A Comparison of the effect of Oral Misoprostol and Vaginal Misoprostol on the Labor Induction at Term / 대한산부인과학회지

OBJECTIVE: To compare the safety and the efficacy of oral 100 microgram versus vaginal 50 microgram misoprostol for labor induction at term. METHODS: Eighty patients with indicated for labor induction were randomized to receive either oral misoprostol 100 microgram or 50 microgram of vaginal misoprostol. In both groups, the dosage was repeated every 6 hours, if needed, to a maximum of four doses. We compared the Bishop score during labor induction, average interval from induction to delivery, vaginal delivery rate within 12 hours and 24 hours, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: In two groups, demographic characteristics were similar. Regarding the change of Bishop score checked after 4 hours and 8 hours, it was statistically shown that the score was significantly high in oral misoprostol group compared to vaginal misoprostol group (5.9+/-1.4 vs. 5.1+/-1.1, p<0.05; 8.6+/-2.3 vs. 7.1+/-2.1, p<0.05). In nulliparous women, the average interval from induction to delivery was shorter in oral misoprostol group than in vaginal misoprostol group (927.4+/-344.7 minutes vs. 1130.6+/-297.0 minutes, p<0.01). In multiparous women, the average interval from induction to delivery was shorter in oral misoprostol group than in vaginal misoprostol group (674.2+/-110.4 minutes vs. 831.1+/-181.6 minutes, p<0.01). There was no clinical or statistical difference between two groups in mode of delivery, cesarean section rate, fetal heart rate abnormalities, tachysystole, hyperstimulation syndrome, meconium staining and fetal outcome (Apgar score at 1 and 5 minutes, birth weight). CONCLUSION: These results suggest that oral misoprostol 100 microgram is more effective for cervical ripening and induction of labor than vaginal misoprostol 50 microgram.

Correlation and measurement between stress of mother and fetus using heart rate variability / 대한산부인과학회지

OBJECTIVE: The maternal stress measurement from the heart rate variability and the fetal stress measurement from the fetal heart rate variability in non-stress test (NST) were conducted and the correlation between two measurements was calculated. METHODS: From June 2004 to August 2004, 30 cases who visited for antenatal care and admitted at our hospital above 27 weeks of pregnancy were analyzed for tests. The test consists of simultaneous 20-minute non-stress test and 5-minute stress test in stable state of supine position. From measurement and analysis of fetal heart rate variability in NST and maternal stress, three factors -- balance of an autonomic nervous system, an activity of a sympathetic nervous system, and an activity of a parasympathetic nervous system -- were calculated and analyzed. RESULTS: A Pearson correlation coefficient of the LF/HF ratio of mother and fetus did not show the high significance for the whole population (whose value was -0.014), but after clustering the population according to the gestational age, LF/HF ratio, norm LF, and norm HF for mothers in 38 weeks of pregnancy showed highly positive correlation -- the values were 0.760 (p-value 0.011), 0.569, and 0.569, respectively; the cluster of mothers in 38 weeks was the largest one in the population. And value of a mother in four different week also showed positive correlation (0.801). CONCLUSION: A noninvasive method for measurement of fetal stress was suggested and positive correlation between maternal stress and fetal stress was observed. Thus positive feedback may be expected by maternal stress relieving methods, such as aroma therapy and psychosocial support, and the possibility and basis for the evaluation of the effectiveness on maternal and fetal stability by prenatal education was settled.

A Case of Peritoneal Inclusion Cyst caused by Chlamydia Trachomatis Infection / 대한산부인과학회지

Peritoneal inclusion cysts are fluid collections among adhesions occurring after an inflammatory process in the peritoneal cavity or after an operation. The typical ultrasound morphology of a peritoneal inclusion cyst is that of a cystic mass following the contours of the pelvis, and with a deformed ovary suspended among adhesions centrally or peripherally in the cyst, and the cyst may contain both septa and papillary projection. So sometimes it is difficult to distinguish an ovarian mass from peritoneal inclusion cyst. We experienced one case of huge peritoneal inclusion cyst caused by chlamydia trachomatis infection and then we report it together with a brief review of literatures.

A clinical evaluation of chlamydia trachomatis infection in women with pelvic inflammatory disease / 대한산부인과학회지

OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganism in pelvic inflammatory disease (PID). In this infection tubal obstruction, infertility, tubal pregnancy and recurrent pelvic infection has involved. Also, perinatal infection, spontaneous abortion and preterm labor of pregnant women increased in chlamydia infection. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis in symptomatic women. METHODS: From March, 2003 to March, 2004, in OB-Gyn development, endocervical swab were obtained in 218 patients (137 impatients of PID and 81 outpatients) by Amplicor Chlamydia Transfer Kits and Human papilloma virus kit. They were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. Also, in this study we investigated the prevalence of human papilloma virus and N. gonorrhea in the Chlamydia infection group. RESULTS: The prevalence rate of Chlamydia trachomatis was 27.5% (61/218) in pelvic inflammatory disease. As regarding the age distribution of Chlamydia trachomatis positive group was the high prevalence rate in twenties (52.8%). Chlamydia infection was related to the history of artificial abortion, oral contraception, occupation status, history of gynecologic disease (PID, Ectopic pregnancy). Women with chlamydial infection were 2.5 times greater risk of coincidal HPV infection and 2 times greater risk of coincidal N. gonorrhea infection and both were statistically significant. CONCLUSION: The prevalence rate of Chlamydia infection is higher than any other sexually transmitted disease and Chlamydia infection has serious complication on reproduction. It appears weak symptom and detection is difficult. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.