Abstract Objectives : To compare the prevalence of anemia and pregnancy outcomes between teenage pregnancies who received teenage prenatal care services and general prenatal care services at Siriraj Hospital. Methods : Medical records of 343 and 347 teenage pregnancies who received antenatal care (ANC) at teenage prenatal care clinic and general ANC clinic for more than 4 times and delivered at Siriraj Hospital were reviewed. Prevalence of anemia at first ANC and before delivery as well as pregnancy outcomes were compared. Various factors associated with anemia were evaluated. Results: Women in teenage prenatal care clinic were younger (16.9 + 1.2 vs. 17.5 + 1.3 years, p 0.05). Improvement and deterioration of anemia status were also comparable between the 2 groups (46.8% vs. 54.4%, and 13.2% vs. 13.6%, respectively, p>0.05). No differences of various pregnancy outcomes were observed between groups, including, preterm birth, low birth weight, primary cesarean delivery rates. Logistic regression analysis demonstrates that anemia at 1 st ANC and maternal age 0.05) เปรยบเทยบภาวะซดทดขนและแยลงระหวางทง 2 กลม (46.8% กบ 54.4% และ 13.2% กบ 13.6% ตามลำดบ, p>0.05) ไมพบความแตกตางของผลของการตงครรภทง 2กลมทงในเรองของการคลอดกอนกำหนด ทารกนำหนกตวนอย หรออตราการผาตดคลอดบตร จากการวเคราะหการถดถอยโลจสตกพบวาภาวะซดทการฝากครรภครงแรกและอายของสตรตงครรภทนอยกวา 17ป จะเพมความเสยงตอการเกดภาวะซดกอนคลอด (adjusted OR 4.7, 95%CI 3.1-7.0, และ 1.8, 95%CI 1.2-2.8 ตามลำดบ) บทสรป : ความชกของภาวะซดและผลของการตงครรภในสตรตงครรภวยรนทไดรบการฝากครรภทคลนกมารดาวยรนและคลนกทวไปไมแตกตางกนอยางมนยสำคญ ภาวะซดทการฝากครรภครงแรกและอายของสตรตงครรภทนอยกวา 17ป เปนปจจยทสมพนธกบการเกดภาวะซดกอนคลอด คำสำคญ : สตรตงครรภวยรน ภาวะซดขณะตงครรภ
目的:比较在Siriraj医院接受青少年产前护理服务和一般产前护理服务的少女妊娠的贫血患病率和妊娠结局。方法:回顾性分析343例和347例在西丽拉医院接受产前保健门诊和普通产前保健门诊产前保健4次以上并分娩的少女妊娠的病历。比较首次ANC和分娩前贫血的患病率以及妊娠结局。评估与贫血相关的各种因素。结果:青少年产前护理门诊妇女年龄更小(16.9 + 1.2岁比17.5 + 1.3岁，p < 0.05)。两组患者贫血状况的改善和恶化也具有可比性(分别为46.8% vs. 54.4%， 13.2% vs. 13.6%， p < 0.05)。各组妊娠结局无差异，包括早产、低出生体重、初次剖宫产率。逻辑回归分析表明,贫血1 st ANC和产妇年龄0.05)เปรยบเทยบภาวะซดทดขนและแยลงระหวางท2งกลม(46.8%กบ54.4%และก13.2% 13.6%บตามลำดบ,p > 0.05)ไมพบความแตกตางของผลของการตงครรภท2งกลมทงในเรองของการคลอดกอนกำหนดทารกนำหนกตวนอยหรออตราการผาตดคลอดบตรจากการวเคราะหการถดถอยโลจสตกพบวาภาวะซดทการฝากครรภครงแรกและอายของสตรตงครรภทนอยกว17ปาจะเพมความเสยงตอการเกดภาวะซดกอนคลอด(调整或4.7,95%可信区间3.1 - -7.0,และ1.8,95%可信区间1.2 - -2.8ตามลำดบ)บทสรป:ความชกของภาวะซดและผลของการตงครรภในสตรตงครรภวยรนทไดรบการฝากครรภทคลนกมารดาวยรนและคลนกทวไปไมแตกตางกนอยางมนยสำคญภาวะซดทการฝากครรภครงแรกและอายของสตรตงครรภทนอยกวา17ปเปนปจจยทสมพนธกบการเกดภาวะซดกอนคลอดคำสำคญ:สตรตงครรภวยรนภาวะซดขณะตงครรภ
{"title":"Anemia and pregnancy outcomes in teenage prenatal care clinic at Siriraj hospital","authors":"Supapen Lertvutivivat, Pattarawalai Talungchit","doi":"10.14456/tjog.2016.26","DOIUrl":"https://doi.org/10.14456/tjog.2016.26","url":null,"abstract":"Abstract Objectives : To compare the prevalence of anemia and pregnancy outcomes between teenage pregnancies who received teenage prenatal care services and general prenatal care services at Siriraj Hospital. Methods : Medical records of 343 and 347 teenage pregnancies who received antenatal care (ANC) at teenage prenatal care clinic and general ANC clinic for more than 4 times and delivered at Siriraj Hospital were reviewed. Prevalence of anemia at first ANC and before delivery as well as pregnancy outcomes were compared. Various factors associated with anemia were evaluated. Results: Women in teenage prenatal care clinic were younger (16.9 + 1.2 vs. 17.5 + 1.3 years, p 0.05). Improvement and deterioration of anemia status were also comparable between the 2 groups (46.8% vs. 54.4%, and 13.2% vs. 13.6%, respectively, p>0.05). No differences of various pregnancy outcomes were observed between groups, including, preterm birth, low birth weight, primary cesarean delivery rates. Logistic regression analysis demonstrates that anemia at 1 st ANC and maternal age 0.05) เปรยบเทยบภาวะซดทดขนและแยลงระหวางทง 2 กลม (46.8% กบ 54.4% และ 13.2% กบ 13.6% ตามลำดบ, p>0.05) ไมพบความแตกตางของผลของการตงครรภทง 2กลมทงในเรองของการคลอดกอนกำหนด ทารกนำหนกตวนอย หรออตราการผาตดคลอดบตร จากการวเคราะหการถดถอยโลจสตกพบวาภาวะซดทการฝากครรภครงแรกและอายของสตรตงครรภทนอยกวา 17ป จะเพมความเสยงตอการเกดภาวะซดกอนคลอด (adjusted OR 4.7, 95%CI 3.1-7.0, และ 1.8, 95%CI 1.2-2.8 ตามลำดบ) บทสรป : ความชกของภาวะซดและผลของการตงครรภในสตรตงครรภวยรนทไดรบการฝากครรภทคลนกมารดาวยรนและคลนกทวไปไมแตกตางกนอยางมนยสำคญ ภาวะซดทการฝากครรภครงแรกและอายของสตรตงครรภทนอยกวา 17ป เปนปจจยทสมพนธกบการเกดภาวะซดกอนคลอด คำสำคญ : สตรตงครรภวยรน ภาวะซดขณะตงครรภ","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"153-160"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679219","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}
Penpak Jensarasart, N. Ayudhya, V. Arnuntasupakul, Amornrat Tangjitbampenboon
Objective: To compare effect of bupivacaine local infiltration with parecoxib intravenous administered for post surgical pain relief in woman undergoing abdominal hysterectomy. Materials and Methods: From August 2014 to January 2015, 42 patients scheduled for abdominal hysterectomy under general anesthesia were randomly allocated to 2 groups. Group P (n=21) were received 40 mg intravenous parecoxib and group B (n=21) were received 0.5% bupivacaine 20 mL intraoperative injection to incisional surgical site before the subcutaneous fat and skin were closed. All patients were received morphine patient-controlled analgesia (PCA) at ward. Main outcome measures: Pain scores, morphine consumption, sedation score and nausea or vomiting were assessed at 2, 6, 10, 14 and 26 hours after surgery. Antiemetic requirement, pruritus and satisfaction scores were evaluated at 26 hours after surgery. Results: No significant differences between 2 groups in age, BMI, surgical time and intraoperative dose of fentanyl were found. Pain scores at rest were significantly lower (p=0.045) in the P group at 2, 14 hours after surgery. There were no significant differences in pain scores during movement, morphine consumption, sedation score, nausea or vomiting, antiemetic requirement, pruritus and satisfaction scores between 2 groups. Conclusion: The use of parecoxib with PCA morphine in post operative analgesia reduced pain significantly when compared with bupivacaine at 2 and 14 hours after surgery.
{"title":"Effect of Bupivacaine Local Infiltration Compared with Parecoxib Intravenous Administered in Post Surgical Pain Management Following Total Abdominal Hysterectomy","authors":"Penpak Jensarasart, N. Ayudhya, V. Arnuntasupakul, Amornrat Tangjitbampenboon","doi":"10.14456/TJOG.2016.31","DOIUrl":"https://doi.org/10.14456/TJOG.2016.31","url":null,"abstract":"Objective: To compare effect of bupivacaine local infiltration with parecoxib intravenous administered for post surgical pain relief in woman undergoing abdominal hysterectomy. Materials and Methods: From August 2014 to January 2015, 42 patients scheduled for abdominal hysterectomy under general anesthesia were randomly allocated to 2 groups. Group P (n=21) were received 40 mg intravenous parecoxib and group B (n=21) were received 0.5% bupivacaine 20 mL intraoperative injection to incisional surgical site before the subcutaneous fat and skin were closed. All patients were received morphine patient-controlled analgesia (PCA) at ward. Main outcome measures: Pain scores, morphine consumption, sedation score and nausea or vomiting were assessed at 2, 6, 10, 14 and 26 hours after surgery. Antiemetic requirement, pruritus and satisfaction scores were evaluated at 26 hours after surgery. Results: No significant differences between 2 groups in age, BMI, surgical time and intraoperative dose of fentanyl were found. Pain scores at rest were significantly lower (p=0.045) in the P group at 2, 14 hours after surgery. There were no significant differences in pain scores during movement, morphine consumption, sedation score, nausea or vomiting, antiemetic requirement, pruritus and satisfaction scores between 2 groups. Conclusion: The use of parecoxib with PCA morphine in post operative analgesia reduced pain significantly when compared with bupivacaine at 2 and 14 hours after surgery.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"216-223"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679354","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 pregnancy rate resulting from IUI between the use of husband’s sperm and donor’s sperm. Methods : Data on 306 cycles per groups of IUI using husband’s sperm (IUI-H) and IUI using donor’s sperm (IUI-D) were collected from couples attending Infertility Unit at Siriraj Hospital. Baseline data, as semen analysis parameters were retrieved. Pregnancy rate was compared between groups. Results: Mean age of the women was younger among IUI-D than IUI-H group (33.6 + 5.3 vs. 34.4 + 3.4 years, p=0.025). And their husbands were older among IUI-D than IUI-H group (38.0 + 8.1 vs. 35.4 + 3.8 years, p 2 independently increased pregnancy rate (adjusted OR 2.2, 95%CI 1.2-4.3, p=0.018; and 3.5 95%CI 1.7-6.9, p<0.001). Conclusion: Pregnancy rate was significantly higher among IUI cycle using donor’s sperm.
{"title":"Comparison of pregnancy rate following IUI between the use of husband’s sperm and donor’s sperm in Siriraj Hospital","authors":"Achjima Tankul, Japarath Prechapanich","doi":"10.14456/TJOG.2016.23","DOIUrl":"https://doi.org/10.14456/TJOG.2016.23","url":null,"abstract":"Objective : To compare pregnancy rate resulting from IUI between the use of husband’s sperm and donor’s sperm. Methods : Data on 306 cycles per groups of IUI using husband’s sperm (IUI-H) and IUI using donor’s sperm (IUI-D) were collected from couples attending Infertility Unit at Siriraj Hospital. Baseline data, as semen analysis parameters were retrieved. Pregnancy rate was compared between groups. Results: Mean age of the women was younger among IUI-D than IUI-H group (33.6 + 5.3 vs. 34.4 + 3.4 years, p=0.025). And their husbands were older among IUI-D than IUI-H group (38.0 + 8.1 vs. 35.4 + 3.8 years, p 2 independently increased pregnancy rate (adjusted OR 2.2, 95%CI 1.2-4.3, p=0.018; and 3.5 95%CI 1.7-6.9, p<0.001). Conclusion: Pregnancy rate was significantly higher among IUI cycle using donor’s sperm.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"175-183"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679141","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}
Cervical cancer is one of the major cancer types, the leading causes of cancer-related deaths in women worldwide, with a significant socioeconomic burden. Metformin, an inexpensive, traditional oral anti-hyperglycemic drug, is one of the most widely used antidiabetic drug for type 2 diabetes mellitus. In recent years, there has been an increasing interest in the use of metformin to reduce cancer risk and improve oncological outcomes of various cancer types, including cervical cancer. The precise mechanism of the antitumor effect of metformin is still unclear. Herein I review the scientific evidence from preclinical and clinical studies on the antitumor effect of metformin on cancer risk and oncological outcomes of cervical cancer.
{"title":"Metformin – a possible way to reduce risk and improve oncological outcome of cervical cancer","authors":"J. Hanprasertpong","doi":"10.14456/TJOG.2016.24","DOIUrl":"https://doi.org/10.14456/TJOG.2016.24","url":null,"abstract":"Cervical cancer is one of the major cancer types, the leading causes of cancer-related deaths in women worldwide, with a significant socioeconomic burden. Metformin, an inexpensive, traditional oral anti-hyperglycemic drug, is one of the most widely used antidiabetic drug for type 2 diabetes mellitus. In recent years, there has been an increasing interest in the use of metformin to reduce cancer risk and improve oncological outcomes of various cancer types, including cervical cancer. The precise mechanism of the antitumor effect of metformin is still unclear. Herein I review the scientific evidence from preclinical and clinical studies on the antitumor effect of metformin on cancer risk and oncological outcomes of cervical cancer.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"142-144"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679191","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}
Background: In Thailand, village health volunteer play an important role for breastfeeding support in the community. Objective: to assess the knowledge, attitudes and breastfeeding support practices provided by village health volunteers. Materials and Methods : The subjects were 72 village health volunteers from three sub-districts; Klong Yai, Buangsan and Chomphol of the Ongkharak district in the Nakhon Nayok province. The study was done during the period from the beginning of March to the end of June, 2014. The questionnaire has been designed to assess the knowledge, attitudes and breastfeeding support practice provided by the village health volunteers. The questionnaires were distributed to the village health volunteers and the data analyzed. The 6-month exclusive breastfeeding rates of each area were determined by home visitation. The data was collected and analyzed by the Chi square and Kruskal-Wallis test. Results: The knowledge score totaled 8 points. The median of the knowledge scores of Klong Yai, Buangsan and Chomphol were 7, 8 and 7 points, respectively. The attitude score totaled 30 points. The median of attitude scores of Klong Yai, Buangsan and Chomphol were 26, 30 and 28 points; percentages of the village health volunteer’s home visits and breastfeeding support were 75.0, 90.5 and 87.5; and the exclusive breastfeeding rates for six months were 33.3%, 39.3% and 37.0%, respectively. Conclusion: The knowledge, attitudes and breastfeeding support practices among village health volunteers in the three sub-districts were high and were consistent with the 6-month, exclusive breastfeeding rates for each area.
{"title":"Knowledge, Attitudes and Practices Regarding Breastfeeding Support among Village Health Volunteers in Nakhon Nayok, Thailand","authors":"Pawin Puapornpong","doi":"10.14456/TJOG.2016.11","DOIUrl":"https://doi.org/10.14456/TJOG.2016.11","url":null,"abstract":"Background: In Thailand, village health volunteer play an important role for breastfeeding support in the community. Objective: to assess the knowledge, attitudes and breastfeeding support practices provided by village health volunteers. Materials and Methods : The subjects were 72 village health volunteers from three sub-districts; Klong Yai, Buangsan and Chomphol of the Ongkharak district in the Nakhon Nayok province. The study was done during the period from the beginning of March to the end of June, 2014. The questionnaire has been designed to assess the knowledge, attitudes and breastfeeding support practice provided by the village health volunteers. The questionnaires were distributed to the village health volunteers and the data analyzed. The 6-month exclusive breastfeeding rates of each area were determined by home visitation. The data was collected and analyzed by the Chi square and Kruskal-Wallis test. Results: The knowledge score totaled 8 points. The median of the knowledge scores of Klong Yai, Buangsan and Chomphol were 7, 8 and 7 points, respectively. The attitude score totaled 30 points. The median of attitude scores of Klong Yai, Buangsan and Chomphol were 26, 30 and 28 points; percentages of the village health volunteer’s home visits and breastfeeding support were 75.0, 90.5 and 87.5; and the exclusive breastfeeding rates for six months were 33.3%, 39.3% and 37.0%, respectively. Conclusion: The knowledge, attitudes and breastfeeding support practices among village health volunteers in the three sub-districts were high and were consistent with the 6-month, exclusive breastfeeding rates for each area.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678858","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: Cesarean section rates are increasing with associated increase in placenta previa and accreta. Placenta accreta is a major cause of maternal morbidity and mortality. Our objective was to evaluate of a new method of combined surgical steps in management of morbidly adherent placenta (MAP) to face its burden, psychological and marital disintegration if managed by hysterectomy in our low facilities. Materials and Methods: In this case series, we evaluated the use of sequential surgical steps for conservative management of 20 cases of MAP as regard the intra-operative and post-operative outcomes in Assiut Women Health Hospital, Egypt from June to December 2014. The sequential steps started by perfect dissection of urinary bladder, then delivery of the fetus followed by exteriorization of the uterus and application of 4 ring forceps on both uterine and ovarian vessels. Trial of placenta removal followed by application of two towels in the uterine cavity to achieve hemostasis. Ligation of uterine artery bilaterally at double low level. Finally, plication of the friable lower uterine segment from anterior wall after removal of towels. Results: The mean age of the included women was 29.95±4.8 years. All cases had previous uterine scar and placenta previa. Ten cases (50%) had placenta accreta, 8 cases (40%) had placenta increta and 2 cases had placenta percreta. Our procedure was successive in all 18 cases of placenta accreta and increta but the last 2 cases of placenta percreta required hysterectomy. No post partum hemorrhage in all cases. There were no maternal deaths. Discussion: This new method was favorable in the management of MAP and decreased the incidence of hysterectomy in cases of placenta accreta and increta.
{"title":"Sequential surgical steps for conservative management of Morbidly Adherent Placenta: Case series","authors":"A. B. A. Mitwaly, A. Abbas","doi":"10.14456/TJOG.2016.20","DOIUrl":"https://doi.org/10.14456/TJOG.2016.20","url":null,"abstract":"Objective: Cesarean section rates are increasing with associated increase in placenta previa and accreta. Placenta accreta is a major cause of maternal morbidity and mortality. Our objective was to evaluate of a new method of combined surgical steps in management of morbidly adherent placenta (MAP) to face its burden, psychological and marital disintegration if managed by hysterectomy in our low facilities. Materials and Methods: In this case series, we evaluated the use of sequential surgical steps for conservative management of 20 cases of MAP as regard the intra-operative and post-operative outcomes in Assiut Women Health Hospital, Egypt from June to December 2014. The sequential steps started by perfect dissection of urinary bladder, then delivery of the fetus followed by exteriorization of the uterus and application of 4 ring forceps on both uterine and ovarian vessels. Trial of placenta removal followed by application of two towels in the uterine cavity to achieve hemostasis. Ligation of uterine artery bilaterally at double low level. Finally, plication of the friable lower uterine segment from anterior wall after removal of towels. Results: The mean age of the included women was 29.95±4.8 years. All cases had previous uterine scar and placenta previa. Ten cases (50%) had placenta accreta, 8 cases (40%) had placenta increta and 2 cases had placenta percreta. Our procedure was successive in all 18 cases of placenta accreta and increta but the last 2 cases of placenta percreta required hysterectomy. No post partum hemorrhage in all cases. There were no maternal deaths. Discussion: This new method was favorable in the management of MAP and decreased the incidence of hysterectomy in cases of placenta accreta and increta.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"136-140"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678675","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 effect of the addition of intravenous ergometrine to a standard oxytocin infusion on the blood loss during vaginal delivery. Study design : Prospective, double-blinded, randomized controlled trial. Materials and methods : Three hundred and twenty-three women were randomized to receive infusion of either ergometrine 0.2 mg plus oxytocin 20 IU or oxytocin 20 IU, diluted in 1,000 ml of 5%D/N/2, immediately after delivery of the baby. The primary outcome was the estimated blood loss. The secondary outcomes included PPH, changes in hemoglobin level, the use of additional uterotonics, need for blood transfusion and adverse effects. Results : The estimated postpartum blood loss was similar in the oxytocin–ergometrine and oxytocin groups (145 ml versus 150 ml, p=0.979). None of the women in the oxytocin–ergometrine group had PPH while one woman (0.6%) in the oxytocin group encountered this complication (p=0.498). There was no significant difference between both groups in terms of changes in hemoglobin level, use of additional uterotonics and need for blood transfusion. Hypertension was significantly more common in the oxytocin–ergometrine group than in the oxytocin group (6.2% VS 0%, p< 0.001). Conclusions : There was no difference in postpartum blood loss during vaginal delivery between oxytocin–ergometrine and oxytocin groups. Hypertension was frequently found in the oxytocin–ergometrine group. However, other adverse effects were not significantly different between both groups.
目的:探讨在标准催产素输注基础上静脉加用麦角新碱对阴道分娩出血量的影响。研究设计:前瞻性、双盲、随机对照试验。材料与方法:随机选取323名妇女，在分娩后立即输注麦角新碱0.2 mg加催产素20 IU或催产素20 IU，稀释于1000 ml 5%D/N/2中。主要结果是估计的失血量。次要结局包括PPH、血红蛋白水平变化、额外子宫强张剂的使用、输血需求和不良反应。结果:催产素-麦角新碱组和催产素组产后出血量相近(145 ml vs 150 ml, p=0.979)。催产素-麦角新碱组中没有女性出现PPH，而催产素组中有一名女性(0.6%)出现PPH并发症(p=0.498)。两组在血红蛋白水平变化、使用额外子宫强张剂和输血需求方面无显著差异。催产素-麦角新碱组高血压发生率明显高于催产素组(6.2% VS 0%， p< 0.001)。结论:催产素-麦角新碱组和催产素组阴道分娩时的产后出血量无差异。催产素-麦角新碱组常出现高血压。然而，其他不良反应在两组间无显著差异。
{"title":"Prevention of Postpartum Hemorrhage with Oxytocin versus Ergometrine Plus Oxytocin in the third stage of labor","authors":"Thitipun Nuamsiri, Kasemsis Kaewkiattikun","doi":"10.14456/TJOG.2016.12","DOIUrl":"https://doi.org/10.14456/TJOG.2016.12","url":null,"abstract":"Objective : To evaluate the effect of the addition of intravenous ergometrine to a standard oxytocin infusion on the blood loss during vaginal delivery. Study design : Prospective, double-blinded, randomized controlled trial. Materials and methods : Three hundred and twenty-three women were randomized to receive infusion of either ergometrine 0.2 mg plus oxytocin 20 IU or oxytocin 20 IU, diluted in 1,000 ml of 5%D/N/2, immediately after delivery of the baby. The primary outcome was the estimated blood loss. The secondary outcomes included PPH, changes in hemoglobin level, the use of additional uterotonics, need for blood transfusion and adverse effects. Results : The estimated postpartum blood loss was similar in the oxytocin–ergometrine and oxytocin groups (145 ml versus 150 ml, p=0.979). None of the women in the oxytocin–ergometrine group had PPH while one woman (0.6%) in the oxytocin group encountered this complication (p=0.498). There was no significant difference between both groups in terms of changes in hemoglobin level, use of additional uterotonics and need for blood transfusion. Hypertension was significantly more common in the oxytocin–ergometrine group than in the oxytocin group (6.2% VS 0%, p< 0.001). Conclusions : There was no difference in postpartum blood loss during vaginal delivery between oxytocin–ergometrine and oxytocin groups. Hypertension was frequently found in the oxytocin–ergometrine group. However, other adverse effects were not significantly different between both groups.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"97-103"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678908","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 use of endocervical curettage(ECC) at the time of colposcopy for low-grade cytologic abnormalities to improve the diagnosis of high-grade diseases. Materials and methods: A prospective diagnostic study was conducted. We included women with low-grade cytologic abnormalities: low-grade squamous intraepithelial lesion (LSIL) who had undergone colposcopy at Chonburi Hospital between January 2014 to March 2015. Data collected were age, menopausal status, HIV status, parity, contraception, colposcopic findings and pathological report of biopsy and ECC. Main outcome measure: Primary outcome was the increasing rate of ECC in colposcopy for LSIL to detect high-grade lesion. Result: Eighty-seven women met criteria. Nine cases (10.3%) were ECC positive for high-grade lesion. Of these nine cases, seven cases were only ECC positive, resulting in 8.04% increased detection with ECC independently of biopsy, with a sensitivity of 20.0%, specificity of 91.91%, positive predictive value of 22.22% and negative predictive value of 89.74%. Therefore, twelve to thirteen ECCs needed to be performed to detect one case of high-grade diseases. Among post-menopausal women or women older than 40 years old, the sensitivity of ECC improved, with a sensitivity of 100% and 85% respectively. Conclusion: The increased detection rate of ECC to detect high-grade lesions in women who had low-grade cytological abnormalities in our study was 8.04%. Routine ECC at the time of colposcopy for LSIL in young women is debatable. However, the sensitivity of ECC was found to be increased in women aged over 40 and post-menopausal women. Therefore, ECC may be useful in older and post-menopausal women.
{"title":"The utility of routine endocervical curettage at the time of colposcopy for low-grade cytologic abnormalities to improve diagnosis of high-grade diseases","authors":"C. Suebthawinkul, Thitiwan Chaisuriyapun","doi":"10.14456/tjog.2016.19","DOIUrl":"https://doi.org/10.14456/tjog.2016.19","url":null,"abstract":"Objective: To determine the use of endocervical curettage(ECC) at the time of colposcopy for low-grade cytologic abnormalities to improve the diagnosis of high-grade diseases. Materials and methods: A prospective diagnostic study was conducted. We included women with low-grade cytologic abnormalities: low-grade squamous intraepithelial lesion (LSIL) who had undergone colposcopy at Chonburi Hospital between January 2014 to March 2015. Data collected were age, menopausal status, HIV status, parity, contraception, colposcopic findings and pathological report of biopsy and ECC. Main outcome measure: Primary outcome was the increasing rate of ECC in colposcopy for LSIL to detect high-grade lesion. Result: Eighty-seven women met criteria. Nine cases (10.3%) were ECC positive for high-grade lesion. Of these nine cases, seven cases were only ECC positive, resulting in 8.04% increased detection with ECC independently of biopsy, with a sensitivity of 20.0%, specificity of 91.91%, positive predictive value of 22.22% and negative predictive value of 89.74%. Therefore, twelve to thirteen ECCs needed to be performed to detect one case of high-grade diseases. Among post-menopausal women or women older than 40 years old, the sensitivity of ECC improved, with a sensitivity of 100% and 85% respectively. Conclusion: The increased detection rate of ECC to detect high-grade lesions in women who had low-grade cytological abnormalities in our study was 8.04%. Routine ECC at the time of colposcopy for LSIL in young women is debatable. However, the sensitivity of ECC was found to be increased in women aged over 40 and post-menopausal women. Therefore, ECC may be useful in older and post-menopausal women.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"128-135"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678610","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}
This second issue of Thai Journal of Obstetrics and Gynaecology (TJOG) 2016 contains many interesting articles. One special article states the way to eliminate congenital syphilis in Thailand from the National Guideline.
{"title":"Editorial (doi: 10.14456/tjog.2016.18)","authors":"Vorapong Phupong","doi":"10.14456/TJOG.2016.18","DOIUrl":"https://doi.org/10.14456/TJOG.2016.18","url":null,"abstract":"This second issue of Thai Journal of Obstetrics and Gynaecology (TJOG) 2016 contains many interesting articles. One special article states the way to eliminate congenital syphilis in Thailand from the National Guideline.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"65"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679068","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}
Background: Postpartum hemorrhage remains a leading cause of maternal death. Although there had been the improvement of various treatments, such as prostaglandin and s-Lynch suture, some women did not respond to these treatments and needed Emergency peripartum hysterectomy (EPH) to control intractable bleeding. The aim of this study was to determine clinical characteristics associated with EPH in Sisaket Hospital. Objective: To determine the incidence, indications, clinical characteristics and risk factors influencing EPH. Design: A retrospective hospital-based descriptive and case control study. Setting: Department of Obstetrics and Gynecology, Sisaket Hospital. Methods and Materials: Women who was pregnant 28 weeks gestational age or more and carried out EPH within 24 hours after delivery at Sisaket Hospital from January 2012 to June 2015 (total 26 cases) were identified from labor registration records. Their medical records were reviewed to assess the following outcomes (1) incidence of EPH (2) indications for EPH (3) clinical characteristics and risk factors associated with EPH (4) complications after EPH. Women who gave birth before (2 cases) and after (2 cases) the cases of EPH (total 104 cases ) were the control used to assess the risk factors associated with EPH. Result: During the study period, there were 17,566 deliveries at 28 weeks gestational age or more. Among them, there were 26 cases undergoing EPH. The incidence was 1.48 per 1,000 deliveries. Medical records showed that placenta adherent (65.38%) was the most common indication of EPH followed by uterine atony (26.92%) and uterine rupture (7.69%). The significant risk factors affecting EPH by multivariate logistic regression analysis were maternal age ≥ 35 years, cesarean delivery and delivery at 28-36 weeks gestational age. There were two maternal deaths after EPH. Conclusions: Clinical characteristics and risk factors associated with EPH were age ≥ 35 years, cesarean delivery and delivery at GA28-36weeks.
{"title":"Emergency postpartum hysterectomy in Sisaket Hospital: clinical characteristic and risk factors","authors":"P. Angkawanich","doi":"10.14456/tjog.2016.10","DOIUrl":"https://doi.org/10.14456/tjog.2016.10","url":null,"abstract":"Background: Postpartum hemorrhage remains a leading cause of maternal death. Although there had been the improvement of various treatments, such as prostaglandin and s-Lynch suture, some women did not respond to these treatments and needed Emergency peripartum hysterectomy (EPH) to control intractable bleeding. The aim of this study was to determine clinical characteristics associated with EPH in Sisaket Hospital. Objective: To determine the incidence, indications, clinical characteristics and risk factors influencing EPH. Design: A retrospective hospital-based descriptive and case control study. Setting: Department of Obstetrics and Gynecology, Sisaket Hospital. Methods and Materials: Women who was pregnant 28 weeks gestational age or more and carried out EPH within 24 hours after delivery at Sisaket Hospital from January 2012 to June 2015 (total 26 cases) were identified from labor registration records. Their medical records were reviewed to assess the following outcomes (1) incidence of EPH (2) indications for EPH (3) clinical characteristics and risk factors associated with EPH (4) complications after EPH. Women who gave birth before (2 cases) and after (2 cases) the cases of EPH (total 104 cases ) were the control used to assess the risk factors associated with EPH. Result: During the study period, there were 17,566 deliveries at 28 weeks gestational age or more. Among them, there were 26 cases undergoing EPH. The incidence was 1.48 per 1,000 deliveries. Medical records showed that placenta adherent (65.38%) was the most common indication of EPH followed by uterine atony (26.92%) and uterine rupture (7.69%). The significant risk factors affecting EPH by multivariate logistic regression analysis were maternal age ≥ 35 years, cesarean delivery and delivery at 28-36 weeks gestational age. There were two maternal deaths after EPH. Conclusions: Clinical characteristics and risk factors associated with EPH were age ≥ 35 years, cesarean delivery and delivery at GA28-36weeks.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678806","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：