No abstract available.
Cefazolin* ; Erythromycin* ; Latency Period (Psychology)* ; Membranes* ; Rupture*

OBJECTIVES: the aim of this study was to evaluate plasmin system in placenta fiom women with normal and preeclamptic pregnancy. METHODS: The levels of urokinase-type plasminogen activator(uPA), tissue-type plasrninogen activator(tPA), uPA receptor(uPAR) and plasminogen activatar inhibitor-1(PAI-1) mRNAs were measured by Northern blotting in placenta hom sixteen women with normal (n""8) and preeclamptic (n""8) pregnancy. The levels of tPA protein and PAI-1 protein were also measured by Westerrn blotting. RESULTS: Densitometric measurements revealed no difference in the levels of uPA mRNA, uPAR mRNA, tPA protein and PAI-1 protein in placentas fiom normal and preeclamptic pregnancies. There was, however, a significant decrease in the level of 3.2 kb PAI-I mRNA in placentas from preeclamptic women compared to normal pregnant women. CONCLUSION: To the contrary of our expectation, 3.2 kb PAI-1 mRNA level was significantly lower in placenta from women with preeclampsia compared to normal pregnancy. This seems to reflect differential accumulation of PAI-1 mRNAs due to environmental intluences or decreased differentiation potential of villous trophoblasts to invasive trophoblasts in placenta from preeclamptic women compared to normal pregnant women. The mechanism that regulates plasmin system in human placenta needs further investigations.
Blotting, Northern ; Female ; Fibrinolysin* ; Humans ; Placenta* ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women ; RNA, Messenger ; Trophoblasts

A 24-year-old pregnant woman started to have severe hyperemesis gravidarum at 6 weeks' gestation. Six weeks later, dizziness, ataxia, visual disturbance, diplopia and confusion were developed. On admission, she presented ophthalmoplegia, nystagmus, deaeased tendon reflex, intention tremor, ataxia, confusion and memory disturbance. She was diagnosed to Wernicke-Korsakoff syndrome and 100mg of thiamine was administered intravenously daily till 28 weeks gestation and then intramuscularly. Her ocular symptns, together with neurological signs, were gradually improved. Memory disturbance slightly improved but remained at the time of delivery. The case will be presented in more details with a brief revie of literatures.
Ataxia ; Diplopia ; Dizziness ; Female ; Humans ; Hyperemesis Gravidarum* ; Korsakoff Syndrome* ; Memory ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Reflex, Stretch ; Thiamine ; Tremor ; Young Adult

No abstract available.
Fetus*

OBFECTIVE: A nuchal skinfold thickness measurement of >or=6mm is widely used as anonivasive tool in screening fetuses with Down syndrome. The aim of this study is to obtainnormative data on the nuchal skinfold thickness in chromosomally normal fetuses duringsecond trimester. METHOD: Fetal nuchal skinfold thickness was measured in the suboccipitobregmaticplan as part of second trimester ultrasonography. Three hundred thirtyfive fetuses,confirmed to be without chromosomal abnormality through evaluation by amniocentesisand/or postnatal examination, were included. RESULT: The mean of measurements increased from 2.74mm to 5.30mm between 15Weeks and 26 weeks of gestation. The measurements of fetal nuchal kinfold thicknesscorrelated linearly with gestational age(y=-1.755+0.29, r(2)=0.406, p=0.0001). Fetal genderhad no influence on this measurement. In contrast to the fact that three of 271 fetuses at or=21 weeks showed nuchal thickness measurement of >or=6mm. CONCLUSION: During second trimester, measurements of fetal nuchal skinfold thicknessincreases as a function of gestational age in normal fetuses. There were no influence offetal gender and no ethnic difference from other countries in this measurement at 15~20weeks of gestation. However, measurements of fetal nuchal skinfold thickness >or=6mm asa screening tool for Down syndrome seems to be confined to fetuses at 15~20 weeks` gestation.
Chromosome Aberrations ; Down Syndrome ; Female ; Fetus* ; Gestational Age ; Humans ; Mass Screening ; Pregnancy ; Pregnancy Trimester, Second* ; Skinfold Thickness* ; Ultrasonography

No abstract available.
Pregnancy*

OBJECT: To assess the relative risk of an adverse pregnancy outcome in women with a false-positive riskfor Down syndrome by prenatal screeen using triple markers(maternal serum alpha-fetoprotein[AFP], unconjugated estrio[uE3], and human chorionic gpna dotropin[hGC] levels) and age. METHODE: Case-Control study including sixity four women with false-positive screens for Down sydromeand a matched control group of 128 women whose screen indicated a risk for Down syndrome of less than1 :270. The risk for adverse pregnancy outcome was compared for the two groups,and the roles of maternal serum AFP, uE3, and hCG as predictors of adverse pregnancy outcome weredetermined. RESULT: Women with false-positive screen for Down syndrome were not significantly different from theirmatched controls in the incidence of preterm delivery (5% versus 2%), pretermpremature rupture of membrane(3% versus 0%), placental abruption(0% versus 1%),preeclampsia(3% versus 1%), small for gestational age newborns(5% versus 6%), and fetal demise after20 week's gestation(2% versus 0%). The occurrence of an adverse outcome in 7 of 64(11%) pregnancieswith a flase positive screen for Down syndrome was not different from that in 12 of 128(9%) matchedcontrol pregnancies.Only maternal age (odds ratio 1.19,95% cofidence interval 1.05~1.34, p < 0.005) was siginificantly associatedwith adverse outcome after controlling for the effects of maternal serum AFP, hCG and uF3. CONCLUSION: Althought the sample on this study, women with a false-positive screen for Down syndromedo not seem to be at increased risk for a adverse pregnancy outcome when compared to those with a negativescreen result. Among maternal age, maternal serum AFP, hCG, and uE3level, only maternal age seemed tobe a predictorof an adverse pregnancy outcome.
Biomarkers* ; Case-Control Studies ; Chorion ; Down Syndrome* ; Female ; Gestational Age ; Humans ; Incidence ; Maternal Age ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

OBJECT: To assess the relative risk of an adverse pregnancy outcome in women with a false-positive riskfor Down syndrome by prenatal screeen using triple markers(maternal serum alpha-fetoprotein[AFP], unconjugated estrio[uE3], and human chorionic gpna dotropin[hGC] levels) and age. METHODE: Case-Control study including sixity four women with false-positive screens for Down sydromeand a matched control group of 128 women whose screen indicated a risk for Down syndrome of less than1 :270. The risk for adverse pregnancy outcome was compared for the two groups,and the roles of maternal serum AFP, uE3, and hCG as predictors of adverse pregnancy outcome weredetermined. RESULT: Women with false-positive screen for Down syndrome were not significantly different from theirmatched controls in the incidence of preterm delivery (5% versus 2%), pretermpremature rupture of membrane(3% versus 0%), placental abruption(0% versus 1%),preeclampsia(3% versus 1%), small for gestational age newborns(5% versus 6%), and fetal demise after20 week's gestation(2% versus 0%). The occurrence of an adverse outcome in 7 of 64(11%) pregnancieswith a flase positive screen for Down syndrome was not different from that in 12 of 128(9%) matchedcontrol pregnancies.Only maternal age (odds ratio 1.19,95% cofidence interval 1.05~1.34, p < 0.005) was siginificantly associatedwith adverse outcome after controlling for the effects of maternal serum AFP, hCG and uF3. CONCLUSION: Althought the sample on this study, women with a false-positive screen for Down syndromedo not seem to be at increased risk for a adverse pregnancy outcome when compared to those with a negativescreen result. Among maternal age, maternal serum AFP, hCG, and uE3level, only maternal age seemed tobe a predictorof an adverse pregnancy outcome.
Biomarkers* ; Case-Control Studies ; Chorion ; Down Syndrome* ; Female ; Gestational Age ; Humans ; Incidence ; Maternal Age ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

OBJECTIVES: The purposes of this study were to determine the usefulness of transvaginal ultrasonographic assessment of the uterine cervix and to compare the diagnostic performance of ultrasonographic and digital examination of the cervix in predicting a successful induction of labor. STUDY DESIGN: One hundred-one singleton term pregnancies without ruptured membranes admitted for the labor induction were included in this study. Digital examination and transvaginal ultrasonography of the uterine cervix were performed at the time of admission. Cervical parameters evaluated included cervical length, presence of funneling, funnel length, and funnel width. Labor induction was underwent by prostaglandin E2 (PGE2) vaginal suppository and/or pitocin intravenous infusion. Outcome variable was a successful labor induction within 48 hours after beginning of the induction. RESULTS: The prevalence of induction failure was 10.9% (11/101). Receiver-operator characteristic (ROC) curve and multiple logistic regression analysis indicated a significant relationship between the successful induction of labor and cervical length <3.1 cm. The diagnositic indices of endocervical length was superior to those of Bishop's cervical score in predicting a successful induction of labor. In patients with cervical length <3.1 cm, the labor was induced successfully with fewer tablets of PGE2, less use of pitocin infusion, and shorter induction-delivery interval. CONCLUSION: Transvaginal ultrasonographical examination of the uterine cervix is more accurate than digital examination of the cervix in the prediction of a successful induction of labor in term gestation.
Cervix Uteri* ; Dinoprostone ; Female ; Humans ; Infusions, Intravenous ; Logistic Models ; Membranes ; Oxytocin ; Pregnancy* ; Prevalence ; Suppositories ; Tablets ; Ultrasonography

OBJECTIVES: The purpose of this study was to determine the clinical significance of residual amniotic fluid volume, as measured by the amniotic fluid index(AFI), on the prediction of latency period and perinatal outcomes in patients with preterm premature rupture of the membranes(PPROM). METHODS: Study population consisted of 103 singleton pregnancies with PPROM between 24 and 34 weeks' gestation. Amniotic fluid index was determined using transabdominal ultrasound at admission. Latency period was defined as time interval in hours between admission and delivery. All medical records of mothers and neonates were reviewed. Spearman's rho rank correlation, receiver-operator characteristic(ROC) curve analysis, survival analysis and Cox's proportional hazard model were used for statistical analysis. RESULTS: There was a statistically significant correlation between latency period and AFI at admission. ROC curve analysis showed that AFI at admission had a significant predictive value in the prediction of latency period < 48 hours. Survival analysis demonstrated that AFI < 5.0 was strongly associated with the likelihood of shorter latency period, Cox's proportional hazard model indicated that AFI < 5.0 was a significant independent predictor for the occurrence of latency period < 48 hours even after adjustment of other independent variables. The patients with AFI <5.0 had a higher rate of cesarean section due to fetal distress than those with AFI > 5.0 but the incidence of chorioamnionitis was not significantly different between two groups. Comparing the perinatal mortality and neonatal morbidity including infectious morbidity between the neonates born to mothers with AFI <5.0 and those with AFI > 5.0, there was no significance after adjustment of gestational age at birth. CONCLUSION: AFI at admission has a significant correlation with latency period and predictive value in prediction of latency period in the patients with PPROM. AFI <5.0 is a independent predictor for the shorter latency period.
Amniotic Fluid* ; Cesarean Section ; Chorioamnionitis ; Female ; Fetal Distress ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Latency Period (Psychology)* ; Medical Records ; Membranes* ; Mothers ; Parturition ; Perinatal Mortality ; Pregnancy ; Proportional Hazards Models ; ROC Curve ; Rupture* ; Ultrasonography