• Title/Summary/Keyword: Gestational

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The Impact of Delayed Interval Delivery on Neonatal Mortality and Morbidity (지연 분만이 신생아의 사망률과 이환율에 미치는 영향)

  • Lee, Eun-Hee;Sohn, Jin-A;Lee, Ju-Young;Choi, Eun-Jin;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Jun, Jong-Kwan;Kim, Byeong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.111-116
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    • 2011
  • Purpose: To evaluate the impact of delayed interval delivery on neonatal outcomes. Methods: This was a retrospective study of infants who were born at Seoul National University Hospital by delayed interval delivery from June 2005 to July 2010. Outcomes (neonatal mortality and morbidity) of later babies were compared to those of the first babies and the control group whose gestational ages and birth weights were similar to them. Results: There were 4 twin and 5 triplet pregnancies. The first babies (group 1, n=9) were delivered at $22^{+6}$ to $27^{+5}$ weeks of gestational age, and the later babies (group 2, n=14) were born at $24^{+6}$ to $28^{+0}$ weeks. The mean interval between the first and later deliveries was 10 days, and there was no delay between the second and third deliveries in all triplet pregnancies. There were more small for gestational age (SGA) infants in group 1 than group 2 (66.7% and 21.4% respectively, P=0.03). Two of three babies who died in group 1 were born before 24 weeks of gestational age and expired within a week after birth. The mortality rate of group 2 (7.1%) was lower than group 1 (33.3%), but not significantly (P=0.106). The control group matched to group 2 consisted of 28 infants. There were no significant differences in neonatal mortality and morbidity between the two groups. Conclusion: Although there is a limitation to the number of infants in this study, it suggested that delayed delivery in a multiple pregnancy could decrease the incidence of SGA of the remaining fetuses and that prolonged gestation would not be harmful to those fetuses after birth.

A Case-Control Study of Food Habits and Diet Intakes of Women with Gestational Diabetes Mellitus (임신성 당뇨병 환자의 식습관 및 식이섭취에 관한 환자-대조군 연구)

  • Ji, Sun-Kyung;Jang, Hak-C.;Choi, Hay-Mie
    • Journal of Nutrition and Health
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    • v.41 no.1
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    • pp.41-53
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    • 2008
  • Gestational diabetes mellitus (GDM) is defined as glucose intolerance discovered or onset during pregnancy and attention is needed because of increased risk of perinatal morbidties and higher incidence of diabetes afterward. This study was performed to identify dietary factors associated with the development of gestational diabetes mellitus (GDM). Developed food frequency questionnaire containing 192 food items were used to assess nutritional status of 246 control subjects and 104 GDM subjects. Food habits of subjects were examined in the questionnaire. The more irregularity and less variety of meal were found in GDM group compared to control group and GDM group tended to eat rapidly and do not like vegetables and greasy foods. Total score of food habits in GDM was lower than control group, which suggests that GDM group have undesirable food habits. Mean daily energy and carbohydrate intakes of GDM group were higher than those of control group, and percent energy from protein was significantly higher in control. Nutrient density of protein, calcium, phosphorus and vitamin BI of GDM group was significantly lower than those of control group. Therefore dietary quality of GDM group was lower than that of control group. Odds ratio for GDM was high when energy and carbohydrate intakes were high. And when the intakes of rice, noodle, shiruduk, hamburger, boiled egg, steamed pork shank were high, the odds ratio for GDM was high. These results indicate that the amount and frequencies of several foods and dish items were related with the occurrence of GDM subjects. On the whole, GDM subjects consumed more cereals and less vegetables and less legumes. From these results, pregnant women with GDM tended to have unhealthy food habits, and carbohydrate intake was important dietary factors on the onset of GDM.

Cord blood IL-10, IL-12 in preterm newborns as predictors of respiratory distress syndrome and bronchopulmonary dysplasia (호흡곤란증후군과 기관지폐이형성증 예측 인자로서의 미숙아 제대혈 IL-10, IL-12)

  • Park, Jee Yoon;Kim, Ji Young;Cho, Soo Jin;Kim, Young Ju;Park, Hye Sook;Ha, Eun Hee;Park, Eun Ae
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.248-254
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    • 2007
  • Purpose : Inflammation plays a major role in the pathogenesis of RDS and BPD in the immature lung. We investigated the possible role of IL-10 and IL-12 in the cord blood of preterm newborns with RDS or BPD. Methods : Forty preterm newborns whose mothers received antenatal care at Ewha Womans University Mokdong Hospital between January 2003 to June 2005, and agreed to testing their cord blood samples were enrolled. The gestational ages were below 34 weeks. Cord blood level of IL-10 and IL-12 were determined by ELISA. We separated the patients into 2 groups (RDS group and non-RDS group, BPD group and non-BPD group) and compared the cytokine levels and clinical records of the groups. Results : Cord blood IL-10 level showed a significant inverse correlation with gestational age and birth weight (P=0.001, P=0.005). Preterm infants with RDS showed higher IL-10 level (1.0 vs 0.1 pg/mL; P=0.001) in the cord blood than those without RDS. The differences remained statistically significant after correction for the effect of gestational age between both preterm groups. Despite similar cord blood IL-10 levels, preterm infants with BPD showed no significant difference with those without BPD. Conclusion : Cord blood IL-10 levels are increased in preterm infants which may be due to the immuno-suppression occurring during pregnancy and to fetal immaturity because these levels are inversely correlated with the gestational age. So, Cord blood IL-10 level can be used as the predictor of RDS.

A Study on the physical Status of New Born Babies in Nursery at a Hospital in Seoul. - For Relationship between Neonatal Diseases and risk factors. - (종합병원 분만아의 신생아실 재원기간중 건강상태에 관한 연구 - 질환발생과 제요인과의 관계를 중심으로 -)

  • Park Ae Kyung
    • Journal of Korean Public Health Nursing
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    • v.2 no.2
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    • pp.81-98
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    • 1988
  • The purpose of this study was to fine out the general physical status of the neonates, and to identify the risk factors of the mothers and the neonates which were significantly related to the neonatal diseases during hospitalization. The data were obtained from clinical records of 1098 neonates born in Seoul Red cross Hospital between January 1st of 1984 and December 31th of 1986. The results of this study were summarized as follows: 1. General characteristics of the maternal group. 1) The average of maternal age was 26.6 years, the $91.7\%$ of the mothers de liveried at the age of 20-34 years old. 2) The distribution of the types of delivey were as follows : spontaneous delivery $39.9\%$, cesarean section $32.4\%$, vaccum extraction $25.7\%$, and breech delivery$2.0\%$. 3) The $40.3\%$ of the total de liveried mother had experienced abortion. 4) The $42.3\%$ of the total deliveried mother had one or more obstetric risk factors. 2. General characteristics of the neonatal group. 1) In the distribution of sex, male was $49.4\%$, female $50.6\%$. 2) The average of birth weights was 3,020gm. The distribution of birth weight were as follows; nomal weight $85.5\%$, low birth weight $12.7\%$ and high birth weight $2.5\%$. 3) The average of gestational age was 39.2 weeks. The distribution of gestational age were as follows; full term $77.4\%$, preterm $13.7\%$, and postterm $8.9\%$. 4) The average of Apgar Score was 9.0 at one minute and 9.6 at five minutes. 5) The $5.7\%$ of the neonates had one or more neonatal risk symptoms and signs at birth. 3. Apgar Score by the maternal and neonatal factors. In Apgar Score at one minute, normal group was higher than that of abnormal group. Apgar Score at five minutes was slightly higher than that at one minute. 4. The distribution of the maternal risk factors and the neonatal risk factors. 1) The total numbers of the maternal risk factors were 1376. The distribution of the maternal risk factors were as follows: obstetric factor $33.7\%$, abortion $32.2\%$, breech and cesarean section delivery $27.5\%$ and maternal age under 19 years and over 35 years $6.6\%$. 2) The total numbers of the neonatal risk factors were 517. The distribution of the neonatal risk factors were as follows: gestational age under 37 weeks and over 42 weeks $48.0\%$, birth weight under 2500gm and over 4000gm $12.2\%$, Apgar score under 4 at one munute $6.4\%$ and Apgar score at five munutes $2.7\%$. 3) The total numbers of the obstetric risk factors were 661. The types of the obstetric risk factors were meconium stained amniotic fluid $22.0\%$, premature rupture of membrane $17.5\%$. absence prenatal care $14.1\%$, unmarried pregnancy $10.3\%$, placenta problem $9.0\%$, toxemia $8.0\%$. 4) The total numbers of the neonatal risk symptoms and signs at birth were 83. The types of the neonatal risk symptoms and signs were respiratory distress $65.1\%$, neonatal apnea $14.4\%$, convulsion $13.3%$, meconium aspiration syndrome $4.8\%$, cyanosis $2.4\%$. 5. The relationship between the maternal risk factors and the neonatal risk factors. 1) Maternal age under 19 years or over 35 years was significantly related to Apgar Score under 4 at 5 minutes. 2) Breech delivery or cesarean section was significantly related to neonatal risk factor at birth such as birth weight, gestational age, Apgar Score at one minute and at five minutes. and neonatal risk symptoms and signs. 3) Obstetric risk factors were significantly related to the neonatal risk factors at birth. 4) Abortion was not related to the neonatal risk factors. 6. The relationship between neonatal diseases during hosptalization and the maternal or the neonatal risk factors. 1) The total numbers of neonatal diseases during hospitalization were 281. The distribution of neonatal diseases were as follows: birth trauma $38.1\%$, infectious disease $31.3\%$, hematologic disease $21.4\%$, respiratory disease $6.0\%$, neurologic disease $2.5\%$. cardiovascular disease $0.7\%$. 3) Most maternal risk factors except abortion were significantly related to neonatal diseases. 4) Most neonatal risk factors at birth were significantly related to neonatal diseases.

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Adrenal and thyroid function in the fetus and preterm infant

  • Chung, Hye Rim
    • Clinical and Experimental Pediatrics
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    • v.57 no.10
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    • pp.425-433
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    • 2014
  • Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

Extrauterine Epithelioid Trophoblastic Tumor of Lung in a 35-year-old Woman

  • Kim, Joo Yeon;An, Soyeon;Jang, Se Jin;Kim, Hyeong Ryul
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.471-474
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    • 2013
  • Extrauterine epithelioid trophoblastic tumors constitute an extremely rare gestational trophoblastic disease. We report the case of an extrauterine trophoblastic tumor that was incidentally detected in the left lung. Squamous cell carcinoma was suspected after microscopically examining the specimen obtained upon preoperative needle biopsy. After surgery, the tumor was confirmed by microscopic findings and immunohistochemical features.

A Morphological Study on the Development of the Placenta of the Golden Hamster (Mesocricetus auratus) (Golden Hamster (Mesocricetus auratus) 의 태반형성(胎盤形成)에 관한 형태학적(形態學的) 연구(硏究))

  • Lee, Cha Soo
    • Korean Journal of Veterinary Research
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    • v.13 no.2
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    • pp.111-118
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    • 1973
  • The placentation in the golden hamster (Mesocricetus auratus) and the morphological changes occuring in its placenta from implantation to parturition have been observed by light microscope. The results obtained were summarized as follows. 1. The development of the placenta in the fertilized ovum implanted on the day 5 of gestation was described with increasing gestational age. 2. On the day 8 of gestation, the chorioallantoic placenta was formed by fusion of the allantois to the chorion of ectoplacental cone. 3. On the day 13 of gestation, Reichert's membrane with the parietal yolk sac disappeared in a circumscribed area antimesometrially.

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Bilateral Submammary Skin Incision for Open Heart Surgery (유방하 피부절개를 통한 개심술)

  • 김기봉
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1095-1098
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    • 1988
  • Congenital cystic adenomatoid malformation[CCAM] is a rare disease that cause respiratory distress in the newborn and infants, but is one of the two causes along with lobar emphysema. This malformation has the pathologic characteristics which can be differentiated from other forms of diffuse cystic disease, i.e. CCAM is marked proliferation of the terminal bronchioles and that can enlarge rapidly by air trapping in cystic areas. The CCAM has a clinical importance because of rapid worsening respiratory distress, with tachypnea, subcostal retraction and cyanosis. This is a strict surgical condition and after operation[lobar, segmental resection or pneumonectomy] the symptoms relieved obviously. We experienced 6 cases of CCAM from July, 1980 to September, 1987 at the Department of Cardiovascular and Thoracic Surgery, Severance Hospital, College of Medicine, Yonsei University. The male patients were two and female patients were four. The age distribution was from premature to 10 year old. One of them was 27 weeks gestational premature female who was borne dead. The other 5 patients were performed on thoractomy[1 case pneumonectomy and 5 cases lobectomy]. The postoperative courses were good and no complications were seen.

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Change on Milk Production of Lactating Women in Kwangwon Province during Lactation (강원도 일부지역 수유부의 기간별 모유분비량의 변화)

  • 이정실
    • Journal of Nutrition and Health
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    • v.29 no.10
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    • pp.1105-1111
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    • 1996
  • Breast milk production and factors related to milk production were examined by test-weighting method in the part of Kangwon Province longitudinally from 0.5 to 5 months of postpartum. Milk production of total mothers averaged 639, 789, 871, 843, 848 and 851g/day at 0.5, 1, 2, 3, 4 and 5 months of postpartum respectively. Mean Milk production of multiparae appeared significantly higher than those of primiparac. The number of feed per day showed decreasing trend from 9.6 to 8.4 during the lactation. Mature milk production had a correlation with transitional milk production and no correlation with infants weight at birth, gestational period and weight gain during pregnancy of mothers. The energy, protein and lipid consumption of total mothers had a positive correlation with breast milk production.

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