Preoperative and postoperative agreement of histopathological findings in cases of endometrial hyperplasia.

OBJECTIVE: To determine agreement of preoperative and postoperative histopathology of endometrial hyperplasia (EH). MATERIALS AND METHODS: Histopathology of specimens obtained by curettage and hysterectomy within 1 year was retrospectively compared by a skilled gynecological pathologist. Patients who received hormone therapy were excluded. RESULTS: Of 79 women with a preoperative diagnosis of EH, only 32 were diagnosed as EH from hysterectomy specimens. There was no endometrial cancer. The agreement between preoperative and postoperative histology did not achieve statistical significance (Kappa 0.011). Postoperative histopathology was more severe than preoperative diagnosis in 5 (6.3%) patients, including 3 preoperative diagnoses of simple hyperplasia without atypia, 1 simple hyperplasia with atypia, and 1 complex hyperplasia without atypia. CONCLUSIONS: For EH diagnosed by curettage, we can be sure of the diagnosis. However, 6.3% had more severe histology from hysterectomy specimens. Thus, repeated curettage or other investigations should be reconsidered in women with recurrent bleeding.

Effectiveness of intravenous meperidine for pain relief in the first stage of labour.

OBJECTIVE: To determine the effectiveness and side effects of intravenous meperidine in labour pain relief. MATERIAL AND METHOD: A double blind, randomized controlled trial was conducted in 84 parturients, using normal saline as control. Visual analogue scale, postpartum parturients' opinion of effectiveness, sedative scores, nausea/vomiting, dizziness, delivery method, Apgar scores, and naloxone prescription were assessed. RESULT: There were no statistically significant differences between the mean and median of visual analogue scale of meperidine and control group. In addition, the sedative scores, nausea/vomiting and dizziness in the meperidine group occurred more than those in the control group significantly. Even mean of the pain increment in the meperidine group was less than those in the control group (p < 0.05). The parturients' opinion on the effectiveness of pain relief during labor within 24 hours of the first postpartum day was only 23.80 per cent in the meperidine group, however, it was statistically significantly different when compared to 7.10 per cent in the control group. CONCLUSION: Intravenous meperidine exhibited the effectiveness of pain relief of only 23.80 per cent of the subjects, in addition, it may cause many side effects.

Comparison of the accuracy of ultrasonic fetal weight estimation by using the various equations.

OBJECTIVE: To compare the accuracy of ultrasonic fetal weight estimation using the Hadlock's, Shepard's, Tongsong's and Hansmann's equations. MATERIAL AND METHOD: The analytical-cross sectional study was conducted on 102 pregnant women who were admitted for delivery in the Labor Room at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University between January 1, 1999 and June 30, 1999. The fetal parameters, including biparietal diameter, abdominal circumference, transverse trunk diameter and femur length, were measured by ultrasound. The estimated fetal weight was calculated by those four equations. The mean absolute error was calculated from the absolute of the difference between the estimated fetal weight and the actual birth weight. RESULTS: The mean absolute error and standard deviation of the estimated fetal weight by the Hadlock's, Shepard's, Tongsong's and Hansmann's equations were 8.09 +/- 4.18, 7.94 +/- 4.63, 7.77 +/- 3.70 and 7.83 +/- 4.35 per cent respectively and there were no statistically significant differences at 95 per cent confidence interval (p>0.05). CONCLUSION: Apart from having comparable accuracy in the estimation of fetal weight to those of Hadlock, Shepard and Tongsong, Hansmann's equation employed at Srinagarind Hospital was more convenient to use than the others.

Knowledge-attitude-practice of sexual intercourse of post-menopausal women using hormone replacement therapy.

OBJECTIVE: To study knowledge, attitude, practice and concern related to sexual intercourse of post-menopausal women using hormone replacement therapy. MATERIAL AND METHOD: One hundred and thirty subjects were included in the study from the 1st of May 2000 to the 31st of August 2000 at the Menopause Clinic, Srinagarind Hospital, Khon Kaen. All subjects were interviewed by a researcher with structured questionnaires. RESULTS: Sixty seven per cent of the subjects had an acceptable level of knowledge, whereas, 87.7 per cent thought that they could have sexual intercourse similar to what they had in their pre-menopausal period. It was found that 85.4 per cent and 88.5 per cent of the subjects had either less or absent sexual desire and less sexual activity, respectively. In terms of their concern, 73.9 per cent of the subjects were not worried about sexual intercourse. CONCLUSION: The majority of the post-menopausal women using hormone replacement therapy had a good level of knowledge and attitude concerning sexual intercourse. Although most of them had decreased sexual desire and activity, this sexual activity did not cause them concern.