임신 후기 초음파검사에 의한 태반등급(Placental Grading)과 양수내 Lecithin/Sphingo- myelin Rotio 및 임상예후와의 관계

홍경희(KH Hong),우복희(BH Woo),강신명(SM Kang) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.8

이화여자대학교 의과대학 산부인과학교실에서는 1985년 1월 1일부터 4월 15일까지 총 58예에 대하여 초음파검사에 의한 태반등급 및 lecithin/sphingomyelin 비율(29예)거사를 실시하여 다음과 같은 결론을 얻었다 1 태반등급과 임수주수와의 관계를 보면, 만삭 임신 (37주이상)에서, 태반등급 III은 30예로 51 8%이었고, 등급II는 12예로 20 7%, 등급 I은 9예로 15 5%이었다 임신 27주∼36주인 군에서는 등급 III이 2예로 13 4%, 등급 I이 4예로 6 9%이었고, 27주이하에서는 등급 0이 1예 1 7%인바, 성숙된 태반은 임신주수가 만삭에 이를수록 많이 발견되었다 2 태반등급과 L/S 비율사이의 상관관계는 태반등급 III인 19예중 17예 즉 89 5% (S E : ±7 03)에서 성숙한 L/S 비율을 나타내었다 이것으로 초음파검사에 의하여 결정된 태반성숙은 태아폐성숙과의 좋은 상호연관성을 갖는다는 것을 알 수 있었다 3 태반등급과 L/S 비율, 임신주수와의 관계를 살펴보면, L/S 비율이 2이상인 27예중 25예 (92 6%)가 만삭임신이었고, 이들의 62 9%가 태반등급 III이었다 또한 태반등급 III으로써 L/S 비율이 2이하였던 2예 모두에서 신생아 호흡곤란증은 발생되지 않았고, 이들은 모두 만삭 임신이었다 따라서 이상의 결과로 태반성숙과 동시에 L/S 비율의 증가가 없을 시는 역시 임신 주수에 의존해야 한다는 사실을 알 수 있었다 4 성숙한 L/S 비율을 갖는 27예중 출생시 체중 및 Apgar점수와의 관계를 보면 체중이 2 8kg이상인 23예중 2예만이(8 7%), 1분 Apgar점수가 7미만이었고, 체중 2 8kg미만은 4예중 2예(50%)에서 1분 또는 5분 Apgar 점수가 7미만으로 체중과 Apgar 점수사이에는 통계학적으로 유의한 차이가 있었다 (P = 0 0033, Fisher의 정확성 검정법) 5 태반등급과 태아체중과의 관계를 보면 2 8kg미만인 13예중 태반등급 I이하가 8명(61 5%), 2 8kg이상인 45예중에는 태반등급 I이하가 6예(13 3%)이었다 따라서, 태아체중을 태아성숙의 인자로 간주할 때 태반등급과 태아체중사이에는 연관성이 있는 것으로 나타났다 (P < 0 05) During a three and one-half month period between January 1 and April 15, 1985, placental grading with real time ultrasound was performed on 58 patients, at Ewha Womans University Hospital 29 of whom had undergone amniocentesis for determination of their lecithin/sphingomyelin ratio The results were as follows: 1 Of the 58 term pregnancies (gestational age > 37 weeks), a Grade I placenta was found in 9 (15 5%), a Grade II in 12 (20 7%) and a Grade III in 30 (51 8%) 2 89 5% (17 patients among 19) of Grade III placentas has a mature L/S ratio, and the remaining 2 patients who had an immature L/S ratio had not experienced respiratory distress syndrome (Standard Error±7 03) 3 In the 27 cases with a mature L/S ratio, of the 23 cases with a birth weight of ≥ 2 8 Kg, 2 cases (8 7%) had a low Apgar score (6 or less), of the 4 cases with a birth weight of < 2 8 Kg, 2 cases (50%) had a low Apgar score A statistical significance was therefore established between birth weight and Apgar (P = 0 0033) 4 Of the 45 cases with a birth weight 0f ≥ 2 8 Kg, only 6 cases (13 3%) had placenta Grade I, and of the 13 cases with birth weight of < 2 8 Kg, 8 cases (61 5%) had placenta Grade of I or 0 Therefore a statistical significance was established between placenta grade and birth weight (P < 0 05) Finally Grade III placenta in normal term gestation showed a good correlation with fetal pulmonary maturity as predicted amniotic fluid L/S ratio

혼합결혼한 한국인 임부간의 그 남편 종족별 산과적 예후

황기현(KH Hwang),홍경희(KH Hong),김승일(SI Kim),강신명(SM Kang) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.3

The clinical data presented were based on 300 cases of intermarried Korean- oriental gravid woman admitted into Ewha Womans University Hospital and it was compared with 100 cases of endogamy Korean pregnant woman associated with complications and it is obstetric outcome by the husband ethnic groups during the 8 years period from Jan. 1, 1976 to Dec. 31, 1983. The results obtained were as follows; 1) As to educational attainment of pregnant women, the proportion of wives in Caucasian husband ethnic group, completed high school and primary were 48.5% and 22.5% respectively, whereas the comparable educational level among wives in Black were 25% and 45%. And wives in Korean completed high school and college were 64% and 26%, respectively. Therefore, the samples appear to be representative of woman in somewhat higher socioeconomic strata of Korean husband ethnic group. 2) Obstetric complications were as follows: The most common complication during pregnancy among black ethnic group was S.P.R.M. (spontaneous premature rupture of membranes) (13%), I.U.G.R. (intrauterine growth retardation) (13%), large baby(7%), prematurity (4%), maternal syphilis (4%) and neonatal congenital syphilis (4%). Especially, the incidence of maternal syphilis in Black husband group was high, 4 times that of Caucasian or Korean husband ethnic group. Especially, in Korean husband ethnic group, the rate of toxemia (13%) and hepatitis B virus infection (5.8%) were higher than the other two groups. In Caucasian group, large baby (14.5%), S.P.R.M. (11.3%), I.U.G.R. (7%) and prematurity (6%) were most frequent complications. 3) The incidence of cesarean section in caucasian husband group was 12%, which was slightly higher than the other groups (Black 8%, Korean 9%). The causes of high incidence rate was cephalopelvic disproportion due to heavy neonatal birth weight, 3,832gm, and the rate of large baby weighting 4kg or more (41.6%) was markedly higher than the other two groups (Black 25%, Korean 32.3%). 4) The incidence of smoking mothers during pregnancy in Black husband ethnic group was 44%, which was remarkably higher than other two groups (Caucasian 27.5%, Korean 2%). The birth weight of babies born to smokers was lighter than non-smoking group by an average of 224gm and the difference was statistically significant. (P<0.0008). 5) The incidence of I.U.G.R. in Black husband group (13%) was markedly higher than the other two groups (Caucasian 7%, Korean 1%). The causes of high incidence in Black husband group was considered that mainly due to high incidence of smoking mothers (44%) and infection including syphilis (46%). 6) Mean term birth weight (38th.~42th, week) in Caucasian and Black husband groups were 3,471gm, 3,461gm, respectively and the difference is not statistically significant (P<0.84). But in Black husband group, the mean term birth weight was 3,375gm or somewhat smaller than the other two groups, by an average of 86gm. It was probably due to more incidence of smoking mothers. 7) The incidence of large babies weighing 4kg or more in caucasian husband group was 14.5%, which was higher than the other two groups(Korean 10%, Black 7%). It may be related to the husbands body constitution or diet. 8) The perinatal mortality rate accounted for 14.3 per 1,000 births (2 cases) in black husband ethnic group, 10.8 (7 cases) in Caucasian, 0 in Korean. Almost all of these cases were stillbirth. The most common causes of the perinatal death among Caucasian husband group were low birth weight (28.5%), fatal congenital malformations (28.5%), severe preeclampsia (14.2%), neonatal congenital syphilis (14.2%),or unknown (14.2%). The major cause of perinatal death in Black husband group was neonatal congenital syphilis (50%).

Increased expression of uncoupling protein in brown adipose tissue of the obese rats with bacterial β-glucan feeding

Soon Ah Kang(강순아),Ki-Hyo Jnag(장기효),KH Hong(홍경희),So Hye Kim(김소혜),In-Young Lee(이인영),Yoongho Lim(임융호) 한국생물공학회 2005 한국생물공학회 학술대회 Vol.2005 No.10

Methotrexate 투여한 침윤천공-전치태반 1 례

박정희,고덕영,홍경희,이준형,박종두,김형용,박현중 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

Placenta previa-percreta is a rare but highly morbid condition usually diagnosed clinically, intraoperatively. The cause of placenta accreta is considered to be deficient decidualization and absence of the fibrinous layer of Nitabuch. The condition is usually, but not always, seen in women having previous trauma, eg, cesarean section, manual removal of placenta, or curettage. Magnetic resonance imaging(MRI) might allow antepartum diagnosis of the this condition. Management included cesarean supracervical hysterectomy and bilateral hypogastric arterial ligation, and adjuvant methotrexate administration. We experienced a case of placenta previa percreta at 40 weeks gestational age. Here we present the case with brief review of literature.

산욕기에 발생한 허혈성 뇌경색 1 예

박정희,고덕영,조태일,홍경희,이준형,박종두,박현중 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

본 병원에서 23주 2일된 자궁내 태아 사망아를 질식분만한 경산부에 있어서 분만 2일째에 Grade 1의 폐동맥 역류와, 심실조기 수축을 동반하는 부정맥과 패혈증에 의해 우측 중대뇌동맥 폐색에 의해 발생하였다고 생각되는 허혈성 뇌경색을 경험하였기에 간단한 문헌 고찰과 함께 보고하는 바이다. We present a case of ischemic cerebrovascular accident which occurred at puerperium in a 29 year-old multiparous woman followed by vaginal delivery of a dead fetus of 23 weeks` gestation.