ABSTRACT
Hantavirus infection occuring during pregnancy is rarely progressing to adult respiratory distress syndrome (ARDS), which is accompanied by thrombocytopenia, leukocytosis, fever, oliguria, aggravation of bleeding, hematuria, lactacedemia. Pregnancy may have an unfavorable impact on the pathophysiologic characteristics of ARDS. The high oxygen demands of pregnancy are unable to be matched by oxygen delivery in ARDS and may predispose the patient to multiple organ failure, as well as fetal oxygen deprivation. We present the case with hantavirus pulmonary syndrome complicating pregnancy.
Subject(s)
Humans , Pregnancy , Fever , Hantavirus Infections , Hantavirus Pulmonary Syndrome , Orthohantavirus , Hematuria , Hemorrhage , Leukocytosis , Multiple Organ Failure , Oliguria , Oxygen , Respiratory Distress Syndrome , ThrombocytopeniaABSTRACT
OBJECTIVE: The ovine fetus responds to hemorrhage with a 10-20 fold increase in plasma erythropoietin (EPO) concentration at 24 hr and a return toward normal at 48 hr after the hemorrhage. The objective of the present study was more accurately to compare the magnitude and time course of the plasma EPO response after fetal hemorrhage. METHODS: Chronically catheterized, 12 of late gestation ovine fetus were gradually hemorrhaged 40% of their blood volume over 2 hr (1ml/min). Plasma was sampled for EPO concentration at 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, 24, 30, 36 hr after initiating the hemorrhage were collected at these times. Radioimmunoassay was used to measure plasma EPO concentrations. Analysis of variance was used for statistical analysis. RESULT: After a slow hemorrhage in the ovine fetus (1ml/min over 2hr), plasma EPO concentration increased significantly at 4hr (2.3 times basal values), reached a maximum at 16 hr (33.3 times basal values), and declined thereafter. CONCLUSION: We studied change in time course of the fetal plasma EPO after slow hemorrhage and recent studies have shown that the fetal kidney, liver and placenta express EPO mRNA. These observation suggest that plasma EPO increase may be mediated by a tissue specific up-regulation of EPO transcription in the fetal kidney, liver and placenta. We have studied change in Epo mRNA expression in various fetal tissue after slow haemorrhage.
Subject(s)
Pregnancy , Blood Volume , Catheters , Erythropoietin , Fetus , Hemorrhage , Kidney , Liver , Placenta , Plasma , Radioimmunoassay , RNA, Messenger , Sheep , Up-RegulationABSTRACT
OBJECTIVE: To investigated whether lowering oxygen tension affects invasion of cultured trophoblast. METHODS: Trophoblasts were isolated from the normal placenta in early pregnancy(6-10 weeks in gestation). Isolated trophoblasts were cultured under normoxic(5% CO2, 95% humid air in incubator) and hypoxic(MERCK, 1% O2, 99% CO2) conditions for 24, 48 and 72 hours, respectively. The proliferation ability was measured using [H3] thymidine assay. Total RNA was extracted from the cultured trophoblasts. The expressions of matrix metalloproteinase(MMP-2) and tissue inhibitor of metallo- proteinase(TIMP-2) were determined by reverse transcription- polymerase chain reaction(RT-PCR) and Northern blot analysis. The invasiveness of cultured trophoblast was observed using in vitro invasion assay. RESULTS: [H] thymidine assay indicated that cellular DNA synthesis was not affected by the culture condition. The expression of MMP-2 mRNA was decreased at 24 hours and then progressively increased in the time-dependent manner in each culture condition. The expression of TIMP-2 was decreased in the time-dependent manner under hypoxic condition. In vitro invasion assay revealed that the cultured trophoblasts under hypoxic condition has more invasive ability than them under normoxic condition. CONCLUSION: These data suggests that hypoxic condition may stimulates the invasion of trophoblast in the human placentation. And MMP-2 and TIMP-2 may be related to control their invasiveness under hypoxic condition.
Subject(s)
Humans , Blotting, Northern , DNA , Oxygen , Placenta , Placentation , RNA , RNA, Messenger , Thymidine , Tissue Inhibitor of Metalloproteinase-2 , TrophoblastsABSTRACT
The incidence of uterine prolapse during pregnancy is rare. A 34-year-old G3P1 was initially presented at 16 weeks 5days of gestation with a prolapse of the uterine cervix. The cervix was edematous and protruding beyond introitus. Management included bed rest, and the patient was discharged after several days with a vaginal pessary to help maintain cervical placement. At 35 weeks of gestation, the patient did not experience any further prolapse after the removal of the pessary. Pregnancy progressed to term with no further prolapse. She was readmitted at 38weeks 5days of gestation with spontaneous labor. She delivered a 3.36kg male with an Apgar score at 1 minute and at 5 minutes of 7 and 8 respectively. The patient's cervix remained prolapsed in the early postpartum period; however it was easily reduced prior to discharge. After puerperium, the patient's cervix remained prolapsed. She was fitted with a vaginal pessary for uterine support. We reported this case with related literature.
Subject(s)
Adult , Female , Humans , Male , Pregnancy , Apgar Score , Bed Rest , Cervix Uteri , Incidence , Pessaries , Postpartum Period , Prolapse , Uterine ProlapseABSTRACT
OBJECTIVES: The aim of the current paper is to analyze maternal and neonatal complication of pregestational diabetes mellitus and gestational diabetes mellitus, and to compare with the outcome METHOD: The study included 108 pregnancies with diabetes mellitus among 8,495 admitted to the Department of Obstetrics and Gynecology, Catholic University of Korea Medical College, Holy Family Hospital from January 1, 1995 to December 31, 1998. The pregnancies were divided into pregestational diabetes mellitus group and gestational diabetes mellitus group. The data were analyzed and reviewed retrospectively based on medical records RESULTS: 1) Incidence of maternal complication in gestational diabetes mellitus was 7% of pregnancy induced hypertension, 3% of pyelonephritis, 1% of retinopathy and 1% of chronic hypertension. In case of pregestational diabetes mellitus, 18% of pregnancy induced hypertension, 5% of nephropathy, 9% of retinopathy and 14% of pyelonephritis. 2) Incidence of neonatal complication in gestational diabetes mellitus was 1% of congenital malformation, 1% of shoulder dystorcia, 7.3% of polyhydramnios, 17.7% of hyperbilirubinemia, 40.6% of hypoglycemia and 1% of FDIU. In case of pregestaional diabetes mellitus, 1% of congenital malformation, 18.2% of polyhydramnios, 22.7% of hyperbilirubinemia, 27.3% of hypoglycemia, 18.6% of RDS and 4.6% of FDIU. 3) The outcomes of the treatment of pregestational diabetes; There was no significant difference in the maternal weight gain, neonatal birth wight but the incidence rates of neonatal complication was lower in case of insulin treatment 4) The outcomes of the treatment of gestational diabetes; There was significant difference in the maternal weight gain, neonatal birth weight and the incidence rates of maternal and neonatal complication was decreased in case of treatment. CONCLUSION: Incidence of maternal complication and perinatal complication was higher in pregestaional diabetes mellitus compared with gestational diabetes mellitus, so strict control of blood glucose level and education for diabetes mellitus were essential before gestation. And the proper treatment of gestational DM was necessary because maternal weight gain during pregnancy, neonatal birth weight and the maternal and neonatal complication were affected by treatment.
Subject(s)
Female , Humans , Pregnancy , Birth Weight , Blood Glucose , Diabetes Mellitus , Diabetes, Gestational , Education , Gynecology , Hyperbilirubinemia , Hypertension , Hypertension, Pregnancy-Induced , Hypoglycemia , Incidence , Insulin , Korea , Medical Records , Obstetrics , Parturition , Polyhydramnios , Pyelonephritis , Retrospective Studies , Shoulder , Weight GainABSTRACT
OBJECTIVE: The objectives of this study were to obtain information on MIS levels in normal and RDS neonates and to investigate the relationship between the RDS prevalence and MIS level in preterm and term neonates. METHODS: Total 131 male neonates were selected randomly and they were consisted of 50 term normal neonates, 15 term neonates with RDS, 50 prematurely born normal neonates, and 16 prematurely born neonates with RDS. Total 131 female neonates were also selected like male neonates. The venous blood was collected from all subjects and measured the level of MIS using ELISA. The ANCOVA was conducted to evaluate any influence of adjusted value of gestational age and body weight on MIS level between normal neonates and neonates with RDS. RESULTS: 1) The MIS levels of female neonates were significantly lower than those of male neonates with no overlap. 2) The MIS levels of normal female neonates were not significantly different from those of female neonates with RDS. 3) There were significant negative relationships between MIS concentration and gestational age (r=-0.777, p<0.001), and birth weight(r=-0.728, p<0.001) in normal rnale neonates. 4) There were significant negative relationships between MIS concentration and gestational age (r=-0.726, p<0.001), and birth weight(r=-0.725, p<0.001) in male neonates with RDS. 5) After adjusting the value of gestational age, the MIS level of male neonates with RDS was significantly higher than that of normal male neonates(p<0.001). 6) After adjusting the value of body weight, the MIS level of male neonates with RDS was significantly higher than that of normal male neonates(p<0.001). CONCLUSION: Male neonates with RDS had higher MIS levels than normal male neonates of the same body weight or same calculated gestational age. The results of this study suggest that MIS may play a causative or important ancillary role in the sexual dimorphism that characterizes the neonatal RDS and may be used as a predictive marker of RDS in male neonates.
Subject(s)
Female , Humans , Infant, Newborn , Male , Anti-Mullerian Hormone , Body Weight , Enzyme-Linked Immunosorbent Assay , Gestational Age , Parturition , PrevalenceABSTRACT
Using 3D ultrasound, bilateral chylothorax was diagnosed antenatally in the second trimester. Apparently stable, bilateral pleural effusion progressed rapidly to severe hydrops with facial edema during observation, and then we decided bilateral pleural-amniotic shunt operation. Here we present a case where drainage of pleural effusion by a double reverse pig tail stent made by ourself was achieved, although placement of the thoracoamniotic shunt resulted in near complete drainage of bilateral pleural effusion with normalization of intrathoracic anatomic relationships, subsequent resolution of fetal hydrops, but the ultimate outcome was unsuccessful due to the internalization of one catheter and unknown sudden death. We think that ongoing research is required to further evaluation about complications associated with this procedure, specifically failure of function due to obstruction, migration of the catheter,