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HDL-cholesterol (HDL- C) and triglyceride (TG) concentrations were determined by enzymatic -colorimetric

methods, while serum LDL-cholesterol (LDL-C) levels were calculated using Friedewald formula. Apo E

genotypes were determined by PCR-RFLP. Out of 217 subjects, apo E genotype frequencies were 5.5 per cent

for E2/E2, 12.4 per cent for E2/E3, 81.1 per cent for E3/E3 and 0.9 per cent for E4/E4. In men, advancing

age was associated with increased serum TC (r = 0.28, P < 0.05) and LDL-C (r = 0.27, P < 0.01). Subjects

having the E2 allele had lower TC (r = -0.27, P < 0.05) and LDL-C. (r = -0.25, P < 0.05). Age and apo E

genotypes were not associated with HDL-C and TG in men. In women, increasing age was related to higher

serum TC (r = 0.45, P < 0.001), LDL-C (r = 0.44, P < 0.001), TG (r = 0.40, P < 0.001) and lower HDL-C

(r = -0.36, P < 0.001). The presence of E2 allele was related to lower TC (r = -0.24, P < 0.001), LDL-C (r

= -0.26, P < 0.001), TG (r = -0.15, P < 0.05) and higher HDL-C (r = 0.20, P < 0.01) independent of age and

menopausal status. We concluded that the epsilon 4 allele of apo E gene is rare in Thais. The presence of the

epsilon 2 allele is associated with a more favorable lipid profile and there is a sexual dimorphism concerning

the effect of apo E genotype on serum HDL-C and TG.

No. 62

Authors :

Chanrachakul B, Herabutya Y.

Title :

Active management of labor: experience in a developing country.

Source :

Journal of Obstetrics and Gynaecology Research. 26(1):287, 2000.

Keywords :

Active management, Cesarean section, Labor

Abstract :

This historical cohort study was to evaluate the effectiveness of active management of labour in the setting

of a developing country. The labour characteristics and outcome of 96 nulliparous women with HIV positive

delivered between January 1991 and December 1998 treated with traditional labour management were

compared with 1856 nulliparous women treated with active management of labour in a tertiary centre of

developing country. The total caesarean section rate from 1991 to 1998 was used to find the mean with which

it was then used to select the year with caesarean section rate closest to the mean as control. The length of

labour was significantly shortened in the active management group (6.3+3.3 hrs vs 8.9+6 hrs, p=0.000). A

significant greater proportion of the traditional management group had prolonged labour (29.3% vs 4.9%,

p=0.000). However, caesarean section rate was not different between the two groups (active vs traditional =

17% vs 14.6%, p=0.7) with dystocia as a major indication in both groups. There was no different in maternal

and fetal complications. In conclusion, women treated with active management had shorter length of labour

and less likely to have prolonged labour compared to traditional management, but caesarean section rate was

not different between the two groups.

No. 63

Authors :

Chanrachakul B, Herabutya Y, Punyavachira P.

Title :

Potential efficacy of nitric oxide for cervical ripening in pregnancy at term.

Source :

International Journal of Gynaecology and Obstetrics. 71(3):217-9, 2000(Dec).

Keywords :

Nitric oxide, Cervical ripening, Induction, Pregnancy

Abstract :

Objective : To determine the efficacy and safety of nitric oxide for cervical ripening. Study Methods : Thirty

pregnant women were rancomized to receive intravaginally either 500 mg glyceryl trinitrate, 40 mg isosorbide

mononitrate of 3 mg prostaglandin E2 tablet for cervical ripening. Results : The changing of Bishop score was

not significant difference among the glyceryl trinitrate group, the isosorbide mononitrate group and the

prostaglandin E2 group. Cesarean section rates also were not significant difference among the groups. There

was no serious adverse side-effect in this study. Conclusions : The nitric oxide donors in both forms can induce

cervical ripening. There was no serious adverse side-effect of nitric oxide donors in this study.

No. 64

Authors :

Chanrachakul B, Herabutya Y, Punyavachira P.

Title :

Randomized comparison of glyceryl trinitrate and prostaglandin E2 for cervical ripening at term.

Source :

Journal of Obstetrics and Gynecology. 96(4):549-53, 2000(Oct).

Keywords :

Nitric-oxide, Induction, Cervical ripening

Abstract :

OBJECTIVE: To estimate the adverse effects of glyceryl trinitrate compared with prostaglandin (PG) E2

vaginal tablet for cervical ripening in term pregnancy. METHODS: One hundred ten women with term

pregnancies referred for induction of labor with Bishop scores of 6 or less were randomly assigned to receive

a 500-microg glyceryl trinitrate tablet vaginally (n = 54) or a 3-mg PGE2 tablet vaginally (n = 56), every

6 hours for maximum of two doses. Subjects were sent to the labor ward for amniotomy or oxytocin if

their Bishop scores were more than 6 or their cervices were not ripe 24 hours after treatment. Adverse

effects, changes in the Bishop scores, progress, and outcomes of labor were assessed. RESULTS: Glyceryl

trinitrate was associated with fewer episodes of uterine tachysystole (0% versus 9%; P =.02). The median

Bishop score after 12 hours was lower in women given glyceryl trinitrate compared with those given

PGE2. Adverse effects, including headache and palpitations, were more frequent with glyceryl trinitrate than

with PGE2. The cesarean rate was not significantly different between groups. CONCLUSION: Cervical

ripening with glyceryl trinitrate resulted in fewer episodes of tachysystole, but there were significantly

more minor side effects. It can be used for cervical ripening at term, but it was not as effective as PGE2.