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Perinatal outcomes using knotless barbed suture in cesarean section
( Yezi Kim ),( Ju Yeon Hong ),( Ji Man Heo ),( Ho Yeon Kim ),( Hai-joong Kim ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-
Objective: Cesarean section is the most frequent obstetrical surgery worldwide, with markedly increasing rates along the last several decades. In this regard, competent surgical technology regarding speed, safety, and efficacy is essential in operating cesarean section. This study was conducted to estimate the efficacy and safety of knotless barbed suture for closure of myometrium during cesarean section compared to conventional method. Methods: This is retrospective cohort study. Patients who underwent cesarean delivery at Korea University Ansan Hospital, Republic of Korea between August 2018 and December 2019, were reviewed. Main outcome measures were surgical outcomes including uterine closure time, operative time, estimated blood loss and sonographic results of residual myometrial thickness at site of cesarean section scar at 6 to 8 weeks after operation. Results: Out of total 78 women, 44 women had knotless barbed suture and 34 women had conventional method. The number of previous cesarean section was similar as well as demographic and clinical characteristics between groups. Compared to conventional suture, the suturing time to close the uterine incision were significantly reduced(p=0.012). Operation time, estimated blood loss during operation, hemoglobin difference on third operative day, transfusion and postpartum infection and bleeding demonstrated no significant difference between two groups. At 6 to 8 weeks after operation, transvaginal ultrasound revealed no differences in residual myometrial scar thickness between two groups. Significantly shorter uterine closure time was identified with knotless barbed suture compared to conventional method. There were no increased rate of perioperative complications with knotless barbed suture. Conclusion: Our results support that the use of knotless barbed suture for cesarean section is comparable to conventional method.
A report of anti-M alloimmunization managed with intrauterine transfusion
( Yezi Kim ),( Soyeon Kim ),( Ho Yeon Kim ),( Geum Joon Cho ),( Ki Hoon Ahn ),( Soon Cheol Hong ),( Min Jeong Oh ),( Hai Joong Kim ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-
Hemolytic disease of the fetus causes hydrops fetalis and intrauterine fetal death. Anti-M antibodies are naturally occurring, cold reactive but seldom active at 37C. Such anti-M is capable of causing severe hemolysis. However only a few cases have been reported with fetal hydrops with the anti-M IgG antibody. Hereby we report a successful treatment with intrauterine transfusion. A 32 year old mother had a history of two fetal hydrops resulting termination of pregnancy in second trimester. She visited our center from the beginning of the pregnancy and was diagnosed with suspicious fetal anemia at 24 weeks of gestation. No evidence of fetal hydrops was found but peak systolic velocity of middle cerebral artery was increased to 1.5-2.0 MOM. Her blood test revealed anti-M IgG antibody in serum. We performed intrauterine intravascular transfusion at the placental root of umbilical cord. Two intrauterine transfusions with compatible red blood cells(RBC) resulted in continuation pregnancy until 28 weeks of gestation. The baby(APGAR score 5-6) was delivered by cesarean delivery at 28+2 weeks of gestation with hemoglobin 7.8 g/dL. The baby had three times of transfusion and is healthy at age of 7 months. Although clinically significant anti-M antibodies are rare, once encountered, antigen-negative intrauterine tranfusion is effective in preventing fetal morbidity and mortality.