Indications for cesarean section at Thammasat University Hospital.

OBJECTIVE: To present the indications associated with the increase in cesarean section rate at Thammasat University Hospital during the past three years. MATERIAL AND METHOD: This was a cross-sectional study. Pregnant women who underwent cesarean section between January 2003 and December 2005 at Thammasat University Hospital were recruited for the present study. Cases of fetal anomaly or intrauterine fetal death were excluded. Demographic and obstetric data including indications of cesarean section and pregnancy outcomes were collected and analyzed RESULTS: Among the 1328, 1402, and 1522 cases of cesarean section (27.31, 27.94, and 29.26%) in 2003, 2004 and 2005 respectively, the major indication was previous cesarean section (29%). Cephalopelvic disproportion (CPD), and elective cesarean section were second, and third most common indication (24.64%, 11.23%) respectively. CONCLUSION: The increasing cesarean section rate was due to rising of elective cesarean section or patient's request. Cesarean section without obstetric indication should be reconsidered to lower the cesarean section rate.

The efficacy of ginger in prevention of postoperative nausea and vomiting after major gynecologic surgery.

OBJECTIVE: To study the efficacy of ginger in prevention of nausea and vomiting after major gynecologic surgery. STUDY DESIGN: Double blind randomized controlled trial. SETTING: Department of Obstetrics and Gynecology, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, 12120, Thailand. MATERIAL AND METHOD: From March 2005 to April 2006, 120 patients who underwent major gynecologic surgery were randomized into group A (n = 60) and group B (n = 60). The patients in group A received two capsules of ginger taken one hour before the procedure (one capsule contains 0.5 gram of ginger powder). The patients in group B received the placebo. The visual analog nausea score (VANS) and frequency of vomiting were evaluated at 0, 2, 6, 12, and 24 hours after the operation. RESULTS: The results demonstrated the statistically significant differences in nausea between group A (48.3%) and group B (66.7%). The VANS was lower in group A compared to group B at 2, 6, 12, and 24 hours. The most statistically significant differences occurred at 2 and 6 hour. The incidence and frequency of vomiting in group A were lower than group B. Side effects caused by ginger were not detected. CONCLUSION: Ginger has efficacy in prevention of nausea and vomiting after major gynecologic surgery.