PURPOSE: In Korea, pregnancy termination is frequently reported among women who took medications for an acute or chronic disease during pregnancy, for fear of teratogenic risk. We have previously shown that a service providing evidence-based information is helpful for women who week counseling to make a rational decision regarding their pregnancies. This study aimed to evaluate whether termination of pregnancy based on such perceptions, is justified using the 'DRug Exposure and risk Assessment in Moms' (DREAM) registry. METHODS: The study included 5,032 consenting pregnant women from the clinic and call center at the Korean Motherisk Program, from November 1999 to October 2008. The DREAM registry recorded the pregnancy outcomes (preterm birth, low birth weight, intrauterine fetal death, and congenital anomaly) of 3,328 women. RESULTS: Among women exposed to medications, time of exposure ranged from 3.5-4.6 weeks of gestation. There were 1,308 different drugs prescribed to these women. The drug most frequently prescribed was acetaminophen followed by chlorpheniramine maleate, and pseudoephedrine. There were 4.7% (n=156/3,328) women who underwent a voluntary abortion for fear of birth defects. We compared frequency of birth defects between exposed women and unexposed pregnant women in our institution during gestation. The frequency of major congenital malformations was 2.5% (n=74/2,977) in exposed group and 2.9% (n=75/2,573) in unexposed group (P=0.32). There was no statistically significant difference between exposed and control group in the rate of preterm births, intrauterine fetal death and low-birth weight babies. CONCLUSION: We did not observe increased risk of congenital malformations and adverse pregnancy outcomes in a population of pregnant women exposed to a variety of medications. Therefore these medications are not considered teratogen.
Acetaminophen ; Chlorpheniramine ; Chronic Disease ; Congenital Abnormalities ; Counseling ; Female ; Fetal Death ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Maleates ; Parturition ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Premature Birth ; Pseudoephedrine ; Risk Assessment

The aim of present study was to establish normative data for the distribution of nuchal translucency (NT) thickness in normal Korean fetuses. The data were collected from pregnant women with singleton pregnancies in whom fetal ultrasound was performed and the fetal NT thickness was measured between 11 and 14 weeks of gestation. Among them, a total of 2,577 fetuses with a known normal outcome were included in this study. The distribution of multiple of median (MoM) values of the NT thickness with crown-rump length (CRL) in 10-mm intervals and the 95th percentile of MoM were calculated with the linear regression method. The present study showed that NT measurements increase with increasing CRL and a false positive rate increases with increasing gestational age. Therefore, a fixed cut-off point through the first trimester was not appropriate and each NT measurement should be examined according to the gestational age. The present study offers normative data of the fetal NT thickness in a Korean population, which can be used as reference for screening chromosomal aberrations or other congenital abnormalities in the first trimester.
Adult ; Chromosome Aberrations ; Crown-Rump Length ; Female ; Fetus/*physiology ; *Gestational Age ; Human ; Korea ; Linear Models ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Ultrasonics ; Ultrasonography, Prenatal

OBJECTIVE: To determine the risk of Down syndrome in fetuses with sonographic markers using the likelihood ratios and individual risk assessment. METHODS: We retrospectively evaluated the midtrimester genetic sonographic features of fetuses with Down syndrome and compared them with euploid fetuses. Patients were referred for an increased risk of aneuploidy and evaluated for the presence of structural defects, a nuchal fold, short long bones, pyelectasis, brachycephaly, small stomach, and hyperechoic bowel. Outcome information included the results of genetic amniocentesis (if performed), the results of pediatric assessment, and follow-up after birth. The sensitivity, specificity, and likelihood ratios for markers ware calculated isolated findings. RESULTS: There were 59 fetuses with Down syndrome and 600 euploid fetuses. The presence of any marker resulted in sensitivity for the detection of Down syndrome of 86.4% with a false-positive rate of 13.6%. Structural defect had a likelihood ratio of 77.8. As an isolated marker, the nuchal fold, short humerus, short femur, echogenic bowel and renal pyelectasia has a likelihood ratio of 20.2, 12.7, 3.9, 2.5, 1.1 respectively. Other isolated markers had low likelihood ratios because of the higher prevalence in the unaffected population. CONCLUSION: Combining second-trimester serum testing and fetal sonography is a feasible approach to Down syndrome screening, compatible with current obstetric practice. Although an isolated marker with a low likelihood ratio may not increase a patient's risk of Down syndrome, the presence of such a marker precludes reducing the risk of aneuploidy. This information will be useful in counseling pregnant women who are at high risk for fetal Down syndrome and who prefer to undergo genetic sonography before deciding about genetic amniocentesis.
Amniocentesis ; Aneuploidy ; Counseling ; Craniosynostoses ; Down Syndrome* ; Echogenic Bowel ; Female ; Femur ; Fetus ; Follow-Up Studies ; Humans ; Humerus ; Mass Screening* ; Nuchal Translucency Measurement ; Parturition ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Prenatal Diagnosis ; Prevalence ; Pyelectasis ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Stomach ; Ultrasonography*

OBJECTIVE: To determine the risk of Down syndrome in fetuses with sonographic markers using the likelihood ratios and individual risk assessment. METHODS: We retrospectively evaluated the midtrimester genetic sonographic features of fetuses with Down syndrome and compared them with euploid fetuses. Patients were referred for an increased risk of aneuploidy and evaluated for the presence of structural defects, a nuchal fold, short long bones, pyelectasis, brachycephaly, small stomach, and hyperechoic bowel. Outcome information included the results of genetic amniocentesis (if performed), the results of pediatric assessment, and follow-up after birth. The sensitivity, specificity, and likelihood ratios for markers ware calculated isolated findings. RESULTS: There were 59 fetuses with Down syndrome and 600 euploid fetuses. The presence of any marker resulted in sensitivity for the detection of Down syndrome of 86.4% with a false-positive rate of 13.6%. Structural defect had a likelihood ratio of 77.8. As an isolated marker, the nuchal fold, short humerus, short femur, echogenic bowel and renal pyelectasia has a likelihood ratio of 20.2, 12.7, 3.9, 2.5, 1.1 respectively. Other isolated markers had low likelihood ratios because of the higher prevalence in the unaffected population. CONCLUSION: Combining second-trimester serum testing and fetal sonography is a feasible approach to Down syndrome screening, compatible with current obstetric practice. Although an isolated marker with a low likelihood ratio may not increase a patient's risk of Down syndrome, the presence of such a marker precludes reducing the risk of aneuploidy. This information will be useful in counseling pregnant women who are at high risk for fetal Down syndrome and who prefer to undergo genetic sonography before deciding about genetic amniocentesis.
Amniocentesis ; Aneuploidy ; Counseling ; Craniosynostoses ; Down Syndrome* ; Echogenic Bowel ; Female ; Femur ; Fetus ; Follow-Up Studies ; Humans ; Humerus ; Mass Screening* ; Nuchal Translucency Measurement ; Parturition ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Prenatal Diagnosis ; Prevalence ; Pyelectasis ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Stomach ; Ultrasonography*

OBJECTIVE: To evaluate the relationship between increased nuchal translucency (NT) and abnormal pregnancy outcomes. METHODS: From January 1999 to December 2001, The 298 fetuses of increased nuchal translucency (>or=2.5 mm) in period of 10-14 weeks gestation were reviewed retrospectively. Amniocentesis and high resolution ultrasonography during second trimester were done for all cases. We analyzed septation within NT, karyotypes, structural anomalies, and adverse pregnancy outcomes such as spontaneous abortion, intrauterine fetal death and preterm delivery. RESULTS: The mean age of the patients was 30.5 +/- 3.5 years. The mean gestational age and CRL were 12.5 +/- 0.95 weeks and 6.5 +/- 1.15 mm. We observed 18 (6%) cases of abnormal karyotypes. 7/46 (15.2%) fetuses with internal septation had abnormal karyotype and 11/252 (4.4%) fetuses without internal septation had abnormal karyotype (p=0.013). Among the 280 fetuses with normal karyotype, 8 (2.8%) fetuses had structural anomalies and 18 (6.4%) fetuses had adverse pregnancy outcomes. The chromosomal abnormality and structural anomaly were significantly increased in the group of nuchal translucency thickness above 3.5 mm (p=0.001). CONCLUSION: Increased nuchal translucency is related with chromosomal abnormality and abnormal pregnancy outcomes.
Abnormal Karyotype ; Abortion, Spontaneous ; Amniocentesis ; Chromosome Aberrations ; Female ; Fetal Death ; Fetus ; Gestational Age ; Humans ; Karyotype ; Nuchal Translucency Measurement* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Retrospective Studies ; Ultrasonography

OBJECTIVE: The purpose of this study was to assess the mean fetal biometry and to create a formulae for estimation of gestational week using sonographic biometry measurement. METHODS: A total 271 women of singleton gestation were involved in this study of ultrasonographic fetal biometry. During the period from June 1996 to March 1998, the length of CRL (Crown Rump Length), BPD (Biparietal Diameter), HC (Head Circumference), AC (Abdominal Circumference), HL (Humerus Length) and TL (Tibia Length) of fetuses in normal pregnancy were measured by ultrasonography at Samsung Cheil Hospital and Women's Healthcare Center. The gestational age prediction equations were derived from sigletons with the use of liner regression analysis. RESULTS: We present the percentile ranks of fetal CRL, BPD, HC, AC, HL and TL measurement from 11 to 39 week's gestation and mean value of fetal size at each week. These data were analyzed and several second grade equations were derived from the data. CONCLUSION: We created these authentic equations and tables for mean value of fetal biometry in normal pregnancy at each gestation week with minimal intervariable errors.
Biometry* ; Delivery of Health Care ; Female ; Fetus ; Gestational Age ; Humans ; Pregnancy* ; Ultrasonography*

OBJECTIVE: To evaluate the recent trend of indication for pregnancy termination. METHOD: From 1993 to 2000, 1,087 cases of termination out of 61,842 cases of deliveries in Samsung cheil hospital were analyzed. We reviewed retrospectively the data-base and charts of delivery, and analyzed the indication for pregnancy termination. RESULTS: Among 61,842 cases of deliveries, indications of pregnancy termination were fetal structure anomalies in 399 cases (0.7%), IUFD in 261 cases (0.4%), PROM in 215 cases (0.4%), chromosomal anomalies in 138 cases (0.2%), anhydroamnios in 32 cases (0.05%), rubella infection of mother or fetus in 24 cases (0.04%), and others in 20 cases (0.03%). Autopsy was performed in 242 cases of fetal anomalies (60.7%), 116 cases of UIFD (44%), and 59 cases of fetal chromosomal abnormalities (43%). The cases of chromosomal anomaly as indication of termination increased and rubella infection of mother or fetus decreased recently, and it is statistically significant r=0.95(P=0.00) and r=-0.73(P=0.04). The fetal weight terminated due to PROM is significantly decreased (Y=517-26 x year P=0.002). CONCLUSION: The indications of termination for fetal chromosomal abnormalities were increased, but for rubella infections were decreased. In cases of PROM, the terminated fetal weight were significantly decreased. However, no change was observed in cases of fetal anomaly, IUFD,and PROM.
Autopsy ; Chromosome Aberrations ; Fetal Weight ; Fetus ; Humans ; Mothers ; Pregnancy ; Retrospective Studies ; Rubella

Regulation for new standardized rescue record from of the 119 EMS system was established by law from February 1, 1998. We have recently evaluated the effectiveness of the record from. Records of 192 patients who visited the Emergency department of Sangggye Paik Hospital. Inje University by the 119 EMS system from February 1 to February 28, 1998 were analyzed statistically according to the contents of record form. In conclusion, the new standardized rescue record form of the 119 EMS system was effective in giving information of patients' history and analysing of the 119 EMS system. But, Detailed modification of the record form about disease entities is needed for proper initial evaluation of emergency patient.
Emergencies* ; Emergency Service, Hospital ; Humans ; Jurisprudence ; Retrospective Studies*

No abstract available.
Lung*

No abstract available.
Anemia, Hemolytic* ; Cholelithiasis* ; Hepatolenticular Degeneration*