No abstract available.
Dyslipidemias* ; Pre-Eclampsia*

The preoperative diagnosis of uterine torsion is very difficult due to the rarity of this disorder and its nonspecific clinical course. A primigravida woman visited our hospital with severe abdominal pain at 34 weeks of gestation. Emergency cesarean section was carried out due to development of fetal distress and severe abdominal pain. During the cesarean section, we noticed the uterus was rotated 180 degrees and the torsion was corrected after the delivery by making a vertical incision at the posterior uterine wall. High degree of suspicion and prompt management are important factors contributing to good prognosis of uterine torsion.
Abdominal Pain ; Cesarean Section ; Diagnosis ; Emergencies ; Female ; Fetal Distress ; Humans ; Pregnancy ; Pregnancy Trimester, Third* ; Prognosis ; Uterus

The preoperative diagnosis of uterine torsion is very difficult due to the rarity of this disorder and its nonspecific clinical course. A primigravida woman visited our hospital with severe abdominal pain at 34 weeks of gestation. Emergency cesarean section was carried out due to development of fetal distress and severe abdominal pain. During the cesarean section, we noticed the uterus was rotated 180 degrees and the torsion was corrected after the delivery by making a vertical incision at the posterior uterine wall. High degree of suspicion and prompt management are important factors contributing to good prognosis of uterine torsion.
Abdominal Pain ; Cesarean Section ; Diagnosis ; Emergencies ; Female ; Fetal Distress ; Humans ; Pregnancy ; Pregnancy Trimester, Third* ; Prognosis ; Uterus

The purpose of the current study was to propose a Korean-specific parameter set for calculating the risk of Down syndrome in the second trimester of pregnancy and to determine the screening performances of triple and quadruple tests in Korean women. Using the data on triple or quadruple screening from three hospitals in Korea during 7 yr, we re-converted the concentrations of four serum markers to multiple of median values according to gestational age and maternal weight. After re-calculating the risk of Down syndrome in each pregnancy by multiplying maternal age-specific risk by the likelihood ratio values for the serum markers, screening performances and optimal cut-off values of triple and quadruple tests were analyzed. Among 16,077 pregnancies, 23 cases had Down syndrome (1.4/1,000 deliveries). Compared to the previous program, the tests with new parameters had improved screening performance. The triple and quadruple tests had detection rates of 65.2% and 72.7%, respectively, at a false-positive rate of 5%. The optimal cut-off value for the quadruple and triple tests was 1:250. We have presented a Korean-specific parameter set for Down syndrome screening. The proposed screening test using this parameter set may improve the performance of Down syndrome screening for Korean women.
Adult ; Asian Continental Ancestry Group ; Biological Markers/blood ; Down Syndrome/blood/*diagnosis ; Female ; Genetic Testing/*methods ; Humans ; Predictive Value of Tests ; Pregnancy ; *Pregnancy Trimester, Second ; Prenatal Diagnosis/*methods ; Republic of Korea ; Risk

OBJECTIVE: The purpose of this study was to evaluate intrauterine fetal death and to elucidate the etiology of intrauterine fetal death. METHODS: This is a clinical study of 153 cases of fetal death in utero (FDIU) among 11,866 deliveries at Holy Family Hospital during Mar. 1995 to Feb. 2002. RESULTS: 1. The average incidence of FDIU was 1.29%. 2. The age distribution of mother with FDIU was between 16 to 45 year old and was highest in the 25 to 29 year old age group (45%). 3. The parity of mothers with FDIU was the highest in nulliparous group (58.5%) and there was a decreased tendency with high parity. 4. There were 80 cases (52.1%) with previous history of abortion and 8 cases (5.2%) with previous history of FDIU. 5. The highest incidence rate of FDIU was shown at 20~24 weeks of gestation (36.6%) and in the fetus weighted less than 1,000 gm (56%), and the sex ratio of male versus female fetus was 1.29:1. 6. The mode of delivery FDIU was labor induction (54.3%), laparotomy (15.2%), spontaneous labor (30.4%). The indication for laparotomy were placental abruption, previous cesarean section state, twin and maternal death. As the gestational age and fetal weight decreased, the mean time interval from start of labor induction to fetal expulsion and the variety of labor induction became increase. 7. The etiology factors of FDIU was unexplained causes (44%), congenital anomaly (17%), cord complication (14%) in order. CONCLUSION: The proper antenatal care should be taken of fetuses on the basis of risk factors of antepartum and intrapartum so that unnecessary intrauterine fetal death might be able to be prevented.
Abruptio Placentae ; Adult ; Age Distribution ; Cesarean Section ; Female ; Fetal Death* ; Fetal Weight ; Fetus ; Gestational Age ; Humans ; Incidence ; Laparotomy ; Male ; Maternal Death ; Middle Aged ; Mothers ; Parity ; Pregnancy ; Risk Factors ; Sex Ratio ; Twins

Specific types of HPV are currently implicated as etiologic agents of precuraors and cancerous lesions of the uterine cervix. This study used the data gained from one hundred twenty five wmen who underwent cnnrrent. Papanicoiaou smear, colposcopic diagnosis, and cervicovaginal lavage for HPV BNA test at Dysplasia Clinic in Kangnam St. Mary's Hospital. 38 patients had low-grade squemous intraepithelial lesiona (LGSILs) and 34 had high grade squamoua intrepithelial lesions (HGGILs), 24 invasive cervical cancers, and 29 normal control. Comlposcopic feeturee were prpectiively recorded by Reids colposcopic index and t,hen correlated with histapathologic diagnoeis. Using the colposcopic index, 86.4% was eorrelated with histapathologic findings. DNAs extracted from the cervicovaginal lavages were analyzed by polymerase chain reaction (PCR) using the HPV L1 consensus primers. HPV DNA was detected in 79 of 125 women (63.2%). Prevalences of HPV DNA in the patients with LGSIL (71.1%), HGSIL, (76.5%i) and cervix caneer (75.0%) showed no difference in statistics. Low-risk oncogenic viruses.(HPV-6/11) were present in 13.2% of patients with LGSIL, but none was detect,ed in thoee with HCSIL and cervix cancer. Intermediate-riak oncogenic viruses (HPV-31/33/35) were deterted in 5.3% of patients with LGSIL 8.8% in HGSIL, and none in cervix cancer. Prevalence of high-rsk onccgenie type HPV 16/18 was higher in HGSIL (41.2%) and invnsive cervical cancer (45.8%) than those of LGSII (15.8%) and cnntrols (3.5 %) (P = 0.0001). These data indicate that colposcnpic scoring has adjunctive diagnostic rale in predict,ing his-tology. And, HPV DNAs were found in similar incidence in the various histologic grades of cervical neoplasia. HPV-6/11 were detec only in LGSIL and HPV 31/33/35 in LGSIL and HGSIL, but not in invasive canser. HPV-16/18 were the predominant viruses which were detected in HGSIL, and invasive aervi 1 cancer. In canch.isizn, a combination of HPV testing and colposcopic scoring would provide sensitive screening methade for cervial cencer and pr nceraus lesions. And HFV typing might have prognmtic value in the management of patients with HPV related cervical neoplastic lesions.
Cervix Uteri ; Colposcopy* ; Consensus ; Diagnosis* ; DNA ; Female ; Humans* ; Incidence ; Mass Screening ; Oncogenic Viruses ; Polymerase Chain Reaction ; Prevalence ; Respiratory Sounds ; Therapeutic Irrigation ; Uterine Cervical Neoplasms

Pulmonary hypertension is a rare and potentially life-threatening complication of Systemic lupus erythematosus (SLE), and 5 cases has been previously documented in pregnancy. Four cases died after delivery and only one case was alive. We describe the case of a 28-year-old pregnant woman with pulmonary hypertension related to SLE with no previous history of immunologic disease including SLE. Diagnosis was made at 22 weeks of gestation. Medication including prednisolone and hydroxychloroquinone was commenced immediately and continued throughout the pregnancy. On fetal sonogram, the fetal growth was 3~10 percentile and diastolic notch of uterine arteries was noted. However, a healthy baby girl weighing 2,400 g was born in planned vaginal delivery at gestation week 38. There were no postpartum complications.
Adult ; Female ; Fetal Development ; Humans ; Hypertension ; Hypertension, Pulmonary ; Immune System Diseases ; Lupus Erythematosus, Systemic ; Postpartum Period ; Prednisolone ; Pregnancy ; Pregnant Women ; Uterine Artery

PURPOSE: The aim of this study was to identify the adipocyte-specific gene expression patterns in chorion-derived mesenchymal stem cells during adipogenic differentiation. MATERIALS AND METHODS: Chorionic cells were isolated from the third trimester chorions from human placenta at birth and identified morphologically and by fluorescence-activated cell sorting analysis. After inducing adipogenic differentiation for 28 days, cells at days 3, 10, 21 and 28 were analyzed by Oil red O staining and RNA extraction in order to assess the expression levels of adipocyte marker genes, including CCAAT-enhancer binding protein alpha (C/EBPalpha), peroxisome proliferator-activated receptor gamma (PPARgamma), fatty acid binding protein 4 (FABP4) and Glycerol-3-phosphate dehydrogenase (GPD2). Cells not induced for differentiation were compared with the induced cells as a control group. RESULTS: Chorion-derived cells showed the same pattern as fibroblasts, and expressed CD73, CD105, and CD166 antigens, but not CD45, CD34, and HLA-DR antigens. On day 3 after differentiation, cells began to stain positively upon Oil red O staining, and continuously increased in lipid granules for 4 weeks. The expression level of C/EBPalpha increased 4.6 fold on day 3 after induction, and continued to increase for 4 weeks. PPARgamma was expressed at a maximum of 2.9 fold on day 21. FABP4 and GPD2 were significantly expressed at 4.7- and 3.0-fold, respectively, on day 21, compared to controls, and further increased thereafter. CONCLUSION: Human chorion-derived mesenchymal stem cells exhibited the sequential expression pattern of adipocyte marker genes during differentiation, corresponding to adipogenesis.
Activated-Leukocyte Cell Adhesion Molecule ; Adipocytes ; Adipogenesis ; Carrier Proteins ; Chorion ; Female ; Fibroblasts ; Flow Cytometry ; Gene Expression* ; Glycerolphosphate Dehydrogenase ; HLA-DR Antigens ; Humans* ; Mesenchymal Stromal Cells* ; Parturition ; Placenta ; PPAR gamma ; Pregnancy ; Pregnancy Trimester, Third ; RNA

BACKGROUND: Abnormal umbilical artery Doppler velocimetry is one of the important findings of intrauterine growth restriction (IUGR) and IUGR is associated with high perinatal morbidity and mortality. In addition, this abnormal Doppler velocimetry is correlated with placental insufficiency. The aim of this study was to determine the pathologic differences in the placentas from IUGR pregnancies with and without the absent or reversed end diastolic velocity (AREDV). METHODS: Among the cases that had undergone prenatal follow-up in our institute, a retrospective slide review was conducted for 18 cases of IUGR with AREDV and 17 cases with IUGR that had normal end-diastolic flow of the umbilical artery. RESULTS: The birth weight and the other clinical parameters were not different among the two groups. Grossly, the placental weight percentiles were significantly smaller in AREDV group when they were adjusted according to gestational age. Histologically, chronic deciduitis, mural hypertrophy of the decidual arteries, an intimal fibrin cushion of the large fetal vessels, increased syncytial knots, villous agglutinations, avascular villi, villous stromal-vascular karyorrhexis, and acute atherosis were more frequently found in the AREDV group and their presence showed statistical significance. CONCLUSIONS: These findings suggest that pathologic abnormalities due to fetal and maternal vasculopathies in the placenta may be the cornerstone for inducing AREDV in the umbilical artery.
Arteries ; Birth Weight ; Fetal Growth Retardation ; Fibrin ; Follow-Up Studies ; Gestational Age ; Hypertrophy ; Placenta ; Placental Insufficiency ; Pregnancy ; Retrospective Studies ; Rheology ; Umbilical Arteries

Conjoined twins are very rare and the mortality rate of the fetus is extremely high. Early prenatal diagnosis is crucial, as it provides the opportunity for the mother and father to help in recognizing the conjunction of the twins and to help medical team in defining the prognosis of conjoined twins. We present a case of thoraco-omphalopagus conjoined twins diagnosed by two-dimensional and three-dimensional transabdominal sonography at 14(+2) weeks of gestation.
Fathers ; Fetus ; Humans ; Mothers ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Twins, Conjoined