ABSTRACT
We report 3 cases of advanced cervical cancer with intractable vaginal bleeding. They had all been initially managed by vaginal packing which had failed on 2 occasions. In all cases, bleeding could be controlled by a collagen fleece coated with fibrin glue (Tacho Combฎ) without adverse side effect. Applying a collagen fleece coated with fibrin glue may be an alternative method of bleeding control in selected patients.
ABSTRACT
Cervical pregnancy is a rare, life-threatening from of ectopic pregnancy. Early diagnosis and conservative treatment can preserve the uterus, especially in young women. This report discusses a case of cervical pregnancy treated by combined conservative methods.
ABSTRACT
The retrospective study outcome of the ovarian epithelial cancer stage I-II treated in Obstetrics and Gynaecological Department, Siriraj Hospital during June 1989 – June 1997, received postoperative chemotherapy cyclophosphamide plus cisplatinum (CP) or cyclophosphamide plus carboplatin (C-CP). Stage I disease of unfavourable prognosis 66 cases treated with CP and 25 cases of C-CP, achieved the 5-years disease free survival 82% and 86% respectively (P>0.05). Stage II disease of CP group, 21 cases and C-CP group, 7 cases achieved the 5-years disease-free survival 80% and 82% respectively (P>0.05). The toxicities of chemotreatment were manageble.
ABSTRACT
A randomized double blind clinical trial was carried out at Siriraj Hospital in order to compare the occurrence of vaginal vault granulations between vaginal vault closure, using interrupted figure-of-eight and interlocked continuous sutures with chromic catgut. Eight healthy patients who underwent total abdominal hysterectomy for benign conditions were randomly assigned to one of the two studied techniques. Six weeks after the operation, the patients were examined blinded to see whether there were vaginal vault granulations. The characteristics of both study groups were comparable. The incidence of vaginal vault granulations in patients was 41.2 percent. The granulations occurred in 27.5 percent in the interlocked continuous and 55 percent in the interrupted figure-of-eight suture group (P<0.05). In patients with vaginal vault granulation, 90.9 percent had abnormal vaginal discharge and/or bleeding, while those without did not (P<0.01). Closure of the vaginal vault with interlocked continuous sutures should be employed in cases of total abdominal hysterectomy in order to decrease the occurrence of vaginal vault granulations later on.
ABSTRACT
Cesarean section rates have increased markedly in many centers all over the world in the past 20 years. A retrospective analysis was made using the obstetrics data from one teaching hospital in Bangkok in order to see trends in cesarean section and perinatal mortality during the years 1980-1990. We analysed the annual cesarean section rate, the perinatal mortality rate, and the major indications for cesarean section. Z-test was used to investigate statistical significance. There was a significant increase in the primary cesarean section rate, the repeated cesarean section rate and the total cesarean section rate in the year 1980-1987. After 1987, the rates reached a plateau until December, 1990. Cephalo-pelvic disproportion, breech presentation and fetal distress were the three leading causes of cesarean section in this study. There were significant increase in cephalopelvic disproportion and fetal distress in the second half of the decade compared with the first half. Breech presentation at the time of delivery slightly increased during this time without statistical significance. Perinatal mortality rate decreased significantly from an average of 13.53 between 1980-1984 to 11.12 between 1985-1990. Increasing vaginal birth after cesarean section may be an important means to reduce the cesarean section rate by decreasing the repeated cesarean section rate. This practice has been reposted to lower cesarean section rates in many centers.