Objective: The purpose of the study is to demonstrate the technique of applying Nakornping uterine compression suture after caesarean section and to evaluate the effectiveness of this surgical intervention for the management of uterine atony resistant to traditional medical treatments. Materials and Methods: The medical records of 3,949 patients who had caesarean deliveries at Nakornping Hospital from October 2011 to September 2014 were retrospectively analyzed. Uterine atony occurred in 137 caesarean delivering patients. Sixty one patients with persistent uterine atony after receiving bimanual compression, uterine massage and uterotonic medications as per the hospital standard treatment protocol for postpartum hemorrhage management were treated with the placement of the Nakornping uterine compression suture. The mean time to perform the procedure was 2.2 ± 0.4 minutes. Results: For all sixty one patients receiving Nakornping uterine compression suture, the treatment was successful. Nakornping uterine compression suture was sufficient to stop the bleeding immediately in 100% of the patients. There were no complications observed either during or after the procedure. All sixty one patients had normal lochia post caesarean delivery. The patients were discharged after a median of 4 days hospital stay. When pelvic ultrasound was done on day 3 and day 7 post operations on two patients, the study showed normal uterine contour and no fluid was found in the uterine cavity. Hysterosalpingography was performed on two patients on week 6 after the procedure, the study revealed normal findings. Four patients (6.6%) had subsequent pregnancies with caesarean delivery. Conclusion: Application of Nakornping uterine compression suture was effective in treating uterine atony after caesarean section. It is a simple and rapid procedure in the clinical practice.
{"title":"Efficacy of Nakornping Uterine Compression Suture on Persistent Uterine Atony after Caesarean Section","authors":"Jittra Witthayanukool","doi":"10.14456/TJOG.2016.33","DOIUrl":"https://doi.org/10.14456/TJOG.2016.33","url":null,"abstract":"Objective: The purpose of the study is to demonstrate the technique of applying Nakornping uterine compression suture after caesarean section and to evaluate the effectiveness of this surgical intervention for the management of uterine atony resistant to traditional medical treatments. Materials and Methods: The medical records of 3,949 patients who had caesarean deliveries at Nakornping Hospital from October 2011 to September 2014 were retrospectively analyzed. Uterine atony occurred in 137 caesarean delivering patients. Sixty one patients with persistent uterine atony after receiving bimanual compression, uterine massage and uterotonic medications as per the hospital standard treatment protocol for postpartum hemorrhage management were treated with the placement of the Nakornping uterine compression suture. The mean time to perform the procedure was 2.2 ± 0.4 minutes. Results: For all sixty one patients receiving Nakornping uterine compression suture, the treatment was successful. Nakornping uterine compression suture was sufficient to stop the bleeding immediately in 100% of the patients. There were no complications observed either during or after the procedure. All sixty one patients had normal lochia post caesarean delivery. The patients were discharged after a median of 4 days hospital stay. When pelvic ultrasound was done on day 3 and day 7 post operations on two patients, the study showed normal uterine contour and no fluid was found in the uterine cavity. Hysterosalpingography was performed on two patients on week 6 after the procedure, the study revealed normal findings. Four patients (6.6%) had subsequent pregnancies with caesarean delivery. Conclusion: Application of Nakornping uterine compression suture was effective in treating uterine atony after caesarean section. It is a simple and rapid procedure in the clinical practice.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"231-239"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679407","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 determine the factors that effect the success in management of tubal pregnancy with single–dose methotrexate regimen in Chonburi hospital. Research design : Retrospective descriptive study Material and method : Out-Patient Department (OPD) and In-Patient Department (IPD) charts of the patients who were diagnosed ectopic pregnancy and treated with methotrexate from January 2010 to December 2014 were reviewed from Chonburi hospital database. The successful treatment was defined in case of disease resolution without surgery. Result : For all 70 patients were enrolled in this study. The overall success rate was 88.57% (62/70). The baseline characteristics of patients were not different between success and failure group and included age, BMI, parity gestational age, pretreatment serum β-hCG and average sized of adnexal mass. The absent fetal heart activity (OR 23.12, 95%CI 1.46-366.12, p 0.02) and size of adnexal mass less than 3.5 cms (OR 37.56, 95%CI 2.49-567.62, p 0.01) were independent predictors for successful treatment of ectopic pregnancy after analyzed with logistic regression model. Conclusion: The independent predictors of success in treatment of tubal pregnancy with single dose methotrexate regimen were absence of fetal heart activity and adnexal mass less than 3.5 cms.
目的:探讨影响春武里医院单剂量甲氨蝶呤治疗输卵管妊娠成功的因素。研究设计:回顾性描述性研究材料和方法:从春武里医院数据库中检索2010年1月至2014年12月诊断为异位妊娠并使用甲氨蝶呤治疗的患者的门诊(OPD)和住院(IPD)图表。在没有手术的情况下，疾病的解决被定义为成功的治疗。结果:所有70例患者均入组。总成功率为88.57%(62/70)。成功组和失败组患者的基线特征包括年龄、BMI、胎次胎龄、预处理血清β-hCG和附件肿块的平均大小等均无差异。经logistic回归模型分析，胎心活动缺失(OR 23.12, 95%CI 1.46 ~ 366.12, p 0.02)和附件肿块大小小于3.5 cm (OR 37.56, 95%CI 2.49 ~ 567.62, p 0.01)是异位妊娠成功治疗的独立预测因素。结论:单剂量甲氨蝶呤治疗输卵管妊娠成功的独立预测因素是胎心无活动和附件肿块小于3.5 cm。
{"title":"Predictors of Success with Single-dose Methotrexate Regimen for the Treatment of Ectopic Pregnancy in Chonburi Hospital","authors":"Panisara Niyomyam, P. Tansupswatdikul","doi":"10.14456/tjog.2016.38","DOIUrl":"https://doi.org/10.14456/tjog.2016.38","url":null,"abstract":"Objective : To determine the factors that effect the success in management of tubal pregnancy with single–dose methotrexate regimen in Chonburi hospital. Research design : Retrospective descriptive study Material and method : Out-Patient Department (OPD) and In-Patient Department (IPD) charts of the patients who were diagnosed ectopic pregnancy and treated with methotrexate from January 2010 to December 2014 were reviewed from Chonburi hospital database. The successful treatment was defined in case of disease resolution without surgery. Result : For all 70 patients were enrolled in this study. The overall success rate was 88.57% (62/70). The baseline characteristics of patients were not different between success and failure group and included age, BMI, parity gestational age, pretreatment serum β-hCG and average sized of adnexal mass. The absent fetal heart activity (OR 23.12, 95%CI 1.46-366.12, p 0.02) and size of adnexal mass less than 3.5 cms (OR 37.56, 95%CI 2.49-567.62, p 0.01) were independent predictors for successful treatment of ectopic pregnancy after analyzed with logistic regression model. Conclusion: The independent predictors of success in treatment of tubal pregnancy with single dose methotrexate regimen were absence of fetal heart activity and adnexal mass less than 3.5 cms.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"273-279"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66680236","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 study the validity of the risk of malignancy index 4 in preoperative prediction for women with adnexal masses. Materials and Methods: A cross-sectional diagnostic study of women with adnexal masses admitted at Khon Kaen Hospital between 18 th May to 31 st July, 2015 for elective surgery. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. Receiver operating characteristic (ROC) curve was used to evaluate the optimal cut-off point for the risk of malignancy index (RMI). Results: One hundred and sixteen women with adnexal masses were recruited (89 cases were benign and 27 cases were malignancy). The optimal cut-off point for RMI 4 in our study was 204 giving the sensitivity 82.8%, specificity 79.3%, positive predictive value 52.3%, and negative predictive value 93.2%. Using a cut-off at 450, sensitivity was 63%, specificity was 86.5%, PPV was 58.6% and NPV was 88.5%. The area under the ROC curve for the RMI 4 was 0.852. Conclusion: The RMI 4 had a validity to discriminate between benign and malignant ovarian tumors.
{"title":"Validity of the Risk of Malignancy Index 4 to Preoperative Evaluation of Patients with Adnexal Masses","authors":"Ornwitsanate Mongkolmafai, Thumwadee Tangsiriwatthana","doi":"10.14456/TJOG.2016.42","DOIUrl":"https://doi.org/10.14456/TJOG.2016.42","url":null,"abstract":"Objective: To study the validity of the risk of malignancy index 4 in preoperative prediction for women with adnexal masses. Materials and Methods: A cross-sectional diagnostic study of women with adnexal masses admitted at Khon Kaen Hospital between 18 th May to 31 st July, 2015 for elective surgery. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. Receiver operating characteristic (ROC) curve was used to evaluate the optimal cut-off point for the risk of malignancy index (RMI). Results: One hundred and sixteen women with adnexal masses were recruited (89 cases were benign and 27 cases were malignancy). The optimal cut-off point for RMI 4 in our study was 204 giving the sensitivity 82.8%, specificity 79.3%, positive predictive value 52.3%, and negative predictive value 93.2%. Using a cut-off at 450, sensitivity was 63%, specificity was 86.5%, PPV was 58.6% and NPV was 88.5%. The area under the ROC curve for the RMI 4 was 0.852. Conclusion: The RMI 4 had a validity to discriminate between benign and malignant ovarian tumors.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"302-310"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66680367","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}
Kwanruetai Nampakdianan, C. Kietpeerakool, Yaowapa Chongpensuklert
Objective: to determine the rate and patterns of hysterosalpingography (HSG) abnormality among infertile women at Srinagarind Hospital, Khon Kean University, Thailand. Materials and methods: The study patients were identified through the reports of the Infertile Clinic. In our hospital, HSG was routinely performed in all women undergoing an evaluation of infertility problems. Medical records were abstracted for baseline characteristics, types of infertility, and details of HSG findings. A 95% confidence interval (CI) was calculated to demonstrate the precision of data. Logistic regression model was used to determine an independent impact of the type of infertility on abnormal HSG findings. Results: Overall, 589 women were reviewed. The mean ± SD age was 32.9 ± 5.0 years. Secondary infertility was noted in 163 (27.7%) women. Abnormal HSG was noted in 227 (38.5%, 95% CI, 34.6%-42.6%) women. The most common abnormal HSG findings were tubal occlusion and hydrosalpinx. When adjusted with patients’ age, women with secondary infertility carried a higher risk of having abnormal HSG finding compared to those with primary infertility (an adjusted odds ratio, 2.44; 95% CI, 1.68-3.54). Conclusion: Rate of abnormal HSG findings among infertile women in our setting was approximately 40%. Type of infertility was independently associated with abnormal HSG findings.
{"title":"Abnormal Hysterosalpingographic Findings in Infertile Women","authors":"Kwanruetai Nampakdianan, C. Kietpeerakool, Yaowapa Chongpensuklert","doi":"10.14456/TJOG.2016.30","DOIUrl":"https://doi.org/10.14456/TJOG.2016.30","url":null,"abstract":"Objective: to determine the rate and patterns of hysterosalpingography (HSG) abnormality among infertile women at Srinagarind Hospital, Khon Kean University, Thailand. Materials and methods: The study patients were identified through the reports of the Infertile Clinic. In our hospital, HSG was routinely performed in all women undergoing an evaluation of infertility problems. Medical records were abstracted for baseline characteristics, types of infertility, and details of HSG findings. A 95% confidence interval (CI) was calculated to demonstrate the precision of data. Logistic regression model was used to determine an independent impact of the type of infertility on abnormal HSG findings. Results: Overall, 589 women were reviewed. The mean ± SD age was 32.9 ± 5.0 years. Secondary infertility was noted in 163 (27.7%) women. Abnormal HSG was noted in 227 (38.5%, 95% CI, 34.6%-42.6%) women. The most common abnormal HSG findings were tubal occlusion and hydrosalpinx. When adjusted with patients’ age, women with secondary infertility carried a higher risk of having abnormal HSG finding compared to those with primary infertility (an adjusted odds ratio, 2.44; 95% CI, 1.68-3.54). Conclusion: Rate of abnormal HSG findings among infertile women in our setting was approximately 40%. Type of infertility was independently associated with abnormal HSG findings.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"209-215"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679307","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}
Pornprom Ittiamornlert, P. Sunsaneevithayakul, Dittakarn Borriboonhiransan
Objectives: To determine the incidence of postpartum glucose intolerance among women with gestational diabetes (GDM) and its associated factors. Methods: A total of 110 GDM women who delivered at Siriraj Hospital were enrolled. A 2-hour 75-gram glucose tolerance test and were offered at 6-12 weeks postpartum to determine incidence of glucose intolerance, which include impaired glucose tolerance (IGT), and type 2 diabetes (T2DM). Demographic data, GDM risks and diagnosis data, and delivery data were collected. Incidence of glucose intolerance was estimated. Comparison was made between glucose intolerance groups to determine possible associated factors. Results: Mean age was 33.7±5.1 years, and 46% were nulliparous. According to pre-pregnancy BMI, 45.5% were overweight/obese, and 24.5% gained weight greater than recommendation. Majority was GDM A1 (85.5%), and 63.6% were diagnosed before 20 weeks of gestation. Mean postpartum follow up time was at 6.2 ± 0.9 weeks. Incidence of postpartum IGT and T2DM were 35.5% and 10% respectively. No difference was found between groups in terms of pre-pregnancy BMI, gestational weight gain, weight retention, and severity of GDM. However, HbA1c level was significantly greater among women with postpartum T2DM than IGT and normal results (6.1±0.5%, 5.6±0.4%, and 5.4±0.3% respectively, p 6% significantly increased the chance of T2DM (33.3% vs. 53.4%, p=0.001). Conclusion: Among GDM pregnant women, incidence of postpartum glucose intolerance was 45.5% (35.5% IGT and 10% T2DM). HbA1c level of >6% significantly increased the chance of postpartum T2DM.
{"title":"Incidence of postpartum glucose intolerance among women with gestational diabetes in Siriraj Hospital","authors":"Pornprom Ittiamornlert, P. Sunsaneevithayakul, Dittakarn Borriboonhiransan","doi":"10.14456/TJOG.2016.28","DOIUrl":"https://doi.org/10.14456/TJOG.2016.28","url":null,"abstract":"Objectives: To determine the incidence of postpartum glucose intolerance among women with gestational diabetes (GDM) and its associated factors. Methods: A total of 110 GDM women who delivered at Siriraj Hospital were enrolled. A 2-hour 75-gram glucose tolerance test and were offered at 6-12 weeks postpartum to determine incidence of glucose intolerance, which include impaired glucose tolerance (IGT), and type 2 diabetes (T2DM). Demographic data, GDM risks and diagnosis data, and delivery data were collected. Incidence of glucose intolerance was estimated. Comparison was made between glucose intolerance groups to determine possible associated factors. Results: Mean age was 33.7±5.1 years, and 46% were nulliparous. According to pre-pregnancy BMI, 45.5% were overweight/obese, and 24.5% gained weight greater than recommendation. Majority was GDM A1 (85.5%), and 63.6% were diagnosed before 20 weeks of gestation. Mean postpartum follow up time was at 6.2 ± 0.9 weeks. Incidence of postpartum IGT and T2DM were 35.5% and 10% respectively. No difference was found between groups in terms of pre-pregnancy BMI, gestational weight gain, weight retention, and severity of GDM. However, HbA1c level was significantly greater among women with postpartum T2DM than IGT and normal results (6.1±0.5%, 5.6±0.4%, and 5.4±0.3% respectively, p 6% significantly increased the chance of T2DM (33.3% vs. 53.4%, p=0.001). Conclusion: Among GDM pregnant women, incidence of postpartum glucose intolerance was 45.5% (35.5% IGT and 10% T2DM). HbA1c level of >6% significantly increased the chance of postpartum T2DM.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"193-201"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679279","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 association between the maternal body mass index (BMI) and subtherapeutic serum magnesium level in pregnant women with severe preeclampsia who received magnesium sulfate therapy at Maharat Nakhon Ratchasima Hospital. Study design: Retrospective cross-sectional study. Materials and Methods: A retrospective study from October 1, 2012 to March 31, 2015 was performed to estimate the effect of maternal BMI on serum magnesium level. And 565(2.99 %) pregnant women had severe preeclampsia and eclampsia diagnosed and received magnesium sulfate therapy at Maharat Nakhon Ratchasima Hospital. Inclusion criteria was pregnant women delivered at gestational age ≥ 24 weeks, not expectant management, received magnesium sulfate in regimen loading dose 4 grams, followed by maintenance dose 1 gram/hour intravenously, and monitored serum magnesium level. Serum magnesium level was monitored initially at 3-4 hours after loading dose, and then monitored every 4 hours during magnesium sulfate infusion. The first serum magnesium level after loading dose was used in the study. Association between maternal BMI and subtherapeutic serum magnesium level (magnesium level 1.1 gm/dL) and thrombocytopenia seem to have higher rate of therapeutic magnesium level significantly (P value < 0.05). Conclusion: Most cases of women with severe preeclampsia at Maharat Nakhon Ratchasima Hospital had subtherapeutic serum magnesium level when magnesium sulfate was administered in regimen loading dose 4 grams, followed by 1 gram per hour intravenously. Overweight and obesity were high risk factor contributing to subtherapeutic of serum magnesium level.
目的:评价在Maharat Nakhon Ratchasima医院接受硫酸镁治疗的重度子痫前期孕妇的体重指数(BMI)与亚治疗期血清镁水平的关系。研究设计:回顾性横断面研究。材料与方法:回顾性研究2012年10月1日至2015年3月31日母体BMI对血清镁水平的影响。565名(2.99%)孕妇在玛哈拉特那空叻差玛医院确诊为重度子痫前期和子痫并接受硫酸镁治疗。纳入标准为:胎龄≥24周分娩的孕妇，非准用药，以方案负荷剂量4 g，维持剂量1 g /h静脉注射硫酸镁，并监测血清镁水平。在给药后3-4小时开始监测血清镁水平，在硫酸镁输注期间每4小时监测一次。研究采用负荷剂量后的第一次血清镁水平。孕妇BMI与亚治疗期血清镁水平(镁水平1.1 gm/dL)和血小板减少症的相关性明显高于治疗期血清镁水平(P值< 0.05)。结论:在以方案负荷剂量4 g硫酸镁，随后每小时静脉注射1 g硫酸镁的情况下，大多数在玛哈拉特那叻医院就诊的重度子痫前期妇女血清镁水平均达亚治疗水平。超重和肥胖是导致血清镁亚治疗的高危因素。
{"title":"Association between Maternal Body Mass Index and Sub-therapeutic Serum Magnesium Level in Severe Preeclampsia at Maharat Nakhon Ratchasima Hospital","authors":"Ratana Boonyongchaisawat, Siraya Kitiyodom","doi":"10.14456/TJOG.2016.25","DOIUrl":"https://doi.org/10.14456/TJOG.2016.25","url":null,"abstract":"Objectives: To evaluate association between the maternal body mass index (BMI) and subtherapeutic serum magnesium level in pregnant women with severe preeclampsia who received magnesium sulfate therapy at Maharat Nakhon Ratchasima Hospital. Study design: Retrospective cross-sectional study. Materials and Methods: A retrospective study from October 1, 2012 to March 31, 2015 was performed to estimate the effect of maternal BMI on serum magnesium level. And 565(2.99 %) pregnant women had severe preeclampsia and eclampsia diagnosed and received magnesium sulfate therapy at Maharat Nakhon Ratchasima Hospital. Inclusion criteria was pregnant women delivered at gestational age ≥ 24 weeks, not expectant management, received magnesium sulfate in regimen loading dose 4 grams, followed by maintenance dose 1 gram/hour intravenously, and monitored serum magnesium level. Serum magnesium level was monitored initially at 3-4 hours after loading dose, and then monitored every 4 hours during magnesium sulfate infusion. The first serum magnesium level after loading dose was used in the study. Association between maternal BMI and subtherapeutic serum magnesium level (magnesium level 1.1 gm/dL) and thrombocytopenia seem to have higher rate of therapeutic magnesium level significantly (P value < 0.05). Conclusion: Most cases of women with severe preeclampsia at Maharat Nakhon Ratchasima Hospital had subtherapeutic serum magnesium level when magnesium sulfate was administered in regimen loading dose 4 grams, followed by 1 gram per hour intravenously. Overweight and obesity were high risk factor contributing to subtherapeutic of serum magnesium level.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"145-152"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679199","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 compare maternal and neonatal outcomes in singleton pregnant women with severe preeclampsia with or without underlying chronic hypertension, and singleton pregnant women with normal blood pressure. Materials and Methods: In a retrospective study, 200 pregnant women with severe preeclampsia, with or without underlying chronic hypertension, were compared to 200 pregnant women with normal blood pressure between January 1 st , 2011 and December 31 st , 2012. The demographic characteristics, mode of delivery, complications and outcomes of pregnancy were analyzed. Main outcome measures: Maternal morbidities of acute renal failure, pulmonary edema, neurological complication, HELLP syndrome, coagulopathy, placenta abruption and postpartum hemorrhage were evaluated. Neonatal morbidities were also measured. Results: Maternal outcomes for the 200 women with severe preeclampsia compared to women with normal blood pressure demonstrated significantly increased rates of acute renal failure (4.0% VS 0%, p<0.001), pulmonary edema (2.0% VS 0%, p=0.044), neurologic complications (5.0% VS 0%, p<0.001), and cesarean section (57.5% VS 41.5%, p=0.023). Likewise, there was a significant increase in Neonatal outcomes, including preterm birth (45.0% VS 17%, p=0.011), low birth weight (47.0% VS 14%, p<0.001), rate of neonatal resuscitation (19.0% VS 10%, p=0.011), and stillbirth (3.5% VS 1%, p=0.092). Conclusion: Maternal outcomes including acute renal failure, pulmonary edema, neurological complications and cesarean section rates were significantly worse in the study group. Neonatal outcomes consist with rate of preterm birth, low birth weight, neonatal resuscitation and stillbirth were also worse in the study group.
目的:比较伴有或不伴有慢性高血压的重度子痫前期单胎孕妇与血压正常的单胎孕妇的孕产妇和新生儿结局。材料与方法:在一项回顾性研究中，将2011年1月1日至2012年12月31日期间200名伴有或不伴有慢性高血压的重度子痫前期孕妇与200名血压正常的孕妇进行比较。分析人口统计学特征、分娩方式、并发症及妊娠结局。主要观察指标:观察产妇急性肾功能衰竭、肺水肿、神经系统并发症、HELLP综合征、凝血功能障碍、胎盘早剥、产后出血的发生率。还测量了新生儿发病率。结果:与血压正常的妇女相比，200名重度子痫前期妇女的产妇结局显示急性肾功能衰竭(4.0% VS 0%， p<0.001)、肺水肿(2.0% VS 0%， p=0.044)、神经系统并发症(5.0% VS 0%， p<0.001)和剖宫产(57.5% VS 41.5%， p=0.023)的发生率显著增加。同样，新生儿结局也有显著增加，包括早产(45.0% VS 17%， p=0.011)、低出生体重(47.0% VS 14%， p<0.001)、新生儿复苏率(19.0% VS 10%， p=0.011)和死产(3.5% VS 1%， p=0.092)。结论:研究组的产妇结局包括急性肾功能衰竭、肺水肿、神经系统并发症和剖宫产率明显较对照组差。新生儿结局与早产、低出生体重、新生儿复苏和死胎的发生率一致，研究组的新生儿结局也较差。
{"title":"Pregnancy Outcomes amongst Normotensive and Severe preeclampsia with or without Underlying Chronic Hypertension pregnancy","authors":"Radchaneekorn Kampruan, Kanchapan Sukonpan, Phornsawan Wasinghon","doi":"10.14456/TJOG.2016.29","DOIUrl":"https://doi.org/10.14456/TJOG.2016.29","url":null,"abstract":"Objective: To compare maternal and neonatal outcomes in singleton pregnant women with severe preeclampsia with or without underlying chronic hypertension, and singleton pregnant women with normal blood pressure. Materials and Methods: In a retrospective study, 200 pregnant women with severe preeclampsia, with or without underlying chronic hypertension, were compared to 200 pregnant women with normal blood pressure between January 1 st , 2011 and December 31 st , 2012. The demographic characteristics, mode of delivery, complications and outcomes of pregnancy were analyzed. Main outcome measures: Maternal morbidities of acute renal failure, pulmonary edema, neurological complication, HELLP syndrome, coagulopathy, placenta abruption and postpartum hemorrhage were evaluated. Neonatal morbidities were also measured. Results: Maternal outcomes for the 200 women with severe preeclampsia compared to women with normal blood pressure demonstrated significantly increased rates of acute renal failure (4.0% VS 0%, p<0.001), pulmonary edema (2.0% VS 0%, p=0.044), neurologic complications (5.0% VS 0%, p<0.001), and cesarean section (57.5% VS 41.5%, p=0.023). Likewise, there was a significant increase in Neonatal outcomes, including preterm birth (45.0% VS 17%, p=0.011), low birth weight (47.0% VS 14%, p<0.001), rate of neonatal resuscitation (19.0% VS 10%, p=0.011), and stillbirth (3.5% VS 1%, p=0.092). Conclusion: Maternal outcomes including acute renal failure, pulmonary edema, neurological complications and cesarean section rates were significantly worse in the study group. Neonatal outcomes consist with rate of preterm birth, low birth weight, neonatal resuscitation and stillbirth were also worse in the study group.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"202-208"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679287","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 determine incidence and associated factors of gestational diabetes (GDM) diagnosed at 24-28 weeks of gestation. Methods : A total of 200 pregnant women at risk for GDM who attended antenatal clinic before 20 weeks of gestation and had negative GDM screening tests were enrolled. All women received a second screening test at 24-28 weeks of gestation, according to institutional guideline. Data were retrieved, including demographic data, GDM risks and diagnosis, weight gain during pregnancy, and labor and delivery data. Incidence of GDM diagnosed by second screening test was estimated and possible associated factors were identified. Results : Mean maternal age was 31 years, and 51% were nulliparous. Most common GDM risks were age >30 years (70%) and family history of diabetes (46%). Majority of women had normal pre-pregnancy BMI (63%) and normal weight gain (43.5%), while 38% gained weight greater than recommendation. Incidence of GDM diagnosed at 24-28 weeks of gestation was 15%. Various characteristics were comparable among late-onset GDM and non-GDM group, including age, parity, pre-pregnancy BMI, and gestational weight gain. However, late-onset GDM group had significant greater second trimester weight gain (7.2±2.8 kg vs. 5.9±2.4 kg, p=0.01). Compared to women with normal GCT, abnormal 50-g GCT and abnormal 1 OGTT value at first screening significantly increased the risk of late-onset GDM (9.5%, 18.2%, and 47.4% respectively, p<0.001). Conclusion : Incidence of GDM diagnosed at 24-28 weeks of gestation was 15%. High second trimester weight gain and abnormal first screening results significantly increased the risk of late diagnosed GDM.
目的:了解妊娠24 ~ 28周诊断的妊娠期糖尿病(GDM)的发病率及相关因素。方法:共纳入200名妊娠20周前到产前诊所就诊且GDM筛查试验阴性的有GDM风险的孕妇。根据机构指南，所有妇女在妊娠24-28周时接受第二次筛查试验。检索数据，包括人口统计数据、GDM风险和诊断、妊娠期间体重增加、分娩和分娩数据。估计经第二次筛查试验诊断为GDM的发生率，并确定可能的相关因素。结果:产妇平均年龄31岁，51%为无产。最常见的GDM风险是年龄在50 - 30岁之间(70%)和有糖尿病家族史(46%)。大多数女性孕前体重指数正常(63%)，体重增加正常(43.5%)，而38%的女性体重增加超过建议。妊娠24-28周诊断为GDM的发生率为15%。迟发性GDM组和非GDM组的各种特征具有可比性，包括年龄、胎次、孕前BMI和妊娠体重增加。然而，迟发性GDM组妊娠中期体重增加显著高于对照组(7.2±2.8 kg vs. 5.9±2.4 kg, p=0.01)。与GCT正常的女性相比，首次筛查时50 g GCT异常和1 OGTT值异常的女性发生晚发型GDM的风险显著增加(分别为9.5%、18.2%和47.4%，p<0.001)。结论:妊娠24 ~ 28周诊断为GDM的发生率为15%。妊娠中期体重增加和首次筛查结果异常显著增加晚期诊断GDM的风险。
{"title":"Incidence and associated factors of gestational diabetes mellitus diagnosed during 24-28 weeks of gestation","authors":"Artitaya Singwongsa, Dittakarn Borriboonhiransan","doi":"10.14456/TJOG.2016.27","DOIUrl":"https://doi.org/10.14456/TJOG.2016.27","url":null,"abstract":"Objective : To determine incidence and associated factors of gestational diabetes (GDM) diagnosed at 24-28 weeks of gestation. Methods : A total of 200 pregnant women at risk for GDM who attended antenatal clinic before 20 weeks of gestation and had negative GDM screening tests were enrolled. All women received a second screening test at 24-28 weeks of gestation, according to institutional guideline. Data were retrieved, including demographic data, GDM risks and diagnosis, weight gain during pregnancy, and labor and delivery data. Incidence of GDM diagnosed by second screening test was estimated and possible associated factors were identified. Results : Mean maternal age was 31 years, and 51% were nulliparous. Most common GDM risks were age >30 years (70%) and family history of diabetes (46%). Majority of women had normal pre-pregnancy BMI (63%) and normal weight gain (43.5%), while 38% gained weight greater than recommendation. Incidence of GDM diagnosed at 24-28 weeks of gestation was 15%. Various characteristics were comparable among late-onset GDM and non-GDM group, including age, parity, pre-pregnancy BMI, and gestational weight gain. However, late-onset GDM group had significant greater second trimester weight gain (7.2±2.8 kg vs. 5.9±2.4 kg, p=0.01). Compared to women with normal GCT, abnormal 50-g GCT and abnormal 1 OGTT value at first screening significantly increased the risk of late-onset GDM (9.5%, 18.2%, and 47.4% respectively, p<0.001). Conclusion : Incidence of GDM diagnosed at 24-28 weeks of gestation was 15%. High second trimester weight gain and abnormal first screening results significantly increased the risk of late diagnosed GDM.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"184-192"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679269","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}
Korranat Thanaratsiriworakul, Panya Sananpanichkul, N. Suriya
Objective: To identify which recommendations of weight gain aresuitable for Thai pregnant women to deliver a normal birth weight neonate. Materials and Methods : This retrospective study was performed by reviewing 1,657 medical records of singleton pregnant women who delivered normal birth weight healthy neonates at Department of Obstetrics and Gynecology, Prapokklao Hospital during July 1 st , 2013 – June 30 th , 2014. Pre-pregnancy BMI was categorized according to U.S.Institute of Medicine (IOM) 2009. Gestational weight gain and pregnancy outcomes were compared using IOM and Thai Siriraj Hospital recommendations. One-way ANOVA was used to compare continuous data and Chi-square test was used to compare discrete data among two groups. Results: Mean gestational weight gain of our population in underweight, normal weight, overweight, and obese groups were 13.73±5.43 kg, 13.52±5.63 kg, 11.35±5.65 kg, and 8.81±7.41 kg, respectively. Significant difference of maternal age, pre-pregnancy BMI, gestational weight gain and neonatal birth weight were found among groups (p<0.001). About one-third of both underweight group and normal weight group gained the appropriate weight based on the IOM recommendations whereas two-thirds of both groups gained the appropriate weight using Thai Siriraj recommendations. While the performances of both sets of recommendations were similar in obese women, the Thai Siriraj recommendations performed better in the overweight group, In total, 56.3% of women and 34.8% of women could gain weight within the recommendations of Thai Siriraj and IOM respectively while the neonatal outcomes of both groups of women were comparable. Conclusion: Thai Siriraj recommendations for weight gain during pregnancy appear to be more suitable for our population than the U.S. IOM ones.
{"title":"Comparison of gestational weight gain recommendations between study from Thai population and U.S. Institute of Medicine","authors":"Korranat Thanaratsiriworakul, Panya Sananpanichkul, N. Suriya","doi":"10.14456/TJOG.2016.21","DOIUrl":"https://doi.org/10.14456/TJOG.2016.21","url":null,"abstract":"Objective: To identify which recommendations of weight gain aresuitable for Thai pregnant women to deliver a normal birth weight neonate. Materials and Methods : This retrospective study was performed by reviewing 1,657 medical records of singleton pregnant women who delivered normal birth weight healthy neonates at Department of Obstetrics and Gynecology, Prapokklao Hospital during July 1 st , 2013 – June 30 th , 2014. Pre-pregnancy BMI was categorized according to U.S.Institute of Medicine (IOM) 2009. Gestational weight gain and pregnancy outcomes were compared using IOM and Thai Siriraj Hospital recommendations. One-way ANOVA was used to compare continuous data and Chi-square test was used to compare discrete data among two groups. Results: Mean gestational weight gain of our population in underweight, normal weight, overweight, and obese groups were 13.73±5.43 kg, 13.52±5.63 kg, 11.35±5.65 kg, and 8.81±7.41 kg, respectively. Significant difference of maternal age, pre-pregnancy BMI, gestational weight gain and neonatal birth weight were found among groups (p<0.001). About one-third of both underweight group and normal weight group gained the appropriate weight based on the IOM recommendations whereas two-thirds of both groups gained the appropriate weight using Thai Siriraj recommendations. While the performances of both sets of recommendations were similar in obese women, the Thai Siriraj recommendations performed better in the overweight group, In total, 56.3% of women and 34.8% of women could gain weight within the recommendations of Thai Siriraj and IOM respectively while the neonatal outcomes of both groups of women were comparable. Conclusion: Thai Siriraj recommendations for weight gain during pregnancy appear to be more suitable for our population than the U.S. IOM ones.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"1 1","pages":"161-168"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679116","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 compare outcomes of teenage pregnancy (maternal age younger than 20 years) with adult pregnancy (maternal age 20-34 years). Materials and Methods: A retrospective cohort study compared first birth teenage deliveries to adult deliveries at Buddhachinaraj Hospital from January 2012 to December 2013. Main Outcome Measurement: Maternal outcomes were anemia, hypertensive disorder, gestational diabetes mellitus, mode of delivery, and postpartum hemorrhage. Neonatal outcomes included preterm delivery, low birth weight, fetal growth restriction and birth asphyxia. Results: The prevalence of teenage pregnancy in this study was 17%. Teenage mothers had less frequent antenatal care. Rates of anemia, preterm delivery and low birth weight were significantly higher in teenage compared to adult pregnancy, whereas the rates of gestational diabetes mellitus and postpartum hemorrhage were lower. Rate of normal vaginal delivery was significantly higher in the teenage group compared to the adult pregnancies. No difference in outcome between groups was demonstrated for hypertensive disorder, infectious disorder, fetal growth restriction and birth asphyxia. Conclusion: Teenage pregnancy had preferable obstetric outcomes for the prevalence of vaginal delivery and postpartum hemorrhage, but had increased neonatal adverse events.
{"title":"Comparison of Maternal and Neonatal Outcomes of Teenage versus Adult Pregnancies at Buddhachinaraj Hospital","authors":"Lalita Kositworakitkun, Wiset Watcharoton, Chokdee Junlapakee","doi":"10.14456/TJOG.2016.22","DOIUrl":"https://doi.org/10.14456/TJOG.2016.22","url":null,"abstract":"Objective: To compare outcomes of teenage pregnancy (maternal age younger than 20 years) with adult pregnancy (maternal age 20-34 years). Materials and Methods: A retrospective cohort study compared first birth teenage deliveries to adult deliveries at Buddhachinaraj Hospital from January 2012 to December 2013. Main Outcome Measurement: Maternal outcomes were anemia, hypertensive disorder, gestational diabetes mellitus, mode of delivery, and postpartum hemorrhage. Neonatal outcomes included preterm delivery, low birth weight, fetal growth restriction and birth asphyxia. Results: The prevalence of teenage pregnancy in this study was 17%. Teenage mothers had less frequent antenatal care. Rates of anemia, preterm delivery and low birth weight were significantly higher in teenage compared to adult pregnancy, whereas the rates of gestational diabetes mellitus and postpartum hemorrhage were lower. Rate of normal vaginal delivery was significantly higher in the teenage group compared to the adult pregnancies. No difference in outcome between groups was demonstrated for hypertensive disorder, infectious disorder, fetal growth restriction and birth asphyxia. Conclusion: Teenage pregnancy had preferable obstetric outcomes for the prevalence of vaginal delivery and postpartum hemorrhage, but had increased neonatal adverse events.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"169-174"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679130","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}
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