Percentage of Pregnant Women Reading the Maternal and Child Health Handbook and Associated Factors at Srinagarind Hospital

Objectives: To evaluate the percentage of pregnant women who read the maternal and child health handbook (MCHH) at Srinagarind hospital, associated factors, attitudes toward the MCHH and to compare maternal knowledge between handbook readers and non-readers.Materials and Methods: This was a cross-sectional study conducted from September 2016 to March 2017. All primigravida pregnant women who had been given the MCHH at least for one month previously were included. A questionnaire-based interview was conducted for evaluating the percentage of participants who read the MCHH and associated factors. “Read” meant the participants had read more than 50% of the MCHH’s contents and at least four of the eight topics.Results: Out of 317 pregnant women, 206 (65%) read the MCHH. The most read item was dietary recommendations (78.2 %). The two least read items were iodine deficiency disease and prevention of mother to child transmission of HIV (49.5 %). The participants who read the MCHH were 2.5 times more likely to pass the exam than who did not. The most influential factor affected the reading of the MCHH was “reading prior current pregnancy”. The top two reasons for not reading the MCHH were choosing to receive the information from other sources and the style of the handbook not being attractive.Conclusion: The percentage of participants who read the MCHH in Srinagarind Hospital was 65%. The factor that affected the reading of the MCHH was “reading prior current pregnancy”. Moreover, women who read the MCHH had a more knowledge about pregnancy compared with those who did not

Knowledge and attitude of pregnant women at risk for having a fetus with severe thalassemia after genetic counseling at Srinagarind Hospital

Objectives: The primary objective was to assess the knowledge and attitude of pregnant women at risk for having a fetus with severe thalassemia after receiving genetic counseling from Maternal and Fetal Medicine Staffs at Srinagarind Hospital and the secondary objective was to analyze the factors associated with decision of prenatal diagnosis and termination of pregnancy.Materials and Methods: Descriptive study recruited 105 pregnant women who were at risk for having a fetus with severe thalassemia after genetic counseling during September 1, 2010 to January 31, 2011. The questionnaire consisted of four parts demographic characteristics, knowledge of thalassemia, attitude towards thalassemia and factors associated with decision of prenatal diagnosis and termination of pregnancy after genetic counseling. Data analysis was done by using descriptive statistics, chi-square test and odds ratio.Results: More than half of the participants (57.1%) had adequate knowledge of thalassemia. The three significant contributing factors of thalassemia knowledge were education level (bachelor degree) (OR 33.4, 95% CI 3.6-310.3), family income (more than 20,000 Baht/month) (OR 6.4, 95% CI 1.5-27.1) and desire to have children (unplanned pregnancy) (OR 0.3, 95% CI 0.13-0.82), (p<0.05). Most of participants (85.7%) had good attitudes towards thalassemia. Ninety five percents of participants decided to have prenatal diagnosis of thalassemia when indicated and 88.0% of those accepted to terminate pregnancy if the fetuses were affected. Conclusion: Knowledge and attitude of thalassemia in pregnant women at risk were adequate and good. Factors associated with decision of prenatal diagnosis and termination of pregnancy probably were education level, family outcome and desire to have children

Amniotic Fluid Index (AFI) for Normal Pregnant Women in Northeastern Thailand

Objective:To construct normal reference chart of amniotic fluid volume by using the amniotic fluid index (AFI) method from 20 to 40 weeks of gestation in northeastern Thailand.Study design: A cross-sectional prospective descriptive study.Setting: Antenatal care clinic, Srinagarind Hospital, Khon Kaen University, Khon Kaen.Material and methods: All recruited 381 pregnant women with an uncomplicated singleton pregnancy from 20 to 40 weeks of gestation in northeastern Thailand from March 1, 2013 to June 30, 2014 enrolled in this study. All of them had an abdominal ultrasonography for amniotic fluid measurement using AFI method. Stat software was used to analyse the data and mean of the AFI was used in each gestational age.Main outcome measures: Normal reference chart of AFI for normal pregnancy women from 20 to 40 weeks of gestation in northeastern Thailand.Result: Mean AFI in study is 13.85 (± 3.61) cm. AFI trends to increase from GA 20 weeks to GA 29 weeks. The highest mean AFI is 15.38 cm at GA 29 weeks. Then the AFI trends to decline until GA 40 weeks. The normal reference chart of AFI was then established in this study.Conclusion: The author established normal reference chart of AFI for northeastern Thai pregnant women that can be implemented in the population of this region. The result from this study can be used to develop reference standard criteria for oligohydramnios and polyhydramnios in Thailand

Second Trimester Genetic Amniocentesis: Khon Kaen University 14-year experience

Objective: To evaluate the results of second trimester amniocentesis for prenatal diagnosis of chromosomal abnormalities at Khon Kaen University.Material and Method: A review of data from 2,825 genetic amniocenteses between January 1, 1993 and December 31, 2006 at Srinagarind Hospital,Faculty of Medicine,Khon Kaen University. Data reviewed included medical records, amniocentesis record forms and questionnaires sent by mail that inquired about complications and pregnancy outcomes. The mail out questionnaires response rate was 75.5%.Main outcome measure: Fetal loss rate after amniocentesis within 2 weeks.Results: The most common indication for genetic amniocentesis was advanced maternal age (90.7%). Chromosomal abnormalities were found 3.1%. The most common chromosomal abnormality was trisomy 21 (0.91%). The procedure failed in only one case (0.03%). Additional tapping was required in 1.29% of them. The culture failure rate was 2.01%. The fetal loss rate after amniocentesis was 0.6%.There were no significant differences in the factors affecting fetal loss that included maternal age, gestational age, placental puncture, operator, number of tappings, myoma uteri and color of amniotic fluid. Pregnancy outcome of the fetus with normal chromosomes included fetal death (0.3%) and preterm delivery (5.1%). Conclusion: Second trimester genetic amniocentesis at Khon Kaen University was a safe procedure in prenatal diagnosis of chromosomal abnormalities

Epidemiology and factors associated with preterm births in multiple pregnancy: a retrospective cohort study

Abstract Objective Multiple pregnancies carry an increased risk of maternal and perinatal complications, notably prematurity. Few studies have evaluated the risk factors for preterm births in multiple pregnancies within the Thai population. This study aims to ascertain maternal and perinatal outcomes and identify factors linked to preterm births in multiple pregnancies. Methods This study was carried out at Khon Kaen University, Faculty of Medicine, Department of Obstetrics and Gynecology in Thailand. We reviewed the medical records of women with multiple pregnancies who delivered at a gestational age of more than 20 weeks between January 1, 2012 and December 31, 2021. We excluded patients with incomplete data or those for whom data were missing. Results Out of 21,400 pregnancies, 427 were multiple pregnancies, constituting approximately 1.99%. Over the ten-year period, 269 multiple pregnancies (65.1%) resulted in preterm births. Of these, 173 (64.3%) were monochorionic twins, and 96 (35.7%) were dichorionic twins. Monochorionic twins had a notably higher rate of preterm delivery (AOR, 2.06; 95%CI 1.29—3.30). Vaginal delivery was observed in 7.9% of the cases, while cesarean sections were performed for both twins in 91.5% of cases. In 0.5% of the cases, only the second twin was delivered by cesarean section. In terms of neonatal outcomes, 160 infants (19.4%) weighed less than 1,500 g at birth, and there were 78 perinatal deaths (9.4%). Birth asphyxia was noted in 97 cases (20.2%) among monochorionic twins and in 28 cases (8.1%) for dichorionic twins. Conclusion The prevalence of multiple pregnancies was 1.99%, with 65.1% resulting in preterm births. Neonatal complications were notably more frequent in monochorionic twins. Monochorionic placenta and antepartum complications emerged as significant risk factors for preterm birth

Auditing cesarean section indications in women of Groups 1 to 4 of Robson's Ten-Group Classification System: A descriptive study at a university hospital in Thailand

Cesarean audi

Auditing cesarean section indications in women of Groups 1 to 4 of Robson's Ten-Group Classification System: A descriptive study at a university hospital in Thailand

International audienceAim: To determine the appropriateness of indication for cesarean section in women at term with a single fetus in cephalic presentation without previous CS irrespective of parity and how labor started (Robson's Ten-Group Classification System [RTGCS] groups 1-4). Methods : This was a descriptive study assessing medical records of 311 women in RTGCS groups 1- 4, between 1 st January 2020 and 31 st December 2020 who underwent a CS in Srinagarind Hospital, a university hospital, Khon Kaen, Thailand. Appropriateness of CS indications was assessed using criteria developed by our institute. Indications were classified into three categories: cephalopelvic disproportion (CPD), fetal indications, and other maternal indications. Results: The overall appropriate rate of CS indications in RTGCS groups 1-4 was 32.5% (95% CI 26.8% – 38.7%). The appropriate rates of CS indications in RTCGS group 1, 2a, 2b, 3, 4a, and 4b were 43.0% (95% CI 35.2% - 51.2%), 10.6% (95% CI 0.0% - 24.9%), 11.7% (95% CI 0.0% - 25.0%), 50.0% (95% CI 32.1% - 68.6%), 0% (95% CI 0.0% - 100%), and 40.0% (95% CI 20.0% - 74.8%) respectively. Conclusion: Low appropriateness in CS indications in RTGCS groups 1-4 leads to high CS rates. Increasing appropriateness of CS indications in this population will reduce unnecessary CS. Interventions focusing on increasing appropriateness in CS indications are urgently required to achieve appropriate use of CS