Maternal death in Siriraj Hospital: A 25-year review.

The medical record of 465,086 deliveries at Siriraj Hospital between the years 1974-1999 were analyzed in order to estimate the maternal mortality ratio and to identify the types and causes of maternal death. There were a total of 137 maternal deaths. The overall mortality ratio for the period was 29.61 per 100,000 live births. The maternal mortality ratio showed a downward trend year by year but has remained rather stable over the last 15 years. Direct maternal death, 73.72%, was the most common cause of maternal death followed by indirect maternal death (20.44%) and non maternal death (5.84%) respectively. Obstetric infection was the most common causes of direct maternal death while cardiac disease was the most common cause of indirect maternal death. Non maternal death did not play significant role in maternal mortality since it contributed a very small proportion and was mostly due to malignancy at various sites. Increasing maternal age showed a correlation with an increasing maternal mortality ratio while maternal parity showed a different pattern. The findings of this study will help us to plan policies to reduce the maternal mortality ratio in the future.

Colpocytologic study by ink staining technique for assessing ovulation.

Vaginal smears were taken from women who came for artificial insemination using donor’s semen, to assess the time of ovulation. The smears were obtained from the upper 1/3 of the lateral vaginal wall, and immediately placed in a staining bottle containing sheaffer ink sulution. The slides were examined under light microscope, and the eosinophillic index (E.I.) were recorded. The result of the study of 78 cycles demonstrated that 59 in 65 cycles (90.8%) which were evaluated between 3 days before and 2 days following ovulation showed the E.I. over 50. Vaginal smears from 2 normal menstruating women were also examined daily, and the peak of E. I. Was clearly over 50 at the time of ovulation. The E.I. values of this technique were compared to the maturation index which stained by Papanicolaou method, and good correlation was recognized. We concluded that the colpocytologic study ink staining technique is simple, rapid, and inexpensive. It can be used reliably with other methods to assess the time of ovulation.