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      • KCI등재SCOPUS

        응급 주산기 자궁적출술의 5 년간 경험

        안현경(H . K . Ahn),김은성(E . S . Kim),한정열(J . Y . Han),김문영(M . Y . Kim),류현미(H . M . Ryu),최규홍(K . H . Choi),양재혁(J . H . Yang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12

        Objective : To review the cases of peripartum hysterectomy in women delivered at a Hospital. Methods : This is a retrospective study of all cases of emergency peripartum hysterectomy performed between August 1994 and July 1998. Results : During the study period a total of 35 emergency peripartum hysterectomy was performed. The overall incidence was 0.9/1,000 deliveries. The mean age of patients was 33.7±0.8 years old, the median gravidity was 5 and mean gestational age was 37.7±0.4 weeks. The main indications for hysterectomy were massive bleeding due to abnormal placental adhesions or uterine atony. There was no maternal death, However, maternal morbidity was 34.3%. Conclusions : The data show abnormal adherent placentation as the primary cause for gravid hysterectomy. The data illustrate how the incidence of emergency peripartum hysterectomy increases significantly with increasing parity, especially when influenced by a current placenta previa or a prior cesarean section. Maternal morbidyity remained high although no maternal deaths occurred.

      • KCI등재SCOPUS

        다운증후군의 산전진단을 위한 다양한 선별검사의 기여율 비교 - 산전 및 신생아때 진단된 96 례 분석 -

        한정열(J . Y . Han),김문영(Y. M . Kim),조준형(J . H . Cho),안현경(H . K . Ahn),류현미(H . M . Ryu),김진미(J . M . Kim),김영미(Y . M . Kim),박소연(S . Y . Park),한혜경(H . K . Han),이영호(Y . H . Lee),양재혁(J . H . Yang) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10

        Objective : The purpose of this study was comparison of the contribution rate for prenatal diagnosis of Down syndrome using various screening methods (Age: greater than or equal to 35 years old, Serum markers: Triple test, Ultrasonography: abnormal sonographic findings, nuchal translucency, nuchal fold thickness).Methods : Total 96 cases of Down syndrome, prenatally or postnatally diagnosed between Jan. 1990 and Sept. 1999, made up the study population. We got the contribution rate of various prenatal screening methods of down syndrome, and obtained the efficiency of various screening program applied for last 10 years. Results : The frequencies of Down syndrome confirmed in prenatal and postnatal were 68 (71%) and 28 (29%) in respectively. The mean age of mother of Down syndrome fetus was 33.0±5.7 years old. The frequency rate of Down syndrome was 0.4, 1.3, 0.7, 0.7, 1.6, 0.7, 1.2, 2.2, 2.0 and 2.3 a 1,000 deliveries from 1990 to 1999 (Y= 0.28+0.18 year, P=0.01). The percentage of Down syndrome diagnosed prenatally was 0 (0/2), 43 (3/7), 50 (2/4), 25 (1/4), 56 (5/9), 100 (5/5), 71 (5/7), 78 (14/18), 78 (14/18) and 89 (17/19) from 1990 to 1999 (Y= 12.9+8.9 year, P=0.000). The contribution rate of prenatal diagnosis for Down syndrome was 30.2±5.6% by age, 18.2±3.4% by triple test and 51.7±6.3% by ultrasonography, and was significantly difference among each screen methods (P=0.008). Conclusions : This study shows that our prenatal screening program is highly effective to detect Down syndrome and especially ultrasonographic findings (abnormal sono findings, Nuchal translucency, Nuchal fold thickness) may be more important than that of age or Triple test to detect the Down syndrome prenatally.

      • KCI등재SCOPUS

        염색체 이수성질환을 선별하기 위한 삼중 표지물질 검사의 성과에 관한 연구

        최용관(Y. K. Choi),김문영(M. Y. Kim),한정열(J. Y. Han),류현미(H. M. Ryu),양재혁(J. H. Yang),김은성(E. S. Kim),이홍복(H. B. Lee),한인수(E .S. Kim),고명인(M. I. Ko),한호원(H. W. Han) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.9

        Objective: To evaluate the effectiveness of a screening protocol using a combination of maternal age and three biochemical markers for the antenatal detection of fetal chromosomal aneuploidy Materials and methods: In our retrospective, 5,308 women who were screened for Down syndrome at second trimester of pregnancy and delivered between March 1994 and February 1996 at Samsung Cheil hospital were studied. Also, 1,378 women were simultaneously studied for screening for Edward syndrome between November 1995 and February 1996. According to maternal age and the concentration of measured maternal serum markers (α-fetoprotein, unconjugated E3, hCG), the risk ratio of Down syndrome and Edward syndrome were calculated by α-software V. 4.1. The screening positive women were performed amniocentesis for fetal karyotyping after genetic counseling. Results: The average age was 28 years old. The average of the geatational weeks was 16.3 weeks. The followings are equations of expected median for each maternal serum markers. AFP(ng/ml)=10(0.474+0.0652xGestational week) uE3(nmol/L)=10(-0.852+0.0932xGestational week) hCH(IU/ml)=217,523/[1+Exp(5.62+0.17xGestational week)] Among 5,308 cases, screen positive was in 248 cases(4.7%). But amniocentesis was performed in 126 cases(2.4%). Down syndrome was detected in 7 cases. The difference of the prevalance rate for Down syndrome between younger than 35 years old (1.2/1,000) and older than or equal to 35 years old(6.7/1,000) was statistically significant (P=0.035). However, in screen negative cases, Down syndrome was detected in 2cases. Overall, the detection rate, false positive for Down syndrome were 77.8%, 4.5% respectively and the ratio for OAPR was 1:35. In Edward syndrome, screen positive was in 4 cases(0.3%). Edward syndrome was confirmed in 2 cases by amniocentesis The detection rate, false positive for Edward syndrome were 100%, 0.1 % and the ratio for OAPR was 1:2. Conclusion: The prenatal screening test by the combination of maternal age and the concentration of maternal serum markers was effective to detect Down syndrom and Edward syndrome at second trimester of pregnancy.

      • KCI등재SCOPUS

        임신 제일삼분기 약물 및 진단용 방사선 노출 임신부에서 기형 발생 위험에 관한 근거중심적 상담의 효과

        한정열(J . Y . Han),박소연(S . Y . Park),김영미(Y . M . Kim),김진우(J . W . Kim),정상희(S . H . Jung),정영철(Y . C . Chung),최준식(J . S . Choi),안현경(H . K . Ahn),오민정(M . J . Oh),류현미(H . M . Ryu),김문영(M . Y . Kim),궁미경(M . K 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.1

        Objective : To evaluate the effectiveness of evidence-based teratogenic risk counseling by relevant medical literature concerning pregnant women exposed to medication or diagnostic radiation during the first trimester. Methods : Between January 2001 and April 2001, 67 pregnant women exposed to medication or diagnostic radiation visited our clinic for teratogenic risk counseling. We counseld the teratogenic risk of their fetus by relevant medical literature.Also, We measured the score to terminate pregnancy and the perceptive risk on their fetus with major congenital anomaly using 10cm visual analogue scale. Results : None of them were exposed to any known teratogenic drugs or radiation in any teratogenic doses. Other physicians had already recommended, to about a third of patients, pregnancy termination. Their perceptive estimation on the risk of major congenital malformation in the general population was 4.6±1.1%. The perceptive risk on their fetus with major congenital anomaly decreased from 39.5±3.1% before consultation to 10.8±1.6% thereafter (P<0.05). Also, their score on the visual analogue scale to terminate pregnancy was 6.4±2.7 before consultation and 9.1±1.6 thereafter. Their tendency to terminate pregnancy significantly decreased after consultation (P<0.05). Conclusion : Evidence-based counseling for pregnant women exposed to medication or diagnostic radiation during the first trimester may prevent unnecessary pregnancy terminations as well as reduce anxiety.

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