Fetal cardiac function measured by myocardial performance index of small-for-gestational age fetuses.

AIM: The aim of this study was to demonstrate the changes of right and left myocardial performance indices (MPI) in small-for-gestational age (SGA) fetuses during 28-40 weeks of gestation. MATERIAL AND METHODS: Singleton pregnant women during 28-40 weeks of gestation were enrolled. Estimated fetal weight was used to classify the subjects into appropriate-for-gestational age (AGA) and SGA groups. The Doppler indices of umbilical and middle cerebral arteries, including amniotic fluid index, were used to distinguish constitutional SGA (both normal Doppler indices and amniotic fluid index) from intrauterine growth restriction (IUGR) fetuses (abnormal Doppler indices and/or oligohydramnios). MPI was obtained and compared between the groups. Inter- and intra-observer variations were also assessed. RESULTS: Fifty women had AGA fetuses whereas another 50 cases had SGA fetuses (41 constitutional SGA and nine IUGR). Right MPI in AGA fetuses was constant whereas left MPI was slightly increased. The MPI of SGA fetuses were significantly greater than those of AGA fetuses starting from 30 weeks gestation until delivery (P < 0.01 and <0.05 in right and left side, respectively). Subgroup analysis demonstrated right and left MPI of IUGR fetuses increased with advancing gestation and were significantly greater than those of constitutional SGA and AGA fetuses, which appeared to be similar. The reproducibility of the test was high. CONCLUSIONS: In SGA fetuses, the MPI of right and left ventricles was significantly increased with advancing gestation compared to AGA cases.

Dysmenorrhea in Siriraj medical students; prevalence, quality of life, and knowledge of management.

OBJECTIVE: To determine the prevalence of dysmenorrhea, effect on daily activity, academic activities, quality of life, and knowledge of management in Siriraj medical students. MATERIAL AND METHOD: A cross-sectional descriptive study at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand that included 552 female medical students who were asked to complete two questionnaires. The first questionnaire (32 items) included demographic data, menstrual pattern, severity of dysmenorrhea, pain score, impact of dysmenorrhea on daily and academic activities, the method and knowledge of medications to treat dysmenorrhea. The second questionnaire was Short Form (SF)-36 questionnaires used to evaluate the health-related quality of life. RESULTS: The prevalence of dysmenorrhea was 77.7%. The prevalence of mild, moderate, and severe dysmenorrhea was 35.3%, 39.3%, and 3.1% respectively. Age of menarche, duration of menses, and the family history of dysmenorrhea were significantly different between two groups. Students who had moderate to severe dysmenorrhea reported the negative impact on daily and academic activities. The scores of SF-36 in moderate and severe group was significantly lower than the mild group (p < 0.001). In the moderate to severe dysmenorrhea group, 82.9% and 66.7% of participants used mefenamic acid and paracetamol for pain relief respectively. CONCLUSION: Dysmenorrhea in medical students has high prevalence and it has negative effects on daily activities, academic activities, and quality of life. Most of the subjects know that mefenamic acid and/or paracetamol can relief dysmenorrhea. Dysmenorrhea is a significant public health problem.