Prevalence of Postpartum Mental Health Problem in Siriraj Hospital

Objective: To study the prevalence of postpartum mental health problem (postpartum MHP). Study design: Cross-sectional descriptive study. Materials and Methods: The 260 women in the first 48 hrs postpartum of > 24 weeks of gestation who were admitted at the postpartum ward, Siriraj Hospital during May 8th to August 2nd, 2008 were enrolled. After consent forms were done, they were asked to complete self-administered questionnaire including Thai GHQ-30 (mental health problem screening tool) and frequent psychosocial stressor forms. Main outcome measurement: Percentage of the positive Thai GHQ-30/ or probable of mental health problem. Results:The prevalence of postpartum mental health problem was 28.8%. There were statistic significances in some demographic and socioeconomic status: worrying about baby care, quantity of breast milk, number of marriage and postpartum complications, with adjusted OR 3.24 (95%CI 1.68, 6.25), 2.62 (95%CI 1.37, 5.01), 3.68 (95%CI 1.46, 9.27), 3.38 (95%CI 1.29, 8.85), respectively (P<0.05). The prognostic factors of psychosocial stressors were worrying about pregnancy and delivery, financial problem and bad events in life, with adjusted OR 5.91 (95%CI 2.00, 17.51), 3.57 (95%CI 1.49, 8.56), 2.23 (95%CI 1.01, 4.90), respectively. Conclusion:The prevalence of probable postpartum MHP was 28.8%. The prognostic factors of psychosocial stressors were worrying about pregnancy and delivery, financial problem and bad events in life

Epithelial ovarian cancer in the young in Siriraj Hospital

Objective: To access incidence, risk factors, 5-year progression free survival and overall survival in young patients with epithelial ovarian cancer (EOC) in Siriraj Hospital. Methods: Medical records of patients equal or younger than 40 year of age treated with EOC in Siriraj Hospital from January 1998 to December 2007 were reviewed for clinical characteristics, treatments, and outcomes. Survival curves were generated using Kaplan-Meier method. Cox regression analysis to determine multivariate factor for recurrence and survival was performed. Results: Incidence of patients equal or younger than 40 year old with EOC in Siriraj Hospital was 5.8 % of all EOC. Mean age was 33.4±5.4 years. Sixty five percents of patients had abnormal pretreatment CA-125 level. Majority of the patients were in stage I of EOC. Sixty five percents of patients underwent optimal surgery. Adjuvant chemotherapy was applied in 83.7%. Twenty two patients were dead with a median time to death of 3 months. Five-year progression survival was 84.8% and 5-year overall survival was 76% with the median follow up time of 20.5 months. Abnormal pretreatment CA-125 level and suboptimal surgery were the only two independent prognostic factors for survival. Conclusions: The incidence of EOC in the patients equal or younger than 40 year of age is 5.8% of all EOC. The 5-year overall survival rate was 76%. From multivariate analysis, the independent prognostic factors for overall survival were abnormal pretreatment CA-125 level and suboptimal surgery with the hazard ratio of 6.69 (P<0.001) and 2.79 (P=0.033)

Knowledge and Attitude of Obstetricians to the Protection of Children Born from Assisted Reproductive Technology

Objectives: This study aims to examine the attitudes and knowledge of obstetricians in related to the Protection of Children Born from Assisted Reproductive Technologies Act 2015. Materials and Methods: This was a survey study using a mailed questionnaires sent to 2,550 Obstetricians who were registered with The Royal Thai College of Obstetricians and Gynaecologists (RTCOG) and sent to their registered addresses. The questionnaires consisted of knowledge and attitude questions.Results: Replies were received from 340 obstetricians with a response rate of 13.3%. Of these Thai Obstetricians, 81.5% had a good attitude to the law while 14.7% and 3.8% respectively had moderate and poor attitude. The majority (56.7%) had a good knowledge of the law, while 37.1% had a moderate knowledge and just 6.2% had a poor knowledge. Nearly one hundred percent strongly agreed that there should be a law to control ART, that the law will help monitor ART and maintain good morals as well as protecting the dignity of attending obstetricians. Conclusion: The responded obstetricians have a good attitude towards and knowledge of the Protection of Children Born from Assisted Reproductive Technologies Act 2015. The RTCOG should inform nationwide obstetricians about this law and provide data center support