The intestinal obstruction during pregnancy is rare but early diagnosis and treatment is essential. This disease can be diagnosed very late because the presenting symptoms such as nausea, vomiting and abdominal pain are often seen in normal pregnancies and most pregnant women avoid radiologic examinations. Moreover, this disease can be accompanied by high aspartate transaminase/alanine transaminase (AST/ALT) which can be also found in acute fatty liver of pregnancy or preeclampsia, and it makes diagnosis to be much delayed. If the diagnosis were delayed much, maternal and perinatal mortality would be increased highly. Therefore, the previous record of abdominal surgery or above mentioned symptom should be considered as the intestinal obstruction, and simple abdominal x-ray for early diagnosis and prompt operation step are critical. We present a case of small bowel obstruction accompanied with high AST/ALT during pregnancy which had the history of previous cesarean section with a brief review of the literature.
Abdominal Pain ; Aspartic Acid ; Cesarean Section ; Early Diagnosis ; Fatty Liver ; Female ; Humans ; Intestinal Obstruction ; Nausea ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, Third ; Pregnant Women ; Vomiting

Angular pregnancy is rare, in which the embryo in the lateral angle of uterine cavity and located medial to the utero-tubal junction. Angular pregnancy is differentiated from interstitial pregnancy. There is no report about term angular pregnancy in Republic of Korea, a few reports in other countries. Angular pregnancy has different clinical characteristics according to the trimester. We diagnosed angular pregnancy by ultrasonography and computed tomography (CT). The CT is a useful diagnostic method. We report a case of term angular pregnancy with placenta accreta and review the diagnostic process and complications.
Embryonic Structures ; Placenta ; Placenta Accreta ; Pregnancy ; Republic of Korea

OBJECTIVE: The survey was conducted to improve the health of Korean adolescents and to prepare adequate teaching programs by investigating their sexual behavior. METHODS: The participants of the survey was 80,000 middle and high school students aged 13 to 18. The survey was conducted from September 1st, 2007 to September 22nd, 2007. RESULTS: 78,834 students were surveyed and 74,698 (94.8%) students responded the survey. 35,232 (47.2%) of respondents were male students and 39,466 (52.8%) of respondents were female students. 38,820 (52.0%) of respondents were middle school students, 25,051 (33.5%) of respondents were high school students and 10,827 (14.5%) of respondents were technical high school students. 5.2% of respondents experienced sexual intercourse. The average age of the first sexual intercourse was 14.2 years old. 1.0% of respondents had a sexual intercourse before they enter the middle school. The pregnancy rate was 0.3%. Among respondents who experienced sexual intercourse, the rate of the use of contraceptive methods was 38.2%. The rate of using inappropriate contraceptive methods was 21.6%. The average age of a first wet dream for boys was 13.2 years old. The average age of menarche for girls was 12.4 year old. The rate of respondents who had a sex education was 72.2%. CONCLUSION: The average age of the first wet dream and menarche had been decreased. The average age of the first sex experience among adolescents had been decreased. The rate of adolescents who experienced a sexual intercourse was increased. However, the rate of using reliable contraceptive methods was very low. Therefore, adequate sex educations including effective contraceptive methods needs to be conducted to prevent unwanted pregnancy of adolescents.
Adolescent ; Aged ; Coitus ; Contraception ; Surveys and Questionnaires ; Dreams ; Female ; Humans ; Male ; Menarche ; Pregnancy ; Pregnancy Rate ; Pregnancy, Unwanted ; Sex Education ; Sexual Behavior

OBJECTIVE: This study was designed to analyze outcome of removal of non-palpable Implanon(TM) by ultrasound guidance. METHODS: This is retrospective study of patients who were referred from local clinic where removal of non-palpable Implanon(TM) had been failed. The cases were 32 patients who visited to Yonsei University Gangnam Severance Hospital between March 2004 through March 2009. RESULTS: Implanons(TM) were localized on ultrasound in all 32 cases. 18 cases were located in subcutaneous layer, 10 cased were located in fascial layer, 4 cases were located in muscle layer. All cases were successfully removed. The average length of time required for removal was 19.3 minutes. There was no complication except one patient, who had mild median nerve injury. CONCLUSION: Ultrasound guidance removal was safe and effective procedure to remove non palpable Implanon(TM).
Humans ; Median Nerve ; Muscles ; Retrospective Studies

OBJECTIVE: To investigate whether sudden rise or already increased level of maternal serum CA125 predicts spontaneous abortion in early pregnancy with vaginal bleeding. And if so, to decide the CA125 cut-off level for poor pregnancy outcomes. METHODS: The prospective study was performed in forty women presenting with any vaginal bleeding at early pregnancy. Maternal serum CA125 levels were evaluated on the first visit and followed up during the first trimester, or until the time to diagnose abortion. Serial maternal serum beta-hCG and ultrasonographic evaluation were also performed at the same time. RESULTS: There were eventually fourteen abortions and twenty-six ongoing pregnancies. Using receiver-operating characteristic curve, 150 U/mL of serum CA125 was the most useful value for predicting spontaneous abortion. In most of abortion women, the serum CA125 level was increased over than 150 U/mL immediately before the abortion. The twelve of 17 women who were 150 U/mL or more resulted in abortion, while there were just two cases of abortion among 23 women who were less than 150 U/mL. Its positive predictive value was 70.6% and negative predictive value was 91.3% respectively (P<0.01). CONCLUSION: There was a strong correlation between high level of serum CA125 and subsequent spontaneous abortion in early pregnancy. It should be valuable to check maternal serum CA125 added to beta-hCG and ultrasound for predicting pregnancy outcome at the early pregnancy, especially in the cases with vaginal bleeding.
Abortion, Spontaneous ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Prospective Studies ; Uterine Hemorrhage

OBJECTIVE: To determine the accuracy and usefulness of prenatal ultrasonographic and molecular genetic diagnosis in detection of skeletal dysplasia. METHODS: This study was based upon data of the 17 cases of skeletal dysplasia diagnosed by prenatal ultrasound and 7 cases by molecular diagnosis performed among the 17 cases and the 2 cases who has familial skeletal dysplasia by molecular diagnosis during the first trimester at Ewha and Eulji University from March 1998 to August 2005. A final diagnosis was sought on the basis of radiographic studies, molecular testing, or both. RESULTS: The mean gestational age at diagnosis was 24.9 weeks (range, 17 to 35 weeks). Nine cases were diagnosed before 24 weeks. A final diagnosis was obtained in 16 cases (94.1%). There was 1 false-positive diagnosis. The antenatal diagnosis was correct in 14 cases (82.4%). The 8 cases were prenatally confirmed and 1 case was postpartum confirmed using molecular genetic testing and accurate antenatal diagnosis and prediction was done. We were able to rule out skeletal dysplasia through chorionic villus sampling during the first trimester in the 2 cases with the family history with skeletal dysplasia. CONCLUSION: Prenatal diagnosis of skeletal dysplasia can be a considerable diagnostic challenge. However, skeletal dysplasia is correctly diagnosed on the basis of prenatal meticulous ultrasound and antenatal prediction of lethality was highly accurate. Using prenatal molecular diagnosis, skeletal dysplasia can be diagnosed at first trimester of pregnancy and nonlethal skeletal dysplasia can be confirmed when prenatal ultrasound was nonspecific.
Chorionic Villi Sampling ; Female ; Gestational Age ; Humans ; Molecular Biology ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, First ; Prenatal Diagnosis

Human epidemiological and animal studies show that many chronic adult disease have their antecedents in compromised fetal and early postnatal development. Developmental programming is defined as the response by the developing mammalian organism to a specific challenge during a critical time window that alters the trajectory of development with resulting persistent effects on phenotype. Each individual's phenotype is influenced by the developmental environment as much as their genes. Also, the term 'fetal origins of adult disease' was coined on the basis of the inverse association between low birth weight and blood pressure, adult-onset diabetes, coronary heart disease, and stroke seen in numerous epidemiological studies. However, it seems unlikely that birth weight is involved in causal pathways underlying theses observations, and if it were then the significance to public health of these findings is very limited because of our inability to modify birth weight to a relevant extent in humans. There has been a major focus on maternal nutrition. Important targets for future research include distinction between the effects of different pregnancy conditions, such as maternal malnutrition, preeclampsia, and maternal infection, which may have dissimilar late-life consequences. This will be a crucial step when the associations that are currently emerging will be translated into disease prevention.
Adult ; Animals ; Birth Weight ; Blood Pressure ; Coronary Disease ; Fetal Development ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Malnutrition ; Numismatics ; Phenotype ; Pre-Eclampsia ; Pregnancy ; Public Health ; Stroke

Recently, in our society, there have been a lot of talks about fetocide and artificial abortion. I suppose it would be natural in a way. Because the very problem of fetocide and artificial abortion has been always there in our society and various concerns about it still hover above our lives. Fetocide in the criminal law, by legal definition, means the artificial evacuation of growing fetus from mother's uterus or killing the fetus in the mother's uterus. Meanwhile, artificial termination in the mother and child health law, by legal definition, means artificial evacuation of growing fetus and gestational by-products through medical procedure within such a early period in fetal life unable to survive outside the mother's uterus. A couple of jurisprudential reasoning about fetocide and artificial abortion could be possibly constituted in accordance with the legal point of view. But, in the scene of medical practice of Obstetrics and Gynecology, there would be very little difference in terms of criminal charges. It is concluded that both occasions of any artificial abortion with no allowable reasons and any artificial abortion with allowable reasons committed in the period beyond 24 weeks of gestation are to be punished by the current criminal law.
Child ; Child Health ; Criminal Law ; Criminals ; Fees and Charges ; Fetus ; Gynecology ; Homicide ; Humans ; Jurisprudence ; Mothers ; Obstetrics ; Pregnancy ; Uterus

OBJECTIVE: This exploratory study was undertaken to analyze the anxiety of parents of prenatally diagnosed fetal congenital disease and satisfaction after the multidisciplinary counseling. METHODS: The study included 32 prospective parents of antenatally diagnosed congenital disease fetus who received multidisciplinary counseling at The Catholic Congenital Disease Center (CCDC) for the period from May, 2009 through March, 2010. The Korean version of the Spielberger State-Trait Anxiety Inventory (STAI) was utilized to assess parental anxiety. Categories of satisfaction survey were classified into accessibility, professionalism, empathy, recoverability, satisfaction, and expectation after counseling. RESULTS: The mean time and number of medical professionals for each counseling were 58.0+/-36.9 min and 3.5+/-1.1 persons. Most common congenital diseases were cardiovascular (36.1%) and urogenital diseases (25.0%). STAI scores were significantly decreased after than before counseling (43.5+/-5.9 vs 36.9+/-6.0, P=0.0007). STAI scores after counseling showed significant decrease in prospective mothers who were nulliparous (P=0.0005), less than 35 years old (P=0.0014), had religion (P=0.0014) and counseled more than 40 minutes (P=0.0027). The mean rate of positive satisfactory response about multidisciplinary counseling was 85.6% in satisfaction survey. CONCLUSION: This study provides evidence of the positive impact on the prospective parental anxiety of a multidisciplinary counseling in prenatal management of fetal congenital diseases.
Anxiety ; Counseling ; Empathy ; Fetus ; Humans ; Mothers ; Parents ; Prospective Studies

OBJECTIVE: This study was to evaluate the safety of cesarean delivery through transplacental incision in anterior placenta previa and its effect on mother and neonate. METHODS: We examined 74 cases of placenta previa retrospectively who underwent cesarean section from May 2006 to December 2009, in Chungbuk National University Hospital. They were divided into two groups according to the placental incision. Transplacental incision was made in all cases of anterior placenta previa. We compared postoperative maternal hemoglobin change, neonatal hemoglobin and hematocrit, intra and/or postoperative transfusion volume, neonatal intensive care unit (NICU) admission days between the two groups. RESULTS: There were no differences in maternal characteristics, hemoglobin changes, transfusion volume between the two groups. Nor the neonatal hemoglobin and hematocrit level, Apgar score and admission days were different. There was no neonatal acidosis below pH 7.20. CONCLUSION: The cesarean delivery through transplacental incision in anterior placenta previa seems to be safe because it did not increase maternal and fetal blood loss nor NICU admission days.
Acidosis ; Apgar Score ; Cesarean Section ; Female ; Fetal Blood ; Hematocrit ; Hemoglobins ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Intensive Care, Neonatal ; Mothers ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies