Ginger is a promising natural galactagogue to improve breast milk volume in the immediate postpartum period without any notable side effect.

Among the mothers who delivered by cesarean section, the use of the laid-back breastfeeding position had not shown different breastfeeding outcomes from the side-lying breastfeeding position. It might be an alternative breastfeeding position, which can be taught for mothers delivering by cesarean section along with the side-lying position.

Among the postpartum mothers who had breast engorgement, the herbal compresses could decrease breast engorgement pain. The pain reduction after herbal compresses was found to be greater than with the hot compresses.

Thalassaemia is a common haematologic health condition in Southeast Asian countries (SEA) including Thailand. Reducing the birth of new thalassaemia cases is an effective method to control disease. The background level of knowledge and attitude of pregnant women on the disease influences their decision to perform antenatal screening. Unfortunately, the information about pregnant women's knowledge and attitude on antenatal thalassaemia screening in a developing country such as Thailand is lacking. We therefore conducted this cross-sectional study to examine patients' knowledge and to evaluate the factors which influence the patient's knowledge and attitude on antenatal thalassaemia screening. 1006 pregnant women who attended antenatal care at the Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhon Nayok, Thailand were enrolled. We found that women's knowledge on antenatal thalassaemia screening is low. A maternal age of ≥35 years was associated with a higher level of knowledge. A higher level of education and multigravidity, a family history of thalassaemia and a positive level of attitude were found more likely to have higher scores for knowledge. A higher level of education and level of knowledge score were also more likely to have a positive attitude score, but multigravidity negatively affected the attitude score. Effective counselling should be monitored among women with a lower levels of education, those with no family history of thalassaemia, and in primigravidas. Lastly, a concurrent Down syndrome screening or foetal sex determination may be useful incentives to encourage the decision to undergo screening. Impact statement What is already known about this subject? Screening for the paternal and maternal thalassaemia carrier status is important for reducing the incidence of severely thalassaemia-affected children. Poorer education and receiving genetic counselling for the first time were the predictive factors for the low post-counselling knowledge in genetic counselling before second trimester genetic amniocentesis. What do the results of this study add? Pregnant women's knowledge of antenatal thalassaemia screening was low. We found that pregnant women aged ≥35 years had a higher level of knowledge. Women with a higher level of education, multigravidity, the presence of a family history of thalassaemia and a positive attitude were more likely to have higher scores for knowledge. A higher level of education and level of knowledge score were also more likely to have a positive attitude score but multigravidity negatively affected the attitude score. The encouraging factors, such as an adjunctive Down syndrome screening or foetal structural screening or foetal sex determination may be useful as the incentive tools. What are the implications of these finding for clinical practice and/or further research? The awareness of a possible incorrect understanding is important for the antenatal counselling in the developing countries. Intensive monitoring of effec...

Objective: To study the validity of sonographic lower uterine segment (LUS) thickness in predicting intraoperative cesarean scar defect (CSD) and thin incision sites in term pregnancy. Methods: This was a cross-sectional study involving 111 full-term pregnant women who were scheduled for repeat cesarean delivery from April, 2019 to January, 2020. The sonographic myometrial LUS thickness was measured prior to surgery. The cesarean scar was assessed using the morphologic classification system as either grade 1 (a normally formed LUS), grade 2 (a thin LUS, but without visible content), or grade 3 (a thin LUS with visible content). Then, the ophthalmic caliper was used to measure the incision site’s uterine-wall thickness. The correlations between the sonographic measurements and intraoperative findings were reported. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.Results: There were two cases (1.8%) of grade 3 CSD. The overall correlation between the sonographic and intraoperative incision-site thickness showed r=0.559 with p-value < 0.001. The sonographic cut-off value of 1.5 mm could predict CSD and a thin incision-site uterine wall with sensitivity, specificity, PPV, NPV of 50.0%, 90.8%, 9.1%, 99.0%, and 37.5%, 94.6%, 54.5%, 90.0%, respectively. A receiver operating characteristic curve was generated to determine the optimum cut-off value at 2.5 mm with a sensitivity of 76.5% and a specificity of 73.3%. The area under the curve was 0.8 (a 95% confidence interval, 0.718-0.885).Conclusion: Abdominal sonography is a valuable tool for the preoperative prediction of CSD. A myometrial LUS thickness of more than 1.5 mm is associated with a lower likelihood of cesarean scar dehiscence.