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만삭임신의 Prostaglandin E2에 의한 분만유도시의 Hormone변동에 관한 연구
김종환(JW Kim) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.11
The mechanism by which prostaglandins induce labor or abortion remain incompletely understood. They may have direct stimulating effects on myometrial contractility, may induce oxytocin release and, at least in ovine pregnancy, may induce a rapid increase in maternal plasma estrogen levels. Prostaglandin initiation of labor at term requires orchestration of the uterus, for estrogen and progesterone after prostaglandin E2 induction of labor and delivery. A total 35 cases were studied and plasma progesterone and estrogen were determined serially before and after oral ingestion of prostaglandin E2 for induction of labor at Korea University Hospital. The result obtained were summarized as follows; 1. After delivery, the mean concentration of progesterone and estrogen in the maternal peripheral veins were 127.5+-2.27ng/ml and 1.97+-0.10ng/ml. And n cases of PGE2 administration, their mean concentrations were 111.7+-2.55ng/ml and 1.71+-0.05ng/ml, respectively. 2. Following PGE2 administration, no consistent change was seen in maternal plasma concentration of progesterone and estrogen, according to the total geven dosage of prostaglandin E2. 3. Prostaglandin E2 appeared to have no direct effect on estrogen and progesterone biosynthesis. The insignificant fluctuation of plasma progesterone and estrogen levels before delivery may be caused by the strong uterine contraction leading to impaired function of the placental tissue. 4. The progesterone levels in fetal umbilical veins were 883.9+-9.96ng/ml, and they were higher than in the maternal peripheral veins(1.97+-0.10ng/ml). 5. In the PGE2 administrated group, the progesterone levels in fetal umbilical veins were 729+-7.6ng/ml and they were higher than in the maternal peripheral veins(111.7+-2.55ng/ml). The differences were statistically significant(p<0.05). The estrogen levels in fetal umbilical veins were 2.32+-0.05ng/ml and they were slightly higher than in the maternal peripheral veins(1.71+-0.05ng/ml).
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이재관(JK Lee),김종화(JH Kim),강순범(SB Kang),김종환(JW Kim),서경필(KP Suh) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.8
Patients who have had cardiac valve replacement are being seen increasingly often as candidates for antenatal care. The outcome of 23 pregnancies in 14 patients with bioprosthetic cardiac valves is analyzed and reported here. The results were summarized as follows: 1. Twenty three pregnancies in 14 patients with bioprosthetic cardiac valves resulted in 11 healthy, 2 low birth weight infants, 2 spontaneous abortions, 7 elective terminations of pregnancy, and one tubal pregnancy. 2. Pregnancy and labor seemed to have been tolerated relatively well in these patients. 3. There were 3 males and 10 females among the 13 infants born. 4. Birth weights ranged from 2,140 to 3,670g(mean 3,030). 5. Apgar scores at five minutes ranged from 4 to 10 (mean 9.1). 6. There were no instances of congenital malformations, maternal or fetal hemorrhagic complications. 7. There were 4 spontaneous vaginal deliveries, 7 elective vacuum extraction deliveries, 1 elective forcep delivery, and 1 cesarean section. 8. All patients received prophyllactic broad-spectrum antibiotics for infective endocarditis, and no nistances of endocarditis developed. 9. There were no stillbirth, no neonatal deaths, and no maternal deaths. 10. There were 2 instances of thromboembolism; one in the immediate postoperative period, and the other 5 years after valve replacement. All seemed to be unrelated to pregnancy. 11. Anticoagulants were not used in pregnancies which went to term except one patient, in whom coumarin was administered until 6th week of gestation. 12. One pregnancy was complicated with premature labor, one with gestational edema, one with preexisting chronic active hepatitis, five with worsening of cardiac status (one of the five, with newly developed atrial fibrillation). 13. 34.8% of all pregnancies after cardiac valve replacement were unwanted ones, and at the same time preventable `risk factors`.
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