Thai Journal of Obstetrics and Gynaecology

Reproductive Health in Adolescent Women

Jitti Hanprasertpong, Tharangrut Hanprasertpong — Sat, 28 Feb 2026 00:00:00 +0700

Adolescence is a crucial period in human life. Several changes have occurred. Understanding the physiological and emotional changes that occur in adolescent girls and women (GW) and also knowing and having comprehensive knowledge on the common issues that adolescent GW often seek care for in order to provide them correct and appropriate care. According to several studies, health problems will follow sexual intercourse. Thus, adolescent GW should be encouraged to have no sex as the first choice. If adolescents have sex, encourage them to use effective contraception, along with condoms, to protect them from the sexually transmitted infections.

Intriguing Review and Topics in Second Issue of Thai Journal of Obstetrics and Gynaecology 2026

Vorapong Phupong — Sat, 28 Feb 2026 00:00:00 +0700

This second issue of Thai Journal of Obstetrics and Gynaecology 2026 contains many interesting articles. The special article is “Reproductive health in adolescent women”. The topics included physiological changes in adolescent girls and women, adolescent contraception, sexually transmitted infections in adolescent girls and women, and adolescent pregnancy⁽¹⁾.

This issue also contains seven original articles. Tomuen et al performed a single-blind randomized controlled trial to evaluate the efficacy of postoperative chewing gum in promoting gastrointestinal recovery following complete surgical staging for gynecologic malignancies. The results showed chewing gum significantly reduced the time to first flatus in women undergoing complete surgical staging for gynecologic malignancies⁽²⁾.

Effect of Gum Chewing on Gastrointestinal Function after Complete Surgical Staging in Gynecologic Malignancies: A Randomized Controlled Trial

Pattarapapa Tomuen, Kitiya Wutthibenjarussamee — Fri, 13 Mar 2026 00:00:00 +0700

Objectives: To evaluate the efficacy of postoperative chewing gum in promoting gastrointestinal recovery following complete surgical staging for gynecologic malignancies.
Materials and Methods: A single-blind randomized controlled trial was conducted in women who underwent complete surgical staging for gynecologic malignancies. Participants were randomly assigned to two groups. The intervention group received the sugar-free chewing gum for 15 minutes, four times per day, in addition to standard postoperative care, while the control group received standard postoperative care. The primary outcome was the time to first flatus.
Results: From July 2024 to March 2025, 68 participants were enrolled in this study. The chewing gum group showed significantly shorter time to first flatus compared to the control group (33.5 ± 11.7 hr vs 42.7 ± 11.7 hr, mean difference -9.2 hr, 95%CI -14.9, -3.6, p = 0.002). Furthermore, the use of additional anti-emetic drugs was significantly lower in the chewing gum group [3 (8.8%) vs 11 (32.4%), p = 0.036]. No significant differences were observed in time to first defecation, postoperative nausea, postoperative vomiting, and additional analgesic use. No serious adverse effects were reported in this study.
Conclusion: Chewing gum significantly reduced the time to first flatus in women undergoing complete surgical staging for gynecologic malignancies.

Effects of Intramuscular Pethidine on Labor Duration: A prospective cohort study

Kantapong Paibulsirichit, Pakprapa Chaipakdi — Mon, 09 Mar 2026 00:00:00 +0700

Objectives: This study evaluated the impact of intramuscular pethidine on labor duration as well as associated maternal and neonatal outcomes.
Materials and Methods: A prospective cohort study at Hatyai Hospital recruited 114 women with singleton, cephalic pregnancies at 37–41 weeks and spontaneous labor in the active phase from May to December 2024. A total of 59 patients chose to receive intramuscular pethidine at a dose of 1 mg/kg, while 41 patients chose not to receive it. Obstetric outcomes, labor characteristics, pain assessment by visual analog scale, and maternal and neonatal drug adverse outcomes were recorded. Multivariable linear regression identified factors associated with labor duration, adjusting for confounders including maternal age, body mass index (BMI), and parity.
Results: The median duration of the active phase of the first stage of labor was significantly shorter in the pethidine group (165 min [interquartile range (IQR) 110, 245]) compared to the non-pethidine group (220 min [IQR 140, 330], p = 0.046). After adjusting for maternal age, BMI, and parity, pethidine administration was found to be associated with a significant reduction in active phase duration by 67.45 minutes (adjusted coefficient = -67.45, 95% confidence interval -118.67, -16.23, p = 0.010). None of birth asphyxia was reported, and no significant differences was observed in neonatal intensive care unit admission. Mild maternal side effects included drowsiness and nausea in the pethidine group, but no severe adverse effects were observed in either group.
Conclusion: Intramuscular pethidine administration significantly shortened the active phase of the first stage of labor compared to the non-pethidine group after adjusting for confounding factors, without increasing adverse maternal or neonatal outcomes.

Modified Word Catheter and Marsupialization in Women with a Cyst or Abscess of the Bartholin Gland: A randomized clinical trial

Supapun Wattanacharoen, Chanchai Suprasongsin — Sat, 28 Feb 2026 00:00:00 +0700

Objectives: To compare outcomes of a cyst or abscess of the Bartholin gland after surgical treatment using a modified Word catheter or marsupialization.
Materials and Methods: We conducted a single-center, open-label, randomized controlled trial at Vachira Phuket Hospital, in Thailand. Women presenting with a symptomatic Bartholin gland cyst or abscess were randomly assigned to undergo either modified Word catheter placement, using a Foley catheter, or marsupialization under local anesthesia. Participants were followed-up at 1 week, 4 weeks, 6 months, and 12 months post-procedure. The primary outcome was recurrence within one year. Secondary outcomes included procedural time and perioperative pain. Analyses were performed according to the intention-to-treat principle.
Results: A total of 50 women were enrolled between June 2023 and March 2024. Recurrence occurred in 3 of 25 women (12%) in the modified Word catheter group and in 3 of 24 women (12.5%) in the marsupialization group (relative risk 0.96; 95% confidence interval [CI] 0.21, 4.3; p = 0.957). The median procedural time was shorter with modified Word catheter placement (10 minutes; interquartile range [IQR] 8, 12) compared to marsupialization (14.5 minutes; IQR 14, 16; p < 0.001). Pain scores during the procedure were lower in the modified Word catheter group (mean ± standard deviation [SD] 4.7 ± 1.2) than in the marsupialization group (mean ± SD 6.6 ± 1.1; p = 0.001).
Conclusion: In women with a Bartholin gland cyst or abscess, treatment with a modified Word catheter provides similar recurrence rates to marsupialization, but with shorter procedural time and less perioperative pain.

Peripheral Blood Natural Killer Cells and Th1 Cytokines in Unexplained Female Infertility

Priyanka Munjal, Kiran Agarwal, Reena Yadav — Sat, 28 Feb 2026 00:00:00 +0700

Objectives: To compare the percentage and absolute numbers of peripheral blood (PB) natural killer (NK) cells and its subsets and levels of T helper cells 1 (TH1) cytokines [interferon-gamma (IFNγ) and tumor necrosis factor-alpha (TNFα)] in women with unexplained infertility with that of healthy fertile women.
Materials and Methods: This was a three-year study which included 31 women with history of UI and 33 fertile controls. Flow cytometry was done on ethylene di-amine tetra-acetic acid samples to determine the percentage and absolute count of total PB NK cells and its subsets. Enzyme linked immunosorbent assay was done on serum samples for IFNγ and TNFα.
Results: The ratio of mean percentages of CD56dim and CD56bright NK cells [31.36 in patients vs 18.06 in controls (p = 0.034)], mean percentage of CD56+CD16+ NK cells [7.04 in patients vs 4.96 in controls (p = 0.034)] and CD56dim CD16+NK cells [81.02 in patients vs 60.49 in controls (p = 0.004)] was significantly increased in infertile women compared to fertile women. The percentage and absolute count of CD56+CD16- NK cells [p = 0.017 and p = 0.022, respectively] and CD56dimCD16- NK cells [p = 0.002 and p = 0.02, respectively] was significantly raised in fertile controls compared to infertile patients. Mean percentage of total PB NK cells, mean percentage and absolute count of CD56bright, CD56dim, CD56brightCD16+, CD56brightCD16-NK cells and mean serum levels of TNF-α and IFN-γ in infertile groups were higher but not significant compared to fertile group.
Conclusion: CD56+CD16+ NK cells which constitute the major population of PB NK cells and its major subset, CD56dim CD16+ NK cells was significantly raised in unexplained infertile women.

Prevalence of Illicit Drug use during Pregnancy between Teenage and Non-teenage in Thailand

Chayanis Khorprasert , Kittipong Kongsomboon, Tharangrut Hanprasertpong — Sat, 28 Feb 2026 00:00:00 +0700

Objectives: The primary outcome was to compare the prevalence of illicit drug use during pregnancy between teenage and non-teenage. The secondary outcomes were to investigate the possible factors predicting of illicit drug use before and during pregnancy and also to compare the incidence of adverse maternal/neonatal outcomes and overall adverse pregnancy outcomes between the participants who had a history of illicit drug use during pregnancy and those who did not.
Materials and Methods: This prospective cross-sectional study was conducted at HRH Princess Maha Chakri Sirindhorn Medical center, Srinakharinwirot University, Thailand, between September 2024 and May 2025. The participants were asked to complete a questionnaire to provide their information.
Results: 310 participants were enrolled. The prevalence of participants who had a history of any illicit drug use before pregnancy was 50/62 (80.6%) and 170/248 (68.5%) in the teenage and non-teenage group, respectively. Teenage pregnancy was not actually found to be a factor that predicted the risk of illicit drug use during pregnancy (adjusted odds ratio 0.716, 95%CI 0.305, 1.682, p = 0.443), while a lower educational level (junior high school or lower), more than 7-hour social media use per day, and age at first sexual intercourse were statistically significantly associated with illicit drug use. Adverse neonatal outcomes were significantly higher in the participants who had a history of illicit drug use during pregnancy than those who did not.
Conclusion: Prevalence of illicit drug use during pregnancy in teenage was not different from in non-teenage. Teenagers alone were not at risk of engaging in illicit drug use. A level of education of junior high school or lower, more than 7 hours per day social media use, and a young age at first sexual intercourse were significant factors associated with a higher prevalence of illicit drug use during pregnancy.

Correlation of Total Dosage and Duration of Magnesium Sulfate Administration in Pregnant Women Associated with Magnesium Levels in Umbilical Cord Blood

Sarocha Pariyanont, Paroon Sanoonrat — Sat, 28 Feb 2026 00:00:00 +0700

Objectives: To evaluate the correlation between the total dosage and duration of maternal magnesium sulfate (MgSO₄) administration and umbilical cord blood magnesium levels, and to determine clinically useful cutoff values associated with elevated neonatal magnesium concentrations.
Materials and Methods: The cross-sectional study included 47 pregnant women ≥ 24 weeks’ gestation who received MgSO₄ following the regimen of loading dose 4 grams, followed by a maintenance dose of 2 gram/hour intravenously at Rajavithi Hospital. Maternal serum magnesium was collected within 1 hour before delivery, and umbilical cord blood samples were obtained immediately after placenta delivery. Total MgSO₄ dose, infusion duration, and biochemical parameters were recorded. Pearson’s correlation, linear regression, and receiver operating characteristic (ROC) curve analysis were performed.
Results: Total dosage of MgSO₄ and infusion duration showed significant positive correlations with cord blood magnesium levels (r = 0.65, p < 0.001). Maternal serum magnesium demonstrated the strongest correlation (r = 0.73, p < 0.001) and remained an independent predictor in the multivariable model together with maternal serum creatinine. ROC analysis identified two clinically useful cutoff values for predicting cord magnesium ≥ 5 mg/dL: a total dose of 12.8 g (sensitivity 100%, specificity 71.4%) and an infusion duration of 280 minutes (sensitivity 100%, specificity 68.6%). A higher level of exposure, corresponding to 31.3 g of total dose or 855 minutes of infusion, yielded 100% specificity.
Conclusion: Both the total dosage of MgSO₄ and infusion duration were strong predictors of neonatal cord blood magnesium levels. The identified cutoff values provided practical guidance for assessing the risk of elevated neonatal magnesium exposure and support targeted newborn surveillance following maternal MgSO₄ therapy.

Prevalence and Associated Factors of Endometrial Hyperplasia and Endometrial Cancer in Women with Abnormal Uterine Bleeding and Body Mass Index less than 30 kg/m2 at Charoenkrung Pracharak Hospital

Jidapa Xanthavanij, Piyathida Thongrong, Jiraporn Luengmettakul — Sat, 28 Feb 2026 00:00:00 +0700

Objectives: The primary objective was to determine the prevalence and the associated risk factors of endometrial hyperplasia and endometrial cancer in women with abnormal uterine bleeding (AUB) and body mass index (BMI) less than 30 kg/m2
Materials and Methods: A cross-sectional retrospective study was conducted. The medical records of women with AUB and BMI less than 30 kg/m2 who underwent endometrial sampling or fractional curettage or hysteroscopy with endometrial biopsy from January 1, 2018 to December 31, 2023 were reviewed. The demographic data included age, parity, BMI, menopause, diabetes mellitus, hypertension, tamoxifen used and histopathological reports were collected. The data were analyzed to determine the prevalence of endometrial hyperplasia and endometrial cancer, and multivariate logistic regression were utilized to identify associated risk factors.
Results: Of all 226 women were recruited. The prevalence of endometrial hyperplasia and endometrial cancer was total 9.2%. In multivariate logistic regression analysis, postmenopause (adjusted odds ratio (aOR) 9.39, 95% CI 1.56, 56.71, p = 0.015) and woman older than 60 years old (aOR 12.27, 95% CI 1.93, 78.20, p = 0.008) were independently associated with endometrial hyperplasia and endometrial cancer.
Conclusion: Postmenopause was an important factor for endometrial hyperplasia and endometrial cancer in women with AUB and BMI less than 30 kg/m2, risk increasing significantly in those aged over 60 years. Early detection strategies should be considered.