A Clinical Study in Pregnant Women Over the Age of 35 / 대한산부인과학회잡지

OBJECTIVES: Although pregnancy in women who are 35 years old or more is considered a high risk pregnancy, it has occurred more frequently in recent years. The aim of our study was to evaluate the course of delivery and perinatal outcomes in women who are 35 years old or more. METHOD: We have compared 765 cases of the elderly gravida over the age of 35 at the department of Obstetrics and Gynecology, Mokpo, Catholic Hospital, from January 1, 1997 to December 31, 1999, with 800 cases of randomly chosen young pregnant women during the same period. RESULTS: There were 765 cases of the elderly gravida among total 8285 deliveries and the incidence of the elderly gravida for 3 years was 9.2%. The rate of elderly gravida was increased from 8.2% in 1997 to 10.0% in 1999. 46.9% were in the age group of 35 to 36 years. The incidence of primigravida was 13.9%. 93.6% of total cases was vertex presentation breech presentation was 5.2%, and transverse lie was 1.2%. The percentage of preterm pregnancy was 9.5% in elderly gravida, and 4.0% in control group. post-term pregnancy was 2.0% in elderly gravida, and 1.0% in control group.The rate of cesarean section was 48.8%, compared with 26.7% in the control group. Among the indications of cesarean section, the highest incidence was previous cesarean section (40.0%) and elderly primigravida (18.0%), fetal distress (10.7%), cephalopelvic disproportion (7.5%), and abnormal presentation (6.7%). Concerning the prenatal complications, the incidence of hypertensive disorder was 4.3%, and 2.6% in control group. The incidence of low birth weight and macrosomia were 8.9%, 8.8% in elderly gravida, and 5.5%, and 9.3% in control group. The incidence of IUFD was 3.1% in elderly gravida, and 0.63% in control group. Male-to-female sex ratios were 1.12:1 in elderly gravida, 1:1.16 in elderly primigravida, 1.17:1 in elderly multi gravida, and 1.20:1 in control group. CONCLUSION: The rate of elderly gravida increased in recent years, and the cesarean rate was higher compared with the control group. But there was no difference in perinatal mortality. The reasons for increasing rate of cesarean delivery may be due to physician and patient concern over pregnancy outcome in older women. Therefore it is necessary to exert more attention to pregnancies in those over the age of 35.

A Case of Large Placental Chorioangioma Combined with Polyhydramnios / 대한산부인과학회잡지

No abstract available.

Effect of Chronic exposure to Low-Levels of n-Hexane on Peripheral Nervous System / 대한산업의학회지

OBJECTIVES: The effect of chronic exposure to low levels of n-hexane on peripheral nervous system and the relationship between duration of employment and impairment of peripheral nervous system was studied. METHODS: In 21 workers at two shoe - maker factories and 21 unexposed controls, measurement of exposure of solvents, symptom Questionnaire, physical examination and electrophysiological study were conducted. RESULTS: Mean ages of study subjects in the exposed and the unexposed were 39.9 and 40.1 years old. Mean durations of employment were 15.1 and 10.0 years, respectively. Mean concentraions of urinary 2,5-HD were 2.23 mg/kg creatinine, 0.23 mg/kg creatinine, respectively. Mean concentration of solvents in air were 21.1 ppm of n-hexane, 72.2 rpm of toluene and 0.5 ppm of MEK. There were no differences in the prevalence of subjective symptoms and abnormal neurological signs between the exposed and the unexposed. But vibration extinction time(VAT) of the exposed(8.8 second) was shorter than that of the unexposed(11.9 second)(p < 0.05). Mean values of electrophysiological studies(EPS) of the two groups were within normal limit. However, mean conduction velocity of median motor nerve and median F wave(MMNCV and MFCV), mean amplitude of median sensory action potential(MSAP) were decreased in the exposed(p < 0.05). Moreover, the rate of abnormal finding more than one in sensory nerves wart increased in the exposed than those in the unexposed(p,0.05). Correlation coefficients between duration of employment and mean conduction velocity of median sensory nerve (MSNCV) and between duration of employment and MFCV were -0.57 -0.43, respectively(p < 0.05). CONCLUSIONS: These results showed that chronic (mean 15 years) low level(mean 23 ppm) exposure to n-hexane cause subclinical impairment of peripheral nervous system. These results also suggest that the longer duration of employment, the shorter values of EPB and VAT.