Primary ovarian cancer: A five-year review.

This retrospective study reports on 187 cases of ovarian carcinoma treated at Siriraj Hospital over five-year period from 1988-1992. The incidence was 17.6% of all ovarian tumors. Common epithelium was the most common group found in this study (85%). A total of 9.1% of the patients were in the germ cell group and the rest were in the stromal cell group (5.9%). The mean ages of the common epithelium germ cell and stromal cell groups were 47.5+14, 28.6+17.4 and 56.9+18.3 years respectively. The common presenting symptom was either abdominal mass (40.1%) or abdominal bloating (32.6%). The tumors, which developed in nearly three-fourths of the patients (72.2%), were between 6.20 cm in greatest diameter. Serous, dysgerminoma and granulosa cell tumors were the most common cell types found in the common epithelium, germ cell and stromal cell groups respectively. Half of the patients (50.8%) were in an advanced stage of the disease and radical surgery was performed in 62.3% of the patients.

Incidence and risk factors of emergency cesarean hysterectomy.

To identify risk factors associated with emergency cesarean hysterectomy at Siriraj Hospital, medical records of 93 patients who underwent emergency cesarean hysterectomy from January 1986 through December 1995 were retrospectively compared with those of 372 selected controls who underwent cesarean section at the time close to the first group (case : control = 1:4). The incidence of emergency cesarean hysterectomy during the period was 4.07 / 1,000 cesarean sections. Multivariable analysis revealed that age > 35 years (OR=9.7,95% CI : 3.7-24.9), placenta preview (OR = 4.8, 95% CI : 2.2-10.6), age 31-34 years (OR=4.3,95% CI : 1.7-11.3) and parity >3 (OR=3.4,95% CI : 1.6-7.1) were independent factors significantly associated with emergency cesarean hysterectomy (P<0.01). Emergency cesarean hysterectomy remains a necessary procedure for life saving during abdominal delivery. Identification of patients at risk, knowledge of this operation and skill at its performance can be very helpful in reducing maternal morbidity and mortality.