Aim: We examined the difference in pain levels between using the controlled-release dinoprostone vaginal delivery system (PROPESS) and mechanical methods.

Methods: Between December 2023 and January 2024, 13 nulliparous women used PROPESS and 13 nulliparous women used mechanical methods (as control) for cervical ripening at 41 weeks of gestation. After the selected insertion methods were completed, the patients were asked about their pain levels during the insertion, with the pain scored on a ten-point Numeric Rating Scale (NRS). In addition, successful cervical ripening was defined when the Bishop score was >6 or the patient delivered vaginally by the next day following insertion of PROPESS only or mechanical cervical dilation only.

Results: The average NRS score after PROPESS insertion was 2.6±2, which was significantly lower than that after mechanical methods (5.7±3, P<0.01). There was no significant difference in the success rate of cervical ripening between mechanical method and PROPESS insertion groups (38 vs. 31%, respectively, P=0.68).

Conclusion: The potential benefit of PROPESS being pain-free was observed in women requiring cervical ripening.

The Maternal and Child Health (MCH) handbook is an essential home-based health promotion tool and recording instrument that ensures utilization of maternal and child care services among pregnant women, mothers, and children. To recognize the significance of effective MCH and MCH Handbook programs, the International Committee on MCH Handbook organizes the biennial International Conference on MCH Handbook, that brings together experts and stakeholders from around the globe. In 2024, the 14th International Conference on MCH Handbook was staged concurrently with the 1st Regional Conference on MCH in the Philippines’ CaLaBaRZon Region. The first day of the conference highlighted MCH handbook implementation and evaluation from 18 different countries and MCH recommendations from international organizations such as the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and Japan International Cooperation Agency (JICA). The second day of the conference featured the MCH situation and MCH handbook implementation in the CaLaBaRZon Region and ways forward towards effective MCH care. The conference concluded with the formal introduction of the Manila Declaration, with renewed commitment and strengthened collaboration towards effective implementation and sustainability of the MCH Handbook program, to ensure a safe beginning and thriving future to mothers and children in CaLaBaRZon and worldwide.

Aim: This study aimed to evaluate the effectiveness of the MCH Handbook in Thailand by examining its utilization, exploring oral care practices, assessing dental health and eating habits, and analyzing attitudes toward oral education messages to identify opportunities for improving oral healthcare.

Methods: A descriptive cross-sectional survey with mixed-methods was conducted at Public Health Center No. 54 in Bangkok. The study involved 160 participants recruited through purposive sampling. Data collection included structured questionnaires and key informant interviews with local healthcare providers and Ministry of Health representatives. Quantitative and qualitative analyses were performed using Epi Info.

Results: The study found widespread ownership and use of the MCH Handbook among participants. While general oral hygiene practices were good, there was limited engagement with the comprehensive oral health information provided in the handbook. Despite the handbook’s availability, gaps in addressing early childhood caries persisted.

Conclusion: The MCH Handbook is a valuable resource, but its effectiveness in promoting comprehensive oral health needs improvement. Enhancing the handbook’s oral health education components could further improve maternal and child dental care, contributing to broader health outcomes and aligning with Universal Health Care goals.

Aim: To compare serum levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) and the serum sFlt-1/PlGF ratio in a case of isolated HELLP syndrome and cases of HELLP syndrome accompanied by either gestational hypertension (GH) or preeclampsia.

Methods: We measured serum levels of sFlt-1 and PlGF using Elecsys sFlt-1 and Elecsys PlGF assays in a patient with isolated HELLP syndrome (case patient) and 14 women with HELLP syndrome accompanied by either GH or preeclampsia (controls). The one-sample t-test was used to compare data between the case patient and controls.

Results: The serum log₁₀ PlGF level was markedly higher in the case patient than in controls (3.356 vs. mean [−SD–+SD]: 1.817 [1.547–2.087], P<0.001). The serum log₁₀ sFlt-1 level was significantly lower in the case patient than in controls (3.972 vs. 4.190 [3.899–4.481], P=0.015). The serum log₁₀ (sFlt-1/PlGF) was markedly lower in the case patient than in controls (0.616 vs. 2.373 [1.988–2.758], P<0.001).

Conclusion: Increases in serum levels of both PlGF and sFlt-1 may be characteristic of isolated HELLP syndrome.

Aim: We examined whether a reduction in the dose of uterotonic agents before amniotomy affects the amount of intrapartum hemorrhage.

Methods: Women who underwent planned painless vaginal delivery through labor induction with oxytocin and amniotomy at our hospital (n=294) were included in this study. The amount of intrapartum hemorrhage was compared among patients divided into the following two groups: (1) the oxytocin down dose (ODD) group (n=134), in which the dose of oxytocin was halved before amniotomy (from January to December 2023); and (2) the non-ODD group (n=160), in which the dose of oxytocin was not reduced before amniotomy (from January to December 2022).

Results: The incidence of postpartum massive hemorrhage (PPMH) did not differ between the two groups. However, while obstetrical disseminated intravascular coagulation (DIC) was not observed in the ODD group, five patients in the non-ODD group experienced obstetrical DIC, although not significant. Among patients with obstetrical DIC, uterine-type amniotic fluid embolism (AFE) was suspected in two patients.

Conclusions: The findings of this study indicate that, while amniotomy for labor induction poses a potential risk of obstetrical DIC and AFE, careful use of uterotonic agents may reduce this risk.