Diagnostic laparoscopy of subfertile women of non demonstrable causes.

From 1983 to 1987, seventy-five subfertile women of non demonstrable causes in the Infertility Unit, Department of Obstetrics & Gynaecology at the Siriraj Hospital, Mahidol University had diagnostic laparoscopy. Thirty-five of seventy-five subfertile women (46.66%) had pelvic pathologies which were not suspected by clinical examination. The two common pathologies of subfertile women of non demonstrable causes were pelvic inflammatory diseases (18.6%: pelvic and peritubal adhesion) and mild endometriosis (16%). Pathophysiology of subfertile women with chronic pelvic inflammatory disease was mainly due to disturbances of tubal ovarian anatomy and function. The possible mechanism of mild endometriosis which may interfere with pregnancy was discussed in the text. The results of this study indicated that diagnostic laparoscopy should be performed in all subfertile women of non demonstrable causes to find out the pelvic pathology in order to correct the causes of infertility.

A prophylactic supplementation of iron and folate in pregnancy.

The supplementation of iron and folic acid were studied in 567 pregnant women with 18 and 26 weeks of gestation. Sixty mg and 180 mg of iron were given daily to pregnant women of group I and group II respectively while 180 mg of iron and 5 mg folic acid were given to group III. The Hb values increased significantly in group II and III after supplementation for 1 1/2 months, however if supplementation was extended for 3 months, highly significant increase in Hb levels were observed in all these groups. These findings indicated that in supplementation for a shorter period, i.e. 1 1/2 months at least 180 mg of iron was needed, and only 60 mg of iron was sufficient to increase Hb levels for a supplementation of 3 months. Vitamin B12 deficiency was not detected in pregnant women both before and after supplementation with iron and iron plus folate for 3 months. It was suggested therefore that perhaps it was not necessary to supplement vitamin B12 to Thai pregnant women. In this study 15% of pregnant women had low serum folate with normal red cell folate level, and a greater number of women with low serum folate concentrations were observed after supplementation with iron alone for 3 months. However, increased serum folate and red cell folate levels after supplementation with 5 mg folic acid indicated that some pregnant women needed folate supplementation in preventing folic acid deficiency during pregnancy.