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A case of prenatally detected fetal scalp mass.

Young Sun KIM ; Shin Young KIM ; Yeong Min LEE ; Ki Yeol YANG ; Ji Hyun HAN ; Eui JUNG

Korean Journal of Perinatology.2008;19(4):398-401.

Prenatal ultrasonographic appearance and Doppler characteristics of extracranial masses are variable, depending on the location, vasculature, amount of arteriovenous shunting, and degree of proliferation. Epidermoid cysts are found in a variety of locations around the skull and midface. They are thought to occur as a result of the persistence of ectodermal elements at sites of suture closure, neural tube closure, and diverticulation of the cerebral hemispheres. They contain ectoderm but no skin element. We experienced 33-year-old primigravida with fetal extracranial mass at 23 weeks gestation. We presumed that this extracranial mass was hemangioma. However, the mass was suspected as scalp epidermoid cyst on postnatal ultasonography.
Adult ; Cerebrum ; Ectoderm ; Epidermal Cyst ; Hemangioma ; Humans ; Neural Tube ; Pregnancy ; Scalp ; Skin ; Skull ; Sutures

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A case of normal spontaneous vaginal delivery after transvaginal radiofrequency myolysis.

Hyun Young KIM ; Chan Hee JIN ; Jeong Hoon RHO ; In Taek HWANG ; Young Rae SONG ; Ki Hwan KIM

Korean Journal of Perinatology.2008;19(4):393-397.

Radiofrequency myolysis does not require general anesthesia and is safe and effective treatment for uterine myomas tried to women in women who wish to conserve the uterus. However, a controversial issue is whether radiofrequency myolysis is safe to women who desire future pregnancies. We report a case who experienced full term spontaneous vaginal delivery without uterine rupture after radiofrequency myolysis.
Anesthesia, General ; Female ; Humans ; Myoma ; Pregnancy ; Uterine Rupture ; Uterus

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Listeriosis in baby and mother confirmed with blood and amniotic fluid cultures.

Seung Hyeon LEE ; Dong Woo SON ; So Yeon SHIM ; Yiel Hea SEO ; Suk Young KIM

Korean Journal of Perinatology.2008;19(4):388-392.

Neonatal listeriosis is not uncommon in Western developed countries, and has significant mortality and morbidity. However, its incidence in Asian countries is relatively low and it has rarely been reported in Korea. Once infected, Listeria monocytogenes (L. monocytogenes) can have high mortality and listeriosis in pregnancy may present serious hazards to the fetus and the newborn as sepsis and death through direct infection of the placenta and chorioamnionitis. Because early detection of L. monocytogenes infection is difficult, only high index of suspicion toward this disease can hopefully prompt treatment of this life-threatening perinatal infection. We experienced a case of L. monocytogenes yielded in cultures of blood and amniotic fluid of the newborn and the mother who delivered at 25+1 weeks of gestation because of preterm labor that developed without any specific evidence of infection. We report this case with a brief review of the literature.
Amniotic Fluid ; Asian Continental Ancestry Group ; Chorioamnionitis ; Developed Countries ; Female ; Fetus ; Humans ; Incidence ; Infant, Newborn ; Korea ; Listeria monocytogenes ; Listeriosis ; Mothers ; Obstetric Labor, Premature ; Placenta ; Pregnancy ; Sepsis

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A case of neonatal major burn by electrical heating pad.

Ji Hyun NA ; Eun Sung KIM ; Hyung Min CHO ; Eun Jung YOO ; Kwon JUNG ; Eun Young KIM ; Yong Wook KIM ; Kyoung Sim KIM

Korean Journal of Perinatology.2008;19(4):382-387.

Burn in neonates have been reported following the use of pulse oximeters, phototherapy blanket, infrared heating lamp, laryngoscope, and warming bottle. This case reports a newborn who had major burn injuries of 45% total body surface area (TBSA) including 3rd degree burns of 20% TBSA on her back, buttocks, both thighs and heels by exposure to an electrical heating pad for 3 hours. She developed significant systemic response, showing disseminated intravascular coagulation, electrical imbalance, jaundice, hypoalbuminemia, acute renal failure, and persistent pulmonary hypertension of the newborn. The potential hazard of the electric heating pad is reported in order to alert clinicians to this specific risk, to stimulate concern about other similar problems with materials in contact with skin, and to prevent burn of newborns in the neonate unit.
Acute Kidney Injury ; Body Surface Area ; Burns ; Buttocks ; Disseminated Intravascular Coagulation ; Heating ; Heel ; Hot Temperature ; Humans ; Hypertension, Pulmonary ; Hypoalbuminemia ; Infant, Newborn ; Jaundice ; Laryngoscopes ; Phototherapy ; Skin ; Thigh

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A case of epignathus tumor causing obstruction of upper airway immediately after birth.

Wook Hyun CHOI ; Ji Hyun KIM ; Jae Hee LEE ; Jung Ju LEE ; Sin Weon YUN ; Soo Ahn CHAE ; In Seok LIM ; Dong Keun LEE ; Eung Sang CHOI ; Byoung Hoon YOO

Korean Journal of Perinatology.2008;19(4):377-381.

Teratoma originate from one or more germ cell layer and commonly arise from sacrococcygeal area in neonate. Teratoma arising from the oropharyngeal cavity is called "epignathus tumor" and is extremely rare in neonate. Clinical manifestation of epignathus tumor vary from asymptomatic to severe respiratory distress symptom. It is reported that most of the tumor are benign in nature. Large teratoma can be diagnosed by prenatal ultrasonography, but most cases were diagnosed with computed tomography or magnetic resonance image after birth. Prognosis is determined by the need for neonatal resuscitation for respiratory distress at the time of birth and the extent of tumor, involving large vessles, skull base or communication with the brain. We experienced a case of epignathus tumor in a neonate with severe respiratory distress immediately after birth, so that reported with review of the literature.
Brain ; Germ Cells ; Humans ; Infant, Newborn ; Magnetic Resonance Spectroscopy ; Parturition ; Prognosis ; Resuscitation ; Skull Base ; Teratoma ; Ultrasonography, Prenatal

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The detection rate of Ureaplasma urealyticum and Mycoplasma hominis in patients with impending preterm birth and mid-trimester cervical swab.

Mi Ju KIM ; Min Hye CHOI ; Won Joon SEONG ; Tae Bon KOO ; Il Soo PARK

Korean Journal of Perinatology.2008;19(4):370-376.

PURPOSE: The purpose of this study was to examine the risk of preterm birth in pregnant women with Ureaplasma urealyticum and/or Mycoplasma hominis infection and the prevalence of these organisms in normal pregnancy. METHODS: Between February 2002 and July 2002, we included 43 pregnant women prior to 37 weeks of gestation with definite gross leakage of amniotic fluid (n=16) (group 1), 47 healthy women without any obstetric problems between 18 and 24 weeks of gestation (group 2) and 64 women who delivered fullterm fetuses who had taken cervical swabs around 36 weeks gestation (group 3). Cervical swabs (Dacron(R)) were taken on admission in group 1 and at outpatients in group 2 and 3. Detections of U. urealyticum and M. hominis were done using commercial kits (MYCOFAST(R) Evolution 2, International Microbio Signes, France). RESULTS: There was no significant difference between mid-gestation (group 2) and fullterm (group 3) in cervical swab result. In group 1, the detection rate of Ureaplasma uealyticum was higher in impending preterm birth over 32 weeks of gestational age (15/20, 75%) than 32 weeks or less (10/ 23, 43.4%) (p<0.05). In group 2, there was no significant difference in preterm birth rate between the exposed and the non-exposed to U. urealyticum and/or M. hominis in middle of 2nd trimester. CONCLUSION: U. urealyticum does not seem to be a predictor of preterm birth, and there seems to be some different mechanism according to gestational age. We couldn't varify that M. Hominis and U. urealyticum were related to preterm birth, although U. urealyticum was highly detected in impending preterm birth.
Amniotic Fluid ; Female ; Fetus ; Gestational Age ; Humans ; Mycoplasma ; Mycoplasma hominis ; Obstetric Labor, Premature ; Outpatients ; Pregnancy ; Pregnant Women ; Premature Birth ; Prevalence ; Ureaplasma ; Ureaplasma urealyticum

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Umbilical cord artery blood pH analysis at term pregnancy.

Yeun Hee KIM ; Se Youn LEE ; Ji Young KWON ; Jong Chul SHIN ; In Yang PARK

Korean Journal of Perinatology.2008;19(4):364-369.

OBJECTIVE: To assess the gestational age adjusted values of umbilical cord artery blood pH in term pregnancy METHODS: We retrospectively analyzed umbilical arterial blood pH values and obstetric data of 1,918 term singleton deliveries without maternal medical disease, pregnancy induced hypertension and fetal distress during labor periods at Kangnam St. Mary's Hospital, Catholic University medical college between January 2004 and December 2006. Low pH was defined as less than 7.10 as a stationary cutoff value, whereas pH less than (mean -2 standard deviations [SDs]) was used when gestational age was considered. We evaluated the risk of 5 minute Apgar score of less than 7 and meconium staining more than grade II at low pH. RESULTS: A significant negative correlation was found between gestational age and umbilical artery pH (p=0.000). We evaluated the umbilical artery pH value in different delivery mode. Vaginal delivery cases showed negative correlation (p=0.000), but elective cesarean section cases didnt. Low pH patients defined by both criteria of pH less than 7.10 and pH less than (mean -2SD) showed significantly increased risk of 5 minutes Apgar score of less than 7 (pH less than 7.10: p=0. 000, pH less than (mean -2SD): p=0.001) and meconium staining more than grade II (pH less than 7.10: p=0. 001, pH less than (mean -2SD): p=0.001). CONCLUSION: Our results suggest that umbilical cord pH has a negative relation with gestational age during term period.
Apgar Score ; Arteries ; Cesarean Section ; Female ; Fetal Distress ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pregnancy-Induced ; Meconium ; Pregnancy ; Retrospective Studies ; Umbilical Arteries ; Umbilical Cord

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Comparative study between pregnancies with and without hypertensive disorders in placental abruption.

Jung Soo CHOI ; Sae Kyung CHOI ; Ji Sun WE ; Hyun Young AHN ; Jong Chul SHIN

Korean Journal of Perinatology.2008;19(4):356-363.

OBJECTIVE: The aim of this study was to compare the clinical characteristics of placental abruption according to the presence or absence of hypertensive disorders in pregnancy. METHODS: The retrospective analysis was performed in total 363 cases of placental abruption among 25,895 deliveries during 5 years from January, 2003 to December, 2007 in 8 hospitals of Catholic university in Korea. Maternal characteristics and neonatal outcomes were compared with parametric test. RESULTS: The incidence of placental abruption was 1.40% during the study period. The proportion of patients complicated with hypertensive disorders was 33.1%. There was no difference in maternal age and the number of previous pregnancy between two groups with or without hypertensive disorders. As expected, mean gestational age at delivery was lower in placental abruption with hypertensive disorders compared to those without the diseases (237.1 days vs 239.1 days). The incidence of abnormal fetal presentation, multiple gestation, PPROM, and polyhydramnios were more common in patients with placental abruption without hypertensive disorders. On the other hand, the incidence of maternal thrombophilia was significantly higher in patients with placental abruption with hypertensive disorders. The patients with placental abruption with hypertensive disorders had higher incidence of abdominal pain, fetal distress, uterine contraction, and uterine hypertonus (p<0.05). In terms of maternal complication, the patients with placental abruption with hypertensive disorders had more severe complications including shock, coagulopathy and renal failure (p<0.05) and had worse perinatal outcome including FDIU (fetal death in uterus) and neonatal death (10.8% vs 10.3%). CONCLUSION: In patients with placental abruption with hypertensive disorders in pregnancy, maternal complications were more common and prenatal outcome was worse compared to patients with placental abruption without hypertensive disorders.
Abdominal Pain ; Abruptio Placentae ; Female ; Fetal Distress ; Gestational Age ; Hand ; Humans ; Incidence ; Korea ; Labor Presentation ; Maternal Age ; Polyhydramnios ; Pre-Eclampsia ; Pregnancy ; Renal Insufficiency ; Retrospective Studies ; Shock ; Thrombophilia ; Uterine Contraction

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Change of cytokine expression in normal pregnancy and the puerperium.

Kye Hyun KIM ; Hyeong Ok KIM

Korean Journal of Perinatology.2008;19(4):351-355.

PURPOSE: To investigate the serial relationship of cytokine production during normal pregnancy and in the puerperium. METHODS: Plasma cytokine (TNF-alpha, INF-gamma, IL-2, TGF-beta, IL-4, and IL-6) levels were determined by enzyme-linked immunosorbent assay (ELISA) in 90 healthy gravidas during the second trimester and 6 weeks postpartum. RESULTS: TNF-alpha, INF-gamma, and TGF-beta levels increased significantly after delivery (p<0.05). Although IL-2, IL-4, and IL-6 had a tendency to increase after delivery, the change was not significant. CONCLUSION: There was a decrease in cytokine levels during pregnancy when compared to puerperium. In particular, TNF-alpha, INF-gamma, and TGF-beta were inversely related to the maintenance of normal pregnancy.
Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Plasma ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Second ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

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Analysis of gene expression in placenta of severe preeclampsia.

Gui Se Ra LEE ; Young LEE ; Dong Eun YANG ; Jong Chul SHIN

Korean Journal of Perinatology.2008;19(4):341-350.

OBJECTIVE: This study was designed to detect genes specifically expressed in severe preeclamptic placentas. METHODS: Placenta tissues were collected immediately after delivery from 5 preeclamptic patients and 5 normal pregnant women. Total RNAs of each placenta were extracted and hybridized for a cDNA microarray. Of the microarray data, four up-regulated genes (DSCR4, GPA, PCDHGB1, Hemogen) and four down-regulated genes (IL1R2, MGST1, GAS1 GREB1) were selected and reverse transcriptase-polymerase chain reaction was used to confirm the results of cDNA microarray. RESULTS: The expression fold for each up-regulated gene was 2.2 times for DSCR4, 2.7 times for PCDHGB1, 3.5 times for Hemogen, 5.2 times for GPA on the cDNA microarray. The expression fold for each down-regulated gene was 3.3 times for IL1R2, 4.2 times for MGST1, 4.9 times for GAS1 and 2.3 times for GREB1 on the cDNA microarray. The expression fold for each up- regulated gene was 5.21 times for DSCR4, 3.01 times for PCDHGB1, and 4,53 times for Hemogen and 2.2 times for GPA on RT-PCR. The expression fold for each down-regulated gene was 2.7 times for IL1R2, 2.22 times for MGST1, 2.53 times for GAS1 and 1.83 times for GREB1 on the RT-PCR. CONCLUSION: DSCR4, PCDHGB1, Hemogen and GPA as the up-regulated genes and IL1R2, MGST1, GAS1 and GREB1 as the down-regulated genes, which were found and selected by the cDNA microarray, might be considered to be novel biomarkers for preeclampsia.
Biomarkers ; Chimera ; Female ; Gene Expression ; Humans ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Placenta ; Pre-Eclampsia ; Pregnant Women ; RNA

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