• Title/Summary/Keyword: Gestational

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Does Vitex Agnus-Castus L. Have Deleterious Effect on Fertility and Pregnancy Outcome? An Experimental Study on Rats for Prediction of Its Safety

  • Najib, Fateme Sadat;Poordast, Tahereh;Mahmudi, Monireh Sufi;Shiravani, Zahra;Namazi, Niloofar;Omrani, Gholamhossein Ranjbar
    • Journal of Pharmacopuncture
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    • v.25 no.2
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    • pp.106-113
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    • 2022
  • Objectives: Herbal medicine is a worldwide health topic. Vitex agnus-castus L. (VAC) is a popular plant used for gynecologic problems due to its hormonal effects. The aim of this study is to reveal VAC extract effect on fetus when this herb is used started from antenatal period or during pregnancy. Methods: Performed from starting day of January 2019 till February 2019, 48 rats were assigned in randomly divided eight-member six groups: control (C1), treated group with 365 mg/kg VAC from initiation of insemination (T1) and 30 days prior to pregnancy (T2), control that underwent caesarean section on 15th day of gestational age (C2) and treated group with 365 mg/kg VAC from initiation of insemination (T3) and 30 days prior to pregnancy (T4) that underwent caesarean section. Weight, sex and number of fetuses, abortion and still birth rate and estradiol level were evaluated using t-test by SPSS software. Results: We showed increased weight among T1 group considering totally and sex-dependent which is significant (all p-value < 0.05). We also detected significantly decreased weight in T2 in total (p-value < 0.0001) and when considering female fetuses (0.043) but not males (0.17). Although the results showed slightly non-significant increased weight among fetuses of T3 (totally or based on the fetus sex) compared to the control group (C2), T4 group had statistically decreased weight compared to control group. Pregnancy rate and pregnancy outcome were affected by VAC usage. The time of VAC initiation also affected live birth and abortion rates. Conclusion: VAC extract may affect pregnancy rate, live birth rate, abortion and stillbirth rates. Its effect on the weight and the sex showed dual pattern depends on the time of initiation and pregnancy trimester of evaluation. Prescribing this medicinal plant for patients being prone to pregnancy should be with caution. Further study is recommended.

A Study on Factors Related to Sleep Disordered Breathing in Children (어린이의 수면 호흡 장애 관련 위험인자)

  • Nawoon, Kim;Daewoo, Lee;Jaegon, Kim;Changkeun, Lee;Yeonmi, Yang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.2
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    • pp.180-187
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    • 2022
  • The aim of this study was to investigate the risk factors associated with sleep disordered breathing (SDB) by comparing intraoral factors, body mass index (BMI), and medical history with pediatric sleep questionnaire (PSQ) findings. Seven hundred eighty-seven subjects aged between 7 to 11 years old were included. Their caregivers were asked to complete questionnaires. Oral manifestations including Angle's classification, overjet, and Brodsky tonsil grade were examined. Children with PSQ scores of more than 0.33 points were classified into the SDB high-risk group. Among the 787 subjects, 34 (4.3%) were classified into the SDB high-risk group. Children with allergic rhinitis, atopic dermatitis, excessive overjet, or large tonsil size had a significantly higher risk for SDB versus those without. Also, there was a significant difference in SDB risk according to BMI status. Gender, gestational age, breastfeeding, and Angle's classification were not associated with SDB. Children at high risk for SDB were predisposed to tonsillar hypertrophy, allergic rhinitis, obesity, and atopic dermatitis. Children with these factors could be candidates for early intervention to prevent the progression of SDB.

Factors associated with the growth of preterm infants (미숙아의 성장과 관련 요인 연구)

  • Jeon, Jisu;Seo, Won Hee;Chung, Sang-Jin
    • Journal of Nutrition and Health
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    • v.55 no.5
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    • pp.572-586
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    • 2022
  • Purpose: This study examined the factors that may affect the growth status of preterm infants. Methods: This study included 91 preterm infants born at <37 weeks of gestation (22.9-36.9 weeks of gestation), including 48 (52.7%) males and 43 (47.3%) females. Diet-related data were collected through parental questionnaires, and growth-related data, such as height and weight, were collected through the hospital medical records. Results: No significant difference in weight and growth was observed between early and late preterm infants. On the other hand, smaller averages of all weight z-score (recent weight at 40 weeks of gestation) included lower birth weight, height, and head circumference. On the other hand, infants' birth weight, height, and head circumference in the weight z-score of <0 (<50% in the age-weight growth chart) was smaller than those in the weight z-score of ≥0. Furthermore, neonatal intensive care unit (NICU) hospitalization period and NICU discharge were shorter with growth cessation age in weight z-score of <0. The weight growth velocity was associated with gestational age, birth weight, and medical treatment in the NICU. Thus, parents of preterm infants with low growth rates prefer more community care services for their children. Conclusion: Birth weight, age of preterm infants, and medical treatment in the NICU were factors related to early birth weight growth. Following NICU discharge, poor intake and intake issues were associated with poor growth after 40 weeks of gestation. Therefore, monitoring the growth of preterm infants requires continuous active involvement and supports for growth-promoting factors after NICU discharge.

Assessing Cerebral Oxygen Metabolism Changes in Patients With Preeclampsia Using Voxel-Based Morphometry of Oxygen Extraction Fraction Maps in Magnetic Resonance Imaging

  • Qihao Zhang;Chaofan Sui;Junghun Cho;Linfeng Yang;Tao Chen;Bin Guo;Kelly McCabe Gillen;Jing Li;Lingfei Guo;Yi Wang
    • Korean Journal of Radiology
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    • v.24 no.4
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    • pp.324-337
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    • 2023
  • Objective: The objective of this study was to analyze the different brain oxygen metabolism statuses in preeclampsia using magnetic resonance imaging and investigate the factors that affect cerebral oxygen metabolism in preeclampsia. Materials and Methods: Forty-nine women with preeclampsia (mean age 32.4 years; range, 18-44 years), 22 pregnant healthy controls (PHCs) (mean age 30.7 years; range, 23-40 years), and 40 non-pregnant healthy controls (NPHCs) (mean age 32.5 years; range, 20-42 years) were included in this study. Brain oxygen extraction fraction (OEF) values were computed using quantitative susceptibility mapping (QSM) plus quantitative blood oxygen level-dependent magnitude-based OEF mapping (QSM + quantitative blood oxygen level-dependent imaging or QQ) obtained with a 1.5-T scanner. Voxel-based morphometry (VBM) was used to investigate the differences in OEF values in the brain regions among the groups. Results: Among the three groups, the average OEF values were significantly different in multiple brain areas, including the parahippocampus, multiple gyri of the frontal lobe, calcarine, cuneus, and precuneus (all P-values were less than 0.05, after correcting for multiple comparisons). The average OEF values of the preeclampsia group were higher than those of the PHC and NPHC groups. The bilateral superior frontal gyrus/bilateral medial superior frontal gyrus had the largest size of the aforementioned brain regions, and the OEF values in this area were 24.2 ± 4.6, 21.3 ± 2.4, and 20.6 ± 2.8 in the preeclampsia, PHC, and NPHC groups, respectively. In addition, the OEF values showed no significant differences between NPHC and PHC. Correlation analysis revealed that the OEF values of some brain regions (mainly involving the frontal, occipital, and temporal gyrus) were positively correlated with age, gestational week, body mass index, and mean blood pressure in the preeclampsia group (r = 0.361-0.812). Conclusion: Using whole-brain VBM analysis, we found that patients with preeclampsia had higher OEF values than controls.

Transcatheter Arterial Embolization for Palliation of Uterine Body Cancer Bleeding (자궁체부암 출혈에 대한 보존적 치료로써의 경카테터 동맥 색전술)

  • Jaeyeon Choi;Ji Hoon Shin;Hee Ho Chu
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.606-614
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    • 2023
  • Purpose This study aimed to evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for bleeding due to uterine body cancer. Materials and Methods In this retrospective study, six patients with varying types of uterine body cancer who underwent TAE for bleeding control were investigated. Angiographic findings, cross-sectional images, TAE details, and clinical outcomes were studied. Technical and clinical success rates were calculated. Results The identified patients had endometrioid adenocarcinoma, sarcoma, and gestational trophoblastic neoplasia, and most were patients with advanced-stage cancer. In four patients, tumor bleeding presented as vaginal bleeding. Technical success was achieved in all seven TAE procedures in six patients. Two patients with recurrent masses who had undergone hysterectomy presented with hematochezia, and TAE was able to provide technical success in these patients as well. The clinical success rate was 50%, indicating bleeding control for > 1 week. Rebleeding was directly associated with death in one patient. On the following day, mild fever was observed in one patient. Conclusion TAE can be considered an effective and safe method of bleeding control for uterine body cancer, especially during critical periods throughout the disease course of patients with inoperable, advanced-stage cancer.

A Review of Clinical Research Trends on Korean Medicine Treatment for Bell's Palsy during Pregnancy (임신 중 벨 마비 한방치료에 대한 국내외 증례 연구 고찰)

  • Hyo-Jeong Kim;Young-Tae Ahn;Ji-Soo Hyun;So-Youn Choi;Back-Jun Kim;Yoon-Jae Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.37 no.3
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    • pp.1-19
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    • 2024
  • Objectives: The purpose of this study is to analysis the clinical study trends on Korean Medicine treatment for Bell's palsy during pregnancy. Methods: Key words such as 'facial palsy', 'Bell's palsy, 'Korean medicine', 'herbal medicine', 'acupuncture', 'pregnancy' were searched through the 'RISS', 'OASIS', 'KISS', 'PubMed' and 'CNKI' databases. Results: Ten clinical studies with 107 patients were selected, and 1 randomized controlled trial and 9 case reports were included as the target studies. In the 9 case reports, the gestational age at the onset of facial palsy was most common in the third trimester (29-42 weeks) in 38 cases (56.7%). The most commonly used Korean medicine interventions were acupuncture, with the most frequently used acupoints being ST4, ST2, ST6, BL2, TE23, LI20, GB1, GB14, SI18, and CV24. The herbal medicine treatment most commonly utilized was Geumgwedanggwi-san (金匱當歸散), which is related to the principles of clearing heat, nourishing blood, and stabilizing the fetus (淸熱養血安胎). Among the 65 participants evaluated using the House-Brackmann facial nerve grading system, 81.5% showed complete recovery to grade 1, while 6% remained at grade 4 with no effect, indicating the efficacy of Korean medicine treatment for facial palsy during pregnancy. All the selected studies reported no abnormalities in the mothers or fetal growth, and all participants who had the reported delivery had full-term childbirth. Conclusions: The effect on Korean Medicine treatment for Bell's palsy during pregnancy had mostly positive results. However, further large, well-designed clinical trials are needed to establish the foundation of Korean Medicine treatment for Bell's palsy during pregnancy.

Nanotechnology-enabled diagnostics for the correlation between serum APN, Cystatin C and MMP-9 levels in patients with hypertension during pregnancy

  • Hui Deng;Yu-Lan Fan;Yu-Qi Wang;Yin Yang;Da-Yong Jiang
    • Advances in nano research
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    • v.17 no.3
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    • pp.213-219
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    • 2024
  • Nanotechnology is one of the critical factors involved in enhancing the sensitivity of serum biomarker detection. To explore the relationship between serum APN, Cystatin C and MMP-9 levels in patients with hypertension during pregnancy and the severity and prognosis of the disease. A total of 75 cases of hypertensive disorder complicating pregnancy (HDCP) patients who were admitted to the hospital from February 5, 2023 to May 9, 2024, were selected as the study group, and 70 healthy pregnant women who were in the same gestational week were selected as the control group. The serum APN, MMP-9 and Cys C levels of pregnant women and HDCP patients with different disease severity were compared between the two groups, and the receiver characteristic curve (ROC) was used to analyze its diagnostic value. The serum APN, MMP-9 and Cys C levels of HDCP patients with different prognosis were compared, and the factors affecting the prognosis of patients were analyzed by Logistic regression. Nanoparticles could aslo enable the sensitive detection and quantification of APN, Cystatin C, and MMP-9 in serum samples, thus increasing the accuracy of the study. The serum MMP-9 and Cys C levels of pregnant women in the study group were significantly increased, and the APN level was significantly decreased (P<0.05). Serum MMP-9 and Cys C levels in patients with pregnancy-induced hypertension, mild preeclampsia, and severe preeclampsia gradually increased (r=0.768, 0.766; P<0.001), and APN levels gradually decreased (r=-0.748, P< 0.001). In the diagnosis of patients with HDCP, the sensitivity, specificity and AUC of APN single diagnosis were 70.00%, 82.67% and 9.848 respectively. The sensitivity, specificity and AUC of MMP-9 single diagnosis were 82.86%, 74.67% and 298.300 respectively. The sensitivity, specificity and AUC of Cys C single diagnosis were 80.00%, 74.67% and 1.301 respectively. There were significant differences in age, BMI, parity, dysthymia, disease severity, APN, MMP-9 and Cys between patients with poor prognosis of HDCP and patients with good prognosis of HDCP (P<0.001). The patient's age, BMI, disease severity, APN, MMP-9 and Cys Cwere all related to HDCP. They were related risk factors of HDCP (P<0.05).

Clinical course and prognosis of hemodynamically significant congenital heart defects in very low birth weight infants (혈역학적으로 의미있는 선천성 심기형을 가진 극소 저체중 출생아의 임상경과 및 예후)

  • Yoo, Hye Soo;Kim, Ji Eun;Park, Soo Kyoung;Seo, Hyun Ju;Jeong, Yoo Jin;Chio, Seo Heui;Jeong, Soo In;Kim, Sung Hoon;Yang, Ji Hyuk;Huh, June;Chang, Yun Sil;Jun, Tae Gook;Kang, I Seok;Park, Won Soon;Park, Pyo Won;Lee, Heung Jae
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.481-487
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    • 2009
  • Purpose : This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs). Methods : Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The data for these patients with hemodynamically significant CHD (n=33) were compared with those without CHD (n=1,065). Results : The incidence of CHD was 3.0% (33 patients) 7 patients (21%) had CHD combined with the congenital abnormalities or chromosomal disorders. The most common CHD was a ventricular septal defect. The incidence of intrauterine growth retardation was higher in patients with CHD than in patients without CHD (34% vs. 20%), but there were no significant differences in gestational age, birth weight, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, severe intraventricular hemorrhage (${\geq}$Gr III), and periventricular leukomalacia. Cardiac surgery was performed on 13 patients (39%). Nine patients received staged operations, and 10 patients received early intervention. The overall mortality in patients who had CHD was higher than in the patients who did not have CHD (27% vs. 16%). In patients with CHD, congenital abnormalities or chromosomal disorders were more important factors for increased mortality (86% vs. 11%) than the degree of complexity of CHD (19% vs. 42%). Conclusion : The most important prognostic factors of VLBWI with CHD are the associated congenital abnormalities or chromosomal disorders.

The factors associated with the efficacy of indomethacin treatment in premature infants with patent ductus arteriosus (인도메타신 투여 시 미숙아 동맥관개존 치료효과에 영향을 미치는 인자)

  • Yoon, Min Jeong;Yoon, Hye Sun;Chung, Sung Hoon;Han, Mi Young;Bae, Chong Woo
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.531-535
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    • 2007
  • Purpose : Indomethacin treatment is successful in about 90% of patent ductus arteriosus (PDA) in premature infants, but in some, repeated administration or surgical closure is required. The object of the present study is to determine the factors affecting the efficacy of indomethacin treatment and to predict the treatment result. Method : The 29 preterm neonates, admitted to neonatal intensive care unit of Kyunghee university medical center and Eulji university hospital between September 2002 and April 2006 were diagnosed of PDA and treated with indomethacin. The risk factors that might affect the efficacy of treatment were studied retrospectively. Results : The single-administered group was 19 patients out of 29 (65.5%) and among the repeated-administered group, 5 patients (17.2%) had repeated indomethacin administration and the other 5 patients (17.2%) underwent surgery due to reopening of the duct after repeated medical treatment. In repeated-administered group, the diameter of PDA was significantly larger ($3.66{\pm}0.8mm$ vs $2.55{\pm}0.8mm$, P<0.01), especially when larger than 3.5 mm (sensitivity: 70%, specificity: 89%). Also, the mean postnatal age of the first indomethacin administration was significantly delayed in repeated-administered group (19.7 days vs 12.5 days, P<0.05). There were no significant differences in gestational age (32 wk 5 days vs 30 wk 8 days) and in birth weight (1598.9 g vs 1750.5 g). There were no significant differences in associated morbidities. Conclusion : In patients with larger diameter of PDA (>3.5 mm) and older postnatal age (>7 days), the effect of indomethacin was decreased. Therefore in such cases, repeated dose of indomethacin or surgical ligation should be considered earlier.

The influence of some intrauterine growth variables on neonatal blood pressure (태아기 자궁내 성장지표와 신생아 혈압과의 관련성)

  • Min, Jungwon;Park, Eun Ae;Kong, Kyoungae;Park, Bohyun;Hong, Juhee;Kim, Young Ju;Lee, Hwayoung;Ha, EunHee;Park, Hyesook
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.966-971
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    • 2006
  • Purpose : 'Programming' describes the process that stimulus at a critical period of development has lifelong effects. The fact that low birth weight links to the risk of elevated blood pressures in adult life is well known. This study aims to examine whether this link is evident in the newborn by investigating the relationship of the intrauterine growth indices and neonatal blood pressure(BP). Methods : We studied 127 neonates who were born at Ewha Womans' Hospital and their mothers enrolled our cohort study during pregnancy. Data on the mothers and details of the birth records were tracked and collected from medical charts. Neonatal BP was measured within 24 hours after birth. Results : Neonatal SBP was positively correlated to intrauterine growth indices; birth weight(BW)(r=0.4), head circumference(HC)(r=0.4), and birth height(r=0.3). However, an inverse relationship existed, between HC/BW ratio and neonatal SBP(r=-0.4). After adjusting for the baby's sex, maternal BP, and gestational age, neonatal SBP still associated with intrauterine growth indices. SBP was 7 mmHg higher in the highest BW group(${\geq}90percentiles$) compared to the lowest group(<10 percentiles). On the other hand, SBP was 17 mmHg lower in the highest HC/BW group(${\geq}90percentiles$) compared in the lowest group(<10 percentiles). Conclusion : This study could not find the evidence that intrauterine growth retardation affect on elevated neonatal BP. It suggests that the initiating events of BP programming may occur during postnatal growth period. To identify the critical starting period that intrauterine growth retardation leads to elevated BP, a study tracking BP changes from birth to childhood is required.