Comparison of success rate of nifedipine, progesterone, and bed rest for inhibiting uterine contraction in threatened preterm labor.

AIM: To compare the success rates and gestational ages at delivery of nifedipine, proluton depot administration as a tocolytic agent and bed rest groups to pregnant women with threatened preterm labor. MATERIAL AND METHODS: A total of 150 pregnant women with threatened preterm labor between 28 and 35 weeks of gestation were enrolled in the study. All women underwent contraction inhibition randomly sorted into three groups. The first and second groups were inhibited with nifedipine and proluton depot, respectively. The third group was admitted for bed rest. RESULTS: Nifedipine, proluton depot and bed rest can be used to inhibit contraction in threatened preterm labor. However, when time-to-event test was used, nifedipine took the shortest time for contraction inhibition with statistical significance. CONCLUSION: Nifedipine, proluton depot and bed rest can be used successfully to inhibit contraction in threatened preterm labor. However, nifedipine took the shortest time to inhibit uterine contraction in threatened preterm labor.

Prevalence of bacterial vaginosis in Thai pregnant women with preterm labor in Siriraj hospital.

OBJECTIVE: To study the prevalence of bacterial vaginosis (BV) in pregnant women with preterm labor in Siriraj hospital. MATERIAL AND METHOD: A cross-sectional study of 158 pregnant women with suspected preterm labor was performed between January and July 2005. The subjects enrolled in the present study were between 28+0 and 36+6 menstrual weeks. BV blue test was performed on the vaginal fluid collected from lower one- third of vagina. RESULTS: The prevalence of BV in women in the preterm labor group was 25.8% compared to 14.1% in the preterm contraction group (p = 0.07). CONCLUSION: Compared with preterm contractions a higher prevalence of BV was found in the pregnant women with preterm labor. Given that a quarter of pregnant women with preterm labor tested positive for BV, it might be appropriate to perform this test in the triage setting.

Adverse pregnancy outcomes in gestational diabetes mellitus.

OBJECTIVE: To evaluate adverse pregnancy outcome in women diagnosed with gestational diabetes mellitus (GDM) at Siriraj hospital. STUDY DESIGN: Cross- sectional study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. MATERIAL AND METHOD: One hundred and sixty two women who were diagnosed with GDM and who received treatment following clinical practice guideline at Siriraj hospital were enrolled. Data were abstracted from medical record regarding adverse pregnancy outcomes of both the mothers and their infants. RESULTS: The most common clinical risk for GDM was age > or = 30 years (116 cases, 71.6%), followed by family history of diabetes mellitus (81 cases, 50%) and obesity (47 cases, 29%). Majority of the women were GDM class A1 (156 cases, 96.3%) and only six cases (3.7%) were GDM class A2. Maternal complications were found in 35 cases (21.6%) and the most common complications were postpartum hemorrhage (17 cases, 10.5%), mild preeclampsia (6 cases, 3.7%) and severe preeclampsia (3 cases, 1.9%). The most common neonatal complication was hypoglycemia (111 cases, 68.5%). This occurred in all infant of GDM class A2 mothers. Macrosomia was found in 29 cases (17.9%). No significant differences in maternal and neonatal complications were found between GDM class A1 and class A2. CONCLUSION: Women with GDM who were diagnosed and treated following treatment guidelines demonstrated no severe maternal and neonatal complications.

Two different treatment regimens in women with preterm contractions who were admitted to a hospital due to a presumptive diagnosis of preterm labor: an observational study.

AIM: To determine the effect of adherence to a set of clinical practice guidelines (CPG) for the management of preterm contractions on health-care resource consumption and pregnancy outcomes. METHODS: This prospective observational study was conducted in a tertiary care university hospital from January 2003 to December 2004. Comparisons were made between the cases receiving treatment according to the CPG (CPG group) and those receiving treatment deviating from the CPG (non-CPG group). RESULTS: There were 203 patients with preterm contractions. Compared with the CPG group, the non-CPG group had a higher rate of both tocolytic and steroid use, a longer maternal hospital stay, and a lower neonatal birthweight. CONCLUSIONS: Adherence to CPG in patients with preterm contractions at 28(+0)-36(+6) weeks' gestation consumes fewer health-care resources without compromising pregnancy outcomes.