Congenital syphilis (CS) is an infection in infants born to mothers infected by Treponema pallidum. It is transmitted via placenta or direct exposure to vaginal secretion during vaginal birth. World Health Organization aims to eliminate CS by 2015, which is defied as an incidence of 0.5 cases or fewer per 1,000 births. Thailand has already achieved the goal for many years. However, new syphilis cases have been increasingly reported, especially among young people. The National Guideline on the management for the elimination of congenital syphilis in Thailand, 2015 has been developed to tackle the problem and enhance the healthcare system for this preventable condition. The optimal goal is to reduce the incidence of CS to less than 0.05 per 1,000 livebirths by 2020. For early detection and early treatment, the guideline focuses on the early ANC and the same-day-result testing of syphilis for pregnant women with late or no ANC. We, obstetricians, can play essential roles in this mission.
{"title":"Elimination of Congenital Syphilis in Thailand: What can be done during antenatal period? (doi: 10.14456/tjog.2016.16)","authors":"Chenchit Chayachinda","doi":"10.14456/TJOG.2016.16","DOIUrl":"https://doi.org/10.14456/TJOG.2016.16","url":null,"abstract":"Congenital syphilis (CS) is an infection in infants born to mothers infected by Treponema pallidum. It is transmitted via placenta or direct exposure to vaginal secretion during vaginal birth. World Health Organization aims to eliminate CS by 2015, which is defied as an incidence of 0.5 cases or fewer per 1,000 births. Thailand has already achieved the goal for many years. However, new syphilis cases have been increasingly reported, especially among young people. The National Guideline on the management for the elimination of congenital syphilis in Thailand, 2015 has been developed to tackle the problem and enhance the healthcare system for this preventable condition. The optimal goal is to reduce the incidence of CS to less than 0.05 per 1,000 livebirths by 2020. For early detection and early treatment, the guideline focuses on the early ANC and the same-day-result testing of syphilis for pregnant women with late or no ANC. We, obstetricians, can play essential roles in this mission.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679039","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}
Lalida Chookijkul, S. Prommas, Piyawan Pariyawateekul, Nawaporn Orungrote, Buppa Smanchat, K. Suwannarurk
Objective: To compare the cesarean section rate between discontinuing oxytocin infusion for labor induction or augmentation when the active phase of labor is established and continuing oxytocin infusion until delivery. Materials and methods: This was a prospective randomized controlled trial of 340 pregnant women who underwent labor induction or augmentation at Bhumibol Adulyadej Hospital during February 2014 to January 2015. Parturient were randomly and equally allocated into two groups. The continued group received oxytocin infusion throughout all stages of labor. The discontinued group received oxytocin infusion and early discontinued when the active phase of labor had begun. Intention to treat analysis was used in this study. Results: Three hundred and forty pregnant women were enrolled for the study. They were assigned randomly into two groups, 170 patients for each group. Cesarean section rate in continued and discontinued group were 31.8% and 27.7%, respectively ( p = 0.40). The infusion of intravenous fluid in CG group was stopped due to non-reassuring fetal heart rate pattern in 15 women and total oxytocin doses used were significantly higher than that in DG group. In DG group, additional oxytocin was required due to poor uterine contraction. Duration of each stage of labor, maternal complications and adverse neonatal outcomes were not significantly different. There were only two cases of postpartum hemorrhage in discontinued group that was successful managed by medical treatment. Conclusion: There was not sufficient evidence to support whether discontinuation or continuation of oxytocin in active phase of labor influenced cesarean section rate. However, higher doses of oxytocin used was found in continuation group. Future well-randomized design with enough sample size is needed.
{"title":"Cesarean Section Rate in Oxytocin Infusion between Continuous Until Delivery and Discontinuation at Active Phase of Labor: a Randomized Controlled Study","authors":"Lalida Chookijkul, S. Prommas, Piyawan Pariyawateekul, Nawaporn Orungrote, Buppa Smanchat, K. Suwannarurk","doi":"10.14456/TJOG.2016.17","DOIUrl":"https://doi.org/10.14456/TJOG.2016.17","url":null,"abstract":"Objective: To compare the cesarean section rate between discontinuing oxytocin infusion for labor induction or augmentation when the active phase of labor is established and continuing oxytocin infusion until delivery. Materials and methods: This was a prospective randomized controlled trial of 340 pregnant women who underwent labor induction or augmentation at Bhumibol Adulyadej Hospital during February 2014 to January 2015. Parturient were randomly and equally allocated into two groups. The continued group received oxytocin infusion throughout all stages of labor. The discontinued group received oxytocin infusion and early discontinued when the active phase of labor had begun. Intention to treat analysis was used in this study. Results: Three hundred and forty pregnant women were enrolled for the study. They were assigned randomly into two groups, 170 patients for each group. Cesarean section rate in continued and discontinued group were 31.8% and 27.7%, respectively ( p = 0.40). The infusion of intravenous fluid in CG group was stopped due to non-reassuring fetal heart rate pattern in 15 women and total oxytocin doses used were significantly higher than that in DG group. In DG group, additional oxytocin was required due to poor uterine contraction. Duration of each stage of labor, maternal complications and adverse neonatal outcomes were not significantly different. There were only two cases of postpartum hemorrhage in discontinued group that was successful managed by medical treatment. Conclusion: There was not sufficient evidence to support whether discontinuation or continuation of oxytocin in active phase of labor influenced cesarean section rate. However, higher doses of oxytocin used was found in continuation group. Future well-randomized design with enough sample size is needed.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"73-80"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66679053","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}
A. Abbas, M. El-Baz, O. Shaaban, Khalid M. Mohany, Thorya S. El-Deeb, Amira M. El-Noweihi
Objective : Egypt has one of the highest incidences of intrauterine fetal growth restriction (IUGR) around the world. In the current study, we tried to explore the effect of Aflatoxin B1 toxicity as a risk factor of IUGR and to determine the role of placental apoptotic indices in the pathogenesis of IUGR and their association with maternal risk factors as residency, working and exposure to smoking. Materials and Methods : A case-control study was done at Women Health Hospital; Assiut University, Egypt included 60 pregnant women with asymmetrical IUGR besides a control group of 40 normal pregnancies were selected. Maternal urine samples were obtained for measuring Aflatoxin B1 level by layer chromatography. Quantitative determination of human placental Bcl-2 and caspase-3 using a monoclonal antibody-based enzyme-linked immunosorbent assay kits were performed. Results : The results showed that aflatoxin B1 positive cases in the IUGR group had significantly higher placental caspase-3 and lower placental Bcl-2 concentrations than those which were aflatoxin B1 negative (p<0.01). The levels of placental apoptotic indices were higher in working women who lived in urban areas and those exposed to cigarette smoke than non-working women who lived in rural areas and non-smokers. Conclusions : Aflatoxin B1 may affect the fetal growth by increasing the placental apoptosis. These results may highlight the importance of aflatoxin B1 which may contribute to the complex etiology of IUGR. Placental apoptotic indices levels were significantly affected by maternal residency, working and exposure to smoking in pregnancies complicated with IUGR.
{"title":"The correlation between Aflatoxin B1 and Placental Apoptosis in Pregnant women with Intrauterine Growth Restriction","authors":"A. Abbas, M. El-Baz, O. Shaaban, Khalid M. Mohany, Thorya S. El-Deeb, Amira M. El-Noweihi","doi":"10.14456/TJOG.2016.8","DOIUrl":"https://doi.org/10.14456/TJOG.2016.8","url":null,"abstract":"Objective : Egypt has one of the highest incidences of intrauterine fetal growth restriction (IUGR) around the world. In the current study, we tried to explore the effect of Aflatoxin B1 toxicity as a risk factor of IUGR and to determine the role of placental apoptotic indices in the pathogenesis of IUGR and their association with maternal risk factors as residency, working and exposure to smoking. Materials and Methods : A case-control study was done at Women Health Hospital; Assiut University, Egypt included 60 pregnant women with asymmetrical IUGR besides a control group of 40 normal pregnancies were selected. Maternal urine samples were obtained for measuring Aflatoxin B1 level by layer chromatography. Quantitative determination of human placental Bcl-2 and caspase-3 using a monoclonal antibody-based enzyme-linked immunosorbent assay kits were performed. Results : The results showed that aflatoxin B1 positive cases in the IUGR group had significantly higher placental caspase-3 and lower placental Bcl-2 concentrations than those which were aflatoxin B1 negative (p<0.01). The levels of placental apoptotic indices were higher in working women who lived in urban areas and those exposed to cigarette smoke than non-working women who lived in rural areas and non-smokers. Conclusions : Aflatoxin B1 may affect the fetal growth by increasing the placental apoptosis. These results may highlight the importance of aflatoxin B1 which may contribute to the complex etiology of IUGR. Placental apoptotic indices levels were significantly affected by maternal residency, working and exposure to smoking in pregnancies complicated with IUGR.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"104-116"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66680448","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 five-year overall survival rate of patients with endometrial cancer after complete treatment at Phramongkutklao hospital. Materials and Method: This was a retrospective descriptive study. A total of 54 patients were enrolled with histologically confirmed diagnosis of endometrial cancer and that had complete treatment from January 1, 2009 to December 31, 2010 at Phramongkutklao hospital. Overall survival was estimated according to the Kaplan-Meier method and univariate analysis employed Log-rank test to compare between groups. Main outcome measure: The five-year overall survival rate of patients with endometrial cancer. Results: The mean age of the 54 patients was 60 ± 10.6 years. All presented symptoms of abnormal uterine bleeding. The majority had early stage disease (66.7%), histopathology cell types were endometrioid carcinoma (90.6%). The majority of adjuvant therapies in advanced stage was chemotherapy plus radiotherapy (27.7%), and early stage was radiotherapy alone (33.4%). The five-year overall survival rate of endometrial cancer was 80.1% that depend on stage were 91.6% in early stage (FIGO stage I-II) and 50% in advanced stage (FIGO stage III-IV). The statistically significant variables affecting overall survival included stage, tumor grade, cervical invasion, lymph nodes metastasis, positive peritoneal cytology and post operative residual tumor more than 2 cm. Conclusion: The five-year overall survival rate of endometrial cancer was 80.1%. The FIGO stage and tumor grade were correlated with overall survival of patients with endometrial cancer.
{"title":"Survival rate of endometrial cancer patients at Phramongkutklao Hospital","authors":"Sansanee Payanta, Suttida Intharaburan","doi":"10.14456/TJOG.2016.9","DOIUrl":"https://doi.org/10.14456/TJOG.2016.9","url":null,"abstract":"Objective: To determine the five-year overall survival rate of patients with endometrial cancer after complete treatment at Phramongkutklao hospital. Materials and Method: This was a retrospective descriptive study. A total of 54 patients were enrolled with histologically confirmed diagnosis of endometrial cancer and that had complete treatment from January 1, 2009 to December 31, 2010 at Phramongkutklao hospital. Overall survival was estimated according to the Kaplan-Meier method and univariate analysis employed Log-rank test to compare between groups. Main outcome measure: The five-year overall survival rate of patients with endometrial cancer. Results: The mean age of the 54 patients was 60 ± 10.6 years. All presented symptoms of abnormal uterine bleeding. The majority had early stage disease (66.7%), histopathology cell types were endometrioid carcinoma (90.6%). The majority of adjuvant therapies in advanced stage was chemotherapy plus radiotherapy (27.7%), and early stage was radiotherapy alone (33.4%). The five-year overall survival rate of endometrial cancer was 80.1% that depend on stage were 91.6% in early stage (FIGO stage I-II) and 50% in advanced stage (FIGO stage III-IV). The statistically significant variables affecting overall survival included stage, tumor grade, cervical invasion, lymph nodes metastasis, positive peritoneal cytology and post operative residual tumor more than 2 cm. Conclusion: The five-year overall survival rate of endometrial cancer was 80.1%. The FIGO stage and tumor grade were correlated with overall survival of patients with endometrial cancer.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"117-127"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66680461","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 intention and using of long-acting reversible contraception (LARC) in adolescents in the postpartum period. Material and Method: A prospective cohort study was conducted at Maharat Nakhon Ratchasima hospital, from June 2014 to November 2014. Postpartum adolescents under the age of 20 who willing to participate were enrolled in this study. A structured interview questionnaire was used to determine the intention of contraceptive use prior to discharge. Then, phone interviewed at 12 weeks postpartum to determine contraceptive use and reasons. Results: Three hundred and ninety eight of 456 adolescents had a documented postpartum visit at 12 weeks, giving an overall response rate of 87.3%. 336 adolescents (73.7%) intended to use LARC prior to discharge and 209 adolescents (56.9%) had used LARC within 12 weeks postpartum. The most common reason of LARC use was convenience. Injectable contraception was the most common LARC used that included 54.77% of participants. Intended birth interval and pregnancy desire were significant factor of choosing LARC at postpartum ward. Significant factors associated with using LARC at 12 weeks postpartum were intended birth interval and previous contraception. Conclusions: The intention to use LARC was 73.7% and the using rate of LARC at 12 weeks postpartum was 56.9%. Convenience was the most common reason of LARC use at 12 weeks postpartum.
{"title":"Postpartum Long-Acting Reversible Contraception Use in Adolescent at Maharat Nakhon Ratchasima Hospital","authors":"Lalita Songsathaporn, Siraya Kitiyodom","doi":"10.14456/TJOG.2016.2","DOIUrl":"https://doi.org/10.14456/TJOG.2016.2","url":null,"abstract":"Objective: To determine the intention and using of long-acting reversible contraception (LARC) in adolescents in the postpartum period. Material and Method: A prospective cohort study was conducted at Maharat Nakhon Ratchasima hospital, from June 2014 to November 2014. Postpartum adolescents under the age of 20 who willing to participate were enrolled in this study. A structured interview questionnaire was used to determine the intention of contraceptive use prior to discharge. Then, phone interviewed at 12 weeks postpartum to determine contraceptive use and reasons. Results: Three hundred and ninety eight of 456 adolescents had a documented postpartum visit at 12 weeks, giving an overall response rate of 87.3%. 336 adolescents (73.7%) intended to use LARC prior to discharge and 209 adolescents (56.9%) had used LARC within 12 weeks postpartum. The most common reason of LARC use was convenience. Injectable contraception was the most common LARC used that included 54.77% of participants. Intended birth interval and pregnancy desire were significant factor of choosing LARC at postpartum ward. Significant factors associated with using LARC at 12 weeks postpartum were intended birth interval and previous contraception. Conclusions: The intention to use LARC was 73.7% and the using rate of LARC at 12 weeks postpartum was 56.9%. Convenience was the most common reason of LARC use at 12 weeks postpartum.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"26-34"},"PeriodicalIF":0.0,"publicationDate":"2016-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678624","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}
Noochanart Pattanapanyasat, S. Luengratsameerung, Paiboon Charoenchainont
Objective: To compare cervical length at midgestation (18+0 - 23+6 weeks of gestation) between primigravida teenage (<19 years) and adult (≥19 years) pregnant women. Study design: Prospective cohort study Material and methods: A transvaginal ultrasound measurement of cervical length at midgestation was performed in each primigravida teenage or adult pregnant woman who attended our antenatal clinic between June 2014 and February 2015. Cervical length as well as prevalence of shortened cervix (≤ 25 mm) were compared between both groups of women. Results: A total of 44 teenage and 46 adult pregnant women completed the study. The mean cervical length in the teenage group was not significantly different from that in the adult group (34.42 ± 6.71 mm. VS 36.89 ± 7.83 mm; P = 0.112). The prevalence of shortened cervix were also not significantly different between both groups (6.8% VS 6.5%; P = 0.995). Women who had a shortened cervix had a significantly higher prevalence of preterm delivery than those with a normal cervix (83.3% VS 13.1%; P = 0.001). Conclusion: There were no significantly differences in cervical lengths and the prevalence of shortened cervix at midgestation between primigravidae teenage and adult pregnant women.
目的:比较初生少女(<19岁)和成年(≥19岁)孕妇妊娠中期(18+0 ~ 23+6周)宫颈长度。研究设计:前瞻性队列研究材料和方法:对2014年6月至2015年2月在我们产前门诊就诊的每位初潮少女或成年孕妇进行妊娠中期宫颈长度经阴道超声测量。比较两组妇女的宫颈长度和宫颈缩短(≤25mm)的发生率。结果:共有44名青少年和46名成年孕妇完成了研究。青少年组颈椎平均长度(34.42±6.71 mm)与成人组差异无统计学意义。VS 36.89±7.83 mm;P = 0.112)。两组间宫颈缩短的患病率也无显著差异(6.8% VS 6.5%;P = 0.995)。宫颈短的妇女早产的发生率明显高于宫颈正常的妇女(83.3% VS 13.1%;P = 0.001)。结论:初产科少女与成年孕妇妊娠中期宫颈长度及宫颈短缩率无显著差异。
{"title":"Comparison of the Cervical Length during Second Trimester of Pregnancy between Teenage and Adult Primigravidae","authors":"Noochanart Pattanapanyasat, S. Luengratsameerung, Paiboon Charoenchainont","doi":"10.14456/TJOG.2016.7","DOIUrl":"https://doi.org/10.14456/TJOG.2016.7","url":null,"abstract":"Objective: To compare cervical length at midgestation (18+0 - 23+6 weeks of gestation) between primigravida teenage (<19 years) and adult (≥19 years) pregnant women. Study design: Prospective cohort study Material and methods: A transvaginal ultrasound measurement of cervical length at midgestation was performed in each primigravida teenage or adult pregnant woman who attended our antenatal clinic between June 2014 and February 2015. Cervical length as well as prevalence of shortened cervix (≤ 25 mm) were compared between both groups of women. Results: A total of 44 teenage and 46 adult pregnant women completed the study. The mean cervical length in the teenage group was not significantly different from that in the adult group (34.42 ± 6.71 mm. VS 36.89 ± 7.83 mm; P = 0.112). The prevalence of shortened cervix were also not significantly different between both groups (6.8% VS 6.5%; P = 0.995). Women who had a shortened cervix had a significantly higher prevalence of preterm delivery than those with a normal cervix (83.3% VS 13.1%; P = 0.001). Conclusion: There were no significantly differences in cervical lengths and the prevalence of shortened cervix at midgestation between primigravidae teenage and adult pregnant women.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"14-19"},"PeriodicalIF":0.0,"publicationDate":"2016-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66680437","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}
A. Abbas, O. Shaaban, S. Badran, A. Shaltout, A. Nasr, S. A. Abdullah
Objective: The complaint of abnormal vaginal discharge is very common particularly in developing countries with low socioeconomic level as Egypt. The study aims to determine the frequency of vaginal infections among Upper Egypt women with evaluation of the related risk factors and health hazards in addition to study the habit of vaginal douching, its possible relation to vaginal infections. Materials and Methods: A cross sectional observational study was done in Women Health Hospital – Assiut University-Egypt. A trained clinic nurse administered an interview-administered questionnaire to 326 women. Women presented to the outpatient clinic and diagnosed to have any type of vaginal infections were approached for participation. The principle outcome was to study the common predisposing factors, different types of vulvovaginal infection and possible common reproductive hazards. Results: During 6-months’ study period, 3894 patients attended the outpatient Gynecology Clinic, from whom 326 women (8.24%) proved to have vaginal infections. The mean age (±SD) of the study participants was 34.61±9.33 years. The majority of women (89.6%) were housewives, multipara (85.9%), living in rural and semi urban areas (79.5%). Among the study group, candidiasis was the most common type of infection (60.8%). The recurrence rate was high for both bacterial vaginosis “BV” (75.2%) and vulvovaginal candidiasis “VVC” (64.1%). No significant difference between candidiasis and bacterial vaginosis regarding preterm labor, ectopic pregnancy and pelvic inflammatory disease. Conclusions: Vaginal infections are quiet common in our locality with high frequency of recurrence. Vaginal douching is a common practice that may predispose to many reproductive health hazards as preterm labor and pelvic inflammatory disease.
{"title":"Risk Factors and Health Hazards of Vaginal Infections in Upper Egypt: A Cross Sectional Study","authors":"A. Abbas, O. Shaaban, S. Badran, A. Shaltout, A. Nasr, S. A. Abdullah","doi":"10.14456/TJOG.2016.14","DOIUrl":"https://doi.org/10.14456/TJOG.2016.14","url":null,"abstract":"Objective: The complaint of abnormal vaginal discharge is very common particularly in developing countries with low socioeconomic level as Egypt. The study aims to determine the frequency of vaginal infections among Upper Egypt women with evaluation of the related risk factors and health hazards in addition to study the habit of vaginal douching, its possible relation to vaginal infections. Materials and Methods: A cross sectional observational study was done in Women Health Hospital – Assiut University-Egypt. A trained clinic nurse administered an interview-administered questionnaire to 326 women. Women presented to the outpatient clinic and diagnosed to have any type of vaginal infections were approached for participation. The principle outcome was to study the common predisposing factors, different types of vulvovaginal infection and possible common reproductive hazards. Results: During 6-months’ study period, 3894 patients attended the outpatient Gynecology Clinic, from whom 326 women (8.24%) proved to have vaginal infections. The mean age (±SD) of the study participants was 34.61±9.33 years. The majority of women (89.6%) were housewives, multipara (85.9%), living in rural and semi urban areas (79.5%). Among the study group, candidiasis was the most common type of infection (60.8%). The recurrence rate was high for both bacterial vaginosis “BV” (75.2%) and vulvovaginal candidiasis “VVC” (64.1%). No significant difference between candidiasis and bacterial vaginosis regarding preterm labor, ectopic pregnancy and pelvic inflammatory disease. Conclusions: Vaginal infections are quiet common in our locality with high frequency of recurrence. Vaginal douching is a common practice that may predispose to many reproductive health hazards as preterm labor and pelvic inflammatory disease.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"50-56"},"PeriodicalIF":0.0,"publicationDate":"2016-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678937","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: The route of delivery effects on breastfeeding. The LATCH score for assessment of breastfeeding practices have been widely used here in Thailand. LATCH scores greater than 8 correlated with exclusive breastfeeding at six weeks postpartum. Materials and Methods: The subjects were 1,316 normal postpartum primiparous women who delivered without complications and their newborns at the HRH Princess Maha Chakri Sririndhorn Medical Center in the Nakhon Nayok province during the period from January 2010 to April 2013. The mothers were categorized in two groups; those who delivered by cesarean section and those with normal deliveries. At the first day postpartum, both groups of mother were encouraged to breastfeed their infant. The mothers were assessed LATCH scores at the second day postpartum prior to discharge. Telephone follow-ups at the sixth week postpartum period were collected and used for exclusive breastfeeding data collection. Demographic data and exclusive breastfeeding rates were analyzed by the t-test, Chi-square test, Odds ratios with 95% confidence intervals and Logistic regression analysis. Results: The data shows that mean of LATCH scores at the second day postpartum were 7.9 ± 1.7 points in cesarean section group and 8.1 ± 1.3 points in normal delivery group. There were statistical differences between the mean in the two groups. the crude odds ratio and adjusted odds ratio of LATCH scores more than 8 between the cesarean section group as compared with the normal delivery group was 0.67 (95% CI 0.42-0.94) and 0.82 (95% CI 0.690.97). By telephone follow up at the sixth week postpartum the number of exclusive breastfeeding mothers were 369 (56.1%) in cesarean section group and 388 (59.0%) in normal delivery group. The most common of breastfeeding cessation at sixth week postpartum was insufficient breast milk. Conclusion: The mothers with cesarean section deliveries had significantly lower LATCH scores than the mothers with normal deliveries. The adjusted odds ratios of LATCH scores greater than 8 between the mothers with cesarean sections and normal deliveries was 0.8.
目的:探讨分娩路径对母乳喂养的影响。用于评估母乳喂养做法的LATCH评分在泰国被广泛使用。LATCH评分大于8分与产后6周纯母乳喂养相关。材料与方法:研究对象为2010年1月至2013年4月在那空Nayok省Maha Chakri sririnhorn公主医疗中心分娩的1316名无并发症的正常产后产妇及其新生儿。母亲们被分为两组;剖宫产和正常分娩者。在产后第一天，两组母亲都被鼓励母乳喂养婴儿。在产后第二天出院前对母亲进行LATCH评分。收集产后第6周的电话随访，并用于纯母乳喂养数据收集。采用t检验、卡方检验、95%置信区间的优势比和Logistic回归分析人口统计学资料和纯母乳喂养率。结果:资料显示，剖宫产组产后第2天的平均LATCH评分为7.9±1.7分，正常分娩组为8.1±1.3分。两组的平均值有统计学差异。剖宫产组与正常分娩组相比，LATCH评分大于8的粗优势比和调整优势比分别为0.67 (95% CI 0.42 ~ 0.94)和0.82 (95% CI 0.690.97)。产后6周电话随访，剖宫产组纯母乳喂养母亲369例(56.1%)，正常分娩组388例(59.0%)。产后6周停止母乳喂养最常见的原因是母乳不足。结论:剖宫产产妇的LATCH评分明显低于正常分娩产妇。剖宫产母亲与正常分娩母亲的LATCH评分大于8的调整优势比为0.8。
{"title":"Comparison of LATCH Scores at the Second Day Postpartum between Mothers with Cesarean Sections and Those with Normal Deliveries","authors":"Supree Buranawongtrakoon, Pawin Puapornpong","doi":"10.14456/TJOG.2016.6","DOIUrl":"https://doi.org/10.14456/TJOG.2016.6","url":null,"abstract":"Objective: The route of delivery effects on breastfeeding. The LATCH score for assessment of breastfeeding practices have been widely used here in Thailand. LATCH scores greater than 8 correlated with exclusive breastfeeding at six weeks postpartum. Materials and Methods: The subjects were 1,316 normal postpartum primiparous women who delivered without complications and their newborns at the HRH Princess Maha Chakri Sririndhorn Medical Center in the Nakhon Nayok province during the period from January 2010 to April 2013. The mothers were categorized in two groups; those who delivered by cesarean section and those with normal deliveries. At the first day postpartum, both groups of mother were encouraged to breastfeed their infant. The mothers were assessed LATCH scores at the second day postpartum prior to discharge. Telephone follow-ups at the sixth week postpartum period were collected and used for exclusive breastfeeding data collection. Demographic data and exclusive breastfeeding rates were analyzed by the t-test, Chi-square test, Odds ratios with 95% confidence intervals and Logistic regression analysis. Results: The data shows that mean of LATCH scores at the second day postpartum were 7.9 ± 1.7 points in cesarean section group and 8.1 ± 1.3 points in normal delivery group. There were statistical differences between the mean in the two groups. the crude odds ratio and adjusted odds ratio of LATCH scores more than 8 between the cesarean section group as compared with the normal delivery group was 0.67 (95% CI 0.42-0.94) and 0.82 (95% CI 0.690.97). By telephone follow up at the sixth week postpartum the number of exclusive breastfeeding mothers were 369 (56.1%) in cesarean section group and 388 (59.0%) in normal delivery group. The most common of breastfeeding cessation at sixth week postpartum was insufficient breast milk. Conclusion: The mothers with cesarean section deliveries had significantly lower LATCH scores than the mothers with normal deliveries. The adjusted odds ratios of LATCH scores greater than 8 between the mothers with cesarean sections and normal deliveries was 0.8.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"6-13"},"PeriodicalIF":0.0,"publicationDate":"2016-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66680392","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 the effectiveness and side effects of misoprostol as a cervical ripening agent through two different routes of administration before curettage. Materials and Methods: The study employed a hospital based prospective randomized controlled trial. A total of 70 patients were simple random divided in two groups for 400 micrograms sublingual and vaginal administration. The drug was administered 6 hours before dilatation and curettage or fractional curettage. Efficacy was assessed on cervical dilatation achieved, pain score and vaginal blood loss. The tolerable limit was noted based on side effects. Results: The sublingual group had significantly more cervical dilatation than the vaginal group (median cervical dilatation 7 mm vs. 5 mm, P < 0.001). Significantly less pain scores (VAS) in sublingual group than vaginal group (3.3 vs. 4.8, P < 0.001). Postoperative vaginal blood loss in the sublingual group was significantly greater than the vaginal group (20 ml vs. 10 ml, P < 0.001). Other side effects such as fever, chill, nausea, vomiting and diarrhea did not differ in both groups. Conclusion: Sublingual misoprostol could be more effective for cervical dilatation, but presents greater postoperative vaginal blood loss than vaginal route.
目的:比较米索前列醇作为宫颈催熟剂在刮宫前两种不同给药途径的疗效和不良反应。材料与方法:采用基于医院的前瞻性随机对照试验。将70例患者简单随机分为两组，分别给予400微克舌下和阴道给药。本品于扩张刮除或部分刮除前6小时给药。以宫颈扩张程度、疼痛评分和阴道出血量进行疗效评价。可耐受限度是根据副作用来确定的。结果:舌下组宫颈扩张明显大于阴道组(宫颈扩张中位数为7 mm比5 mm, P < 0.001)。舌下组疼痛评分(VAS)明显低于阴道组(3.3比4.8,P < 0.001)。舌下组术后阴道出血量明显大于阴道组(20 ml vs 10 ml, P < 0.001)。其他副作用，如发烧、发冷、恶心、呕吐和腹泻，在两组中没有差异。结论:舌下米索前列醇用于宫颈扩张更有效，但术后阴道出血量大于阴道途径。
{"title":"Comparison of Sublingual and Vaginal Misoprostol for Cervical Ripening before Curettage: A Randomized Controlled Trial","authors":"Sukanya Chamnan, Suttida Intharaburan","doi":"10.14456/TJOG.2016.13","DOIUrl":"https://doi.org/10.14456/TJOG.2016.13","url":null,"abstract":"Objective: To compare the effectiveness and side effects of misoprostol as a cervical ripening agent through two different routes of administration before curettage. Materials and Methods: The study employed a hospital based prospective randomized controlled trial. A total of 70 patients were simple random divided in two groups for 400 micrograms sublingual and vaginal administration. The drug was administered 6 hours before dilatation and curettage or fractional curettage. Efficacy was assessed on cervical dilatation achieved, pain score and vaginal blood loss. The tolerable limit was noted based on side effects. Results: The sublingual group had significantly more cervical dilatation than the vaginal group (median cervical dilatation 7 mm vs. 5 mm, P < 0.001). Significantly less pain scores (VAS) in sublingual group than vaginal group (3.3 vs. 4.8, P < 0.001). Postoperative vaginal blood loss in the sublingual group was significantly greater than the vaginal group (20 ml vs. 10 ml, P < 0.001). Other side effects such as fever, chill, nausea, vomiting and diarrhea did not differ in both groups. Conclusion: Sublingual misoprostol could be more effective for cervical dilatation, but presents greater postoperative vaginal blood loss than vaginal route.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"43-49"},"PeriodicalIF":0.0,"publicationDate":"2016-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678920","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 assess the efficacy of simple clinical maneuver to reduce shoulder pain after gynecologic laparoscopic surgery. Study design: Randomized controlled trial. Method: One hundred and four patients who were scheduled for elective gynecologic laparoscopic surgery were randomly allocated to either the current standard as a control group or to additional efforts to remove residual CO 2 at the end of surgery groups. For 54 patients in control group, CO 2 was removed by passive deflation of the abdominal cavity through the cannula. While in 50 patients in the intervention group, CO 2 was removed by means of Trendelenbrerg position (30 degrees) and a pulmonary recruitment maneuver consisting of 5 manual inflations of lung . Postoperative shoulder pain was recorded on a verbal rating scale (VRS 1-6) at 24, 48 hours after operation. Result: There are no significant differences in age, time of surgery, type of surgery, body mass index between 2 groups except for the postoperative hospital stay (mean,SD) which are 2.5 + 0.57 days in the control group compared to 2.1 + 0.47 days in the intervention group (p < 0.001). Postoperative shoulder pain (VRS 2-6) in first 48 hrs was evaluated. The significant pain is found in11 in 50 patients (22%) in the intervention group compared with34 in 54 patients (63%) in the control group (p < 0.001). Conclusion: This simple clinical maneuver can reduce the number of patients complaining of shoulder pain after Gynecologic laparoscopic surgery with statistical significance.
{"title":"Simple Clinical Maneuver for Reducing Shoulder Pain Following Gynecologic Laparoscopic Surgery at Maharat Nakhonratchasima Hospital: A Randomized Controlled Trial","authors":"Chatchai Jantaweetip","doi":"10.14456/TJOG.2016.15","DOIUrl":"https://doi.org/10.14456/TJOG.2016.15","url":null,"abstract":"Objective: To assess the efficacy of simple clinical maneuver to reduce shoulder pain after gynecologic laparoscopic surgery. Study design: Randomized controlled trial. Method: One hundred and four patients who were scheduled for elective gynecologic laparoscopic surgery were randomly allocated to either the current standard as a control group or to additional efforts to remove residual CO 2 at the end of surgery groups. For 54 patients in control group, CO 2 was removed by passive deflation of the abdominal cavity through the cannula. While in 50 patients in the intervention group, CO 2 was removed by means of Trendelenbrerg position (30 degrees) and a pulmonary recruitment maneuver consisting of 5 manual inflations of lung . Postoperative shoulder pain was recorded on a verbal rating scale (VRS 1-6) at 24, 48 hours after operation. Result: There are no significant differences in age, time of surgery, type of surgery, body mass index between 2 groups except for the postoperative hospital stay (mean,SD) which are 2.5 + 0.57 days in the control group compared to 2.1 + 0.47 days in the intervention group (p < 0.001). Postoperative shoulder pain (VRS 2-6) in first 48 hrs was evaluated. The significant pain is found in11 in 50 patients (22%) in the intervention group compared with34 in 54 patients (63%) in the control group (p < 0.001). Conclusion: This simple clinical maneuver can reduce the number of patients complaining of shoulder pain after Gynecologic laparoscopic surgery with statistical significance.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"24 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2016-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66678989","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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