Adolescent counselling service

 A project on health education and heallh services regarding human reproduction and contraception among adolescents was carried out in 1987-1988.  It was conducted by the family Planning Unit of the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, with the support of the United Nations Population Fund.  The project design was a longitudinal, prospective study.  A total of 5,651 students (2,875 male and 2,776 female) from three vocational schools in Khon Kaen were recruited as the target population, ranging in age from 15 to 26 years.  For the health services, special adolescent clinics were set up in schools, in Khon Kaen City and in Srinagarind (University) Hospital.  A total of 761 students (13.5%) in the project used the services.  Seventy-five percent of the students who came to the clinics came for counselling on sex-related health matters and 25% for general health.  Males came twice as often as females.  Forty-one percent of the students requested birth control, 16.1% came for sexually-transmitted disease treatment and 9% came for counselling on unwanted pregnancies.  Fewer students living with their families (parents) came for health counselling than those living independently.

Screening for Rubella Antibodies in Normal Pregnant Women and Active Immunization Program in Post Partum Period, A Cost

 During the period from January 1989 to June 1989, 586 normal pregnant women who came for first visit at antenatal care unit, Srinagarind Hospital were screened for rubella antibodies.  Rubella hemagglutination inhibition antibody technique was used to detect maternal rubella antibody.  56.7 Percents of them were non immune.  Occupation, geographic distribution and general health were statistically significance factors (P

Prenatal diagnosis of microcephaly with fronto-ethmoidal Meninggoencephalocele by ultrasound – A case report

 Microcephaly is a congenital anomaly of the central nervous system.  It’s effect on the fetus depends on the severity and the causes.  Other associated malformations are important prognostic factors.  Microcephalus means the head circumference is equal or less than 3 standard deviations below the mean.  However only 14% of all microcephalic infants diagnosed by the first year of age had been detected at birth.  Both genetic and environmental factors are involved in the causes of this anomaly.  At present time prenatal diagnosis by ultrasound makes much more progress in Medicine.  Measurement of the fetal head by ultrasound helps to make the diagnosis of microcephaly and screening for other associated anomalies.  The earlier onset of microcephaly has the more severe mental retardation.  If the diagnosis is made before viability,  the option of termination of pregnancy should be considered.  A case of microcephalic fetus with frontoethmoidal meningoencephalocele was diagnosed in antepartum period by ultrasound at 27 weeks of gestation.  After counseling process, termination of pregnancy was performed without any complications.

The Normal Fetal Biparietal Diameter Against Week of Gestation in Normal Pregnant Women at Srinagarind Hospital

\ The fetal biparietal diameters (BPD) between 12th and 40th weeks were measured by two ultrasonologists, using a Hitachi model 50 A, at Srinagarind Hospital during October 1987-March 1990.\  The measurements that were confirmed gestational age by paediatricians after births were 565 occasions in 409 newborns.\  The gestational ages were based on the history of the last menstrual period and the correlated fundal height.\  No medical, surgical or obstetrical complication was found during these pregnancies.\  The mean increase in the BPD between the 12th and 28th weeks, the 29th and 35th weeks, the 36th and 39th weeks were 3.16  0.9, 1.95  1.2 and 0.61  0.6 mm./mk. respectively.\  The growth of BPD in this study followd the curves similar to those in Western countries in the third trimester.\  The growth of BPD in this study compared with in country study was similar to Chula\’s study but it was more than Health Promotion Center 4\’s study.\ 

Return of ovulation at first post partum visit

 During the period from December 1986 to Agust 1987, 224 women who attended the post partum clinic, at Srinagarind Hospital were-studies.  Their ages ranged from 15-40 years old with the majority between 21-25 years, Most of them were primipara, farmers and had less than primary school education Endometrial samplings were taken at the first post partum visit.  Most of them were lactating and had adequate mount of breast milk.  However 19.64 percents of them already had menstruation and 30.80 percents had sexual intercourse before post partum check up.  Sexual intercourse mostly began at 1 month post parturition.  Endometrial biopsy revealed ovulation in only 1 case which was at 43 days after delivery.

Clinical Characteristics of Pregnant Women with Anencephalic Fetuses In Srinagarind Hospital and Problems in Management

 Retrospective study of pregnant women with anencephalic fetuses in Srinagarind hospital from July 1977 to December 1987 revealed the total of 28 cases. The incidence of anencephalic fetus was 1 L776 births. Maternal age ranged from 19-38 years with the majority between 26-30 years, in gravida 1 and parity 0. All of the patients had attended antenatal care and most of them were private cases, Thai ethic and lived in KhonKaen Province. The gestational ages at the times of termination of pregnancy varied widely. Prenatal diagnosis of these anmalies could be made in only 46.4% of the patients by using radiographic examination in the majority of cases. The cesarean cases were unable to diagnose rate in these patients was 21.4%. All of the cesarean cases were unable to diagnose prenatally due to unawareness of this condition. The most common obstetric complication was polyhydrammios. Female to male ratio was 1 : 1.45. The biggest anencephalic fetus weighed 3,370 grams. Some of anencephalic fetuses also had another associated anomalies.

Prenatal diagnosis of anencephaly by ultrasound : Two cases report

 Anencephaly was a lethal congenital anomalies of the central nervous system. The cerebral hemisperes were either rudimentary or absent and absence of the overlying skull. Both genetic and environmental factors were involved in the causes of these anomalies. It caued several obstetric complications in antepartum, intrapartum and post partum periods. Two cases of anencephalic fetuses were diagnosed in antepartum period by ultrasound at 25 and 18 weeks of gestations respectively. Termination of pregnancies were done without any complications.

Use of Ultrasound in Obstetrics and Gynecology

 Ultrasound has been used in diagnostic and therapeutic medicine for 30 years.  Its improvement results in much progress in Obstetrics and Gynecology.  Ultrasound can demonstrate pelvic organ, fetus and fetal movement so anatomy and physiology can be studied at the same time.  Until now, no side effect to the fetus or female genital organ can be found.

Emergency Contraception (Postcoital Contraception)

no abstract

Teenage Pregnancy

no abstract