No abstract available.
Gonadotropins* ; Humans*

No abstract available.
Humans ; Infant, Newborn ; Infant, Premature*

No abstract available.
Humans ; Infant* ; Infant, Very Low Birth Weight* ; Korea* ; Mortality*

Twin reversed arterial perfusion (TRAP) sequence is a rare specific anomaly of twin gestation with fused placenta and umbilical anastomosis. This syndrome occurs once in about 34,600 births and reported first by Beneditti in 1533. We report on prenatal diagnosis of a case of TRAP sequence with color Doppler sonography, this case is presented with a brief review of the literature.
Humans ; Parturition ; Perfusion ; Placenta ; Pregnancy ; Prenatal Diagnosis*

OBJECTIVE: We analyzed the clinical features of amniotic fluid embolism confirmed by autopsy or clinical dicision for making a plan of rapid diagnosis and intensive emergency care. STUDY DESIGN: We experienced 2 clincal cases in Ewha Mokdong Hospital and Severance Hospital at 1995, and reviewed the medical record & autopsy report of 15 cases in National Institute of Scientific Investigation from Jan, 1991 to Dec, 1995. RESULTS: The mean maternal age was 31+/-3 years. The mean gestational age was 40+/-1 weeks. The number of delivery were 1.4+/-0.8. The number of abortion history. were 2.6+/-2. The sexuality of fetus were six males (35 %), five females (29%), and unknown six cases (35 %) and the fetal mortality rate was 29 % (5 cases). The initial clinical symptoms and signs were hypotension (12 patients, 71%), vaginal bleeding(ll patients, 65%), cardiac arrest (6 patients, 35 %), dyspnea (5 patients, 29 %), and seizure (2 patients, 12%). In the case of normal spontaneous vaginal delivary (NSVD), the symptoms occurred during induction in 3 (18%), during delivery in 1 (6%), and after delivery in 9 (53%). In the case of Cesarean section, the symptoms occurred during section in 2 (12%), and after section in 1 (6%). There are one case whose symptoms occurred during 3rd gestational period. CONCLUSIONS: We should alert for the amniotic fluid embolism in the clinical findings of acute collapse and vaginal bleeding, respiratory symptoms, and seizure at any peripartum. With eary suspicion of this disease and aggressive intensive care we can reduce amniotic fluid embolism mortality rate and it's legal problem.
Abortion, Induced ; Amniotic Fluid* ; Autopsy ; Cesarean Section ; Diagnosis ; Dyspnea ; Embolism, Amniotic Fluid* ; Emergency Medical Services ; Female ; Fetal Mortality ; Fetus ; Gestational Age ; Heart Arrest ; Humans ; Hypotension ; Critical Care ; Male ; Maternal Age ; Medical Records ; Mortality ; Peripartum Period ; Pregnancy ; Seizures ; Sexuality ; Uterine Hemorrhage

OBJECTIVE: The purpose of this study was to evaluate the fetal fibronectin as a diagnostic method of preterm rupture of membanes and its clinical usefulness compared with standard tests. STUDY DESIGN: Seventy-eight women who had recieved antenatal care and complained of fluid leakage prior to 37 weeks were enrolled in this study. Standard tests-vaginal peculum examination, Nitrazine test, transabdominal sonography-were perfomed. Rupture of membranes was diagnosed if any two of the standard tests were positive. Fetal fibronectin in posterior vaginal fornix was determined qualitatively by ROM kit (Adeza Biochemical, Sunnyvale, USA). RESULTS: The sensitivity of fetal fibronectin for prediction of rupture of membranes in the women who complained of fluid leakage was 90.6% and its specificity, positive and negative predictive value were 65.7%, 76.4% and 85.1% respectively. 12 women were not diagnosed as rupture of membrane on standard tests but were positive for fetal fironectin. CONCLUSION: Fetal fibronectin would be a useful diagnotic method for rupture of membranes, especially in the women who complained of fluid leakage but not diagnosed by standard tests.
Female ; Fibronectins* ; Humans ; Membranes* ; Rupture ; Sensitivity and Specificity

The amniotic band syndrome is a collection of fetal malformations caused by fibrous bands that appear to entangle or entrap various parts of fetus in utero, leading to deformation, malformation, or disruption involving the limbs, craniofacial region and trunk. The incidence of this syndrome is relatively rare. This syndrome often shows irreversible serious outcome. So, early diagnosis of amniotic band syndrome is important. Ultrasonography enables us to detect the amniotic band syndrome prenatally. In the second and third trimester of the pregnancy, it is relatively easy to detect major anomalies of amniotic band syndrome by its characteristic features, including amputation and/or constriction of the extremities, facial clefts, asymmetric encephaloceles and gastroschisis. Five cases of amniotic band syndrome which have been diagnosed prenatally by ultrasonography are discussed. The diagnosis was based on sonographic visualization of amniotic band and associated fetal deformation, malformations or disruption known to characterize the amniotic band syndrome.
Amniotic Band Syndrome* ; Amputation ; Constriction ; Diagnosis* ; Early Diagnosis ; Encephalocele ; Extremities ; Female ; Fetus ; Gastroschisis ; Humans ; Incidence ; Infant, Newborn ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography*

The purpose of this study is to demonstrate a new postoperative analgesic which minimize the physiological changes of patients. Recently, it has become popular to administer opioids to epidural space rather than intravenously or by intramuscular administration. However, the side effects of opioids have limited the usefulness of this procedure. We tried to find out a way of providing postoperative analgesia while minimizing the side effects of opioids. This study has tested the effects of administering a mixture of small doses of morphine, fentanyl and bupivacaine and epidural morphine alone. The data of this study has taken from 20 paturients who have scheduled for cesarean section. We have classified into two groups which consist of 10 paturients each. We have administered epidural morphine alone to the first group and a small doses of morphine-fentanyl-bupivacaine mixture to second group. We have evaluated analgesic effects by comparing both groups' pain scores of the operative day and of the first postoperative day and evaluated such side effects as the degree of itching, nausea, vomiting, dizziness and respiratory depression by asking to paturients. This study has found the followings: 1) Pain scores of the first group in the operative day and the first postoperative day are 1.2+/-0.4 and 0.4+/-0.5. The second group's pain scores are 0.2+/-0.4 and 0, and the second group's pain scores have significantly reduced (p<0.05). 2) Frequencies of such side effects as itching, nausea and vomiting are higher in the first group (8) than in the second group(4). In conclusion, small doses of morphine-fentanyl-bupivacaine mixture has demonstrated a more effective postoperative analgesia with minimum side effects in pain controlling after cesarean section than epidural morphine alone.
Analgesia* ; Analgesics, Opioid ; Bupivacaine ; Cesarean Section* ; Dizziness ; Epidural Space ; Female ; Fentanyl ; Humans ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Vomiting

Blood glucose levels were measured in 89 healthy term neonates during the first 72 hours using the SureStep, a newly developed reagent test strip method by LifeScan. The blood samples were obtained by heel-stick puncture and blood glucose concentrations were monitored at birth(0), 2, 4, 6, 12, 24, 48, and 72 hours after birth. Mean and standard deviation of their measurement were compared according to postnatal hours and type of delivery. Comparison of significance between mean plasma glucose levels were made with the Wilcoxon rank sum test and significance level of 0.05 was used to determine which pair-wise comparisons were significantly different. The mean plasma glucose concentrations of first 6 hours were significantly lower than those of 12, 24, 48, 72 hours. This finding indicates that plasma glucose stabilization in healthy fullterm neonates can be expected with the feedings. The mean plasma glucose concentration at birth in the neonates of cesarean section (64.5+-8.06 mg/dl) was significantly lower than that of vaginal delivery (80.3+-20.7 mg/dl), but there were no significant differences after 2 hours. This may be due to the difference in prenatal care of obstetric department of Horamae hospital (C/S: midnight NPO and Hartmann solution, V/D: NPO with labor pain and 5% dextrose solution intravenously). In summary, the changes in perinatal care, especially prenatal fluid therapy and time of first feeding should be considered in defining neonatal hypoglycemia. Our data suggest that hypoglycemia should he defined as below 40 mg/dl during the first 6 hours and below 55 mg/dl thereafter.
Blood Glucose* ; Cesarean Section ; Female ; Fluid Therapy ; Glucose ; Humans ; Hypoglycemia ; Infant, Newborn* ; Labor Pain ; Parturition ; Perinatal Care ; Plasma* ; Pregnancy ; Prenatal Care ; Punctures ; Reagent Strips*

No abstract available.