• Title/Summary/Keyword: Multiple Pregnancy

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Diagnosis and treatment of positional plagiocephaly

  • Jung, Bok Ki;Yun, In Sik
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.80-86
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    • 2020
  • Positional plagiocephaly is increasing in infants. Positional plagiocephaly is an asymmetric deformation of skull due to various reasons; first birth, assisted labor, multiple pregnancy, prematurity, congenital muscular torticollis and position of head. Positional plagiocephaly can mostly be diagnosed clinically and by physical examinations. The simplest way to assess the severity of plagiocephaly is to use a diagonal caliper during physical examination, which measures the difference between the diagonal lengths on each side of the head. Plagiocephaly can be treated surgically or conservatively. Positional plagiocephaly, which is not accompanied by craniosynostosis, is treated conservatively. Conservative treatments involve a variety of treatments, such as change of positions, physiotherapy, massage therapy, and helmet therapy. Systematic approaches to clinical examination, diagnosis and treatment of positional plagiocephaly can be necessary and the age-appropriate treatment is recommended for patients with positional plagiocephaly.

Legal Implications of In Vitro Fertilization and Embryo Transfer (체외수정 및 배이식에 관한 법율고)

  • Bai, Byoung-Choo
    • Clinical and Experimental Reproductive Medicine
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    • v.13 no.2
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    • pp.129-136
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    • 1986
  • While the technique of In Vitro Fertilization and Embryo Transfer has been proven undoutedly, it is for from reaching a consensus on the legal implication. Legal authority regarding clinical therapeutic In Vitro Fertilization and Embryo Transfer is, for all practical purpose, nonexistant. In this paper, it is discussed existing regulation dealing with In Vitro Fertilization and Embryo Transfer and related areas i.e. the regulation related medical technologies, the use of donor sperm, donor eggs, surrogate uteri, multiple pregnancy, miscarriages, extra embryos, the technique of cryopreservation. The legality of embryo donation, the responsibility for embryo preservation or destruction and the legal status of the embryos are surveyed. Finally the various legal theories that may give rise to physician liability in connection with clinical In Vitro Fertilization are also reviewed.

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Condition and Effect of Sex Education Program for Korean Middle School Students (중학생의 성교육 실태 및 프로그램 효과분석)

  • Moon, In-Ok;Youn, Young-Ok;Kim, Ro-Eul
    • The Journal of Korean Society for School & Community Health Education
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    • v.8 no.1
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    • pp.1-11
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    • 2007
  • Objectives: School must provide the proper sex education to students, thereby, the students for have right standards of sexuality and preventing from sexual crimes. This study conducted to identify the effectiveness and students' satisfaction level on Sex education program for middle school students prepared by the Ministry of Education and Human Resources. Methods: The sample size of the study was 644 students(458 female students and 186 male students) in middle school. A self reporting type of questionnaire survey was conducted from May 2 through May 27, 2005. Collected data were processed using SPSSwin 12.0; The data were analysed through t-test, stepwise multiple regression analysis. Results: Lectures and audiovisual materials were mostly used for sex education for students. Many students were satisfied with the program of physical and sexual organ development, pregnancy, contraceptive methods and sexual abuse. Many students wanted to study more on courtship, love, and marriage. The programs which the students did not understand well were sexually transmitted diseases, pregnancy and mass media and sex. Forty six percentage of the students reported that they were satisfied with the education program. Thirty three percentage of the students said that they were not satisfied with the program. The students who had earlier menstruation experience and the students whose academic achievement were higher were more satisfied with sex education program (P<.05). The students who were satisfied with the sex education CD prepared by the ministry of education were more satisfied with sex education program. (P<.001). When the CDs were appropriately used, the students were more satisfied with the education program (P<.05). The sound and pictures in the CD did not much affect the students. Audiovisual programs were more effective than lectures.

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쌍태임신에 관한 임상 간호학적 관찰

  • 이귀향;이성학;박성숙
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.103-110
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    • 1970
  • It is important to point out that the percental mortality rate of the multiple pregnancy is almost twice of the single pregnancy due mainly to their prematurity and the mothers of twins will also be suffered from the plural births to nurse and take care of them. We therefore studied the incidence, the sex ratio, the types of deliveries, the complications and the percental mortality rate of the twin deliveries in order to promote the development of our field of maternal and child nursing. We selected our materials from the 112 patients who had been admitted and delivered twins in the department of OB. & Gyn. of the S.N.U. Hospital from Jan. 1962 to Dec. 1969. The abstructed results of this study were as follows. 1. The incidence of twins among 7, 731 births was 1:69 2. The occurrence of twins from elder multigravida was 4 to 6 times higher than younger primigravida mothers under 35 years of age. 3. The generational length of 45.5% of all twins was under 38 weeks and the mean birth weight of 1st and 2nd twins were 2, 354.7gm and 2, 215.8gm respectively. 4. The sex ratio of twins was 99 males and 124 females. 5. Presentation of twins: 59 cases (52.69%) were in both vertex. 37 cases (33.03%) in vertex plus breech. 15 cases (13.39%) in both breech and one case (0.89%) in transverse presentation. 6. For the types of deliveries Spontaneous deliveries were in 90 babies (40.6%) Breech extraction in 60 babies (26.3%) Vacuum used in 33 babies (15.0%) Cesarean section in 33 babies (9.8%) Forceps in 9 babies (4.2%) and others such as version and destructive measures in 9 babies (4.1%) 7. Intervals between the 1st and 2nd delivery were analyzed and 93% of 2nd twins were delivered within minutes after 1st delivery. 8. The main complications of twin deliveries were totemic (45.5%), second was postmarital hemorrhage (19.6%) and third was hydrations (7.1%) 9. The mean percental mortality of 1st and 2nd twins was 12.52% and 16.96% respectively of which main cause of death were their prematurity.

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Body composition: A predictive factor of cycle fecundity

  • Kayatas, Semra;Boza, Aysen;Api, Murat;Kurt, Didar;Eroglu, Mustafa;Arinkan, Sevcan Arzu
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.2
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    • pp.75-79
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    • 2014
  • Objective: To study the effect of body composition on reproduction in women with unexplained infertility treated with a controlled ovarian hyperstimulation and intrauterine insemination programme. Methods: This prospective observational study was conducted on 308 unexplained infertile women who were scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme and were grouped as pregnant and non-pregnant. Anthropometric measurements were performed using TANITA-420MA before the treatment cycle. Body composition was determined using a bioelectrical impedance analysis system. Results: Body fat mass was significantly lower in pregnant women than in non-pregnant women ($15.61{\pm}3.65$ vs. $18.78{\pm}5.97$, respectively) (p=0.01). In a multiple regression analysis, body fat mass proved to have a stronger association with fecundity than the percentage of body fat, body mass index, or the waist/hip ratio (standardized regression coefficient${\geq}0.277$, t-value ${\geq}2.537$; p<0.05). The cut-off value of fat mass, which was evaluated using the receiver operating characteristics curve, was 16.65 with a sensitivity of 61.8% and a specificity of 70.2%. Below this cut-off value, the odds of the pregnancy occurrence was found to be 2.5 times more likely. Conclusion: Body fat mass can be predictive for pregnancy in patients with unexplained infertility scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme.

Noninvasive prenatal test for the pregnancy with Turner syndrome mosaicism 45, X/47, XXX: A case report

  • Kim, Ji Hye;Lee, Gun Ho;Cha, Dong Hyun;Cho, Eun-Hae;Jung, Yong Wook
    • Journal of Genetic Medicine
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    • v.12 no.2
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    • pp.118-122
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    • 2015
  • Noninvasive prenatal test (NIPT) is a novel screening method for the diagnosis of fetal chromosomal aneuploidies. NIPT is based on technology that detects cell-free fetal DNA in maternal plasma and analyzes it with massively parallel sequencing technology to determine whether the fetus is at risk of trisomy 21, trisomy 18, trisomy 13 or sex chromosome abnormalities (SCAs). NIPT has been reported to have sensitivity of 99% and a false positive rate of less than 1% for detecting trisomy 21 and trisomy 18. Although extension of the application of NIPT to other SCAs has been attempted, there are concerns in extending NIPT to SCAs because of maternal or fetal mosaicism, undetected maternal SCAs, and multiple pregnancies. Recently, we assessed a pregnancy with the rare Turner syndrome mosaicism 45, X/47, XXX, which was reported as 45, X with NIPT. We present the case here and briefly review the current literatures on NIPT in testing for fetal monosomy X. To the best of our knowledge, this is the first report of the 45, X/47, XXX mosaicism in Korea to be reported as 45, X by NIPT with whole genome sequencing. This case report will provide valuable information for counseling women who want to undergo NIPT.

Impact of Advanced Maternal and Paternal Age on Perinatal Outcome (분만여성과 배우자의 출산연령이 산모와 신생아 합병증에 미치는 영향)

  • Lee, Min-Kyung;Shin, Hye-Sook;Lee, Yun-Jung;Kim, Ju-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.18 no.1
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    • pp.95-101
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    • 2012
  • Purpose: This study aimed to analyze the impact of advanced maternal and paternal age on perinatal outcome in Korea. Methods: We conducted a retrospective study involving 1,622 Korean women who delivered at M Woman Hospital from January to December 2010 and their spouses were included. We obtained obstetrics database which included demographic characteristics, medical and obstetrics history, course of the current pregnancy and advised perinatal outcome. Multivariable logistic regression was used to adjust for potential confounding variables. Results: Women giving birth age 35 or older were statistically significant in paternal age, gravidity, spontaneous abortion experience, method of conception, method of delivery, and multiple gestation compared to women aged <34 years. After adjusting for the confounding effects of maternal characteristics, women aged 35 or older were at increased risk for cesarean section delivery (adjusted OR 1.6, 95% CI 1.22-2.13) and preterm birth (adjusted OR 2.2, 95% CI 1.03-4.63). Conclusion: In this population of Korean women, advance maternal and paternal age is independently associated with specific adverse perinatal outcome, especially preterm birth and cesarean section delivery.

Outcomes of Non-Metastatic Gestational Trophoblastic Neoplasia: Twelve Year Experience from a Northern Thailand Tertiary Care Center

  • Suprasert, Prapaporn;Manopunya, Manatsawee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5913-5916
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    • 2015
  • Gestational trophoblastic neoplasia (GTN) is the malignant form of gestational trophoblastic disease. In non-metastatic GTN, the outcomes of treatment are impressive with methotrexate (MTX) or actinomycin D. We retrospectively reviewed the outcomes of non-metastatic GTN treated at our center from January, 1999 to December, 2013. One hundred and nine patients were recruited to the study. The median age was 33.1 years and over 90% were referral cases. Abnormal vaginal symptoms developed in 37.6% while 56.4% were asymptomatic. The most common antecedent pregnancy was a complete mole (92.7%) with the median interval time from antecedent pregnancy to GTN development being 2.0 months. The median pretreatment B-hCG was 5,624 mIu/ml. The most common first line treatment was methotrexate (MTX) and folinic acid (91.7%) followed by weekly MTX (4.6%), etoposide+ MTX+actinomycin D (EMA) (2.8%), and actinomycin D (0.9%), with the median number of cycles at 5.0. The positive response to first line chemotherapy was 73.8%. The patients were given subsequent chemotherapeutic regimens after resistance to the first line therapy and showed a final remission rate of 89.9%.The significant factor that was frequently found in patients who were non-responders to the first line treatment was a hysterectomy procedure. Two patients developed lung metastasis and brain metastasis at one and four years after the first treatment, respectively. In conclusion, the outcomes of non-metastatic GTN were excellent. However, the patients need long term follow up due to the possibility of developing multiple organ metastases.

Studies on Serum Estradiol (E2), Androstenedione (ADD) and Testosterone (T) Levels in the Hyperstimulated Ovulatory Cycles (과배란유도 월경주기에서 혈중 Estradiol Andrstenedione 및 Testerone농도의 동태에 관한 연구)

  • Kim, Jong-Hwa;Lee, Jin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.13 no.2
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    • pp.101-112
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    • 1986
  • It is now common practice to attempt ovarian hyperstimulation in vitro fertilization and embryo transfer (IVF-ET) to promote the development of multiple preovulatory follicles and to maximize the number of mature egg available. There are several drugs for hyperstimulation such as clomiphene citrate only, clomiphene citrate and human menopausal gonadotropin (HMG) and HMG only. Accumlated experience has shown that the hyperstimulation of the ovary in IVF-ET results in high pregnancy rate. But the hyperstimulation of the ovary in IVF-ET may cause the hyperandrogenism, so we must consider the adverse effect on pregnancy rate of the hyperandrogenism. Little is known about the functional significance of androgen for the follicular growth, however, the hyperandrogenism might interfere with oocyte maturation. The aim of the present investigation was to determine the serum profiles of estradiol, androstenedione and testosterone during the hyperstimulated menstrual cycles in IVF. The results were summarized as follows: 1. There was a gradual increase in the mean levels of serum estradiol, androstenedione, and testosterone approaching follicular maturation. 2. The mean serum estradiol levels in the hyperstimulated groups were significantly higher than that in the control group in late follicular phase and ovum retrieval (ovulation) day (p<0.01). 3. The mean serum androstenedione levels in the clomiphene citrate groups were significantly higher than that in the control group in late follicular phase (p<0.01). There was no statistically significant different in the mean serum androstenedione levels between the control group and the HMG group (p>0.05). 4. There was no statistically significant difference in the mean levels of testosterone among each group (p>0.05). 5. There was no statistically significant different in the mean levels of estradiol, androstenedione and testosterone between the fertilized patients and non-fertilized patients in clomiphene citrate and HMG group (p>0.05).

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A Case of Successful Pregnancy with Electroejaculation and In Vitro Fertilization (전기사정과 시험관아기시술에 의한 성공적인 임신 1례)

  • Nam, Y.S.;Kim, H.J.;Jun, Y.J.;Kim, H.K.;Oum, K.B.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.117-121
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    • 1999
  • Although anejaculation is a relatively uncommon occurrence in the general population, over 12,000 new cases are reported annually. Anejaculation may result from spinal cord injury, retroperitoneal lymph node dissection, diabetes mellitus, transverse myelitis, multiple sclerosis, or psychogenic disorders. At least 30% of men with this problem are or will be married and many will seek help to remedy their infertile state. The evolution of technique and instrumentation over the last 30 years has made electroejaculation an accessible and acceptable form of therapy. Recent successes in inducing ejaculation by means of rectal probe electrostimulation or vibratory stimulation combined with assisted reproductive techniques, such as zygote intrafallopian transfer (ZIFT), gamete intrafallopian transfer (GIFT), and in vitro fertilization (IVF), have provided these men means of producing their own biologic offspring. We have experienced a successful pregnancy with electroejaculation and in vitro fertilization in a infertile patient whose husband had an ejaculatory disturbance due to a spinal cord injury. So we report this case with a brief review of literatures.

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