Effectiveness of recombinant activated factor VII (rFVII a) for controlling intractable postpartum bleeding: report of two cases and literature review.

BACKGROUND: Recombinant activated factor VII is used for the treatment in patients with inherited or acquired hemophilia with inhibitors and congenital factor VII deficiencies. OBJECTIVE: Using recombinant activated factor VII in primary postpartum hemorrhage. MATERIAL AND METHOD: Two cases of women who had postpartum hemorrhage and were treated with recombinant activated factor VII after all conventional treatment failed. RESULTS: The intractable hemorrhage stopped after treatment with recombinant activated factor VII CONCLUSION: The present report showed that massive postpartum hemorrhage that failed to all procedures was controlled successfully by recombinant activated factor VII.

Impact of stress urinary incontinence and overactive bladder on quality of life in Thai women attending the urogynecology clinic.

OBJECTIVE: To investigate the impact of stress urinary incontinence (SUI) and overactive bladder (OAB) on the quality of life (QOL) using disease specific health-related QOL questionnaire. MATERIAL AND METHOD: Three hundred and nineteen women with SUI and/or OAB, attending the urogynecolgy clinic, Ramathibodi Hospital were recruited in the present study. Information on QOL was collected, using the Thai version of modified incontinence-specific quality of life questionnaire (I-QOL) and short form incontinence impact questionnaire (IIQ-7). RESULTS: In 319 cases, the diagnosis of SUI, OAB, and both were 55 cases, 78 cases, and 186 cases, respectively. There was no statistically significant difference in patients' characteristics in three groups. The patients with both SUI and OAB showed significantly lower scores in all domains of I-QOL than the SUI and OAB groups, whereas QOL, assessed by IIQ-7, showed significant impairment in the combined SUI and OAB group, only in the emotional health domain. CONCLUSION: Stress urinary incontinence and overactive bladder have a detrimental impact on patient health-related QOL. Women with a combination of SUI and OAB have the greatest impairment in QOL.

Lower urinary tract symptoms in Thai women attending the menopause clinic: prevalence and associated factors.

OBJECTIVE: To determine the prevalence of lower urinary tract symptoms and associated factors in women attending the menopause clinic. METHOD: Nine hundred and fifty-six women attending the menopause clinic, Ramathibodi Hospital were interviewed regarding their general health issues and lower urinary tract symptoms by means of an anonymous questionnaire. Demographic data, obstetric history, and underlying diseases were analysed by using Student t-test, Chi-square and Fisher exact test. P < 0.05 was considered as a level of significance. RESULTS: A total of 956 women, mean age 52.89 +/- 5.80 years, completed the questionnaire. The prevalence of stress incontinence, nocturia, urgency, frequency, and urge incontinence were 58.3%, 40.3%, 33.9%, 22.7%, and 6.6%, respectively. Lower urinary tract symptoms was found to be associated with marital status, coexisting medical diseases, menopausal status, previous term delivery, and vaginal delivery (P < 0.05). CONCLUSIONS: Lower urinary tract symptoms was a common problem among women attending the menopause clinic. Marital status, coexisting medical diseases, menopausal status, parity, and mode of delivery were associated with this problem.

Alleviation of the climacteric symptoms with oral sequential hormone replacement therapy.

The efficacy of the oral hormone replacement therapy (HRT) preparation estradiol valerate/levonorgestrel (EV/LNG, Klimonorm) in the alleviation of the menopausal complaints of peri- and postmenopausal Thai women was studied in a prospective, open, uncontrolled phase IV clinical trial. Of the 50 peri- or postmenopausal women screened, 39 completed the study. From them 31 were postmenopausal and 8 perimenopausal. The participants received EV/LNG over a period of 6 cycles. The Menopause Rating Scale II (MRS II) was used to assess the effect of EV/LNG on the menopausal symptoms. The changes in the main parameters of the MRS II during the treatment with EV/LNG showed that the general score decreased by 34.9 per cent after 3 months and was kept at the same value after 6 months of treatment. The somato-vegetative complaints decreased by 32.5 per cent after 3 months and by 35 per cent after 6 months. The psychological complaints decreased by 34.1 per cent after 3 months and by 32.9 per cent after 6 months. The urogenital complaints decreased by 29.3 per cent after 3 months, and remained at the same level after 6 months of treatment. In conclusion, the 6-months administration of the oral HRT preparation estradiol valerate/levonorgestrel caused a considerable alleviation of the climacteric symptoms in menopausal women.