ABSTRACT
OBJECTIVE: The purpose of this study was to establish reference ranges for the fetal orbital diameters (OD) and outer orbital diameters at 16 to 38 weeks' gestation. METHODS: This prospective longitudinal study enrolled 41 consecutive women with uncomplicated singleton gestations during their first trimester of pregnancy. Serial measurements of the fetal orbits by ultrasound examination were performed at intervals of 4 weeks until 28 weeks, and then every 2 weeks until 36 weeks, and weekly thereafter. Linear regression was used for statistical analysis. RESULTS: A total of 331 fetal orbital diameters and 298 outer orbital diameters were measured. The reference ranges for orbital diameters and outer orbital diameters were presented as mean, 95% confidence interval of the mean and percentiles. A linear growth function was observed between gestational age (GA), orbital diameter (Y=0.654 x GA - 0.856; r2=0.948; p<0.0001) and outer orbital diameter (Y=1.679 x GA+0.510; r2=0.942; p<0.0001). Significant correlation was also found between orbital diameter and outer orbital diameter (Y=2.451 x OD+4.840; r2=0.906; p<0.0001). CONCLUSION: We have presented percentile tables and regression formulas for fetal orbital diameters and outer orbital diameters. These results provide normative data of the growth of the fetal orbit and may be useful in assessing fetal orbital architecture in patients at risk of ocular abnormalities.
Subject(s)
Female , Humans , Pregnancy , Gestational Age , Linear Models , Longitudinal Studies , Orbit , Pregnancy Trimester, First , Prospective Studies , Reference Values , UltrasonographyABSTRACT
Acute leukemia is one of the most common malignant neoplasms of female. Fortunately, the incidence of leukemia during pregnancy has been estimated at only 1 per 100,000 pregnancies. Since the management of acute leukemia in pregnancy consists of the challenge of optimizing chances for prolonged remission and cure in the mother while minimizing the toxicity to the unborn fetus, so there are many therapeutic and ethical dilemmas. Causing thrombocytopenia and anemia, neutropenia, leukemia can be an obstacle to the adequate obstetric management. The management of this subset of pregnant patients requires a team approach including patient, family, obstetrician and hematologist-oncologist. We experienced a case of the pregnancy with acute myelogenous leukemia at 32 gestational weeks. With induction of labor, she was delivered of a 2,250 g, healthy male baby at 34 gestational weeks. After delivery of infant, she underwent combination chemotherapy. We present this case with review of related literatures.
Subject(s)
Female , Humans , Infant , Male , Pregnancy , Anemia , Drug Therapy, Combination , Fetus , Incidence , Leukemia , Leukemia, Myeloid, Acute , Mothers , Neutropenia , ThrombocytopeniaABSTRACT
Acute leukemia is one of the most common malignant neoplasms of female. Fortunately, the incidence of leukemia during pregnancy has been estimated at only 1 per 100,000 pregnancies. Since the management of acute leukemia in pregnancy consists of the challenge of optimizing chances for prolonged remission and cure in the mother while minimizing the toxicity to the unborn fetus, so there are many therapeutic and ethical dilemmas. Causing thrombocytopenia and anemia, neutropenia, leukemia can be an obstacle to the adequate obstetric management. The management of this subset of pregnant patients requires a team approach including patient, family, obstetrician and hematologist-oncologist. We experienced a case of the pregnancy with acute myelogenous leukemia at 32 gestational weeks. With induction of labor, she was delivered of a 2,250 g, healthy male baby at 34 gestational weeks. After delivery of infant, she underwent combination chemotherapy. We present this case with review of related literatures.
Subject(s)
Female , Humans , Infant , Male , Pregnancy , Anemia , Drug Therapy, Combination , Fetus , Incidence , Leukemia , Leukemia, Myeloid, Acute , Mothers , Neutropenia , ThrombocytopeniaABSTRACT
OBJECTIVE: To investigate the clinical efficacy of assisted hatching (AH) with partial zona dissection (PZD) in intrauterine embryo transfer in the patients who failed more than 2 times with standard IVF-ET protocol (Group R), were more than 37 years old (Group A), or had high basal serum FSH levels more than 15 mIU/ml (Group F). METHODS: From January, 1998 to June, 2002, 156 cycles of AH with partial zona dissection were performed in 117 infertile patients in Department of Obstetrics and Gynecology, Seoul National University Hospital. The outcomes of AH were analyzed according to pregnancy rate. RESULTS: The number of oocytes retrieved after controlled ovarian hyperstimulation (COH) was 8.3 +/- 5.2 in 104 cycles of 75 patients who failed more than 2 times with standard IVF-ET protocol (Group I: Groups R, R+A, R+F, and R+A+F), 7.7 +/- 5.0 in 82 cycles of 67 patients who were more than 37 years old (Group II: Groups A, R+A, A+F, and R+A+F), and 7.2 +/- 4.9 in 38 cycles of 30 patients who had high basal serum FSH levels more than 15 mIU/ml (Group III: Groups F, R+F, A+F, and R+A+F). The number of embryos transferred after AH was 4.1 +/- 1.5 in Group I, 3.7 +/- 1.3 in Group II, and 4.0 +/- 1.7 in Group III. The mean cumulative embryo score (CES) was 81.9 +/- 46.5 in Group I, 75.9 +/- 43.0 in Group II, and 75.7 +/- 40.2 in Group III. There were no significant differences in the numbers of oocytes retrieved, embryos transferred and CES among 3 groups. The overall clinical pregnancy rate was 22.4% (35/156) per cycle and 29.9% (35/117) per patient. The clinical pregnancy rate per cycle and per patient was 18.3% (19/104) and 25.3% (19/75) in Group I, 15.9% (13/82) and 19.4% (13/67) in Group II, and 31.6% (12/38) and 40.0% (12/30) in Group III, and there was a significant difference between Group II and Group III. CONCLUSION: AH of human embryos with PZD might be promising for the improvement of pregnancy rates, especially in the patients with the past history of repeated failure, old age, or high basal serum FSH level.