Maternal serum soluble Fas/Fas ligand level and expression of Fas/Fas ligand in placenta in preeclampsia / 대한산부인과학회지

OBJECTIVE: The aims of this study were designed to determine that serum soluble Fas and Fas ligand levels are altered in women with preeclampsia and HELLP syndrome, and to assess the expression of placental Fas and Fas ligand in women with preeclampsia and HELLP syndrome. METHODS: Blood samples were obtained from 31 women with normal pregnancy, 27 women with preeclampsia and five women with HELLP syndrome. Serum Fas/Fas ligand levels were measured by enzyme linked immunoassay. Immunohistochemical stain with polyclonal antibodies of Fas/Fas ligand were used to identify apoptosis. Mann-Whitney test, x2 test, Pearson correlation coefficients and multiple regression test were used for statistical analysis. RESULTS: Both soluble Fas ligand and Fas were detected in the sera of normal pregnancy, preeclampsia and HELLP syndrome. The mean serum level of soluble Fas was 5.83+/-0.37 U/mL in women with normal pregnancy, 10.84+/-0.93 U/mL in women with preeclampsia, and 10.79+/-00.69 U/mL in women with LELLP syndrome. The mean serum level of soluble Fas ligand was 0.59+/-0.03 U/mL in women with normal pregnancy, 0.51+/-0.21 U/mL in women with preeclampsia, and 0.60+/-0.01 U/mL in women with LELLP syndrome. The mean serum levels of soluble Fas were significantly higher in women with preeclampsia and HELLP syndrome than in women with normal pregnancy, but those of Fas ligand were no significant difference in each group. Apoptosis was conclusively demonstrated within placental tissue. The immunohistochemical analysis of Fas revealed diffuse immunoreactive stains were increased in women with preeclampsia than in women with normal pregnancy. But the immunohistochemical analysis of Fas ligand revealed diffuse immunoreactive stains were decreased in women with preeclampsia than in women with normal pregnancy. CONCLUSION: Placental apoptosis and altered expression of Fas and Fas ligand in trophoblast might influence the pathogenesis or pathophysiologic mechanism of preeclamsia. Elevated serum soluble Fas levels is associated with preeclampsia and HELLP syndrome. The source of elevated serum soluble Fas in preeclampsia and HELLP snydrome remains to be determined.

Analysis of Indication and Rate of Cesarean Deliveries at Dongsan Medical Center for Ten Years / 대한주산의학회잡지

OBJECTIVE: The aim of this study was to evaluate the rate and indications of cesarean delivery. METHODS: All live birth >27weeks at the Dongsan Medical Center, Keimyung University from 1993 to 2002(n=35,891) were retrospectively analyzed of delivery route, indication of cesarean birth, gestational age, and maternal age. RESULTS: Total cesarean rate was 29.0%(10,411/35,891) and primary rate was 16.8%(6,041/35,891). The annual primary cesarean birth rate number was increased gradually. The most common maternal age of cesarean section patients was between 26-30 years(43.7%). The most common gestational age of cesarean section patients was over 36 weeks(87.4%). Abnormal presentation and CPD were the most common indication(19.17%, 1,158/6,041) at primary cesarean deliveries. The third common indication was fetal distress(16.44%, 993/6,041). CONCLUSIONS: Total cesarean rate was increased gradually by increasing the previous section rate as well as the primary section rate. Further evaluation will be needed about the relationship between cesarean deliveries and long term fetal outcome, and the effort for VBAC will be needed.

A Case of Congenital Omental Cyst / 대한주산의학회잡지

Omental cyst is a rare disease and its accurate time and cause of outbreak has not been reported. This disease is known as can be afflicted with postnatally and in case of being afflicted with pre-natally the abdominal cavity and thoracic organ of fetus are oppressed due to fetal abdominal distention leading to fetal death caused by organ dysgenesis. No medical report has yet been published on congenital omental cyst of fetus. This study was conducted on a case of congenital omental cyst of fetus we have experienced in a mother with 16weeks of gestational period and the result is hereby reported along with literally documents.