OBJECTIVE: To assess the clinical characteristics, laboratory findings, the maternal and neonatal complications between HELLP syndrome and severe preeclampsia. METHODS: We reviewed the material and neonatal charts of 34 pregnancies complicated by HELLP syndrome and 40 pregnancies complicated by severe preeclampsia managed at our hospital between January, 2001 and December, 2005. We compared the clinical characteristics, laboratory findings, the maternal and neonatal complications between two groups. Results were compared by student T test, chi-square test. RESULTS: Our study showed that in HELLP syndrome patients had the less gestational age at admission, gestational age at delivery, the lower platelet counts, the higher AST, ALT, LDH, and the longer hospitalization period than in severe preeclampsia. Steroid (dexamethasone) use, cesarean delivery rate and MgSO4 use were more frequent in HELLP syndrome than severe preeclampsia. Neonatal birth weight was lower with HELLP syndrome. There was no significant difference in maternal and neonatal complications. CONCLUSION: HELLP syndrome need to be recognized a unique form of severe preeclampsia. It was associated with serious maternal and fetal mortality, the appropriate management would be done by early diagnosis using laboratory tests.
Birth Weight ; Early Diagnosis ; Female ; Fetal Mortality ; Gestational Age ; HELLP Syndrome* ; Hospitalization ; Humans ; Platelet Count ; Pre-Eclampsia* ; Pregnancy

OBJECTIVE: Screening tests for Gestational diabetes (GDM) are performed during the 24~28 weeks of pregnancy. Therefore, in many cases, GDM is not detected during the first trimester of pregnancy while most of important organs are developed during this period. In this review, we performed a retrospective study by dividing GDM mothers into 3 groups: diabetic, impaired glucose tolerance (IGT) and normal. The medical records of mothers and neonates from these three groups were compared. METHODS: 136 out of 536 GDM patients in Holy Family Hospital from 1995 to 2005 took a 75 g OGTT 6 weeks after delivery. As a result, 28 were diagnosed as diabetes, 18 had impaired glucose tolerance, and 90 were normal. The antenatal and perinatal history of above groups were retrospetively compared. RESULTS: In the diabetic group, 46.4% of mothers had a positive family history of diabetes, where as 38% of IGT group, 31.8% of normal group had the history. Secondly, the abortion history rate for each group was 21.4%, 16.6%, 13.3%, and each group had an average HbA1C of 7.20, 5.82 and 5.69. Also, the rate of preterm labor for each group was 17.9%, 11.1%, and 4.45%. The Apgar score (1 min/ 5min) was 7.29/8.54, 7.75/8.75 and 7.89/8.97. Lastly the rate of preeclampsia for each group was 14.3%, 11.1% and 6.8%. CONCLUSION: Three groups had distinctive differences in their perinatal morbidity both before and after delivery. Therefore, in order to reduce the perinatal morbidity and mortality rate, the present frequency or timing of GDM screening test, should be reconsidered.
Abortion, Induced ; Apgar Score ; Diabetes Mellitus ; Diabetes, Gestational* ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Infant, Newborn ; Mass Screening* ; Medical Records ; Mortality ; Mothers ; Obstetric Labor, Premature ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, First ; Retrospective Studies

OBJECTIVE: The study shows that the DFS is a questionnaire that almost effortlessly can be completed within 60-90 seconds during any moment of labor and delivery. The aim of the present study was to test the validity and reliability of the DFS, to identify its factor structure in Korea. METHODS: Review of the medical records from the department of obstetrics and gynecology from January to April 2005, a confirmed 51 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 22 primiparous and 29 multiparous women answered the Delivery Fear Scale (DFS) once during active labor, and the STAI (State-Trait Anxiety Inventory) after delivery. Reliability test to calculate Chronbach alpha and validity test to measure correlation between DFS and STAI was done. Then factor analysis was applied with the method of principal component analysis and varimax rotation. RESULTS: Korean version of DFS proved to be a reliable and valid scale statistically: Cronbach's alpha was 0.7182 in study. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The DFS measures fear during labor and delivery in an effortless and fast away. The development of the Korean version of DFS which is reliable and valid, and consists of three sub-factors may facilitate future research in the field.
Anxiety ; Diagnosis ; Female ; Gynecology ; Humans ; Korea ; Medical Records ; Obstetrics ; Parturition* ; Pregnancy ; Principal Component Analysis ; Surveys and Questionnaire ; Reproducibility of Results

Adnexal torsion during pregnancy is rare condition that is infrequently diagnosed preoperatively. Its incidence is 1 in 5000 during pregnancy, and adnexal torsion in the third trimester is rare. We present two cases of an adnexal torsion during the third trimester. The one had not been previously diagnosed by ultrasound and was associated with fetal distress and the other had been diagnosed having an ovary cyst by ultrasound in the first trimester. Both of patients were sent to our emergency room for sudden onset of severe low abdominal pain. Treatment was maintenance of adequate circulating intravascular volume and rapid surgical intervention.
Abdominal Pain ; Emergency Service, Hospital ; Female ; Fetal Distress ; Humans ; Incidence ; Ovary ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Third* ; Pregnant Women* ; Ultrasonography

Adnexal torsion during pregnancy is rare condition that is infrequently diagnosed preoperatively. Its incidence is 1 in 5000 during pregnancy, and adnexal torsion in the third trimester is rare. We present two cases of an adnexal torsion during the third trimester. The one had not been previously diagnosed by ultrasound and was associated with fetal distress and the other had been diagnosed having an ovary cyst by ultrasound in the first trimester. Both of patients were sent to our emergency room for sudden onset of severe low abdominal pain. Treatment was maintenance of adequate circulating intravascular volume and rapid surgical intervention.
Abdominal Pain ; Emergency Service, Hospital ; Female ; Fetal Distress ; Humans ; Incidence ; Ovary ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Third* ; Pregnant Women* ; Ultrasonography

Placental abnormality is the important predisposing cause of intrauterine growth retardation. Massive subchorionic hematoma is defined as a large size of maternal blood clot that separates the chorionic plate from the villous chorion and can result in serious obstetrical complications. We report a case of massive subchorionic hematoma diagnosed prenatally, and propose an additional peculiar finding detectable on both the ultrasound and magnetic resonance images: a large hematoma in the subchorionic region at 17 weeks gestation. At 18 weeks 2 days gestation, the fetus was miscarried. The clinical and pathological findings were compatible with massive subchorionic hematoma. Recurrent massive subchorionic hematoma without thrombophilic finding was observed at the next pregnancy in 17 weeks 5 days by ultrasound. The patient was managed conservatively and had successful outcome at term. So we report the case with the brief review of literatures.
Chorion ; Fetal Growth Retardation ; Fetus ; Hematoma* ; Humans ; Pregnancy ; Ultrasonography

OBJECTIVE: To determine obstetric outcome in infants > or =4,500 g according to delivery mode. METHODS: Records of 271 mothers and infants weighing > or =4,500 g over a 11-year period (1993~2003) were retrospectively reviewed. Maternal and perinatal outcomes were compared in relation to delivery mode. RESULTS: The frequency of macrosomia ranged 0.38% in 4,500 g or more. Vaginal delivery was achievable in 78/271 (28.8%) of women allowed to labor, of which 71.2% were operative. In macrosomia frequency correlations to parity showed 33.9% (92 cases) in primiparous women, 66.9% (179 cases) in multiparous women. According to the type of delivery, cesarean section has proven to be the most popular mode. The cesarean section group had a higher incidence of maternal BMI (> 25 kg/m2). The frequency of diabetes, hypertension, low Apgar score at 5 and 10 minutes was similar in both groups. CONCLUSION: It would be appropriate to have definite diagnostic schemes and adequate choice of delivery method for macrosomia. Maternal height, weight, BMI (body mass index) may associated with fetal body weight and delivery mode.
Apgar Score ; Cesarean Section ; Female ; Fetal Macrosomia* ; Fetal Weight ; Humans ; Hypertension ; Incidence ; Infant ; Mothers ; Parity ; Pregnancy ; Retrospective Studies

OBJECTIVE: To determine whether severity of proteinuria or urinary protein fractional analysis correlates with adverse maternal and fetal outcomes in women with severe preeclampsia. METHODS: Thirty-six women diagnosed of severe preeclampsia from January, 2002 to April, 2003 were studied. The correlation between proteinuria or urinary albumin fraction, and maternal mean arterial pressure, neonatal birth weight, 1 minute apgar score were analyzed statistically. Thirty-six patients were divided into two groups according to the pattern of urinary protein fraction. One group was a selective proteinuria group if the albumin fraction was over 70%, and another was a non-selective proteinuria group if the fraction was below 70%. The maternal and neonatal outcomes were compared between the two groups. RESULTS: Significant positive correlation was observed between proteinuria and mean arterial pressure, between urinary albumin fraction and neonatal birth weight. Negative correlation was significantly present between proteinuria and neonatal birth weight, 1 minunte apgar score, between proteinuria and albunin fraction. Increased proteinuria, higher mean arterial pressure, higher serum uric acid level, lower creatinine clearance, lower neonatal birth weight, and lower 1 minunte Apgar score were observed in the non-selective proteinuria group than those in the selective proteinuria, although there was no statistical significance. CONCLUSION: With increasing proteinuria and decreasing albumin fraction, there is increased risk of adverse maternal and fetal outcome. Proteinuria fractional analysis by electrophresis might provide useful information regarding the prediction of pregnancy outcomes.
Apgar Score ; Arterial Pressure ; Birth Weight ; Creatinine ; Female ; Humans ; Pre-Eclampsia* ; Pregnancy ; Pregnancy Outcome ; Proteinuria ; Uric Acid

Otocephaly is a rare malformations comprising hypoplasia or absence of the mandible (agnathia), ventromedial displacement and often fusion of external ears (synotia or otocephaly), and hypoplasia of the oral cavity (microstomia) and tongue (hypoglassia). This developmental complex represents a malformation of the first and second branchial arches and occurs sometimes with holoprosencephaly. We present the ultrasound detection of otocephaly and holoprosencephaly with cyclopia in a fetus of 27 gestational weeks 6 days. The use of three-dimensional (3-D) ultrasound made additional diagnostic ultrasound tomograms possible, and the volume reconstructions improved the imaging and the understanding of the condition.
Branchial Region ; Diagnosis* ; Ear, External ; Fetus ; Holoprosencephaly ; Mandible ; Mouth ; Tongue ; Ultrasonography

OBJECTIVE: Pregnant women have various fears and expectations regarding the impending birth. Fears can influence the course of the delivery and post-partum period. The DFS (Delivery Fear Scale) measures fear during labor and delivery in an effortless and fast away. The aim of this study were to compare DFS score and parity, maternal age, history of abortion, baby gender during an early stage of active labor (cervix dilatation 3-5 centimeters). METHODS: Review of the medical records from the department of obstetrics and gynecology from January 2004 to December confirmed 151 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 86 primiparous and 65 multiparous women answered the Delivery Fear Scale (DFS) once during active labor. Mann-Whitney test was applied to test possible differences between DFS and variable factors. Difference were considered to be statistically significant at p<0.05. RESULTS: Primiparous women had higher scores on the DFS than multiparous women during active labor. But DFS was not associated with maternal age, history of abortion, baby gender during an early stage of active labor. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The understanding of a fear during labor is to support the woman in labor in a way that decrease fear and the development of the DFS may facilitate future research in the field.
Diagnosis ; Dilatation ; Female ; Gynecology ; Humans ; Maternal Age ; Medical Records ; Obstetrics ; Parity ; Parturition ; Pregnancy ; Pregnant Women