Scales tipping as more boys born in HK

The number of boys born in Hong Kong is soaring compared with girls, spurred by an influx of mainland mothers who prefer sons. Many use sex-selection services that are illegal across the border.

Figures from the Census and Statistics Department show that the ratio rose from 109.8 boys for every 100 girls born in 2005, to 111.4 in 2006, 112 in 2007 and 113.6 in 2008.

At this rate it may soon approach the 120 to 130 found in some provinces on the mainland.
The trend is backed up by the first comprehensive study of its kind in Hong Kong. The researchers noted that many mothers came to Hong Kong specifically to learn the sex of their babies. Some would cancel their birth bookings on finding that they were expecting girls.

Since a landmark Court of Final Appeal ruling in 2001 gave permanent resident status to children born in Hong Kong to mainland parents, the city has become a “birth hub”.
These Hong Kong-born children may not be raised in the city during their early childhood, but they can come here at any time to enjoy their full rights to education and social services. In 2008, mainland mothers accounted for 42.6 per cent of all births in Hong Kong.
The overall male-to-female ratio in Hong Kong was only 1106.4 to 100 in the 1980s and 1990s, on a par with the international average of 105 to 107.

The study by three obstetricians and gynaecologists at hospitals in Kowloon West – Grace Wong Ying, Leung Wing-cheong and Robert chin kien-howe – was published recently in the Journal of Perinatal Medicine.

The team retrieved data on all the 194,602 babies born in public hospitals between 2003 and 2007. Of these, 140,962 (72.4 per cent) were born to Hong Kong Chinese and 52,741 (27.1 per cent) to mainland mothers. The overall sex ratio at birth during that five-year period was 108.8 to 100. But the ratio is lower for Hong Kong mothers, at 107.8, than for mainland mothers, 111.6.

Wong, the study’s chief author, said the rapid rise in the ratio was a result of and influx of mainlanders who practiced sex selection more than locals.

The researchers said as most mainland women giving birth in Hong Kong came from southern China, biological or environmental reasons alone probably could not explain such a “skewed” sex ratio.

“The most plausible explanation for this is the practice of sex selection. However, these findings do not provide direct evidence that such a high sex ratio is a result of selective abortion of females in women of higher birth order,” the report said.

“It is also possible that patients from mainland China tend to spend more resources on their sons, and are more willing to give birth in Hong Kong if their pregnancy is of a male baby.”
Wong, who formerly worked at the public Princess Margaret Hospital and switched to private practice a year ago, said almost 90 per cent of her patients were from the mainland.
“We have come across several cases in which the mainland mothers have defaulted or cancelled their booking for a delivery in Hong Kong after learning that they are carrying a girl. Some even disappeared without paying the medical fee after an ultrasound scan,' Wong said. The team also analysed the sex ratio of each birth order. They found that while mainland women did not have a clear preference for a son in their first pregnancy, they may have practised some form of sex selection from their second pregnancy.

For Hong Kong women, the sex ratios were 106 to 100 for the first baby, 107.3 for the second and 118.4 for the third child or above. The ratio increases much more steeply among mainland women - from 104.7 for a first baby, 114.9 for the second and 174.5 for the third child or above. The researchers warned that the 'abnormally skewed' sex ratio may have disastrous social consequences. 'High sex ratios at birth have deprived female fetuses of their birth rights. Mothers also suffer from tremendous psychological pressure and reproductive health risks while undergoing abortion.

'Discrimination against women is detrimental for both men and women, hindering the overall economic development. The phenomenon of missing girls will lead to a shortage of marriageable females,' the team said. There are now more women than men among the Hong Kong population aged 20 to 35. But University of Hong Kong demographer Dr Paul Yip Siu-fai said the changing sex ratio at birth would only have a limited effect on the overall sex ratio. 'This is because many Hong Kong men will marry mainland women and bring them to Hong Kong, and women's life expectancy is longer.' He called on the government to monitor demographic trends and prepare for an influx of Hong Kong-born children from the mainland.

Children born in Hong Kong enjoy full residency status In 2008, mainland mothers accounted for the following proportion of births in the city: 42.6%

Reference information:   SCMP
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and gynecologys before considering treatment and should not rely on the information above. 

Gene lab banned over test for sex (2)

'Although I told them I won't refer them to the laboratory, some of them found a way to get the test done and came back with a report. Some are reluctant to pay a deposit for a maternity package before they know the fetus is a boy or girl,' Wong said.

'The test's original purpose is for parents to check if the baby may suffer from severe sex-linked genetic diseases so they can have some prenatal counselling or an abortion, but doctors worry that the test is being used for gender selection including abortion,' she said.

Wong's earlier study, reported by the Post last year, found that the number of boys born in Hong Kong is soaring compared with girls, spurred by an influx of mainland mothers who prefer sons.

Wong said she would say it was unethical for doctors to refer patients for the test without knowing the real intentions behind it.

'Doctors won't know if the patient may use the result for the decision of abortion. Some parents may want to have better planning before the delivery, such as buying clothes for girls or boys,' she said.

Deputy medical director of the Union Hospital Dr Ares Leung Kwok-ling said the hospital's resident obstetricians 'have reached a consensus' not to use the test because the worry of it 'being abused for gender selection'.

'The test is different from ultrasound scans because it can tell the fetal sex in the first trimester [of pregnancy] while the ultrasound can only detect it in the second trimester. At the later stage of pregnancy, it is always easier for doctors to warn against an abortion because it would be more painful and risky to the mother,' said Leung, who is also senior vice-president of the college.

Dr Fung Tak-yuen, head of obstetrics at Baptist Hospital, said doctors in his department received requests from mainland mothers for fetal sexing, but the hospital denied them.

Head of obstetrics at the Hong Kong Sanatorium and Hospital Dr Joseph Chan Woon-tong said fetal sexing test was unnecessary. 'Why do we have to provide it?' he asked.

St Paul's Hospital administration discussed the test after requests from some mothers, but decided to ban it after DiagCor failed to provide scientific proof of its accuracy rate.

A sales and marketing manager at Diagcor, who gave her name only as Ms Ma, said the laboratory test was the first part of a paternity test. Ma said the test, which examines fetal genes contained in the mother's blood, can reveal whether the baby's Y-chromosome matches the father's.

If the baby is a girl, the doctor then takes a sample of amniotic fluid for testing for further matching with the father's genes. Fluid in the amniotic sac surrounding the fetus also contains fetal DNA.

Ma, who declined to provide the total number of requests for the test, would say only that demand is 'growing fast' among mainland mothers giving birth in Hong Kong.

She said how the test results were used was an issue of medical practice and a patient's choice.

'We have never promoted the test for fetal sexing, but some mothers need the paternity test results for immigration applications and other purposes ... other tests such as ultrasounds and samples of the amniotic fluid can also tell the sex of a fetus,' she said.

Two pregnant women from the mainland have appeared in Kowloon City Court accused of using false doctor's certificates to book obstetrics services in Hong Kong.

The women, who are both due to give birth in November, were arrested after they tried to make appointments at the Princess Margaret Hospital last month.

They were refused bail, and the case was adjourned until August 12.

130

The number of boys born for every 100 girls in China, from Henan in the north to Hainan in the south. Without selection it would be 105

Private obstetrician Dr Grace Wong Ying

Reference information:  Sunday Morning Post
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and gynecologys before considering treatment and should not rely on the information above.

Gene lab banned over test for sex (1)

A Hong Kong biotechnology laboratory has been banned by private hospitals amid fears that mainland mums-to-be are using its services for unethical sex selection.

Doctors believe that some women are abusing a genetic test offered by DiagCor Bioscience which can identify the sex of a baby and its chances of developing a severe sex-linked genetic disorder. Parents who have a family history of a severe genetic disorder use this test to determine the chances of the fetus developing a severe genetic disease.

DiagCor in Kowloon Bay is the only laboratory to offer the test, which isolates fetal genes in the mother's blood.

The abortion of female fetuses is notorious in the mainland under the one-child policy. Hong Kong has become a destination for fetal sexing because mainland doctors may not disclose such information.

This issue has come to light days after Hong Kong set quotas for deliveries for mainland mothers next year - capped at 34,400, of which 31,000 will be at private hospitals and 3,400 at public hospitals. The government announced the quotas to ease pressure on services and allay fears among Hong Kong mothers-to-be that they will not get a bed.

DiagCor's test can be done as early as in the eighth week of pregnancy, compared with about 15 to 16 weeks for an ultrasound scan, doctors say.

If the test detects the presence of an XY chromosome pair, this confirms that the baby is a boy. An XX chromosome pair means it is a girl.

Although the test can determine the sex of a fetus, DiagCor says it has never been promoted as a tool for selection.

The College of Obstetricians and Gynaecologists has discussed the ethical issues related to the test but failed to reach a decision on what it should do. Expressing concerns on gender selection, the college held a special seminar for doctors last month on issues related to the test.

In Hong Kong, it is illegal to choose the sex of a child for non-medical reasons in assisted human reproduction treatment. But there is no law prohibiting fetal sexing.

At least four major private hospitals - Baptist Hospital, Union Hospital, St Paul's Hospital and the Hong Kong Sanatorium and Hospital - have banned the test, which is still available at a cost of a few thousand dollars through private practitioners.

Doctors said the laboratory reports had recently been made available in Chinese, making them more popular with mainland parents.

Private obstetrician Dr Grace Wong Ying said she encountered at least one to two mainland mothers each month who specifically requested the test.

Reference information:  Sunday Morning Post
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and gynecologys before considering treatment and should not rely on the information above.

3D立體斷層乳房造影 - 低輻射及更有效檢測乳癌

 

甚麼是3D立體斷層乳房造影 ?

3D立體斷層乳房造影是一項突破性的X光造影技術，經多個臨床研究顯示，能有效找出早期乳房病變。此項技術，已獲FDA及國際認可，用於乳病診斷及乳癌普查。3D立體斷層乳房造影需要大約4秒，儀器便能從X光數據中，重組出立體斷層影像。將乳房的結構及可能出現的病變，以多張影像清楚地呈現出來，大大改善傳統影像技術中乳腺組織重疊的弱點，有效提高準確度。

適合人士包括

    40 歲或以上女士 - 建議每 1 至 2 年進行一次乳房造影檢查。
    若有家族病史，建議 30 歲開始每年進行一次乳房X光造影檢查。
    出現或懷疑有乳房造影檢查例如乳房腫塊。
    曾接受乳房手術的女性也適合進行 3D立體斷層乳房造影。


3D立體斷層乳房造影的特性

準確度

    有效移除干擾診斷的乳腺組織重疊。
    減少加照或乳房重複按壓。
    有效偵查腫塊﹑結構扭曲和不對稱密度，清晰地分析疾病範圍。

安全性

    比傳統菲林或電腦X光影像系統為低。

舒適度

    只需輕微按壓，便能造出清晰影像。
    使用C-View技術，將立體數據重組，縮短乳房按壓時間。

缺點

由於所得的影像一般較傳統造影多數十倍，放射科醫生需要較多的時間審閱立體乳房造影影像，同時成本也較高。







參考資料： http://womencare.com.hk/
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的婦產科專科醫生查詢，而不應單倚賴以上提供的資料