• Journal of Genetic Medicine
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• 제9권1호
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• pp.22-24
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• 2012

Purpose: The aim of this study was to asses the fetal loss rate after mid-trimester amniocentesis. Materials and Methods: This was a retrospective cohort study including singleton pregnant women who underwent mid-trimester amniocentesis at Cheil General Hospital from January 2008 through December 2010. The procedure-related fetal loss was defined as miscarriage within 2 weeks after amniocentesis. We evaluated the fetal loss rate within 2 weeks after amniocentesis and fetal loss rate before 24 gestational weeks. Results: During the study period, a total of 4,356 singleton pregnant women underwent mid-trimester amniocentesis. A total of Five hundred ninety six women were excluded owing to follow up loss and termination of pregnancy due to abnormal karyotype or major anomaly. At our institute, the fetal loss rate within 2 weeks was 0.1% and before 24 gestational weeks was 0.3% after amniocentesis. Conclusion: The fetal loss rate after mid-trimester amniocentesis in our study is lower than previously reported rate. We suggest that amniocentesis is a safe procedure.

• 한국수정란이식학회지
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• 제23권2호
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• pp.109-114
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• 2008

This study examined pregnancy and fetal loss rates according to different estrus synchronization protocols and injection of gonadotropin releasing hormone (GnRH) after transfer of Korean Native Cattle embryos to Holstein recipients. In Experiment 1, recipients received no treatment (Control, n = 119); two injections of prostaglandin$F_{2{\alpha}}$ ($PGF_{2{\alpha}}$ ) 11 days apart (PGF group, n = 120); GnRH (day 0)-$PGF_{2{\alpha}}$ (day 7)-GnRH (day 9) (Ovsynch group, n = 120); and CIDR (day 0)-$PGF_{2{\alpha}}$ and CIDR removal (day 7)-GnRH (day 9) (CIDR group, n = 110). In Experiment 2, the control group was received no treatment of GnRH. The treatment groups were received GnRH at embryo transfer (ET) (day 0), 7 days later, 14 days later, ET and 7 days later, 7 and 14 days later, or ET, 7 and 14 days later. Recipients were assigned to treatment randomly and received two in vitro produced blastocysts. Pregnancy was diagnosed at day 60 by palpation per rectum. Fetal loss to term was determined by palpation every 90 days thereafter. In Experiment 1, the pregnancy rate in the CIDR group (59.1%) were higher than in the Control group (42.0%) (p<0.01); fetal loss rates were similar for all groups (12.0 to 18.5%). In Experiment 2, the pregnancy rate in Day 0+7+14 group was higher (60.2%) than the control (40.2%) (p<0.01) and resulted in a lower fetal loss (p<0.05) than the control (4.6 vs. 11.4%). There were no significant difference between other treatment and the control (p>0.05). These results show that pregnancy rates of bovine embryos can be enhanced by CIDR insertion or GnRH $3{\times}$ treatment. Additionally, fetal loss may be reduced with GnRH treatment after ET.

• 한국임상수의학회지
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• 제25권2호
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• pp.85-89
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• 2008

This study assessed the incidence of embryo and fetal loss following early pregnancy diagnosis using ultrasonography in dairy cows. A positive pregnancy was a recognition of the vesicle, embryo or fetus by ultrasonography. Seven hundreds and two pregnancies determined by ultrasonography following artificial insemination were divided into three groups according to the number of days diagnosed pregnant: early A group (27 to 40 days, n = 143), early B group (41 to 50 days, n = 172), or standard group (51 to 70 days, n = 387). Following a positive pregnancy diagnosis, embryo or fetal loss included all cows with observed abortions and cows found open after the positive pregnancy diagnosis. The incidence rate of embryo or fetal loss within 7 days after pregnancy diagnosis was 1.4, 0.6 and 0.3% for the early A, early B, and standard groups, respectively (P>0.05). The incidence of the embryo or fetal loss during 8 to 30 days after pregnancy diagnosis did not differ (P>0.05) among the early A (0%), early B (1.2%), and standard groups (1.0%). Furthermore, the cumulative incidence of the embryo or fetal loss before calving did not differ (P>0.05) among the early A (9.8%), early B (9.3%), and standard groups (5.9%). These results indicate that early pregnancy diagnosis using ultrasonography does not increase the risk of embryo and fetal loss compared with that of routine pregnancy diagnosis in dairy cows.

• Clinical and Experimental Reproductive Medicine
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• 제30권1호
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• pp.39-45
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• 2003

Objective : To identify the factors affecting the complete fetal loss following multifetal pregnancy reduction (MFPR). Design: Retrospective clinical study. Methods : A total of 256 consecutive treatments of MFPR in IVF-ET cycles performed between 1992 through 2000 in Samsung Cheil hospital were analyzed. MFPR was done around 8 weeks of gestation by transvaginal ultrasono-guided aspiration in multiple pregnancies and reduced to singleton or twins. Stepwise logistic regression was performed to identify the factors affecting the final outcome of pregnancy after MFPR. Dependent variable was complete fetal loss and the independent variables were maternal age, paternal age, initial number of gestational sac (iGSNO), initial number of fetal heart beat, the number of remaining live fetus after MFPR, and chorionicity. Results: The total survival rate was 87.9%, and total fetal loss rate after MFPR was 12.1%. Total fetal loss occurred within four weeks from MFPR procedure was 1.95%. Total loss occurred after four weeks of procedure and before 24 gestational weeks was 8.2%. Seventy nine percent (202/256) of pregnancies delivered after 34 weeks of gestation. The survival rate of pregnancies reduced to singleton was significantly higher than that of pregnancies reduced to twins (93.5% vs. 86.7%, p<0.05). The mean ($\pm$SEM) gestational age at delivery was $36.2{\pm}1.0$ and $34.1{\pm}0.5$ weeks for pregnancies reduced to singletons and twins, respectively (p=0.065). Logistic regression analysis revealed that the maternal age, the number of initial gestational sac (iGSNO), and the number of remaining live fetus after MFPR significantly affected the rate of total fetal loss (Z = 0.174'age + 0.596'iGSNO + 1.324'remaining fetuses -12.07), (p<0.05). Conclusions: MFPR seems to be a relatively safe and efficient method to improve the obstetric outcome in high order multiple pregnancy. Because the maternal age, the number of initial gestational sac and the remaining live fetuses after MFPR affect the total fetal loss rate, restriction of the number of transferred embryos according to the age and MFPR to singleton fetus could be considered for the better obstetric outcome in IVF pregnancy.

• Clinical and Experimental Reproductive Medicine
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• 제23권1호
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• pp.11-24
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• 1996

The number of multifetal pregnancies has increased dramatically as a result of the widespread clinical use of ovulation induction and assisted reproductive technology(ART) in infertile patients. In multifetal pregnancies, the adverse outcome is directly proportional to the number of fetuses within the uterus, primarily because of an increased predisposition to premature delivery. It is extremely difficult to counsel patients about the expected outcome of pregnancies involving three or more fetuses. To increase the chances of delivering infants mature enough to survive without being irreversibly damaged by the sequelae of marked prematurity, selective fetal reduction(SFR) to the smaller number of fetuses should be considered in multifetal pregnancies. From January, 1991 to December, 1992, transabdominal SFR in multifetal pregnancies was performed in 22 patients including 13 triplet, 7 quadruplet, 1 quintuplet and 1 heptuplet pregnancies. Transabdominal SFR using intracardiac KCI injection and aspiration of amniotic fluid was carried out in 8-13 weeks of gestation. After procedure, 20 patients were remained as twin pregnancies, and 2 patients as triplet pregnancies. There have been 11 sets of twin delivery including 2 stillbirths, 2 sets of triplet delivery including 1 stillbirth, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 4 cases in 33 - 37 weeks, and 1 case in 30 weeks. Unfortunately, 3 stillbirths occurred in 20-24 weeks of gestation, and 4 cases were aborted. As 7 losses of pregnanancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 38.9%(7/18) in transabdominal SFR. All babies born after 30 weeks of gestation were healthy, and no fetal anomaly directly related to the procedure was encountered. From July, 1993 to February, 1995, transvaginal SFR was performed in 20 patients including 15 triplet, 4 quadruplet and 1 quintuplet pregnancies. Transvaginal SFR using the same method as transabdominal SFR was carried out in 8-11 weeks of gestation. After procedure, 19 patients were remained as twin pregnancies, and 1 patient as singleton pregnancy. There have been 13 sets of twin delivery including 2 stillbirths, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 5 cases in 36-37 weeks, and 1 case in 30 weeks. Unfortunately, 2 still-births occurred in 20 weeks and 21 weeks of gestation, respectively, and 2 cases were aborted. As 4 losses of pregnancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 25.0%(4/16) in transvaginal SFR. No fetal anomaly directly related to the procedure was encountered. It is suggested that transvaginal SFR could be performed more easily and earlier with the lower fetal loss rate as compared with transabdominal SFR. In conclusion, SFR is a rather safe and ethically justified procedure that may improve the outcome of multifetal pregnancies.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1994년도 춘계학술대회
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• pp.96-99
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• 1994

Despite the simplicity of processing, a conventional autocorrelation function(ACF) method for the precise determination of fetal heart rate (FHR) has many problems. In case of weak or noise corrupted Doppler ultrasound signal. the ACF method is very sensitive to the threshold level and data window length. It is very troublesome to extract FHR when there is a data loss. To overcome these problems, the high resolution pitch detection algorithm was adopted to estimate the FHR. This method is more accurate, robust and reliable than the ACF method. With a lot of calculation, however, it is impossible to process real time FHR estimation. This paper is presented a new FHR estimation algorithm for real time processing.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1993년도 춘계학술대회
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• pp.81-85
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• 1993

Despite the simplicity of processing, conventional autocorrelation function (ACF) method for the precise determination of fetal heart rate (FHR) has many problems. In the case of weak or noise corrupted Doppler ultrasound singnals, the ACF method is very sensitive to the threshold level and data window length. It is real troublesome to extract FHR when there is a data loss. To overcome these problems, the high resolution pitch detection algorithm is adapted to estimate the FHR. The FHR is determined from the correlation of two interconnected segments by its maximum correlation value. FHR is compensated with a constant correlation threshold in a greatly smeared noise signal. This method yields more accurate, robust and reliable than the ACF method.

• Clinical and Experimental Reproductive Medicine
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• 제13권2호
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• pp.137-144
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• 1986

A reveiw of 85 patients with uterine anomalies was made in respect to the incidence, chief complaints, the reason of infertility, fetal wastage rate, pregnancy complications, fetal presentations and obstetric outcome after metroplasty from 1980 to 1985. The results were summarized as follows: 1. Incidence of uterine anomaly was 0.18% among all outpatients (85/48,240). 2. Of the 85 patients, there were 36 with bicornuate deformities (42.3%), 21 septate (24.7%), 18 uterus didelphys (21.2%), 8 arcuate (9.4%) and 2 patients with unicornuate anomalies (2.4%). 3. Uterine anomalies were diagnosed by hysterosalpingogram (54.1%), pelvic examination (14.2%) and other operative procedures. 4. Chief complaints were primary infertility (41.2%), secondary infertility (15.3%), repeated pregnancy loss (12.9%), antenatal care (11.8%) and menstural disturbance (10.6%), etc. 5. Twenty-nine patients with uterine anomalies had primary infertility. The cause of infertility was proved nonuterine in 26 cases and remained unknown in 3 cases. 6. The obstetric outcome of 104 pregnancies was spontaneous abortion in 51.0%, premature delivery in 11.50/0 and fetal loss in 57.7%. 7. Complications of 41 present pregnancies were threatened abortion (22%), premature rupture of membrane (12%) and premature labor (10%), etc. The frequency of abnormal presentation was 35.3% and 64.7% of deliveries was made by Cesarian section. 8. Metroplasty was performed in 13 patients who didn't have a baby because of repeated miscarriage and unknown cause of infertility. Subsequently 8 patients had 9 successful pregnancies: 6 patients had 7 healthy babies and 2 patients are now in pregnancy without any complications.

• 대한의용생체공학회:의공학회지
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• 제16권2호
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• pp.175-182
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• 1995

태아 심음을 측정하기 위한 기존의 자기상관 함수 법은 처리과정이 간편한 반면에 많은 문제점을 가지고 있다. 초음파 도플러 신호가 열악할 경우 고전적인 자기상관 함수 법은 문턱 값의 선정과 창 함수 크기에 매우 민감하다. 특히 데이터 손실이 생길 때 정확한 태아 심박동 수를 찾기가 어렵다. 이들 문제점들을 보완하기 위하여 초음파 도플러 신호로부터 정확한 태아 심박동 수를 찾는 고해상 피치검출 알고리듬이 제안되었다. 이 알고리듬은 자기상관 함수법 보다 정확하고, 잡음에 강하며, 높은 신뢰성을 갖으나 계산량이 많아 실시간 처리가 어렵다. 본 논문에서는 실시간 처리에 적합한 새로운 태아 심음 추출 알고리듬을 제안하고, 제안된 알고리듬을 적용한 실시간 태아 심음 감시시스템에 관하여 연구하였다.

• Journal of Genetic Medicine
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• 제8권1호
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• pp.35-43
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• 2011

목적: 본원에서 최근 10년간 시행한 융모막 융모생검의 적응증에 따른 결과 및 합병증을 조사하고 현재 사용하고 있는 융모막 융모생검의 효용성을 분석해보고자 한다. 대상 및 방법: 2000년 4월부터 2010년 4월까지 최근 10년간 분당차병원 및 강남차병원에서 융모막 융모생검을 시행한 511례의 진료기록 및 검사 결과를 검토하였다. 각각의 환자에 해당되는 모든 적응증을 조사하고 중복을 허용하여 분석하였다. 태아 염색체 검사는 직접법과 배양법을 통하여 시행하였다. 결과: 각각의 적응증을 살펴보면 태아의 비후된 목덜미 두께를 포함한 비정상 초음파 소견이 294례(294/635, 46.3%)로 가장 높았다. 각각의 적응증에 따른 태아 염색체 이상의 양성예측도는 부모 중에 염색체 이상이 있는 경우가 66.7%(14/21)로 가장 높았다. 융모막 융모생검 상 모자이시즘은 3.1% (16/509)였고, 그 중에서 양수검사로 확인된 진모자이시즘은 2례, 태반에 국한된 모자이시즘은 11례였다. 융모막 융모생검 이후 4주 이내에 임신 종결된 경우는 6례로 태아손실률은 1.2% (6/511)였다. 결론: 융모막 융모생검은 산전 유전진단을 하는데 있어서 적합하고 신뢰할 수 있는 시술이다. 융모막 융모생검 결과 모자이시즘을 보이는 경우 반드시 양수검사를 통하여 진모자이시즘인지 태반에 국한된 모자이시즘인지 확인이 필요하다.