1.Clinical observation of meconium aspiration syndrome : in relation to fetal heart rate monitoring.
Young Ran YOON ; Jin Sook KIM ; Mi Kyung KIM ; Sun Young KHO ; Seong Ja LEE ; Mi Jung KIM ; Hye Kyung HAN ; Kyung Hoon CHOI ; Mi Na LEE
Journal of the Korean Pediatric Society 1993;36(12):1656-1662
To identify the neonates at the risk of having meconium aspiration syndrome, the perinatal characteristics and finding of fetal heart rate monitorings in 366 neonates who had meconium-stained amniotic fluid were retrospectively reviewed. The results were as follows; 1) Overall incidence of MAS was 0.7%. 2) Mortality rate of MAS was 5.8%. 3) The mean Apgar scores at 1-and 5-minute were significantly different in the two groups with and without meconium aspiration sydrome (MAS)(p<0.001). 4) PROM, postterm delivery and IUGR were the major obstetric risk factors associated with MAS. 5) Although severe variable decelaeration and decreased variability on FHR monitoring were present more often in the group with MAS, it showed no statistically significant difference between the two groups. 6) The presence of above findings on monitoring and thick meconium in amniotic fluid should alert clinicians to the possibility of a fetus that requires intervention.
Amniotic Fluid
;
Female
;
Fetal Growth Retardation
;
Fetal Heart*
;
Fetus
;
Heart Rate, Fetal*
;
Humans
;
Incidence
;
Infant, Newborn
;
Meconium Aspiration Syndrome*
;
Meconium*
;
Mortality
;
Pregnancy
;
Retrospective Studies
;
Risk Factors
2.In vitro isolation, cultivation and identification of sebocytes and eccrine sweat gland cells from human fetal skin.
Ke TAO ; Bi CHEN ; Song-tao XIE
Chinese Journal of Burns 2005;21(5):343-346
OBJECTIVETo explore the preliminary methods of in vitro isolation, culture and identification of sebocytes and eccrine sweat gland cells from human fetal skin.
METHODSHuman fetal skin was digested with dispase or type II collagenase, and then by micro - sieving to isolate human sebaceous gland and eccrine sweat gland cells. DMEM/F12 (1: 1) was used as the basic culture medium, supplemented with fetal bovine serum, recombinant human epidermal growth factor, L-glutamine, Hydrocortisone, choleratoxin, penicillin and streptomycin as the medium for sebocytes, or fetal bovine serum, recombinant human epidermal growth factor, triiodothyronine, hydrocortisone, insulin, transferrin, sodium selenite to the medium for eccrine sweat gland duct cells. Primary cultures and subcultures were incubated at 37 degrees C in humidified atmosphere of 5% CO2/95% oxygen. Cell morphology was observed by inverted phase contrast microscopy, and the cultured cells were identified with cell clone efficiency determination. The cultured sebocytes were identified with oil red staining and CK4.62, Epithelia Membrane Antigen (EMA) immunohistochemistry staining. The cultured eccrine sweat gland duct cells were identified with CK7, CK19 immunohistochemistry staining.
RESULTSThe isolated sebocytes and eccrine sweat gland cells from human fetal skin could grow by adhering to the wall and proliferate in vitro. The cell clone efficiency of human fetal sebocytes was 2.7%, which was obviously lower than that of human fetal keratinocytes (8.0%, P < 0.01). There was no obvious difference in the cell clone efficiency between human fetal eccrine sweat gland cells (7.3%) and human fetal keratinocytes (7.7%, P > 0.05) . The results of oil red staining indicated that a small quantity of lipid droplets in sebocytes, and immunohistochemistry staining of CK4.62, EMA were positive in subculture sebocytes. The immunohistochemistry staining of CK7, CK19 was positive in subculture eccrine sweat gland duct cells.
CONCLUSIONIn vitro cultured human fetal sebocytes and eccrine sweat gland duct cells displayed the markers and biological characteristics of epithelial lineage, but human fetal sebocytes proliferated more
Cell Culture Techniques ; Eccrine Glands ; cytology ; Fetus ; cytology ; Humans ; Sebaceous Glands ; cytology ; Skin ; cytology ; Vernix Caseosa ; cytology
3.Clinical characteristics of induction of labor in nulliparas.
Young Sil CHOI ; Hyun Kyung PARK ; Su Ran CHOI ; Sung Chun YANG ; Yong Woo LEE
Korean Journal of Obstetrics and Gynecology 2007;50(12):1650-1656
OBJECTIVE: The purpose of this study was to assess clinical characteristics of induction of labor group in nulliparous women at term with a single fetus in cephalic presentation. METHODS: we reviewed retrospectively the medical records of 73 nulliparous women delivered between August 2004 and July 2006. The patients were classified as induction of labor group and spontaneous onset of labor group to compare of obstetrical data. Student t-test, Chi-square, and Fisher's exact test were performed. RESULTS: Induction of labor group than spontaneous onset of labor group had higher < or =4 of Bishop score cervical status and time from admission to delivery was longer (p<0.05). The rate of cesarean delivery and meconium stained amniotic fluid were higher in induction of labor group (p<0.05). In case of Bishop score is higher than 4, normal vaginal delivery is higher than cesarean delivery (p=0.100). CONCLUSION: Induction of labor in nulliparous women is associated with low Bishop score and an increased risk of cesarean delivery. Success of vaginal delivery is tightly associated with favorable cervical status.
Amniotic Fluid
;
Female
;
Fetus
;
Humans
;
Meconium
;
Medical Records
;
Retrospective Studies
4.Approximate Entropy of the Short-term Variability of Fetal Heart Rate as an Efficient Measurement of Fetal Distress.
Eun Ju CHOI ; Dae Young CHUNG ; Young Bo SHIM ; Sang Hoon YI ; Chul Seung LEW ; Ji Hyun LEE ; Jong Chul SHIN ; Hyun Young AHN ; Soo Pyung KIM
Korean Journal of Obstetrics and Gynecology 2003;46(3):514-521
OBJECTIVE: The purpose of this study was to evaluate the usefulness of approximate entropy on fetal heart rate variability of electronic fetal monitoring taken during antepartum and intrapartum periods as a new diagnostic method of fetal distress. METHODS: Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into 3 groups, i.e.; 36 into normal fetus group, 26 into presumed distress group and 14 into acidemic distress group. We performed a frequency analysis on time series of heart rate variability in three groups. In order to perform non-linear analysis on the raw data of the fetal heart rate, after resampling and low pass filtering, we investigated approximate entropy. RESULTS: The results of the approximate entropy showed that the value in normal fetus group was significantly high than the value in distress group. But in the distress group, ApEn value was not difference between acidemic and non-acidemic subgroup. ApEn of HRV was confirmed in nonlinear parameter without low pass filtering and resampling. CONCLUSION: The results show that the fetal heart rate variability has nonlinear characteristics and could distinguish normal fetal heart rate pattern and distress pattern numerically and objectively. And these ApEn value are useful for prediction and diagnosis of fetal distress in ante and prenatal periods.
Ants
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Diagnosis
;
Entropy*
;
Female
;
Fetal Blood
;
Fetal Distress*
;
Fetal Heart*
;
Fetal Monitoring
;
Fetus
;
Heart Rate
;
Heart Rate, Fetal*
;
Humans
;
Pregnancy
;
Pregnant Women
5.Spectral Analysis of Fetal Heart Rate Variability in Fetal Distress.
Yeonhee CHEON ; Dongjoo KIM ; Daeyoung CHUNG ; Kyungtae PARK ; Youngbo SHIM ; Chulseung LEW ; Sanghoon YI ; Jongchul SHIN ; Hyunggeun LEE ; Soopyung KIM
Korean Journal of Obstetrics and Gynecology 2001;44(5):845-851
OBJECTIVE: To evaluate the usefulness of power spectral analysis on fetal heart rate variability as a new diagnostic method of fetal distress. STUDY DESIGN: Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into 3 groups, i.e.; normal fetus group (36), presumed distress group (26) and acidemic distress group (14). In order to perform linear analysis on the raw data of the fetal heart rate, after resampling, we performed Fourier transformation and investigated power distributions among very low frequency (VLF), low frequency (LF), high frequency (HF) bands, and autonomic balance (LF/HF). RESULTS: The results of the spectral analysis showed that in normal fetus group, the difference in the distribution of power spectrums of VLF, LF and HF was significantly higher than in presumed distress group and acidemic distress group. In fetal distress, the LF and VLF value (0.0023, 0.0437) were good predictors (sensitivity 97.5%, 75.0% and specificity 86.1%, 94.4%). The LF value (0.0013) was a good predictor in fetal acidemia (sensitivity 97.5% and specificity 86.1%). CONCLUSIONS: A computerized spectral analysis of fetal heart rate variation is a good predictor of fetal distress, which is made automatically and objectively.
Female
;
Fetal Blood
;
Fetal Distress*
;
Fetal Heart*
;
Fetal Monitoring
;
Fetus
;
Fourier Analysis
;
Heart Rate, Fetal*
;
Humans
;
Pregnancy
;
Pregnant Women
;
Sensitivity and Specificity
6.Nonlinear Dynamic and Chaotic Analysis of Fetal Heart Rate in Fetal Distress.
Sa Jin KIM ; Jong Chul SHIN ; Dae Young CHUNG ; Young Bo SIM ; Sang Hoon YI ; Chang Yi KIM ; Soo Pyung KIM
Korean Journal of Obstetrics and Gynecology 2000;43(6):1071-1079
OBJECTIVES: For estimating the antenatal fetal wellbeing to develop new analysis method of fetal heart rate(FHR) with electronic Fetal Heart Rate Monitoring(eFHRM) and computer. METHODS: Heart rate signal is received from distressed fetus using eFHRM. It is necessary to carry out low pass filtering as a preprocess for the nonlinear method. Nonlinear parameters are calculated and classified to investigate the relations between these parameters and values of umbilical cord blood gas. RESULTS: By dividing values of the umbilical cord blood gas into 5 fetuses of acidemic group and 17 fetuses of non-acidemic group after 22 neonates who presented fetal distress were born, the following results as compared with nonlinear chaotic analysis result were obtained. 1. Delay time through AMI for acidemic group was 16.80+/-3.11, and was higher than 15.41+/-2.27 for non-acidemic group, and is not significant in statistics. 2. Embedding Dimension calculated with FNN method was 5.60+/-2.07 for acidemic group, and 4.71+/-1.26 for non-acidemic group, and it was not significant statistically. 3. Correlation dimension for acidemic group was 1.41+/-0.20, and was higher than 1.10+/-0.38 for non-acidemic group, and is not significant in statistics. 4. Mean crossing value by isoangular return map was 28.80+/-11.34 for acidemic group, and 16.65+/-7.00 for non-acidemic group, and it was significant statistically(P=0.008). 5. In comparison of information entropy in 1-D ED, acidemic group was 6.32+/-0.38 and non-acidemic group was 6.20+/-0.28 and it was not significant statistically. Also, in comparison of value in 2-D ED, acidemic group was 10.20+/-0.34. It was higher than non-acidemic group of 9.51+/-0.43 significantly in statistics(P=0.004). But, in comparison of value in 2-D EP, acidemic group was 8.78+/-0.86 and non-acidemic group is of 9.22+/-0.74 and it wasn't significant statistically. And, 2-D ED(DI) value was 10.64+/-0.14 for acidemic group and 10.51+/-0.18 for non-acidemic group, and it wasn't significant statistically. CONCLUSIONS: By the above result, nonliner dynamics and chaotic analysis of heart rate data with computer can serve as a new diagnosis method which may estimate the fetal wellbeing with real time. Through further studies for establishment of diagnosis standard and computer programming, real time diagnosis method shall be applied to clinical practice.
Diagnosis
;
Entropy
;
Female
;
Fetal Blood
;
Fetal Distress*
;
Fetal Heart*
;
Fetus
;
Heart Rate
;
Heart Rate, Fetal*
;
Humans
;
Infant, Newborn
;
Nonlinear Dynamics*
;
Pregnancy
7.Amniotic Fluid Index and Preinatal Outcome in Postterm Pregnancy.
Korean Journal of Perinatology 1997;8(2):119-127
A pregnancy is considered postterm if it is beyond 294 days (42 complete weeks). Several investigators have demonstrated that postterm pregnancy may be accompanied by a rise in perinatal morbidity and/or mortality. Abnormalities such as meconium staining, cringenital anomalies, intrauterine growth retardation, postmaturity syndrome, fetal asphyxia have been reported in some cases of reduced amniotic fluid volume (oligohyramnios) which is commonly observed in postterm pregnancies. Amniotic fluid volume has been shown to decrease significantly as gestational age advances beyond term. Oligohydramnios has particular relevance to postterm pregnancies. Poor perinatal outcomes of oligohydramnios on postterm pregnancy have been reported by several authors. To date, however, the relationship between oligohydramnios in pastterm pregnancy and fetal outcome is debatable. The purpose of this clinical study was to evaluate the relationship between oligohydr- amnios and perinatal outcome in 64 cases of postterm pregnancies. Amniotic fluid index(AFI) values were measured semiweekly in 64 good dated, uncomplicated singleton pregnancies. AFI values were categorized into 2 groups. The group 1; patients whose final AFI value was above 5.0 cm; Group 2, patients whose AFI value fell below 5.0 cm. Adverse fetal outcome was defined by the presence of meconium staining, fetal heart rate decelerations, cesarean delivery for fetal distress, low Apgar score at 1 and 5 minutes, neonatal intensive care unit admission, and perinatal mortality. The fetal outcome was compared group 1 with group 2 and results obtained were as follows: 1. The incidence of oligohydramnios in postterm pregnancy was 54.7 %. The average diminution of amniotic fluid index was from 8.2 1.8 cm to 5.6+2.2 cm/week. 2. The incidence of meconium-staining in amniotic fluid was 40.6 % (Group 1: 20.7 %, Group 2: 57.1 %) and showed statistically significant difference between the two groups(p= 0.003). 3. The incidence of Apgar score less than 7 was 23.4% in 1 minute (Group 1: 13.8 %, Group 2: 31.4 %) and 4.7 % in 5 minutes(Group 1: 3.4%, Group 2: 5.7 %), respectively and showed no statistically significant difference between the two groups (p=0.140, p=1.000). 4. I'he incidence of cesarean delivery due to fetal distress was 12.5 % (Group 1: 6.9%, Group 2: 17.1 %) and showed no statistically significant difference between the two groups (p=0.275). 5. The incidence of admission to NICU was 12.5 % (Group 1: 6.9%, Group 2: 17.1 %) and showed no statistically significant difference between the two groups (p=0.275). Adverse fetal outcome was not uniformly observed in postterm pregnancies with oligohydramnios. Amniotic fluid index in oligohydramnios group as a single independent guide was not enough to predict fetal outcomes in postterm pregnancy without specific pathologic condition of fetus.
Amniotic Fluid*
;
Apgar Score
;
Asphyxia
;
Deceleration
;
Female
;
Fetal Distress
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Fetal Growth Retardation
;
Fetus
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Gestational Age
;
Heart Rate, Fetal
;
Humans
;
Incidence
;
Infant, Newborn
;
Intensive Care, Neonatal
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Meconium
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Mortality
;
Oligohydramnios
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Perinatal Mortality
;
Pregnancy*
;
Research Personnel
8.Ethical Guidelines on Fetal Mesencephalic Transplantation.
Journal of Korean Neurosurgical Society 1994;23(3):295-298
Research or therapy involving human fetal tissue has been subject of intense political and ethical debate in many country for almost two decades. Especially, Transplantation of cells or tissues from aborted fetuses to treat Parkinson's disease shows great clinical promise but it has some ethical or legal controversy. We can expect that demand of fetal brain tissue is increased explosively near future. So we have to establish our own eithical guidelines urgently. In this article authors report several basic medical or ethical issues which the fetal mesencephalic transplantation brings up inevitably and suggest our own ethical guidelines.
Aborted Fetus
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Brain
;
Ethics
;
Fetus
;
Humans
;
Parkinson Disease
;
Transplantation
9.Relationship between nRBC counts and fetal hypoxia, perinatal outcome in severe preeclampsia.
Yun Kyung LIM ; Suk Joon CHANG ; Se Hee MUN ; Jeong In YANG ; Haeng Soo KIM ; Hee Sug RYU
Korean Journal of Obstetrics and Gynecology 2004;47(11):2077-2084
OBJECTIVE: To determine the usefulness of neonatal nucleated red blood cell counts (nRBC) as an independent predictor of fetal hypoxia and perinatal outcome in severe preeclampsia. METHODS: One hundred thirty eight patients with severe preeclampsia were studied. Umbilical artery Dopppler velocimetry was performed in all patients, and were divided into two groups, the control group with present umbilical artery end diastolic velocity, and the case group with absent or reversed velocity. The patients were also separately grouped as another control (n=58), acute (n=19), and chronic hypoxia (n=55) according to abnormal Doppler findings, presence of oligohydramnios, intrauterine growth restriction (IUGR), and pattern of fetal heart rate tracings during labor. At delivery, the umbilical cord blood was collected and the levels of nRBC per 100 WBC were measured from the samples along with blood gas analysis. The results were compared between the control and acute groups, and chronic hypoxic fetus. Correlation with perinatal outcomes was also evaluated. Student's t-test, ANOVA, and regression analysis were performed for statistical analysis. RESULTS: Those with absent or reversed end diastolic velocity did not have significantly greater nRBC counts, but had lower platelet counts (p=0.02), lower pO2 (p=0.005), and higher pCO2 saturation levels (p=0.01). There were no significant differences with regard to nRBC counts among the control, acute, and chronic hypoxia groups. Elevated nRBC counts were significantly associated with neonatal intensive care unit stay of more than 28 days (p=0.013), respiratory distress syndrome (p=0.003), disseminated intravascular coagulopathy, or sepsis (p=0.041). CONCLUSION: nRBC counts did not show significant difference according to umbilical artery Doppler velocity. Also we could not find any difference between the control, acute, and chronic hypoxic group, suggesting that nRBC counts does not correlate with both hypoxic status, or duration of hypoxia. Correlation with elevated nRBC counts and neonatal intensive care unit stay of more than 28 days, respiratory distress syndrome, disseminated intravascular coagulopathy, and sepsis was observed. However, the overlapping results and the wide range of nRBC counts according to the complications limits its role as a predictor of poor perinatal outcome.
Anoxia
;
Blood Gas Analysis
;
Erythrocyte Count
;
Female
;
Fetal Blood
;
Fetal Hypoxia*
;
Fetus
;
Heart Rate, Fetal
;
Humans
;
Infant, Newborn
;
Intensive Care, Neonatal
;
Oligohydramnios
;
Platelet Count
;
Pre-Eclampsia*
;
Pregnancy
;
Rheology
;
Sepsis
;
Umbilical Arteries
10.Change of blood gas and hemodynamics in the fetal goat undergoing ECMO through umbilical artery and vein.
Chang hun SONG ; Geum young SO ; Kook hyun LEE ; Sok cheon PAK
Korean Journal of Obstetrics and Gynecology 2001;44(9):1657-1663
OBJECTIVES: The purpose of this study is to establish animal model of extracorporeal membrane oxygenation (ECMO) system that uses membreane type oxygenator and circulation circuit of umbilical artery and vein. Blood gas and hemodynamic changes in the fetal goat undergoing ECMO were also evaluated. METHODS: Total 15 pregnant goat had been used to perform extrauterine fetal incubation using ECMO through umbilical artery and vein. Cesarean-section was performed to pregnant goat (35 kg) of 120-130 days of gestation to insert catheters (8 Fr) into the umbilical artery and vein. The tip of inserted catheter's the other end was connected with the circuit system including membrane type oxygenator (Polystan) and roller pump. A total of 300 ml of blood was drawn from donor nonpregnant goat and primed into circuit on the day of surgery. The goat fetus was immersed in a chamber filled with artificial amniotic fluid to monitor blood flow dynamics and blood gas was analyzed. RESULTS: The ECMO system using umbilical cord in the extrauterine incubation of fetal goat was developed and maximum survival of goat fetus was 34.5 hrs (mean survival was 856.6+/-688 min). Oxygen tension (PO2) in umbilical artery and vein were 20.53+/-2.54 mmHg, 31.03+/-13.03 mmHg and oxygen saturation (SO2) in umbilical artery and vein were 46.61+/-18.14 mmHg, 71.56+/-15.39 mmHg. Mean blood flow was 176+/-62 ml/min/kg. CONCLUSION: We suggest that our experimental model as an extrauterine fetal research could be a reasonable method in future advanced studies. However, longterm survival of extrauterine fetus needs more suitable hemodynamic and blood gas condition supported by further researches.
Amniotic Fluid
;
Catheters
;
Extracorporeal Membrane Oxygenation*
;
Female
;
Fetal Research
;
Fetus
;
Goats*
;
Hemodynamics*
;
Humans
;
Membranes
;
Models, Animal
;
Models, Theoretical
;
Oxygen
;
Oxygenators
;
Pregnancy
;
Tissue Donors
;
Umbilical Arteries*
;
Umbilical Cord
;
Veins*