35세 이상 고령 산모의 산과적 예후

박희진 ( Hee Jin Park ),이숙환 ( Sook Hwan Lee ),차동현 ( Dong Hyun Cha ),김인현 ( In Hyun Kim ),전혜선 ( Hye Sun Jun ),이경진 ( Kyoung Jin Lee ),송송아 ( Song Ah Song ),박혜리 ( Hey Ri Park ),정창조 ( Chang Jo Chung ),이정노 ( Ch 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.10

Objective: To estimate the effect of maternal age on obstetric outcomes, a retrospective analysis was done. Methods: Twenty six hundred and forty six women who delivered a singleton baby at our hospital from January 1, to December 31, 2004 were enrolled in this study. Subjects were divided into 3 age groups; 1) less than 35 years, 2) 35-39 years, and 3) 40 years and older. Chi-square test was used to assess the effect of age on obstetrics outcome. Then the odds ratio was calculated to represent clinically meaningful risk. Results: A total of 2646 women with complete data were available; 2245 (84.9%) less than 35 years of age; 350 (13.2%) 35-39 years; and 51 (1.9%) 40 years and older. Increasing age was significantly associated with chromosomal abnormalities (OR 3.9and 8.8 for ages 35-39 years and age 40 years and older, respectively), Preterm premature rupture of membranes (OR 1.3 and 3.2) and cesarean delivery (OR 2.0 and 5.5). Patients aged 35-39 years were at increased risk for placenta previa (OR 1.8) and congenital anomaly (OR 2.8) but these were not statistically significant. The rate of the preterm delivery was increased by age (OR 1.3 and 1.9 for ages 35-39 years and age 40 years and older, respectively) but it was not statistically significant (p=0.121). We did not find advanced maternal age to be associated with a statistically increased risk for preeclampsia, congenital anomaly, gestational diabetes, placenta abruption, low birth weight, macrosomia, neonatal morbidity (NICU admission), and perinatal loss. Conclusion: In conclusion, although the likelihood of adverse outcomes increases with maternal age, patients and obstetric care providers can be reassured that overall maternal and fetal outcomes are favorable in this patient population.

Obstetric Outcomes of Women Who Sustained Traumatic Spinal Injury during Pregnancy: A Systematic Review

Arsh Aatik,Darain Haider 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.2

Literature regarding pregnant women who sustained traumatic spinal injury during pregnancy is limited. Existing papers are mainly case reports, and this indicates a need for more high-quality research evidence in this area. Therefore, this study was designed to systematically review available literature that reported demographic information, clinical characteristics, and obstetric outcomes of women who sustained spinal injury during pregnancy. Studies published from the earliest record to January 2019, which reported traumatic spinal injury during pregnancy, were included. Studies that have reported pregnancy in patients with pre-existing spinal injury, review articles, commentaries, letter to editors, conference papers, and studies published in languages other than English were excluded. Sixteen studies reporting on 26 women were included. Their mean age was 26.7±5.5 years. Motor vehicle accidents were the main cause of spinal injury (n=15, 58%). Of the cases, four women sustained spinal injury during the 1st trimester of pregnancy, of which one had a spontaneous abortion, one delivered a baby with arthrogryposis multiplex congenital disorder, and the third one delivered a premature baby who died shortly after the delivery. Fifteen women sustained injury during their 2nd trimester, of which 14 delivered normal babies, while six sustained spinal injury during the 3rd trimester. Of these women, five delivered normal babies at term. Outcomes of pregnancy appear significantly affected if a spinal injury occurs during the 1st trimester of pregnancy; however, injuries sustained during the 2nd and 3rd trimesters can have good obstetric outcomes.

Retrospective anesthetic evaluation of nonobstetric surgery during pregnancy: single center experience

윤준로,정은용,김의숙,김영혜,정수연,김태관 대한마취통증의학회 2018 Anesthesia and pain medicine Vol.13 No.2

Background: Laparoscopic procedures and ultrasonography are now commonly used in the obstetric field, and more non-obstetric procedures are being performed. However, little domestic data has been published on the topic. This present retrospective study investigated the clinical information and the effect on perinatal outcomes of non-obstetric surgery during pregnancy. Methods: This retrospective study was performed using data of all adult pregnant women that underwent non-obstetric surgery at our institute between from July 2009 to December 2016. Data was collected from the institutional computerized database. The causes, types, and the gestational ages at surgery were collected as our primary outcomes. Basic characteristics of patients, operation times, anesthesia times, anesthetic methods, anesthetic agents, and adverse perinatal outcomes such as abortion or preterm delivery were evaluated as secondary outcomes. Results: During the study period, there were 2,421 deliveries and 60 cases of nonobstetric surgery, an operation rate of 2.48%. The most common cause of non-obstetric surgery was abdominal surgery, followed by orthopedic surgery and neurosurgery. Most of abdominal surgeries were performed laparoscopically during the first trimester. The incidence of adverse perinatal outcomes was increased in the first trimester, was not related with anesthesia. Conclusions: The rate of non-obstetric surgery was found to be 2.48%, which was higher than those reported in previous domestic studies. This increase seems to have resulted from early diagnosis by ultrasonography and non-invasive surgery using laparoscopy. Adverse perinatal outcomes are not related with age, surgery and anestheticrelated factors but seem to be associated with surgery exposure stage, especially the first trimester.

복강경하 자궁근종절제술 후 산과적 결과

유은희 ( Eun Hee Yoo ),김동욱 ( Donguk Kim ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12

Objective: To evaluate the outcomes of pregnancy after laparosocpic myomectomy. Methods: A total of 99 cases of pregnancies after 512 cases of laparoscopic myomectomy which was performed at different 6 hospitals between 1995 and 2004 was selected. Retrospective chart review and telephone survey were performed for identifying outcomes of pregnancies, ectopic pregnancy rate, abortion rate, preterm delivery, spontaneous or cesarean delivery and presence of dangerous outcomes of uterine rupture. Results: There were 20 (20.2%) spontaneous abortion, 2 (2.0%) ectopic pregnancy. Among the delivery of 77 cases, 4 (5.2%) had vaginal deliveries and 73 (94.8%) had cesarean section. No case of uterine rupture was reported. Conclusions: Outcomes of pregnancy after laparoscopic myomectomy showed safe and successful outcomes.

시험관 아기 시술후 쌍태 임신의 결과에 대한 임상적 고찰

김철홍(Cheol Hong Kim),이여길(Yu Il Lee) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.9

Objectives : This study compares the obstetric complications and perinatal outcomes of twin pregnancies after In Vitro Fertilization and Embryo Transfer to twin pregnancies conceived spontaneously.Methods : One hundred sixteen cases of twin pregnancies were reviewed. All deliveries were performed between March 1996 and July 1999 at Chonnam National University Hospital. The study group(n=46) consisted of IVF-ET twin pregnancies and the control(n=70) consisted of spontaneous twin pregnancies delivered within the same time period. Clinical data were examined by age, parity, antenatal care, gestational age at delivery, method of delivery, type of chorioamnionicity, fetal presentation, obstetric complications, as well as perinatal outcomes. Observed obstetric complications included premature rupture of membrane, pregnancy induced hypertension, preterm labor, prematurity, gestational diabetes, placenta previa, placenta abruption and anemia. Results : The women in the IVF-ET group were significantly older than those in the spontaneous group(32.7±3.9 and 28.2±3.6 years, respectively). The proportion of primiparous patients was higher in the IVF-ET group(89.1%) than in the spontaneous group(54.3%). Method of conception did not influence the frequency of obstetric complications. No differences were seen in birth weight, rate of low birth weight, rate of intrauterine growth restriction and perinatal mortality.Conclusions : There is no difference in obstetric complications or perinatal outcomes between the groups. In light of the higher frequency of obstetric complications in twin pregnancies, the rematching task is to reduce the frequency of twin pregnancies in IVF-ET induced pregnancies.

Are women with small endometriomas who undergo intracytoplasmic sperm injection at an elevated risk for adverse pregnancy, obstetric, and neonatal outcomes?

Fatma Ferda Verit,Ayse Seyma Ozsuer Kucukakca 대한생식의학회 2021 Clinical and Experimental Reproductive Medicine Vol.48 No.1

Objective: The aim of the study was to investigate pregnancy, obstetric, and neonatal outcomes in women with small (<4 cm) unilateral endometriomas. Methods: This retrospective study included 177 patients: 91 patients with small endometriomas and 86 controls with unexplained or tubal factor infertility who were treated at the Süleymaniye Gynecology and Maternity Training and Research Hospital Infertility Unit between January 2010 and July 2015. The groups were matched with regards to demographic characteristics such as age, body mass index, and infertility duration. All of the women in this study conceived via intracytoplasmic sperm injection. We compared pregnancy, obstetric, and neonatal outcomes between these groups. Results: Women with endometriomas had a higher biochemical pregnancy rate, but lower clinical pregnancy and live birth rates than women with unexplained and tubal factor infertility (p<0.05 for all). However no significant differences were found in terms of obstetric and neonatal complications between the two groups (p>0.05 for all).Conclusion: In this study, we found that women with endometriomas less than 4 cm were more prone to early pregnancy complications. We also showed that this group did not have any increased risks of late pregnancy, obstetric, and neonatal complications.

Obstetric outcomes after uterine myomectomy: Laparoscopic versus laparotomic approach

( Myo Sun Kim ),( You Kyoung Uhm ),( Ju Yeong Kim ),( Byung Chul Jee ),( Yong Beom Kim ) 대한산부인과학회 2013 Obstetrics & Gynecology Science Vol.56 No.6

Objective To compare the pregnancy-related complications after laparoscopic and laparotomic uterine myomectomy. Methods A retrospective study of 415 women who received laparoscopic (n = 340) or laparotomic (n = 75) resection of uterine leiomyomas in one center. The mean follow-up period was 26.5 months in laparoscopic group and 23.9 months in laparotomic group. Results Fifty-four and 12 pregnancies occurred in laparoscopic and laparotomic myomectomy group, respectively. The major obstetric outcomes were similar between two groups. There was no ectopic pregnancy or preterm birth. There were two cases of obstetric complication in laparoscopic group only; one experienced neonatal death and postpartum hemorrhage due to placental abruption and the other underwent subtotal hysterectomy due to uterine dehiscence identified during Cesarean section. Conclusion Uterine rupture or dehiscence after laparoscopic myomectomy occurred in 3.7% (2/54) which lead to unfavorable outcome. Appropriate selection of patients and secure suture techniques appears to be important for laparotomic myomectomy in reproductive-aged women.

Obstetrical Outcomes of Amniocentesis or Chorionic Villus Sampling in Dichorionic Twin Pregnancies

김미선,문명진,강석호,정상희,장성운,기효진,김보혜,안은희 대한의학회 2019 Journal of Korean medical science Vol.34 No.18

Background: Under certain situations, women with twin pregnancies may be counseled to undergo invasive prenatal diagnostic testing. Chorionic villus sampling and amniocentesis are the two generally performed invasive prenatal diagnostic tests. Studies comparing procedure-related fetal loss between first-trimester chorionic villus sampling and second- trimester amniocentesis in twin pregnancies are limited. This study aimed to evaluate the procedure-related fetal loss and the obstetrical outcomes of these two procedures, chorionic villus sampling and amniocentesis in twin pregnancies. Methods: The data from dichorionic-diamniotic twin pregnancies on which first-trimester chorionic villus sampling (n = 54) or second-trimester amniocentesis (n = 170) was performed between December 2006 and January 2017 in a single center were retrospectively analyzed. The procedure-related fetal loss was classified as loss of one or all fetuses within 4 weeks of procedure, and overall fetal loss was classified as loss of one or all fetuses during the gestation. The groups were compared with respect to the procedure-related and obstetrical outcomes. Results: The difference in proportion of procedure-related fetal loss rate (1.9% for chorionic villus sampling vs. 1.8% for amniocentesis; P = 1.000) and the overall fetal loss rate (7.4% for chorionic villus sampling vs. 4.7% for amniocentesis; P = 0.489) between the two groups was not significant. The mean gestational ages at delivery were not statistically significant. Conclusion: Both the overall fetal loss rate and the procedure-related fetal loss rate of chorionic villus sampling and amniocentesis in dichorionic twin pregnancies had no statistical significance. Both procedures can be safely used individually.

Hyrtl 문합 형태와 그에 따른 산과적 영향

서경아 ( Seo Gyeong A ),김민정 ( Kim Min Jeong ),이귀세라 ( Lee Gwi Se La ),신종철 ( Sin Jong Cheol ),김수평 ( Kim Su Pyeong ),나종구 ( Na Jong Gu ),김사진 ( Kim Sa Jin ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.1

Objective : This study was conducted to investigate the presence and pattern of Hyrtl anastomosis, and to examine the effect that each type has on obstetrical outcome. Methods : This study was carried out from January of 2001 to May of 2003 on 904 randoml

난자 세포질내 정자 주입술시 정자 기원에 따른 산과적 결과와 선천성 기형에 관한 연구

강지현 ( Ji Hyun Kang ),강경화 ( Kyoung Hwa Kang ),최영식 ( Young Sik Choi ),이정렬 ( Jeong Lyol Lee ),정연경 ( Youn Kyung Chung ),지병철 ( Byung Chul Jee ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),최영민 ( Young Min Ch 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.10

Objective: To analyze the obstetric outcomes, the incidence of congenital malformations and chromosomal anomalies of neonates born after intracytoplasmic sperm injection (ICSI) according to the origin of sperm. Methods: A total of 103 neonates born from ICSI between January 1995 and January 2004 was included. They were divided into three groups: ejaculated (n=73), epididymal (n=17) and testicular (n=13) groups. We compared obstetric outcomes such as pregnancy rates, preterm birth rates, abortion rates, multiple pregnancy rates, gestational age at birth, birth-weight, and the incidence of congenital malformations and chromosomal anomalies. Results: There were no differences among the three groups in terms of pregnancy rates, preterm birth rates, abortion rates, multiple pregnancy rates, gestational age at birth and birth-weight. There were no differences in the incidence of low birth-weight babies and very low birth-weight babies. Major malformations were observed in two cases of ejaculatory group (2.7%) and one of testicular group (7.7%). Major malformations included two gastrointestinal malformations and one cleft lip. Minor malformations were observed in three cases of ejaculatory group (4.1%) and one of testicular group (7.7%). Chromosomal anomalies were observed in 6 cases of 105 pregnancies (5.7%), and all of them were from the ejaculatory group. Two cases had autosomal numerical anomalies and 4 cases autosomal structural anomalies. However, sex chromosomal anomalies were not detected in this study. Conclusion: The obstetric outcomes, the incidence of congenital malformations and chromosomal anomalies in ICSI babies were not different according to the origin of sperm. These findings should be further investigated in larger long-term studies.