Prevalence of climacteric symptoms according to years after menopause.

OBJECTIVE: To study the prevalence of menopausal symptoms of women attending the menopause and gynecology clinics at Chulalongkorn Hospital. STUDY DESIGN: A descriptive study was conducted at the menopause and gynecology clinics at Chulalongkorn Hospital. After inclusion and exclusion were done, four hundred and twenty seven participants with premenopause, perimenopause and postmenopause were studied. All the women were classified into seven groups of premenopause, perimenopause and one, two, three, four and > or =five years after menopause. The interview was performed by well-trained social workers using standardized questionnaires. RESULTS: The average age at menopause of the postmenopausal women was 49.46 + 3.30 years. Prevalence of vasomotor symptoms eg. hot flushes in premenopause, perimenopause and one, two, three, four and > or =five years after menopause were 4.4 per cent, 25 per cent, 27.3 per cent, 38.8 per cent, 40 per cent, 11.1 per cent and 10.3 per cent, respectively. Prevalence of psychological symptoms eg. moodiness were 26.5 per cent, 25 per cent, 54.6 per cent, 38.7 per cent, 32.2 per cent, 11.2 per cent and 11.8 per cent, respectively. But the prevalence of headache in this category was 29.4 per cent, 23.3 per cent, 23.7 per cent, 22.6 per cent, 25.0 per cent, 11.1 per cent and 13.2 per cent, respectively. Prevalence of urinary symptoms seemed to increase continuously after menopause. Prevalence of genital symptoms eg. vaginal dryness were 5.9 per cent, 13.3 per cent, 25.5 per cent, 25.8 per cent, 15.0 per cent, 16.7 per cent and 20.6 per cent, respectively. Prevalence of other symptoms eg. muscle and joint pain were 22.1 per cent, 43.3 per cent, 56.4 per cent, 58.0 per cent, 45.0 per cent, 27.8 per cent and 28.0 per cent, respectively. CONCLUSION: The prevalence of menopausal symptoms in this postmenopausal group appeared to increase during the first and second years after menopause and tended to decrease afterwards. The prevalence of other symptoms eg. dry eyes and headache appeared to be unchanged after menopause.

Pregnancy in amniotic band scarred woman.

Amniotic band syndrome is an uncommon syndrome. The incidence is 1:1,200-1:15,000 live births. This syndrome is variable malformation. Amniotic band scar of the abdomen seen in adulthood is rare. We managed a case of a 23 year-old pregnant woman who had suspected amniotic band scar of the abdomen since birth. The uterus could expand until term pregnancy despite no intervention. The healthy female baby was delivered by cesarean section because of obstetric indication. Both mother and baby were in good condition. She and her baby were well at six weeks follow-up. We know of no other reported case of maternal abdominal amniotic band scar who could continue pregnancy until term with good outcome.

Outcome of preterm premature rupture of membranes.

OBJECTIVE: To study the incidence and outcome of preterm premature rupture of membranes (PPROM). DESIGN: Cross-sectional study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University. SUBJECTS: Ninety five PPROM women who were expectant management and delivered between January 1, 1997 and December 31, 1997. RESULTS: The incidence of PPROM was 7.2 per 1000 deliveries. There were 51 women in the gestational age group at or below 34 weeks and 44 women in the gestational age group above 34 weeks. Gestational age, total antenatal care visits, total weight gain and neonatal birth weight were significantly lower in the gestational age group at or below 34 weeks (p < 0.05). Abnormal delivery, maternal and neonatal complications were significantly more common in the gestational age group at or below 34 weeks (p < 0.05). Total maternal and neonatal hospital-stay comprised significantly more days in the gestational age group at or below 34 weeks (p < 0.05). CONCLUSION: Maternal and neonatal outcome were more unfavorable in the gestational age group at or below 34 weeks of PPROM. Expectant management should intervene at the gestational age at or below 34 weeks of PPROM due to unfavorable maternal and neonatal outcome.