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( Jeong Kyu Hoh ),( Laura Hyeyeon Boo ),( Eun Hyun Lee ),( Young Sun Park ),( Kyung Joon Cha ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
The purpose of this study was to compare and analyze differences in maternal oxygen saturation (SpO2), blood pressure (BP), and heart rate (HR) when non-stress test (NST) was performed, according to the fetal reactivity. We selected 8 non-reactive and 119 reactive cases from total NST acquired using a computerized FHR analysis system at Hanyang University Hospital in 2012. Maternal SpO2, BP, and HR were recorded simultaneously when NST was performed. NSTs were performed between 31 and 42 weeks of gestation. Perinatal outcomes were compared, and FHR parameters analyzed. Statistical analysis was performed by Median test or Fisher`s exact test. General characteristics between two groups were not different. NST parameters showed no significant difference between two groups except the amplitude (29.73 vs 24.35; p=0.0274). Maternal BP and HR showed no significant difference between two groups, however, SpO2 showed a statistical difference (96.90 vs 97.23; p=0.0269). Neonatal outcomes between two groups were not different. It might be thought that maternal SpO2 was related to the fetal heart rate reactivity. Further studies would be needed for clarifying our result.
( Jeong Kyu Hoh ),( Laura Hyeyeon Boo ),( Eun Hyun Lee ),( Young Sun Park ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
The purpose of this study was to compare and analyze differences in fetal heart rate (FHR) parameters during pregnancy between fetuses with partial abruptio placenta and non-placental abruption. We surveyed all non-stress test (NST) data acquired using a computerized FHR analysis system at Hanyang University Hospital. 31 cases of partial abruptio placenta, which were identified after delivery, from total NST data between 2003 and 2010 were selected as a study group. NSTs were performed between 31 and 42 weeks of gestation. Perinatal outcomes were compared, and FHR parameters analyzed using a linear method. Non-linear methods; approximate entropy (ApEn), sample entropy (SampEn), short-term/ long-term scaling exponents (α1/ α2) and correlation dimension (CD) were used for analysis of FHR dynamics and system complexity. General characteristics between two groups were not different. NST parameters showed no significant difference between two groups, however, the non-linear indices; ApEn (mean±SD, 0.67±0.17 vs 0.77±0.17; p=0.0005), SampEn (0.54±0.14 vs 0.66±0.17; p<0.0001), / long-term scaling exponents (0.90±0.06 vs 0.87±0.05; p=0.0022), and CD (3.19±0.40 vs 3.34±0.33; p=0.0118) of the partial abruptio placenta group was significantly lower than the non-placental abruption group. Compared to non-placental abruption cases, FHR of partial abruptio placenta 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. Non-linear indices of FHR are useful tools for detecting abnormal FHR patterns that are not found in patients with partial abruptio placenta using conventional linear analysis.
( Jeong Kyu Hoh ),( Laura Hyeyeon Boo ),( Eun Hyun Lee ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
The aim of this study was to determine whether an interval cerclage reduced preterm delivery in those women who had undergone an emergency transvaginal cerclage due to dilated cervix and/or protruding fetal membrane with labor. A retrospective cohort study was conducted on women with a transvaginal cervical cerclage who also went over the interval cerclage. Sixteen cases underwent a transvaginal cerclage and composed the 7 cases of interval cerclage group, whereas 9 others without interval cerclage, only elective cerclage group due to bad obstetric history. Interval cerclage was performed to patients who previously had emergency cerclage due to symptoms of impending preterm delivery at a distance of time. Antibiotics and prophylactic tocolysis were given to all patients. Neonatal outcomes and perinatal complications were analyzed between two groups. Mean initial cervical length before the first surgery was 0.07 cm in interval cerclage group and 4.3 cm in elective cerclage group. Cervical length before second surgery in interval cerclage group was 1.94 cm. Of all 16 cases, no fetal loss was found during present pregnancy. Mean delivery weeks was 35+0 weeks in interval cerclage group while 35+1 weeks in elective cerclage group (p=0.4981). Mean birth weight in interval cerclage group was 1920.0 g and 2145.0 g in elective cerclage group (p=0.2901). Apgar score (1/5 min) was 6/8 in interval cerclage group and 6/8 in elective cerclage group (p=1.000). Other neonatal outcomes and perinatal complications were not different between two groups as well. It is thought that interval cerclage might be a good emergent surgical procedure that can be used in preventing preterm delivery in patients with incompetent internal os of cervix having preterm labor.
OB-48 : Nonlinear analyses of heart rate variability between male and female fetuses
( Jeong Kyu Hoh ),( Laura Hyeyeon Boo ),( Eun Hyun Lee ),( Young Sun Park ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 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; sample entropy, SampEn) between male and female fetuses. We surveyed all non-stress test (NST) data acquired using a computerized FHR analysis system at Hanyang University Hospital. NST of 1,687 male fetuses and 1,831 female fetuses were selected. NSTs were performed between 24 and 42 weeks of gestation. The average baseline FHR and non-linear indices was analyzed according to the gestational ages. Perinatal outcomes were compared, and FHR parameters analyzed using a linear method. Non-linear methods; approximate entropy (ApEn), sample entropy (SampEn), short-term/ long-term scaling exponents (α 1/ α2) and correlation dimension (CD) were used for analysis of FHR dynamics and system complexity. The average of FHR variability, with respect to amplitude (AMP), mean minute range (MMR) and non-linear indices were not different between two groups. Compared by gestational weeks, the ApEn of female group was higher than that of male group from 25 to 30 gestational weeks, however, between 31 and 32 gestational weeks, ApEn of male group was higher than that of female group. The peak of the ApEn of female group was 29-30 gestational weeks (0.92±0.14), whereas the peak of male group was 31-32 gestational weeks (0.93±0.10). Neonatal outcomes were not different between two groups. It might be thought that the heart rate dynamics of female fetuses are matured earlier than that of male fetuses until 30 gestational week. After 32 gestational week, the heart rate dynamics are matured at the same rate until the term pregnancy.
호정규 ( Jeong Kyu Hoh ),정재은 ( Jae Eun Chung ),하창원 ( Chang Won Ha ),문영진 ( Young Jin Moon ),이문휘 ( Mun Hwi Lee ) 대한주산의학회 2007 Perinatology Vol.18 No.4
Placenta increta is a life threatening complication of pregnancy, causing severe post-curettage bleeding. It is usually presented in the postpartum period with hemorrhage during difficult placental removal. It is especially rare in the 1st and 2nd trimesters, which is not easy to find and diagnose. We have confirmed a case of placenta increta after emergency hysterectomy due to severe vaginal bleeding following the dilatation and curettage during the 1st trimester of her pregnancy. So we report it with a brief case history and review of the concerned literatures.
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.