{"title":"Incidence and Risk Factors of Surgical Site Infections after Abdominal Hysterectomy for Benign Diseases","authors":"Punnada Atibovonsuk","doi":"10.14456/TJOG.2020.28","DOIUrl":"https://doi.org/10.14456/TJOG.2020.28","url":null,"abstract":"","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"28 1","pages":"217-223"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45340291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical benefits of cannabis have become widely accepted. In Obstetrics and Gynecology, it was reported to be useful to alleviate nausea and vomiting from morning sickness in pregnant women and in gynecologic cancer patients who received chemotherapy. It has also been used as a pain killer during labor and menstruation. Some also claimed that the cannabis may also prolong life of cancer patients or even cure cancer. Owing to the illegalization of the cannabis in many countries for a long time, there has been no evidence-based data from clinical study to support the use of cannabis for those aforementioned conditions except for chemotherapy induced nausea/vomiting. Systematics reviews confirmed that cannabis was significantly more effective than placebo and at least as effective as various conventional antiemetics. However, due to the availability of many potent new standard antiemetics (5-HT3 receptor antagonists, and neurokinin-1-receptor-antagonists) without psychotropic effects, cannabis is not recommended as a first-line antiemetic agent. The exception is when the new standard antiemetics cannot adequately control nausea and vomiting from chemotherapy. The cannabis is contraindicated in pregnant women or lactating mother because of the possibility of adverse fetal and neonatal outcomes. Once cannabis is legalized for medical use in more countries, its efficacy in those aforementioned conditions can be tested and confirmed in randomized controlled trials.
{"title":"Cannabis (Gan-ja): Relevant Issues in Obstetrics and Gynecology","authors":"S. Manusirivithaya, Vichai Manusirivithaya","doi":"10.14456/TJOG.2018.25","DOIUrl":"https://doi.org/10.14456/TJOG.2018.25","url":null,"abstract":"Medical benefits of cannabis have become widely accepted. In Obstetrics and Gynecology, it was reported to be useful to alleviate nausea and vomiting from morning sickness in pregnant women and in gynecologic cancer patients who received chemotherapy. It has also been used as a pain killer during labor and menstruation. Some also claimed that the cannabis may also prolong life of cancer patients or even cure cancer. Owing to the illegalization of the cannabis in many countries for a long time, there has been no evidence-based data from clinical study to support the use of cannabis for those aforementioned conditions except for chemotherapy induced nausea/vomiting. Systematics reviews confirmed that cannabis was significantly more effective than placebo and at least as effective as various conventional antiemetics. However, due to the availability of many potent new standard antiemetics (5-HT3 receptor antagonists, and neurokinin-1-receptor-antagonists) without psychotropic effects, cannabis is not recommended as a first-line antiemetic agent. The exception is when the new standard antiemetics cannot adequately control nausea and vomiting from chemotherapy. The cannabis is contraindicated in pregnant women or lactating mother because of the possibility of adverse fetal and neonatal outcomes. Once cannabis is legalized for medical use in more countries, its efficacy in those aforementioned conditions can be tested and confirmed in randomized controlled trials.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"26 1","pages":"206-216"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48617609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ravita Chaichanalap, Wipada Laosooksathit, K. Kongsomboon, T. Hanprasertpong
Objectives: To evaluate the effectiveness of music therapy in alleviating immediate postpartum episiotomy wound pain. Material and Methods: A randomized controlled trial was conducted to evaluate the efficacy of music therapy in alleviating immediate pain from an episiotomy wound. Uncomplicated singleton vaginal delivery women with the second degree or less episiotomy wound at Delivery and Postpartum Inpatient Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Thailand were enrolled into the study. Visual analog scale (VAS) scoring was used for comparing pain levels. Results: One hundred postpartum women were enrolled in our study. Baseline characteristics such as age, degree of episiotomy wound tear were similar between both groups. The median pain VAS score was statistically significantly lower in the music group than in the control group at the end of the 2nd hour after finish of episiotomy wound repairing process [24.0 millimeters (8.3-41.5) and 36.5 millimeters (20.0-53.3), p < 0.001]. The median pain VAS score was statistically significantly lower in the music group than in the control group at the end of 6th hour after finish of episiotomy wound repairing process [12.0 millimeters (3.0-21.0) and 22.0 millimeters (15.0-38.0), p < 0.001] Conclusion: Music therapy is effective for reducing the perceived immediate postpartum pain of an episiotomy wound. Keywords: episiotomy pain, music therapy, singleton pregnancy
目的:评价音乐疗法对减轻产后会阴切开术创面疼痛的效果。材料与方法:采用随机对照试验,评价音乐治疗对减轻会阴切口创面即刻疼痛的疗效。研究对象为泰国斯利那卡林沃大学医学院产、产科分娩及产后住院病房有二度及以下会阴切开伤口的单胎阴道分娩女性。采用视觉模拟评分法(VAS)比较疼痛程度。结果:100名产后妇女参与了我们的研究。两组的年龄、会阴切口撕裂程度等基线特征相似。音乐组在会阴切口修复过程结束后第2小时疼痛VAS评分中位数低于对照组[24.0 mm(8.3 ~ 41.5)和36.5 mm (20.0 ~ 53.3), p < 0.001]。音乐组在会阴切口修复过程结束后第6小时疼痛VAS评分中位数低于对照组[12.0 mm(3.0 ~ 21.0)和22.0 mm (15.0 ~ 38.0), p < 0.001]。结论:音乐治疗可有效减轻会阴切口术后即刻疼痛感。关键词:会阴切开疼痛,音乐治疗,单胎妊娠
{"title":"Efficacy of Music Therapy on Immediate Postpartum Episiotomy Pain: A randomized controlled trial","authors":"Ravita Chaichanalap, Wipada Laosooksathit, K. Kongsomboon, T. Hanprasertpong","doi":"10.14456/TJOG.2018.19","DOIUrl":"https://doi.org/10.14456/TJOG.2018.19","url":null,"abstract":"Objectives: To evaluate the effectiveness of music therapy in alleviating immediate postpartum episiotomy wound pain. \u0000Material and Methods: A randomized controlled trial was conducted to evaluate the efficacy of music therapy in alleviating immediate pain from an episiotomy wound. Uncomplicated singleton vaginal delivery women with the second degree or less episiotomy wound at Delivery and Postpartum Inpatient Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Thailand were enrolled into the study. Visual analog scale (VAS) scoring was used for comparing pain levels. \u0000Results: One hundred postpartum women were enrolled in our study. Baseline characteristics such as age, degree of episiotomy wound tear were similar between both groups. The median pain VAS score was statistically significantly lower in the music group than in the control group at the end of the 2nd hour after finish of episiotomy wound repairing process [24.0 millimeters (8.3-41.5) and 36.5 millimeters (20.0-53.3), p < 0.001]. The median pain VAS score was statistically significantly lower in the music group than in the control group at the end of 6th hour after finish of episiotomy wound repairing process [12.0 millimeters (3.0-21.0) and 22.0 millimeters (15.0-38.0), p < 0.001] \u0000Conclusion: Music therapy is effective for reducing the perceived immediate postpartum pain of an episiotomy wound. \u0000Keywords: episiotomy pain, music therapy, singleton pregnancy","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"1 1","pages":"158-165"},"PeriodicalIF":0.0,"publicationDate":"2018-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43296961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the correlation of the spot urine albumin to creatinine ratio (UACR) and the urine protein to creatinine ratio (UPCR) with 24-hour urine protein (UP-24) collection and to explore the diagnostic performances of these parameters for detecting significant proteinuria in pregnancy Materials and methods: This cross-sectional study was conducted on pregnant women at gestational ages 20-41 weeks who had clinically suspected proteinuria and were prospectively enrolled from November 2015 and April 2016. Random urine samples for UACR, UPCR and 24-hour urine collection for protein and creatinine were examined. Results: A total of 115 pregnant women were evaluated. Using UP-24 as the reference standard, significant proteinuria was identified in 39 cases (33.9%). UACR had a higher level of correlation than UPCR with UP-24 ( r = 0.884 and 0.834, respectively). The areas under the receiver characteristics curves (ROC-AUC) of UACR and UPCR were 96.6% (95%CI; 93.8-99.9) and 94.5% (95%CI; 90.4-98.6), respectively. The diagnostic threshold of UACR for significant proteinuria was 42 mg/g. (94.9% sensitivity and 86.8% specificity), whereas the UPCR cutoff value was 0.26, (87.2% sensitivity and 90.8% specificity). Predicted UP-24 using spot UACR adjusted by maternal age had the highest ROC-AUC of 97.4% (95%CI; 95.1-99.6), with a sensitivity of 94.9% and a specificity of 90.8%. Conclusion: Spot UACR showed better correlation with UP-24 than UPCR. Spot UACR adjusted for maternal age was used to predict UP-24, yielding a good diagnostic performance that was not associated with the time of clinical assessment and urine collection or with underlying diseases.
{"title":"Spot Urine Albumin to Creatinine Ratio versus Urine Protein to Creatinine Ratio for the Diagnosis of Proteinuria in Pregnancy","authors":"Paroon Sanoonrat, N. Srisantiroj, M. Yanaranop","doi":"10.14456/TJOG.2017.33","DOIUrl":"https://doi.org/10.14456/TJOG.2017.33","url":null,"abstract":"Objective: To evaluate the correlation of the spot urine albumin to creatinine ratio (UACR) and the urine protein to creatinine ratio (UPCR) with 24-hour urine protein (UP-24) collection and to explore the diagnostic performances of these parameters for detecting significant proteinuria in pregnancy Materials and methods: This cross-sectional study was conducted on pregnant women at gestational ages 20-41 weeks who had clinically suspected proteinuria and were prospectively enrolled from November 2015 and April 2016. Random urine samples for UACR, UPCR and 24-hour urine collection for protein and creatinine were examined. Results: A total of 115 pregnant women were evaluated. Using UP-24 as the reference standard, significant proteinuria was identified in 39 cases (33.9%). UACR had a higher level of correlation than UPCR with UP-24 ( r = 0.884 and 0.834, respectively). The areas under the receiver characteristics curves (ROC-AUC) of UACR and UPCR were 96.6% (95%CI; 93.8-99.9) and 94.5% (95%CI; 90.4-98.6), respectively. The diagnostic threshold of UACR for significant proteinuria was 42 mg/g. (94.9% sensitivity and 86.8% specificity), whereas the UPCR cutoff value was 0.26, (87.2% sensitivity and 90.8% specificity). Predicted UP-24 using spot UACR adjusted by maternal age had the highest ROC-AUC of 97.4% (95%CI; 95.1-99.6), with a sensitivity of 94.9% and a specificity of 90.8%. Conclusion: Spot UACR showed better correlation with UP-24 than UPCR. Spot UACR adjusted for maternal age was used to predict UP-24, yielding a good diagnostic performance that was not associated with the time of clinical assessment and urine collection or with underlying diseases.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"26 1","pages":"249-258"},"PeriodicalIF":0.0,"publicationDate":"2017-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42629501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kanokphon Butmarasri, S. Soontrapa, S. Kaewrudee, C. Somboonporn, W. Somboonporn
Objectives: This study aimed to determine the prevalence of hypothyroidism and its association with menopausal symptoms and evaluated the diagnostic performance of Zulewski’s clinical score for predicting hypothyroidism in peri-/post-menopausal Thai women. Materials and Methods: This hospital-based cross-sectional study was conducted between June 2015 and April 2016 in Srinagarind Hospital, Khon Kaen, Thailand. We enrolled 305 peri-/postmenopausal women 45-65 years of age without previous history of thyroid diseases, radiation exposure at the neck, or concurrent use of lithium. The participants were interviewed by two research assistants’ vis-à-vis symptoms of menopause and hypothyroidism, current medications and menstrual characteristics. Blood samples were taken for TSH and FT4 levels. Main outcomes were prevalence of hypothyroidism, the Menopause-Specific Quality of Life (MENQOL) score, and diagnostic performance of Zulewski’s clinical score . results: Mean age was 56 ± 4.7 years. The prevalence of hypothyroidism was 6.2% (95%CI 3.5% to 8.9%). The sensitivity of Zulewski’s clinical score at the cutoff point ≥ 3 was 70%. Neither the MENQOL domain score nor the composite score was associated with hypothyroidism. Conclusion: The prevalence of hypothyroidism in peri-/post-menopausal Thai women is low. There is no association between MENQOL score and hypothyroidism. Zulewski’s clinical score is not a good screening test for hypothyroidism in this group.
{"title":"Prevalence of Hypothyroidism in Peri-/Post-Menopausal Thai Women","authors":"Kanokphon Butmarasri, S. Soontrapa, S. Kaewrudee, C. Somboonporn, W. Somboonporn","doi":"10.14456/TJOG.2017.36","DOIUrl":"https://doi.org/10.14456/TJOG.2017.36","url":null,"abstract":"Objectives: This study aimed to determine the prevalence of hypothyroidism and its association with menopausal symptoms and evaluated the diagnostic performance of Zulewski’s clinical score for predicting hypothyroidism in peri-/post-menopausal Thai women. Materials and Methods: This hospital-based cross-sectional study was conducted between June 2015 and April 2016 in Srinagarind Hospital, Khon Kaen, Thailand. We enrolled 305 peri-/postmenopausal women 45-65 years of age without previous history of thyroid diseases, radiation exposure at the neck, or concurrent use of lithium. The participants were interviewed by two research assistants’ vis-à-vis symptoms of menopause and hypothyroidism, current medications and menstrual characteristics. Blood samples were taken for TSH and FT4 levels. Main outcomes were prevalence of hypothyroidism, the Menopause-Specific Quality of Life (MENQOL) score, and diagnostic performance of Zulewski’s clinical score . results: Mean age was 56 ± 4.7 years. The prevalence of hypothyroidism was 6.2% (95%CI 3.5% to 8.9%). The sensitivity of Zulewski’s clinical score at the cutoff point ≥ 3 was 70%. Neither the MENQOL domain score nor the composite score was associated with hypothyroidism. Conclusion: The prevalence of hypothyroidism in peri-/post-menopausal Thai women is low. There is no association between MENQOL score and hypothyroidism. Zulewski’s clinical score is not a good screening test for hypothyroidism in this group.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"1 1","pages":"275-283"},"PeriodicalIF":0.0,"publicationDate":"2017-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41732427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To assess characteristics, knowledge, attitude and behavior in contraception among pregnant teenagers. Materials and Methods: The cross-sectional descriptive study was conducted from September 2015 to February 2016 in pregnant teenagers (under 20-year-old) attending ANC or admitted at Buddhachinaraj Phitsanulok Hospital. The questionnaires consisted of general characteristics, contraceptive behavior, contraceptive knowledge, and contraceptive attitude. The data was analyzed using descriptive statistics, Chi square test and Spearman’s rank-order correlation. results: Three hundred and fifty pregnant teenagers were divided into two groups by using contraceptive knowledge mean scores (14.68). The above mean group (group A) composed of 192 teenagers (54.86%) and the below mean group (group B) had 158 teenagers (45.14%). There were significant differences in educational level (p = 0.033), gravidity (p = 0.006) and contraceptive attitude (p < 0.05) between groups. The two most common contraceptive methods were oral contraceptive pills (OCP) (66.86%) and condoms (30.29%) but the future choices will be depot medroxyprogesterone acetate (DMPA) (51.71%) and OCP (28.57%). The main sources of contraceptive knowledge were internet and school. If they had any problems, they asked their friends (47.14%) and used the internet (45.14%). Conclusion: About a half of pregnant teenagers had contraceptive knowledge scores above mean. There was a significant difference in level of education, gravidity, and attitude between the two groups. The most common contraceptive method previously used was OCP but future contraceptive choice will be DMPA.
{"title":"Contraceptive Knowledge, Attitude and Behavior of Contraception in Teenage Pregnancy at Buddhachinaraj Phitsanulok Hospital","authors":"Monwanee Muangchang, P. Pongsuthirak","doi":"10.14456/tjog.2017.31","DOIUrl":"https://doi.org/10.14456/tjog.2017.31","url":null,"abstract":"Objectives: To assess characteristics, knowledge, attitude and behavior in contraception among pregnant teenagers. Materials and Methods: The cross-sectional descriptive study was conducted from September 2015 to February 2016 in pregnant teenagers (under 20-year-old) attending ANC or admitted at Buddhachinaraj Phitsanulok Hospital. The questionnaires consisted of general characteristics, contraceptive behavior, contraceptive knowledge, and contraceptive attitude. The data was analyzed using descriptive statistics, Chi square test and Spearman’s rank-order correlation. results: Three hundred and fifty pregnant teenagers were divided into two groups by using contraceptive knowledge mean scores (14.68). The above mean group (group A) composed of 192 teenagers (54.86%) and the below mean group (group B) had 158 teenagers (45.14%). There were significant differences in educational level (p = 0.033), gravidity (p = 0.006) and contraceptive attitude (p < 0.05) between groups. The two most common contraceptive methods were oral contraceptive pills (OCP) (66.86%) and condoms (30.29%) but the future choices will be depot medroxyprogesterone acetate (DMPA) (51.71%) and OCP (28.57%). The main sources of contraceptive knowledge were internet and school. If they had any problems, they asked their friends (47.14%) and used the internet (45.14%). Conclusion: About a half of pregnant teenagers had contraceptive knowledge scores above mean. There was a significant difference in level of education, gravidity, and attitude between the two groups. The most common contraceptive method previously used was OCP but future contraceptive choice will be DMPA.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"1 1","pages":"232-241"},"PeriodicalIF":0.0,"publicationDate":"2017-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43801337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To evaluate incidence, risk factors and complications of cesarean hysterectomy. Materials and Methods: This was a retrospective case-control study. The study cases included 80 pregnant women with cesarean hysterectomy at Maharat Nakhon Ratchasima Hospital from January 1st, 2010 to December 31st, 2015. The controls referred to 320 pregnant women who underwent cesarean section at the closest time before and after the study cases. The medical records were collected and analysed. Multivariate logistic regression analysis was performed to identify risk factors. Results: During the study period, there were 50,729 deliveries and 80 pregnant women with cesarean hysterectomy (1.58:1,000). The statistically significant risk factors for cesarean hysterectomy were placenta adherent (adjusted odds ratios (AOR) 120.91, 95% confidence interval (95% CI) 22.05-1653.22), uterine atony (AOR 26.77, 95% CI 5.64-127.07), placenta previa (AOR 19.15, 95% CI 5.74-63.92), the tearing of lower uterine segment (AOR 14.92, 95% CI 4.92-45.29), multigravida (AOR 4.84, 95% CI 1.65-14.20) and emergency cesarean section (AOR 3.98, 95% CI 1.26-12.58). Hypovolemia, disseminated intravascular coagulation, postoperative fever and bladder injury were significant common complications. Conclusion: Placenta adherent, uterine atony, placenta previa, the tearing of lower uterine segment, multigravida and emergency cesarean section were identified as significant risk factors for cesarean hysterectomy.
目的:探讨剖宫产子宫切除术的发生率、危险因素及并发症。材料与方法:本研究为回顾性病例对照研究。本研究病例包括2010年1月1日至2015年12月31日在Maharat Nakhon Ratchasima医院行剖宫产子宫切除术的孕妇80例。对照组是在研究病例前后最近时间接受剖宫产手术的320名孕妇。收集并分析了医疗记录。多因素logistic回归分析确定危险因素。结果:研究期间共分娩50,729例,剖宫产子宫切除术孕妇80例(1.58:1,000)。剖宫产子宫切除术的危险因素有胎盘贴附(调整优势比(AOR) 120.91, 95%可信区间(95% CI) 22.05 ~ 1653.22)、子宫张力(AOR 26.77, 95% CI 5.64 ~ 127.07)、前置胎盘(AOR 19.15, 95% CI 5.74 ~ 63.92)、子宫下段撕裂(AOR 14.92, 95% CI 4.92 ~ 45.29)、多胎(AOR 4.84, 95% CI 1.65 ~ 14.20)和紧急剖宫产(AOR 3.98, 95% CI 1.26 ~ 12.58)。低血容量、弥散性血管内凝血、术后发热和膀胱损伤是常见的并发症。结论:胎盘粘附、子宫张力、前置胎盘、子宫下段撕裂、多胎和急诊剖宫产是剖宫产子宫切除术的重要危险因素。
{"title":"Risk Factors for Cesarean Hysterectomy at Maharat Nakhon Ratchasima Hospital","authors":"Krittiya Dankhonsakul, Oraphan Aswakul","doi":"10.14456/TJOG.2017.27","DOIUrl":"https://doi.org/10.14456/TJOG.2017.27","url":null,"abstract":"Objectives: To evaluate incidence, risk factors and complications of cesarean hysterectomy. Materials and Methods: This was a retrospective case-control study. The study cases included 80 pregnant women with cesarean hysterectomy at Maharat Nakhon Ratchasima Hospital from January 1st, 2010 to December 31st, 2015. The controls referred to 320 pregnant women who underwent cesarean section at the closest time before and after the study cases. The medical records were collected and analysed. Multivariate logistic regression analysis was performed to identify risk factors. Results: During the study period, there were 50,729 deliveries and 80 pregnant women with cesarean hysterectomy (1.58:1,000). The statistically significant risk factors for cesarean hysterectomy were placenta adherent (adjusted odds ratios (AOR) 120.91, 95% confidence interval (95% CI) 22.05-1653.22), uterine atony (AOR 26.77, 95% CI 5.64-127.07), placenta previa (AOR 19.15, 95% CI 5.74-63.92), the tearing of lower uterine segment (AOR 14.92, 95% CI 4.92-45.29), multigravida (AOR 4.84, 95% CI 1.65-14.20) and emergency cesarean section (AOR 3.98, 95% CI 1.26-12.58). Hypovolemia, disseminated intravascular coagulation, postoperative fever and bladder injury were significant common complications. Conclusion: Placenta adherent, uterine atony, placenta previa, the tearing of lower uterine segment, multigravida and emergency cesarean section were identified as significant risk factors for cesarean hysterectomy.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"25 1","pages":"191-198"},"PeriodicalIF":0.0,"publicationDate":"2017-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47220721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Teeranuch Leewongtrakul, Y. Kunpalin, T. Ingviya, S. Chaithongwongwatthana
Objectives: To determine the acceptance rate and associated factors of influenza vaccination among Thai pregnant women. Materials and Methods: A cross-sectional descriptive study was conducted at King Chulalongkorn Memorial Hospital from November 2014 to March 2015. Pregnant women were asked to complete self-administered questionnaires that collected data on acceptance of vaccination, knowledge, attitude and practice regarding to influenza vaccination during pregnancy. The associated factors were determined by logistic regression analysis. Results: A total of 412 women completed the questionnaires. Acceptance rate of influenza vaccination among the participants was 40.5% (95% CI 35.9-45.3). Most participants (320 women, 77.7%) had good knowledge about influenza and the vaccine. Factors positively associated with the acceptance were ‘advice from physicians’ (adjusted OR 2.61, 95% CI 1.55-4.39), ‘notification about vaccination in current pregnancy’ (adjusted OR 1.84, 95% CI 1.17-2.89), ‘protection of newborn’ (adjusted OR 2.83, 95% CI 1.74-4.62) and ‘cost of vaccination’ (adjusted OR 2.36, 95% CI 1.46-3.82). Negatively associated factors included ‘experience of side effects following past vaccination’ (adjusted OR 0.19, 95% CI 0.05-0.74), ‘belief that vaccination is unnecessary’ (adjusted OR 0.42, 95% CI 0.21-0.86), and ‘unsafe during the first trimester’ (adjusted OR 0.55, 95% CI 0.34-0.90). Conclusion: Acceptance rate of influenza vaccination during pregnancy among women in King Chulalongkorn Memorial Hospital was 40.5%. To increase vaccination rate, health care providers should advise or mention on influenza vaccination and provide information to support that the immunization can protect their newborns and is safe at any trimester.
{"title":"Acceptance of Influenza Vaccination among Pregnant Women attending the Antenatal Care Clinic, King Chulalongkorn Memorial Hospital","authors":"Teeranuch Leewongtrakul, Y. Kunpalin, T. Ingviya, S. Chaithongwongwatthana","doi":"10.14456/TJOG.2017.12","DOIUrl":"https://doi.org/10.14456/TJOG.2017.12","url":null,"abstract":"Objectives: To determine the acceptance rate and associated factors of influenza vaccination among Thai pregnant women. Materials and Methods: A cross-sectional descriptive study was conducted at King Chulalongkorn Memorial Hospital from November 2014 to March 2015. Pregnant women were asked to complete self-administered questionnaires that collected data on acceptance of vaccination, knowledge, attitude and practice regarding to influenza vaccination during pregnancy. The associated factors were determined by logistic regression analysis. Results: A total of 412 women completed the questionnaires. Acceptance rate of influenza vaccination among the participants was 40.5% (95% CI 35.9-45.3). Most participants (320 women, 77.7%) had good knowledge about influenza and the vaccine. Factors positively associated with the acceptance were ‘advice from physicians’ (adjusted OR 2.61, 95% CI 1.55-4.39), ‘notification about vaccination in current pregnancy’ (adjusted OR 1.84, 95% CI 1.17-2.89), ‘protection of newborn’ (adjusted OR 2.83, 95% CI 1.74-4.62) and ‘cost of vaccination’ (adjusted OR 2.36, 95% CI 1.46-3.82). Negatively associated factors included ‘experience of side effects following past vaccination’ (adjusted OR 0.19, 95% CI 0.05-0.74), ‘belief that vaccination is unnecessary’ (adjusted OR 0.42, 95% CI 0.21-0.86), and ‘unsafe during the first trimester’ (adjusted OR 0.55, 95% CI 0.34-0.90). Conclusion: Acceptance rate of influenza vaccination during pregnancy among women in King Chulalongkorn Memorial Hospital was 40.5%. To increase vaccination rate, health care providers should advise or mention on influenza vaccination and provide information to support that the immunization can protect their newborns and is safe at any trimester.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"25 1","pages":"75-82"},"PeriodicalIF":0.0,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48268923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Tachawatcharapunya, Chenchit Chayachinda, Nichamon Parkpinyo
Objectives: To investigate the prevalence of bacterial vaginosis (BV) in asymptomatic pregnant women during early-third trimester and to compare the pregnancy complications between pregnant women with and without BV. Materials and Methods: A total of 270 asymptomatic pregnant women at GA 28-32 weeks without history of preterm birth (PB) or cervical surgery were screened for BV, along with other vaginal infections, using gram stain. Nugent criteria was used to categorize vaginal smears into no BV (score 0-3), intermediate flora (IF, score 4-6) and BV (score 7-10). Fifteen weeks later, their medical records were reviewed. Outcomes of interest were premature rupture of membranes (PROM), preterm birth <37 weeks (PB) and birth weight <2,500 grams (LBW). Results: From 270 participants, 233 who delivered at Siriraj hospital were eligible for the study. The prevalence of BV, vaginal candidiasis (VC) and IF were 19.3%, 21% and 36.5%, respectively. None had trichomoniasis or gonococcal infection. One of BV cases had chorioamnionitis and none of all participants had post-partum infection. Multivariate analysis showed the increasing trend of pregnancy complications: PROM (IF 1.6, 95% CI 0.6-4.5; BV 2.2, 95% CI 0.8-6.2, p= 0.339), PB (IF 1.3, 95% CI 0.3-5.1; BV 2.3, 95% CI 0.6-9.4, p= 0.489) and LBW (IF 1.4, 95% CI 0.5-4.1; BV 1.5, 95% CI 0.5-4.9, p= 0.761). Conclusion: BV during GA28-32 weeks in asymptomatic Thai pregnant women was prevalent at 19.3% and tended to increase in pregnancy complications, including premature rupture of membranes, preterm birth and low birth weight.
{"title":"The prevalence of bacterial vaginosis in pregnant women during early third trimester and the pregnancy complications","authors":"S. Tachawatcharapunya, Chenchit Chayachinda, Nichamon Parkpinyo","doi":"10.14456/TJOG.2017.15","DOIUrl":"https://doi.org/10.14456/TJOG.2017.15","url":null,"abstract":"Objectives: To investigate the prevalence of bacterial vaginosis (BV) in asymptomatic pregnant women during early-third trimester and to compare the pregnancy complications between pregnant women with and without BV. Materials and Methods: A total of 270 asymptomatic pregnant women at GA 28-32 weeks without history of preterm birth (PB) or cervical surgery were screened for BV, along with other vaginal infections, using gram stain. Nugent criteria was used to categorize vaginal smears into no BV (score 0-3), intermediate flora (IF, score 4-6) and BV (score 7-10). Fifteen weeks later, their medical records were reviewed. Outcomes of interest were premature rupture of membranes (PROM), preterm birth <37 weeks (PB) and birth weight <2,500 grams (LBW). Results: From 270 participants, 233 who delivered at Siriraj hospital were eligible for the study. The prevalence of BV, vaginal candidiasis (VC) and IF were 19.3%, 21% and 36.5%, respectively. None had trichomoniasis or gonococcal infection. One of BV cases had chorioamnionitis and none of all participants had post-partum infection. Multivariate analysis showed the increasing trend of pregnancy complications: PROM (IF 1.6, 95% CI 0.6-4.5; BV 2.2, 95% CI 0.8-6.2, p= 0.339), PB (IF 1.3, 95% CI 0.3-5.1; BV 2.3, 95% CI 0.6-9.4, p= 0.489) and LBW (IF 1.4, 95% CI 0.5-4.1; BV 1.5, 95% CI 0.5-4.9, p= 0.761). Conclusion: BV during GA28-32 weeks in asymptomatic Thai pregnant women was prevalent at 19.3% and tended to increase in pregnancy complications, including premature rupture of membranes, preterm birth and low birth weight.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"25 1","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45137583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To examine correlation between serum level of estradiol (E2) and body mass index (BMI) in postmenopausal women at a menopause clinic of a tertiary care university hospital. Materials and Methods: A retrospective cross-sectional study was performed at the Menopause Clinic, Faculty of Medicine Siriraj Hospital, Mahidol University. One hundred and twenty five consecutive medical records of menopausal women attending the menopause clinic, including both natural and surgical menopause were reviewed. All of them never received hormonal treatment or did not receive any hormonal treatment at least one year at the time of this study. All were confirmed to have serum FSH level ≥ 40 IU/L. Baseline characteristic, data on serum level of E2, BMI, type of menopause and duration of menopause were extracted. Correlation between serum level of E2 and BMI was evaluated by the Statistics Package for the Social Sciences Program (SPSS 18.0 statistical package). Pearson correlation analysis was used to demonstrate the correlation between serum E2 level and BMI, with a p value less than 0.05 considered as statistically significant. Results: Of all 125 patients, the majority were natural menopausal cases (81.6%). Mean E2 level and BMI were 20.38±16.61 pg/ml and 22.96±3.65 kg/m2 respectively. No significant correlation between serum E2 level and BMI was demonstrated (r = - 0.101, p = 0.265). Also no correlation was observed in different type of menopause, different duration of menopause and different BMI classification. Conclusion: There was no significant correlation between serum level of E2 and BMI in postmenopausal women of this study population.
{"title":"The Correlation between Serum Estradiol Level and Body Mass Index in Postmenopausal Women: A cross-sectional study at the Menopause Clinic, Siriraj Hospital","authors":"K. Techatraisak","doi":"10.14456/TJOG.2017.17","DOIUrl":"https://doi.org/10.14456/TJOG.2017.17","url":null,"abstract":"Objectives: To examine correlation between serum level of estradiol (E2) and body mass index (BMI) in postmenopausal women at a menopause clinic of a tertiary care university hospital. Materials and Methods: A retrospective cross-sectional study was performed at the Menopause Clinic, Faculty of Medicine Siriraj Hospital, Mahidol University. One hundred and twenty five consecutive medical records of menopausal women attending the menopause clinic, including both natural and surgical menopause were reviewed. All of them never received hormonal treatment or did not receive any hormonal treatment at least one year at the time of this study. All were confirmed to have serum FSH level ≥ 40 IU/L. Baseline characteristic, data on serum level of E2, BMI, type of menopause and duration of menopause were extracted. Correlation between serum level of E2 and BMI was evaluated by the Statistics Package for the Social Sciences Program (SPSS 18.0 statistical package). Pearson correlation analysis was used to demonstrate the correlation between serum E2 level and BMI, with a p value less than 0.05 considered as statistically significant. Results: Of all 125 patients, the majority were natural menopausal cases (81.6%). Mean E2 level and BMI were 20.38±16.61 pg/ml and 22.96±3.65 kg/m2 respectively. No significant correlation between serum E2 level and BMI was demonstrated (r = - 0.101, p = 0.265). Also no correlation was observed in different type of menopause, different duration of menopause and different BMI classification. Conclusion: There was no significant correlation between serum level of E2 and BMI in postmenopausal women of this study population.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"25 1","pages":"111-118"},"PeriodicalIF":0.0,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49098078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}