Midtrimester Amniotic Fluid Levels and Each Ratio of Activn A, Inhibin A and B in Down's Syndrome and Other Complicated Pregnancies / 대한산부인과학회잡지

OBJECTIVE: To evaluate the amniotic fluid levels and each ratio of activin A, inhin A and B in Down's syndrome and other complicated pregnancies. METHODS: This study was performed in 71 women who had undergone a midtrimester amniocentesis with the clinical indications and whose pregnancy outcome was retrospectively determined. Ten Down's syndrome, 15 complicated pregnancies including, preeclamsia, gestational diabetesis mellitus, preterm labor, intrauterine growth restriction (IUGR), and 46 noncomplicated pregnancies with normal chromosome were included in this study. Amniotic fluid activin A, inhibin A and B were measured using enzyme linked immunosorbent assays (ELISA). Statistical analysis was performed with Mann-Whitney U test and regression analysis. RESULTS: There were significant positive correlation (r=0.277, p=0.011) between the ratio activin A/ inhibin B level and maternal age and significant positive correlation (r=0.261, p=0.015) between maternal age and the ratio inhibin A/inhibin B level. There were also significant positive correlation (r=0.202, p=0.045) between gestational weeks and inhibin A levels and significant positive correlation (r=0.474, p<0.001) between gestational weeks and inhibin B levels. Amniotic fluid inhibin A and inhibin B levels were significantly (p<0.05) decreased in Down's syndrome compared with the normal chromosomal groups but there was no difference in the ratio activin A/inhibin A and in the ratio activin A/inhibin B between these groups. The amniotic fluid levels of activin A, inhibins (A and B), each ratio of complicated pregnancies groups with normal chromosome was not significantly different from those of uncomplicated pregnancies with normal chromosome. CONCLUSION: This study revealed that amniotic inhibin levels were significantly decreased in Down's syndrome. But, activin A and each ratio were unchanged. The results suggest that activin A may be relatively decreased in each case of Down's syndrome.

A Study on the Leptin Concentrations in Maternal and Cord Blood / 대한산부인과학회잡지

OBJECTIVE: In this study, We investigated the circulating level of leptin in the maternal and cord serum to estimate the effect of leptin on the fetal growth. METHODS: In full-term pregnancy, right after delivery, we calculated the concentration of leptin in the maternal and cord serum by using an immunoassay. we studied the relation between these value, the maternal BMI at the time of delivery, the neonatal body weight. RESULTS: At the time of delivery, mean concentration of maternal leptin and cord leptin showed 335.7 pg/ml and 118.3 pg/ml and there was no statistical significance between them. Mean concentration of matenal leptin has positive relation with maternal body weight. but not to neonatal weight. Mean concentration of cord serum leptin has a positive relation with neonatal weight. There was a correlation between the maternal BMI and the neonatal weight at the time of delivery. We evaluated the mean leptin level of neonates of two different sexes, that difference did not show a statistically significant level. CONCLUSION: In this study, no correlation was found between concentration of maternal leptin and cord leptin. These data suggested that the cord serum leptin has a positive relation with fetal growth independantly, regardless of maternal leptin and maternal BMI.

Efficacy and Predictors of Success of Methotrexate Treatment in Women with Unruptured Tubal Ectopic Pregnancies / 대한산부인과학회잡지

OBJECTIVE: To evaluate the efficacy and predictors of success of methotrexate (MTX) treatment in selected cases of unruptured tubal pregnancies. METHODS: This study was retrospectively performed in 36 women who had diagnosed unruptured tubal pregnancies. Patients received intramuscular MTX. Serial beta-hCG measurement was performed weekly, and success was defined as the achievement to beta-hCG concentration of 10 mIU/mL without surgical intervention. Surgical intervention was performed for presumed tubal rupture. Pretreatment serum concentration of beta-hCG, the size of tubal mass and gestational sac by transvaginal ultrasonography were measured to evaluate the predictors of MTX therapy. RESULTS: 29 patients (81%) were successfully treated by MTX systematic treatment. There were not significant differences in the patient's age, parity, gestational age and the size of tubal ectopic mass, but significant differences in the gestational sac size and serum beta-hCG concentration between success group and failure group of MTX treatment. The mean time for achieving successful treatment was 33.8 days. The success rate of systemic MTX was significantly decreased and resolution time was prolonged if the initial pretreatment serum beta-hCG was 10,000 mIU/mL or gestational sac size was >or=1 cm. CONCLUSION: Pretreatment serum beta-hCG concentration and gestational sac size are important predictors of success of MTX treatment in women with unruptured tubal pregnancy.