임신 전 남성관리의 개념 및 필요성

호정규,박문일 대한의사협회 2011 대한의사협회지 Vol.54 No.8

Several international initiatives have taken place with themes such as “Men as Partners in reproductive health”. Furthermore, many articles have recently been published concerning men’s preconception care before pregnancy. However, little attention has been paid to this field in Korea. The concept of preconception health and health care for men is very important for pregnancy outcomes, and furthermore, for the health of their future families. Men’s contribution to the pregnancy is clear for planned pregnancy and also offers an opportunity for disease prevention and health promotion in men themselves. This paper reviews the important concept of men’s health for preparing for pregnancy, and summarizes key component of a comprehensive approach to optimizing the preconception health status of men as expecting fathers. In fact,many clinicians including most obstetricians-gynecologists in Korea are not trained to provide preconception health and care for men. In addition, no consensus has been developed on basic guidelines for preconception care including the pregnancy planning for men and women, laboratory tests before pregnancy, vaccination programs, and much more information on preparing for a successful pregnancy. To improve preconception care for men in Korea, many barriers must be overcome, such as lack of national services, financing, organization, and men’s and women’s understanding of the importance of preconception health for their pregnancy. Therefore,much more research is needed on men’s preconception care in Korea.

Nonlinear analyses of heart rate variability in normal fetuses and fetuses with nuchal cord

호정규,박문일,박영선 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

The purpose of the present study was to compare and analyze differences in antepartal fetal heart rate (FHR) parameters and non-linear indices (approximate entropy, ApEn; correlation dimension, CD) and pregnancy outcomes in normal fetuses and fetuses with nuchal cord (NC). We surveyed all non-stress test (NST) data acquired using a computerized FHR analysis system at Hanyang University Hospital between 2005 and 2008, and selected 150 cases that had NC. NSTs were performed between 37 and 42 weeks of gestation. Subjects were divided into three groups by the number of NCs: no NC and normal (n = 300), single (n = 124) and multiple NCs (n = 26). Neonatal outcomes were compared, and FHR parameters analyzed using computerized fetal monitoring system. Non-linear analysis was performed using ApEn and CD. FHR variability, with respect to amplitude (AMP), mean minute range (MMR) was lower in the multiple NCs group than in the normal group (18.04 ± 0.38 vs 14.54 ± 1.10 bpm, p=0.0207; 55.69 ±1.22 vs 44.35 ± 3.41 ms, p=0.0145, respectively). There were no other statistically significant differences of FHR parameters between the three groups. Non-linear indices (ApEn and CD) were significantly lower in the multiple NCs group than in the normal group (0.91 ± 0.14 vs 0.78 ± 0.15, p<0.0001; 3.79 ± 0.31 vs 3.53 ± 0.37, p=0.0419, respectively). Baby weight was significantly lower in the multiple NCs group than in the normal group (3317 ± 24 vs 3054 ± 55, p=0.0008), and there were no other significant differences between the groups. The heart rate dynamics of fetuses with multiple NCs is less chaotic than that of normal fetuses. Decreased system complexity suggested by correlation dimension may limit the fetuses with multiple NCs. Non-linear analysis of FHR variability would be helpful to assess fetal status, especially in cases of multiple NCs.

Differences of linear indices, approximate entropy of fetal heart rate and perinatal outcomes in patients with partial abruptio placenta

호정규,박문일,박영선 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

The purpose of this study was to compare and analyze differences in fetal heart rate (FHR) parameters during pregnancy, and pregnancy outcomes between fetuses of normal and mothers with partial abruptio placenta. We surveyed all non-stress test (NST) data acquired using a computerized FHR analysis system at Hanyang University Hospital between 2003 and 2010, and selected 56 cases of normal pregnancy that were matched to abruptio placenta cases for gestational age (abruptio placenta vs normal; mean (range), 37.10 (31-42) vs 37.11 (31-42) weeks), rate of signal loss (3.40 (0.0-9.0) vs 3.41 (0.0-9.0) %), and mean FHR (144.20 (136-150) vs 144.20 (133-151) bpm). The average abruption rate was 23% (SD=13.4; 10%=4, 20%=1, 30%=4 and 50%=1 case), and all cases were identified after delivery. NSTs were performed between 31 and 42 weeks of gestation. Perinatal outcomes were compared, and FHR parameters analyzed using a linear method and a non-linear method using approximate entropy (ApEn). Perinatal outcomes and NST parameters showed no significant difference between two groups. However, only the ApEn of the partial abruptio placenta group was significantly lower than the normal group (mean±SD, 0.74±0.16 vs 0.89±0.12; 95% CI, 0.62-0.85 vs 0.86-0.93, p=0.0007). ApEn is a useful tool for detecting abnormal FHR patterns that are not found in patients with partial abruptio placenta using conventional linear analysis.

Fetal heart rate parameters in pregnancy complicated by gestational diabetes mellitus

호정규,이혜진,진성아,강귀언,김라현,이원무,김영재,황정혜,김승룡,박문일 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

Differences of linear and non-linear indices of antepartum fetal heart rate in patients with fetal distress at delivery

호정규,박문일,차경준,박영선 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

The purpose of this study was to compare and analyze differences in antepartal fetal heart rate (FHR) parameters, non-linear indices, and perinatal outcomes between fetuses of normal and fetal distress at delivery. We surveyed all non-stress test (NST) data acquired using a computerized FHR analysis system at Hanyang University Hospital between 2003 and 2010, and selected 725 cases (fetal distress without any other complications=25 cases and normal 700 cases). NSTs were performed between 38 and 42 weeks of gestation, and all cases were delivered in 2 weeks after NST. Perinatal outcomes were compared, and FHR parameters analyzed using a linear method and a non-linear method using approximate entropy (ApEn), correlation dimension (CD), and short-term/ long-term scaling exponents (α1/ α2). One and 5 minutes Apgar scores (Ap1/Ap5) of fetal distress group were significantly lower than those of normal group (Ap1, 5.92±1.85 vs 6.89±0.73, p=0.0151; Ap5, 6.44±1.45 vs 8.87±0.58, p<0.0001). Other perinatal outcomes and NST parameters showed no significant difference between two groups. Non-linear indices (ApEn, CD, and α2) were significantly different in two groups (ApEn, 0.71 ± 0.18 vs 0.91 ± 0.13, p<0.0001; CD 3.49 ± 0.40 vs 3.83 ± 0.27, p=0.0003; α2, 0.91 ± 0.06 vs 0.86 ± 0.05, p=0.0016, respectively). Compared to normal fetuses, fetal distress cases at delivery show a difference in that the irregularity and complexity of the heart rate dynamics are decreased in antepartal NST, although no differences of FHR parameters between two groups. A more apparent difference is that the long-term fractal correlation of the fetal heart is increased and the fetal heart is smoother in the long-term scale.

Variables of fetal heart rate in anencephalic fetuses (초)

호정규 ( Jeong Kyu Hoh ),( Young Sun PARK ),( Yong Jin Park ),( Young Jai Kim ),( Moon Il Park ),( Sung Ro Chung ) 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-

What is considered the normal ranges of the fetal heart rate? (초)

호정규 ( Jeong Kyu Hoh ),( Young Sun PARK ),( Min Kyu Kim ),( Mei Ling Ting Lee ),( Moon Il Park ) 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-

골반 동통의 원인으로서의 비장절제술 후 발생한 골반내 비장

호정규 ( Jeong Kyu Hoh ),김경태 ( Kyung Tai Kim ),조삼현 ( Sam Hyun Cho ),황윤영 ( Yoon Young Hwang ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.12

정상 임신여성과 질염을 가진 임신여성에서 아스코르빈산을 함유한 질정(바지-씨(R) 질정) 투여 시 나타나는 질내 pH 변화 및 질염치료 효과

호정규 ( Jeong Kyu Hoh ),조해중 ( Hae Joong Cho ),정성로 ( Sung Ro Chung ),문형 ( Hyung Moon ),박문일 ( Moon Il Park ) 대한주산의학회 2006 Perinatology Vol.17 No.1

목적 : 임신 여성에서 아스코르빈산을 함유한 비타민-C 질정(바지-C(R) 질정) 투여 후 질내 pH 변화 및 질염치료의 효과와 안전성을 평가하기 위하여 본 연구를 실시하였다. 방법 : 90명의 임신여성(평균 임신주수 : 32±0.5주, range : 28~36주)으로 부터 연구 동의서를 받은 후, 6일간 연속으로 질 내에 비타민-C 질정(250 mg, Vagi-C(R), Taurus Pharma GmbH, Germany)을 투여하였다. 질 pH는 질정투여직전 및 투여 종료 1주일 후에 측정되었다. 90명중 10명은 추적이 안되어 연구대상에서 제외하였다. 연구대상 80명중 10명(12.5%)은 질정 투여 후 질 자극감 등의 부작용으로 투여를 자가중단 하였으며 결국 70명이 최종 연구대상에 포함되었다. 질정 투여 전의 기본적인 세균검사에서 39명은 정상이었으며 나머지 31명은 질염으로 분류되었는데. 15명은 캔디다 질염, 10명은 세균성 질증, 67명은 트리코모나스 질염으로 각각 분류되었으며 중복된 경우는 없었다. 세균성 질증의 진단은 특징적인 clue cell의 발견, 우유 같은 백색 질 분비물, KOH 검사(+), 질 pH> 4.5의 소견중 적어도 3개의 소견이 있는 경우로 하였다. 결과 : 질 pH는 질염군(N=31)에서 바지-씨(R) 투여전의 평균 4.9±0.5이었는데, 질정투여후 4.2±0.2로 의미 있게 감소하였다( p<.05). 한편 각 질염의 증상도 완화되었는데, 실제로 세균성질증에서는 10명중 8명에서 증상의 완화가 있었다(80%). 그러나 캔디다질염에서는 15명중 5명(33.3%), 트리코모나스질염에서는 6명중 2명(33.3%)에서만 원인균의 소실이 있었다. 질염이 없는 정상여성군(n=39)에서는 바지-씨(R) 투여전 평균 질 pH가 4.4±0.3에서 4.2±0.1로 감소하였으나 통계적인 차이를 보이지는 않았다. 결론 : 임신중 질염이 있는 여성에서 아스코르빈산을 함유한 비타민-C 질정(바지-씨(R) 질정) 투여는 질 pH를 의미 있게 감소시키며, 특히 세균성 질증에서는 80.0%의 증상개선효과가 있었다. Objective : The purpose of this study is to evaluate the effect of Vitamin-C vaginal tablets on vaginal pH and vaginitis symptoms of pregnant women. Methods : Ninety pregnant women who visited the antenatal clinic were included in this study after giving their informed consent. The treatment regimen of the vitamin-C vaginal tablets (250 mg, Vagi-C(R), Taurus Pharma GmbH, Germany) was one tablet given once a day for 6 consecutive days. Vaginal pH was measured the day before and the day after the Vit-C vaginal treatment. Ninety women of initial, ten failed to follow-up (participate). After routine screening using microscopic analysis of the vaginal smears, 31 of the 80 participating women fell into one of 3 pathologic groups (15 monilial infection, 10 bacterial vaginosis, 6 trichomonial infection) and leaving 49 pathogen-free pregnant women. 10 of the pathogen- free pregnant women were excluded during the study because they did not complete the treatment period due to vaginal irritation such as itching or burning sensations. The diagnosis of each vaginal infection was made by specific pathologic findings. Result : Mean vaginal pH values for the pathology group decreased significantly from 4.9 to 4.2. Pathologic findings of each infection were also improved without specific treatment. Bacterial vaginosis disappeared in 80.0% (8/10) of patients. The specific pathogens of the remained two vaginitis types were not detected in 33.3% (5/15) of monilial infection and 33.3% (2/6) trichomonial infection 1 week after discontinuation of Vitamin-C vaginal tablets Although it is not significant, mean vaginal pH values decreased from 4.4 to 4.2 in the pathogen-free pregnant women. Conclusion : Vitamin-C, when vaginally applied, is effective in lowering vaginal pH and in the treatment of vaginitis in pregnant women.

Differences of Linear indices, sample entropy of fetal heart rate and perinatal outcomes in maternal anemia (초)

호정규 ( Jeong Kyu Hoh ),( Young Sun PARK ),( Ok Su Yoon ),( Moon Il Park ) 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-