had the best discriminative power (area under the curve of 0.71) and the most favorable cost-effective ratio if implemented in clinical practice. Selective screening of women for GDM using the ADA model with a risk threshold of 3% gave 93% sensitivity for identification of women with GDM with a 27% reduction in the number of OGTTs required. CONCLUSIONSdA simple prognostic model using age and BMI at booking could be used for selective screening of GDM in Vietnam and in other low-and middle-income settings. Copyright © 2013 by the American Diabetes Association.


Tran C.B.N.,University of Oxford | Nguyen H.T.,Hung Vuong Hospital | Phan H.T.T.,District 8 Hospital | van Tran N.,Hospital for Tropical Diseases | And 4 more authors.
PLoS ONE | Year: 2011

Enterovirus 71 (EV71)-associated hand, foot and mouth disease has emerged as a serious public health problem in South East Asia over the last decade. To better understand the prevalence of EV71 infection, we determined EV71 seroprevalence and seroincidence amongst healthy infants and children in Ho Chi Minh City, Viet Nam. In a cohort of 200 newborns, 55% of cord blood samples contained EV71 neutralizing antibodies and these decayed to undetectable levels by 6 months of age in 98% of infants. The EV71 neutralizing antibody seroconversion rate was 5.6% in the first year and 14% in the second year of life. In children 5-15 yrs of age, seroprevalence of EV71 neutralizing antibodies was 84% and in cord blood it was 55%. Taken together, these data suggest EV71 force of infection is high and highlights the need for more research into its epidemiology and pathogenesis in high disease burden countries. © 2011 Tran et al.


Ramoo S.,Royal Prince Alfred Hospital | Trinh T.A.,Hung Vuong Hospital | Hirst J.E.,University of Sydney | Jeffery H.E.,University of Sydney
Breastfeeding Medicine | Year: 2014

Background: The benefits of breastfeeding to both maternal and infant health are vast and widely known. The aim of this study was to elicit the rates of exclusive breastfeeding, early initiation of breastfeeding, and colostrum feeding and to determine the attitudes, knowledge, and influences around breastfeeding in postpartum Vietnamese women.Materials and Methods: A cross-sectional study was conducted at the Hung Vuong Hospital in Ho Chi Minh City, Viet Nam, between December 2010 and January 2011. Postpartum women were randomly selected and interviewed within 48 hours of delivery.Results: Of the 223 women interviewed, 86% had initiated breastfeeding at the time of the interview. Modes of feeding included exclusive breastfeeding (7%), mixed feeding (79%), which included breastmilk and formula or water, and exclusive formula feeding (14%). Of the breastfeeding women, 14% had initiated breastfeeding within 60 minutes of delivery, 92% had initiated within 24 hours, and 8% had initiated after 24 hours of delivery. Of women who had initiated breastfeeding, 37% had discarded their colostrum. Factors that positively influenced breastfeeding were knowledge that breastfeeding is good for the infant, advice obtained from "public information," and the influence of health professionals and family on the decision to breastfeed. Factors that influenced the decision not to initiate breastfeeding included pain or fever after cesarean section and perceived lack of breastmilk after delivery.Conclusions: The rate of exclusive breastfeeding at Hung Vuong Hospital in this study was lower than the national average of 17%. Specific interventions targeting this must be formulated to increase these rates. © 2014, Mary Ann Liebert, Inc.


Widmer M.,The World Bank | Blum J.,Gynuity Health Projects | Hofmeyr G.J.,Universities of the Witwatersrand and Fort Hare | Carroli G.,Centro Rosarino Of Estudios Perinatales | And 10 more authors.
The Lancet | Year: 2010

Background: Post-partum haemorrhage is a leading cause of global maternal morbidity and mortality. Misoprostol, a prostaglandin analogue with uterotonic activity, is an attractive option for treatment because it is stable, active orally, and inexpensive. We aimed to assess the effectiveness of misoprostol as an adjunct to standard uterotonics compared with standard uterotonics alone for treatment of post-partum haemorrhage. Methods: Women delivering vaginally who had clinically diagnosed post-partum haemorrhage due to uterine atony were enrolled from participating hospitals in Argentina, Egypt, South Africa, Thailand, and Vietnam between July, 2005, and August, 2008. Computer-generated randomisation was used to assign women to receive 600 μg misoprostol or matching placebo sublingually; both groups were also given routine injectable uterotonics. Allocation was concealed by distribution of sealed and sequentially numbered treatment packs in the order that women were enrolled. Providers and women were masked to treatment assignment. The primary outcome was blood loss of 500 mL or more within 60 min after randomisation. Analysis was by intention to treat. This study is registered, number ISRCTN34455240. Findings: 1422 women were assigned to receive misoprostol (n=705) or placebo (n=717). The proportion of women with blood loss of 500 mL or more within 60 min was similar between the misoprostol group (100 [14%]) and the placebo group (100 [14%]; relative risk 1·02, 95% CI 0·79-1·32). In the first 60 min, an increased proportion of women on misoprostol versus placebo, had shivering (455/704 [65%] vs 230/717 [32%]; 2·01, 1·79-2·27) and body temperature of 38°C or higher (303/704 [43%] vs 107/717 [15%]; 2·88, 2·37-2·50). Interpretation: Findings from this study do not support clinical use of 600 μg sublingual misoprostol in addition to standard injectable uterotonics for treatment of post-partum haemorrhage. Funding: Bill & Melinda Gates Foundation, and UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. © 2010 Elsevier Ltd. All rights reserved.


Background: To evaluate the safety and immunogenicity of the thiomersalfree (TF) and thiomersal-containing (TC) formulations of Hepavax-Gene in healthy Vietnamese neonates. Methods: A single-blind, randomized, controlled study in Ho Chi Minh City, Vietnam. Healthy infants, born after a normal gestational period (37-42 weeks) to hepatitis B surface antigen-negative mothers, participated in the study. Subjects were randomly allocated in a 1:1 ratio to receive either Hepavax-Gene TC or Hepavax-Gene TF using a standard 0-1-6-month administration schedule. Postvaccination blood samples were taken at months 1, 6 and 7. Parents/legal guardians recorded solicited local and systemic adverse events up to 4 weeks after each vaccination. Results: Very high proportions of subjects were seroprotected. Seroprotection rates at 1, 6 and 7 months were all above 95% using a 10 IU/L cutoff, and were mostly above 90% using a 100 IU/L cutoff. Seroprotection rates between the 2 formulations were equivalent within a 5% margin for either cutoff titer both after 6 and 7 months.There were no significant differences in the number of adverse events reported between the 2 formulations. Safety results were in line with previous reports for Hepavax-Gene. Both formulations of Hepavax-Gene were well tolerated. There were no local adverse events reported in the TF group. No serious adverse events were reported during the study. Conclusions: The thiomersal-free formulation of Hepavax-Gene was noninferior to the thiomersal-containing formulation of Hepavax-Gene in terms of immunogenicity. There was evidence that the thiomersal-free vaccine was associated with fewer local adverse events. Copyright © 2014 by Lippincott Williams & Wilkins.


Trinh A.T.,Hung Vuong Hospital | Khambalia A.,Kolling Institute of Medical Research | Ampt A.,Kolling Institute of Medical Research | Morris J.M.,Royal North Shore Hospital | Roberts C.L.,Kolling Institute of Medical Research
Bulletin of the World Health Organization | Year: 2013

Objective To describe the use of episiotomy among Vietnamese-born women in Australia, including risk factors for, and pregnancy outcomes associated with, episiotomy. Methods This population-based, retrospective cohort study included data on 598 305 singleton, term (i.e. ≥ 37 weeks' gestation) and vertex-presenting vaginal births between 2001 and 2010. Data were obtained from linked, validated, population-level birth and hospitalization data sets. Contingency tables and multivariate analysis were used to compare risk factors and pregnancy outcomes in women who did or did not have an episiotomy. Findings The episiotomy rate in 12 208 Vietnamese-born women was 29.9%, compared with 15.1% in Australian-born women. Among Vietnamese-born women, those who had an episiotomy were significantly more likely than those who did not to be primiparous, give birth in a private hospital, have induced labour or undergo instrumental delivery. In these women, having an episiotomy was associated with postpartum haemorrhage (adjusted odds ratio, aOR: 1.26; 95% confidence interval, CI: 1.08-1.46) and postnatal hospitalization for more than 4 days (aOR: 1.14; 95% CI: 1.00-1.29). Among multiparous women only, episiotomy was positively associated with a third- or fourth-degree perineal tear (aOR: 2.00; 95% CI: 1.31-3.06); in contrast, among primiparous women the association was negative (aOR: 0.47; 95% CI: 0.37-0.60). Conclusion Episiotomy was performed in far fewer Vietnamese-born women giving birth in Australia than in Viet Nam, where more than 85% undergo the procedure, and was not associated with adverse outcomes. A lower episiotomy rate should be achievable in Viet Nam.


Hirst J.E.,University of Sydney | Tran T.S.,Hung Vuong Hospital | Do M.A.T.,Hung Vuong Hospital | Rowena F.,University of Sydney | And 2 more authors.
BMC Pregnancy and Childbirth | Year: 2012

Background: Diabetes is increasing in prevalence globally, notably amongst populations from low- and middle- income countries. Gestational Diabetes Mellitus(GDM), a precursor for type 2 diabetes, is increasing in line with this trend. Few studies have considered the personal and social effects of GDM on women living in low and middle-income countries. The aim of this study was determine attitudes and health behaviours of pregnant women with GDM in Vietnam.Methods: This was a qualitative study using focus group methodology conducted in Ho Chi Minh City. Pregnant women, aged over 18 years, with GDM were eligible to participate. Women were purposely sampled to obtain a range of gestational ages and severity of disease. They were invited to attend a 1-hour focus group. Questions were semi structured around six themes. Focus groups were recorded, transcribed, translated and cross-referenced. Non-verbal and group interactions were recorded. Thematic analysis was performed using a theoretical framework approach.Results: From December 2010 to February 2011, four focus groups were conducted involving 34 women. Median age was 31.5 years (range 23 to 44), median BMI 21.8 kg/m2. Women felt confusion, anxiety and guilt about GDM. Many perceived their baby to be at increased risk of death. Advice to reduce dietary starch was confusing. Women reported being 'hungry' or 'starving' most of the time, unaware of appropriate food substitutions. They were concerned about transmission of GDM through breast milk. Several women planned not to breastfeed. All felt they needed more information. Current sources of information included friends, magazines, a health phone line or the Internet. Women felt small group sessions and information leaflets could benefit them.Conclusions: This study highlights the need for culturally appropriate clinical education and health promotion activities for women with GDM in Vietnam. © 2012 Hirst et al.; licensee BioMed Central Ltd.


Pham V.H.,The University of Medicine & Pharmacy at Ho Chi Minh City | Nguyen T.V.,Hung Vuong Hospital | Nguyen T.T.T.,Hung Vuong Hospital | Dang L.D.,Laboratory for Molecular Diagnostics | And 2 more authors.
Journal of Clinical Virology | Year: 2013

Background: Rubella remains poorly controlled in Southeast Asia, including Vietnam. Objectives: The aim of this study was to characterize rubella virus spread in Vietnam during 2011-2012. Study design: Amniotic fluid, throat swab and placenta samples were collected from 130 patients (110 cases from pregnant women with suspected rubella and 20 cases from fetuses/newborns). Viral RNA was obtained directly from clinical specimens, amplified by PCR, and then the E1 gene containing 739 nucleotides recommended by the WHO to identify the viral genotypes was sequenced. Results: By screening with real-time PCR, viral RNA was detectable in amniotic fluids from 103 out of 110 (93.6%) pregnant women with suspected rubella and in the throat swabs from all of 20 (100%) fetuses/newborns. In addition, viral RNA was also detected in the placenta from all cases of fetuses/newborns. All of 20 fetuses/newborns presented with congenital cataract. Twenty-four strains with the E1 gene were obtained by PCR. Using phylogenetic analysis with rubella reference sequences, all of the strains were found to be genotype 2B. Interestingly, 94% (30/32) of Vietnamese strains, including 9 strains from the database, formed an independent cluster within the genotype 2B suggesting that indigenous viruses are prevalent in this region. Conclusions: Rubella virus identified in Vietnam belonged to the genotype 2B. Importantly, the infection rate of rubella virus in fetuses/newborns was 100% and all of them had congenital cataract. Our results indicate an establishment of rubella prevention in this area is an urgent task in order to improve maternal and child health. © 2013 Elsevier B.V.


Ngoc N.T.N.,Center for Research and Consultancy in Reproductive Health | Blum J.,Gynuity Health Projects | Raghavan S.,Gynuity Health Projects | Nga N.T.B.,Hung Vuong Hospital | And 3 more authors.
Contraception | Year: 2011

Background: Nonsurgical abortion methods have the potential to improve access to high-quality abortion care. Until recently, availability and utilization of mifepristone medical abortion in low-resource countries were restricted due to the limited availability and perceived high cost of mifepristone, leading some providers and policymakers to support use of misoprostol-only regimens. Yet, this may not be desirable if misoprostol-only regimens are considerably less effective and ultimately more costly for health care systems. This study sought to document the differences in efficacy between two nonsurgical abortion regimens. Study Design: This double-blind randomized placebo-controlled trial enrolled women with gestational ages up to 63 days seeking early medical abortion from August 2007 to March 2008 at a large tertiary hospital in Ho Chi Minh City, Vietnam. Eligible consenting women received either (1) two doses of 800 mcg buccal misoprostol 24 h apart or (2) 200 mg mifepristone and 800 mcg buccal misoprostol 24 h later. Participants self-administered all study drugs and returned to the hospital for follow-up 1 week later. The trial is registered at ClinicalTrials.gov as NCT00680394. Results: Four hundred women were randomized to either misoprostol-only (198) or mifepristone+misoprostol (202). Complete abortion occurred for 76.2% (n=147) of women allocated to misoprostol-only vs. 96.5% (n=194) of those given mifepristone+misoprostol (RR 0.79, 95% CI 0.73-0.86). Ongoing pregnancy was documented for 16.6% (32) of misoprostol-only users and 1.5% (3) of mifepristone+misoprostol users (1.62, 0.68-3.90). Side effects were generally similar for both groups, although significantly more women allocated to misoprostol-only reported diarrhea. Conclusions: Mifepristone+misoprostol is significantly more effective than use of misoprostol-alone for early medical abortion. The number of ongoing pregnancies documented with misoprostol-only warranted an early end of the trial after unblinding of the study at interim analysis. Policymakers should advocate for greater access to mifepristone. Future research should prioritize misoprostol-only regimens with shorter dosing intervals. © 2011 Elsevier Inc. All rights reserved.

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