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Objective: To determine the prevalence of pregnancy with placenta previa in Siriraj Hospital. Methods: This study conducted a retrospective review of in-patients medical records of a total of 843 singleton deliveries in Siriraj Hospital with gestational age ≥28 weeks during January to February 2009. Data on baseline characteristics of pregnant women, pregnancy course and the outcomes during delivery were collected. Placenta previa was diagnosed by ultrasonographgy and /or direct visualization of placental location during cesarean section. Results: The mean age of the population was 28.4 ± 6.0 years old. Most of these delivered at term gestation (87.4%). The modes of delivery were normal vertex delivery, emergency cesarean section and elective cesarean section which presented in 60.5%, 26.5% and 12.1% of pregnancies respectively. The prevalence of placenta previa was 0.7% (6/843). The factor significantly associated with placenta previa was previous uterine curettage (p = 0.001). The significant outcomes of pregnancy with placenta previa were maternal blood loss >500 mL (P = 0.008) and baby’s APGAR score at 1st minute ≤7 (p = 0.006). Conclusion: The prevalence of pregnancy with placenta previa in Siriraj Hospital was 0.7%.
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Objective: To determine the prevalence and explore the knowledge, attitude and practice of using feminine hygiene products in Thai women. Methods: A survey was conducted between May and August 2009 in 400 Thai women between the ages of 20-35 who attended at Siriraj Gynecological clinic. Questionnaires dealing with knowledge, attitudes and practice were completed and data were collected and analyzed. Results: The mean age of participants was 28.5 + 4.2 years. The prevalence of participants who have ever used feminine wash and vaginal douche were 70.5% and 14.25%, respectively. To get rid of an unpleasant odor, and feeling clean and fresh were the most common reasons for using both products. The most common timing of using feminine wash was after period, after bath and when having unpleasant odor, whereas having leucorrhea and unpleasant odor were noted in vaginal douche group. Significant association between use of vaginal douche and an experience of sexual intercourse was observed (P < 0.05). Conclusion: Use of feminine hygiene products, especially feminine wash, was quite popular in Thai women. To get rid of unpleasant odor as well as to feel clean and fresh were common reasons for using this product. Recommendations by gynecologists about appropriate use of feminine hygiene products should be carefully considered in daily practice.
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Objective: To explore the risk factors of primary postpartum hemorrhage (PPH) in pregnant women who delivered at Siriraj Hospital. Methods: The medical records of pregnant patients who delivered vaginally at Siriraj Hospital during January 1st to December 31st, 2005 were enrolled into 2 groups. The study group was singleton pregnancy with primary PPH and the control group was sandwich singleton pregnancies who delivered without PPH. The ratio between the study and the control group was 1:2. Baseline characteristics and obstetrics data of each group were collected. Descriptive statistics, independent sample t-test, odds ratio, 95% confidence interval and multiple linear regression analysis were used in this study. Results: A total number of 222 medical records were reviewed. The number of the patients in the study group and control group were 74 and 148, respectively. By multiple linear regression analysis, the data revealed that prolonged third stage of labor and pregnancy induced hypertension were the significant risk factors related to primary PPH (P <0.05, 95%CI 0.2-0.65 and 0.01-0.47, respectively). The three most common causes of primary PPH in the study group were uterine atony (77.03%), birth passage injury (24.32%) and retained pieces of placenta (20.27%), respectively. Conclusion: The significant risk factors of primary PPH in this study were prolonged third stage of labor and pregnancy induced hypertension. Uterine atony, birth passage injury and retained pieces of placenta were the next most common causes of primary PPH.
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OBJECTIVE: To evaluate the correlation between assessment of postvoid residual urine by transabdominal ultrasound and catheterization in patients after radical or transvaginal hysterectomy. MATERIAL AND METHOD: A cross-sectional study was conducted and 46 patients were enrolled after they had radical and transvaginal hysterectomy. After surgery, urinary catheter was indwelled. After catheter removal and the 3rd private voiding, the patients were sent for transabdominal ultrasound assessment of PVR at the Division of Maternal-Fetal Medicine. Complete drainage of bladder with standard catheterization was then performed and catheterized urine volume was recorded. PVR was calculated from previously published equation and compared with actual PVR from catheterization. RESULTS: Mean age of the patients was 55.9 years. The most common diagnoses were procidentia uteri (23.9%), Carcinoma of cervix stage 1b1 (23.9%), and prolapsed uteri grade 2 (21.7%). Radical hysterectomy with pelvic node dissection and vaginal hysterectomy with anterior colporhaphy and posterior colpoperiniorhaphy was performed each in 50% of cases. Mean duration of urinary catheter indwelling was 7.17 days for those underwent radical hysterectomy and 5 days for vaginal hysterectomy. The calculated PVR was significantly correlated with catheterized urine volume with correlation coefficient 0.93 (p < 0.001). If the usual cutoff of PVR > 100 ml was used to determine the necessity of re-indwelling catheter, among those with calculated PVR from ultrasound measurement < 100 ml, still 30% actually had actual PVR of > 100 ml. Among those with calculated PVR from ultrasound measurement >100 ml, all actually had actual PVR of > 100 ml. CONCLUSION: PVR estimation by ultrasound significantly correlated with actual PVR. This could reduce the process of repeat catheterization and give more comfort to the patients when the PVR is > 100 ml.