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( Jose Ferreira Gomes Neto ),( Edward Araujo Junior ),( Jesus Irajacy Fernandes Costa ),( Daniel Aguiar Dias ),( Lindemberg Barbosa Aguiar ),( Francisco Herlanio Costa Carvalho ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.1
Congenital goiter is considered a rare occurrence, and may be related to hypothyroidism, hyperthyroidism, or euthyroidism. In this report, we describe a case of fetal goiter identified in the 34th gestational week in a 41-year-old secundigravida with normal thyroid functions. A conservative approach was followed; the fetal goiter was monitored via ultrasound, which suggested this was a case of hyperthyroidism. After the birth, tests indicated that the newborn was euthyroidic. Consequently, a more detailed study using non-invasive procedures was deemed necessary to discover the precise cause of the fetal goiter during the gestational period.
( Heron Werner ),( Pedro Daltro ),( Taisa Davaus ),( Edward Araujo Junior ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.5
We report a case of a fetus with an ultrasonography diagnosis of a neuroblastoma during a routine third trimester fetal scan, which presented as a hyperechogenic nodule located above the right kidney. No other abnormalities were found in the ultrasonography scan; however, the follow-up ultrasonography during the 36th week of gestation revealed that the lesion had doubled in size. At the same time, magnetic resonance imaging demonstrated a round mass in the topography of the right adrenal gland with a low signal on T1-weighted images and slightly high signal on T2-weighted images, causing a slight inferior displacement of the kidney. The liver had enlarged and had heterogeneous signal intensity, predominantly hypointense on T2-weighted sequences. Based on these findings, a diagnosis of congenital adrenal neuroblastoma with liver metastases was suggested. A newborn male was delivered by cesarean section 2 weeks later. The physical examination of the neonate revealed abdominal distention and hepatomegaly. The infant had a clinical follow-up in which no surgical or medical intervention was required. At 5 months of age, the infant was asymptomatic with a normal physical examination.
( Rosiane Maciel Scandiuzzi ),( Caio Antonio De Campos Prado ),( Edward Araujo Junior ),( Geraldo Duarte ),( Silvana Maria Quintana ),( Fabricio Da Silva Costa ),( Gabriele Tonni ),( Ricardo De Carval 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.5
Objective To assess the maternal demographic characteristics and uterine artery (UA) Doppler parameters at first and second trimesters of pregnancy as predictors for hypertensive disorders (HDs) and adverse perinatal outcomes. Methods This prospective cohort study comprised 162 singleton low-risk women undergoing routine antenatal care. The left and right UA were assessed by color and pulsed Doppler and the mean pulsatility and resistance indices as well as the presence of a bilateral protodiastolic notch were recorded at 11 to 14 and 20 to 24 weeks’ gestation. Multilevel regression analysis was used to determine the effects of maternal characteristics and abnormal UA Doppler parameters on the incidence of HD, small for gestational age newborn, cesarean section rate, Apgar score <7 at 1st and 5th minute, and admission to the neonatal intensive care unit. Results Fifteen women (9.2%) developed HD. UA mean resistance index (RI), UA mean pulsatility index, and parity were independent predictors of HD. Compared to the pregnancies with a normal UA mean RI at the first and second trimesters, pregnancies with UA mean RI >95th percentile only at the first trimester showed an increased risk for HD (odds ratio, 23.25; 95% confidence interval, 3.47 to 155.73; P<0.01). Similar result was found for UA mean pulsatility index >95th percentile (odds ratio, 9.84; 95% confidence interval, 1.05 to 92.10; P=0.05). The model including maternal age, maternal and paternal ethnicity, occupation, parity and UA mean RI increased the relative risk for HD (area under receiver operating characteristics, 0.81). Conclusion A first-trimester screening combining maternal characteristics and UA Doppler parameters is useful to predict HD in a low-risk population.
( Alberto Borges Peixoto ),( Taciana Mara Rodrigues Da Cunha Caldas ),( Ana Helena Bittencourt Alamy ),( Wellington P. Martins ),( Rafael Frederico Bruns ),( Edward Araujo Junior ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.4
To establish reference values for the cervical length (CL) measurement by transvaginal ultrasound between 20 and 24+6 weeks of gestation in a large Brazilian population. A retrospective cross-sectional study was performed with 996 singleton pregnancies. The CL measurement (mm) using the transvaginal ultrasound was obtained in a sagittal view and the calipers positioned to measure the linear distance between the triangular area of echodensity at the external os and the internal os. The median±standard deviation and ranges for the CL measurement (mm) was 37.0±10.7 (range, 8 to 51). CL measurement did not modify significantly with gestational age. The observed percentiles for the CL measurement (mm) considering all number case were the following: 5th, 28 mm; 50th, 37 mm; and 95th, 45 mm. Reference values for the CL measurement by transvaginal ultrasound between 20 and 24+6 weeks of gestation in a large heterogeneous Brazilian population were established.
Association between decreased ovarian reserve and poor oocyte quality
( Viviane Margareth Scantamburlo ),( Renate Von Linsingen ),( Lidio Jair Ribas Centa ),( Kahisa Fontana Dal Toso ),( Debora Scaraboto ),( Edward Araujo Júnior ),( Jaime Kulak Junior ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.6
Objective To analyze the association between oocyte quality and decreased ovarian reserve (DOR) markers in young women undergoing controlled ovarian stimulation (COS). Methods This retrospective study included 49 patients classified as having DOR based on anti-Mullerian hormone (AMH) levels, follicle-stimulating hormone (FSH) levels, or antral follicle counts (AFCs; <10). Images of all obtained oocytes were analyzed, and oocyte quality was classified according to maturity and morphology. The COS protocol utilized gonadotropin (FSH and/or human menopausal gonadotropin [hMG]) doses ranging from 150 to 300 IU/day. The Student’s t test or Mann-Whitney test was used to compare the groups. Spearman’s coefficients were estimated to verify the correlation between the administered dose of FSH/hMG and the number of mature oocytes. To evaluate the association between patient- and oocyte-related variables, logistic regression models were adjusted. Results Women with DOR classified according to FSH level had more immature oocytes (P<0.001). Women with DOR according to AMH had fewer mature oocytes and increased basal FSH levels (P<0.001). Women with DOR according to AFC had an increased risk of abnormally shaped oocytes (P=0.035). Conclusion This study showed that DOR based on AMH levels, FSH levels, and AFC was associated with poorer quality oocytes in young women who underwent COS.
( Alberto Borges Peixoto ),( Taciana Mara Rodrigues Da Cunha Caldas ),( Luisa Almeida Tahan ),( Caetano Galvao Petrini ),( Wellington P Martins ),( Fabricio Da Silva Costa ),( Edward Araujo Junior ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.4
Objective To assess the predictive capacity of cervical length (CL) measurement underwent during the second trimester ultrasound for prediction preterm birth <32, 34, and 37 weeks of gestation in an unselected risk population. Methods A retrospective cohort study was performed with 751 singleton pregnancies between 20 and 24+6 weeks of gestation. The CL measurement (mm) using the transvaginal route was obtained in a sagittal view and the calipers positioned to measure the linear distance between the triangular area of echodensity at the external os and the internal os. To compare the preterm (<37 weeks) and term births (≥37 weeks), we used unpaired t test. We assessed whether the CL measurement was dependent of gestational age by performing a linear regression and assessing the coefficient of determination (R²). We additionally assessed the accuracy of CL measurement to predict preterm birth by assessing the area under receiver operating characteristics curves with its respective confidence intervals (CIs) 95%. Results Preterm birth <37 weeks was found in 13.6% (102/751) of pregnant women. Short cervix (≤25 mm) was found in 2.7% (20/751) of pregnancies. Only 30% (6/20) of pregnant women with short cervix have used progesterone to prevent preterm birth. There was a weak correlation between CL measurement and gestational age at delivery (R2=0.01, P=0.002). Receiver operating characteristics curve analysis of the ability of CL measurement to predict preterm birth <32, 34, and 37 weeks, showed an area under the curve of 0.693 (95% CI, 0.512 to 0.874), 0.472 (95% CI, 0.353 to 0.591), 0.490 (95% CI, 0.426 to 0.555), respectively. Conclusion There was a weak correlation between CL measurement and gestational age at delivery. In an unselected population, CL measurement screening at 20 to 24+6 weeks of gestation does not seem to be a good predictor of preterm birth.