태반조기박리가 동반된 임신성 고혈압 임산부와 정상혈압 임산부에서의 주산기 예후에 대한 비교 분석

박지용(Ji Yong Park),정진훈(Jin Hoon Chung),조용균(Yong Kyoon Cho),최훈(Hoon Choi),김복린(Bok Rin Kim),이홍균(Hong Kyoon Lee),유태환(Tae Hwan Yoo),고수진(Soo Jin Ko),박교훈(Gyo Hoon Park),서정식(Jeong Sik Seo) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11

N/A Objective: The objective of this study was to compare perinatal outcomes of pregnancy-induced hypertensive and normotensive women experiencing abruptio placentae, Our hypothesis is that pregnancy-induced hypertensive women have a less favorable perinatal outcome than do normotensive women. Methods: Women with the diagnosis of abruptio placentae delivered between August 1,1989 and December 1,1996, composed the study group (n-92) in this case-control study. The women with abruptio placentae were divided according to their hypertensive (n 37) or normotensive (n 55) status. Maternal and neonatal medical records were reviewed and abstracted for demographic variables, antepartum complications, delivery route, abruptio placentae grade, neonatal gender, birth weight, Apgar score and perinatal mortality. We compared these perinatal outcome variables between the pregnancy-induced hypertensive and normotensive pregnant women. Results: The incidence of abruptio placentae was 0.35%. The two groups of woman wne similar with regard to age and parity. Abruptio placentae grades 2 occurred more often in hypertensive women (P=0.0053). Pregnancy-inducedhypertensive women were similar to normotensive women with regard to antenatal complications. The mean gestational age of delivery, delivery route, neonatal weight and sex were similar between two groups of women. Neonates from pregnancy-induced hypertensive women were no more likely to have low 1 and 5-minute Apgar score or to die than those from normotensive women. Statistical analysis was performed with two-tailed independent t-test and Kruskal-Wallis analysis. Conclusion: Although pregnancy-induced hypertensive women experiencing abruptio placentae are more likely to have grade 2 abruptio placentae with fetal distress, the overall perinatal outcome was not significantly different from that of normotensive women experiencing abruptio placentae.

토끼에서 자궁내 감염 유발 후 항생제 투여 시간 경과에 따른 임신 예후

문신용(Shin Yong Moon),윤보현(Bo Hyun Yoon),신희철(Hee Chul Syn),박교훈(Gyo Hoon Park) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

N/A Objective: In a pregnant rabbit model using hysteroscopy-guided inoculation of E. coli, we investigated pregnancy outcome according to elapsing time with immediate antibiotic treatment after E. coli inoculation, and in turn determined which of the maintenance of pregnancy with antibiotic and tocolytic administration or prompt delivery in the management of preterm labor complicated with intrauterine infection offered the improvement of pregnancy outcome. Methods: Timed-pregnant rabbits underwent hysteroscopy at 20-21 days of gestation(70%). Animals were inoculated with either E. coli(0.2 ml containing 10' cfu/ml) or saline, and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) in divided doses every 8 hours beginning 30 minutes after microbial inoculation until euthanasia with one of the following; 3 days(n 10), 5 days(n 8), or 7 days(n-8) after hysteroscopy. In the first study, which performed in animals with inoculation of E. coli, pregnancy outcome including fetal survival rate and results of microbial studies and placental pathology were compared among three groups. In second study, which performed in animals with inoculation with saline, pregnancy outcome were compared among three groups for the purpose of elucidating effects of antibiotic administration during inoculation-to-euthanasia interval on pregnancy outcome. Results: Of rabbits inoculated with E. coli and receiving antibiotics immediately, the rate of fetal survival and positive intrauterine cultures in total and live fetuses decreased significantly, and the rate of placental inflammation in total and live fetuses increased significantly with time from intracervical inoculation with E. coli to euthanasia(p<0.05, respectively). Of rabbits inoculated with saline and receiving antibiotics immediately, the rates of fetal survival, positive intrauterine cultures in total and live fetuses, and placental inflammation in total and live fetuses have no difference with time from intracervical inoculation with saline to euthanasia. Conclusion: Fetal complications including fetal death could be induced in utero if persistent subclinical intrauterine infection was present in spite of earlier antibiotics administration initiated after inoculation of E, coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitor the presence of persistent intrauterine infection, and if it is persistent, prompt delivery may be better than maintenance of pregnancy with antibiotic and tocolytic administration for the improvement of pregnancy outcome.

임신 제 일삼분기 질초음파로 진단된 태아 기형에 대한 고찰

김유미 ( You Mi Kim ),한성식 ( Sung Sik Han ),우헌탁 ( Hun Tack Woo ),김문영 ( Moon Young Kim ),구천회 ( Chun Hoe Ku ),이철민 ( Chul Min Lee ),박교훈 ( Gyo Hoon Park ),조용균 ( Yong Gyun Cho ),최훈 ( Hoon Choi ),김복린 ( Bok Rhyn 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.12

목적 : 임신 제 일삼분기에 선천선 태아 기형을 진단하기 위해 시행된 초음파 검사의 유용성을 분석하고자 연구를 시행하였다. 연구 방법: 2000년 4월부터 2002년 4월까지 인제의과대학 상계백병원에 산전 진찰을 위해 내원한 임신 9~14주의 임부를 대상으로 후향적 연구를 시행하였다. 초음파 검사는 질식 초음파를 원칙으로 하였으며 필요에 따라 복식초음파 검사를 사용하였다. ACOG (1993) 권장 사항에 추가하여 태아 목뒤의 nuchal translu Objective : The purpose of this study was to evaluate the efficiency of transvaginal ultrasonography for detection of fetal anomalies in first trimester. Methods : This cohort included pregnant women between 9~14 weeks of gestation from April 2000 to Apri

자간전증 임신부의 Vascular Endothelial Growth Factor (VEGF) 의 혈청농도

최훈,이홍균,김복린,박교훈,조용균,민현주 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.11

Objective : To assess whether there is correlation between serum concentrations of vascular endothelial growth factor(VEGF) and development of preeclampsia. Methods : The authors measured serum concentrations of VEGF in 18 preeclamptic women admitted to Sanggye Paik Hospital, Inje University from February 1999 to September 1999 and in 18 normotensive pregnant women matched in maternal age, maternal body weight, parity and gestational age. VEGF was measured with a sensitive and specific enzyme immunoassays. Results : VEGF was detected in all pregnant women. The results of this study showed that the serum concentrations of VEGF are significantly higher in the preeclamptic women than in the normotensive pregnant women. The values of median and range of VEGF are 7.74 ng/ml and 0.5-35.94 ng/ml in the preeclamptic women, and 0.5 ng/ml and 0.5-2.16 ng/ml in the normotensive pregnant women, respectively. There is significant difference in serum concentrations of VEGF between two groups(p$lt;0.001, Mann-Whitney U test). Positive correlations were noted between VEGF concentraions and the systolic and diastolic blood pressure(Systolic BP: r2=0.688, Diastolic BP: r2=0.722, Spearman rank test). Conclusion : The high serum concentration of VEGF is thought to be important in the development or pathophysiologic mechanism of preeclampsia. In the next study, the prospective analysis will be necessary to identify whether serum concentration of VEGF is abnormally high in early gestational pregnant women who are destined to preeclampsia.

침윤성 자궁경부암 환자의 수술전 평가에 있어서 방광경 검사 및 전산화단층촬영의 임상적 의의에 관한 고찰

강영숙,박영준,최훈,한성식,이철민,이홍균,이제훈,김복린,박교훈,조용균 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.11

Objective : Cystoscopy has been included as diagnostic procedure for pretreatment evaluation of cervical cancer by FIGO. However, its invasiveness brings up a question regarding the necessity of inclusion in staging work up of cervical cancer. We performed this study to evaluate the clinical implication of cystoscopy in cervical cancer staging. Methods : 128 patients with invasive cervical cancer patients who were histologically diagnosed from Jan 1995 to Dec 1999 were retrospectively reviewed. Physical examination, computed tomography (CT), cystoscopy were performed in all patients. The distribution of FIGO stage was Ib 48.4%, II 35.2%, III 8.6%, and IV 7.8%. Bladder invasion was evaluated in CT and histopathologic examination was performed on cystoscopy when invasion was suspected. McNemar test was used to compare the finding in CT and cystoscopy for matched patients. P-value of 0.05 was regarded as statistically significant. Results : Among seven patients whose bladder was suspected to be invaded by cervical cancer in CT scan, three patients had actual bladder invasion confirmed by cystoscopy (positive predictive rate = 42.9%). CT was statistically comparable to cystoscopy (P = 0.375, McNemar test; contingency coefficient = 0.481). Conclusion : Cystoscopy, which is an invasive procedure, may not be necessary and might be substituted by CT scan for pretreatment evaluation in some subset of cervical cancer patients.