ABSTRACT
OBJECTIVE: We intended to know how the cryoprotectant ethylene glycol (EG) would affect the outcome of the embryo development when used in slow freezing method. And to know if there is any difference in the outcome of frozen-thawed embryos according to freezing methods and the timing. METHODS: We used 5-6 weeks old ICR female mice and T6 containing 0.4% BSA for basic culture media. The embryos at the developmental stages of 1-cell, 8-cell and blastocyst were cryopreserved respectively by slow freezing method using EG, propylene glycol (PROH), and glycerol as a cryoprotectant. We also compared the results of slow freezing and vitrification methods with the same cryoprotectant, EG. And finally, we evaluated the quality of blastocysts by counting the cell numbers in each group. RESULTS: The post-thaw embryo development were better in EG group when they were frozen at 1-cell and blastocyst stage (P<0.05). Although there were no differences in the recovery rate, the survival rate in vitrification group was significantly higher (P<0.05). Post-thaw embryo development to morula and blastocyst were better in vitrification group when frozen at 1-cell embryo (P<0.05), not at 8-cell and blastocyst group. The cell counts of blastocyst derived from 1-cell stage frozen EG group were significantly increased than that of PROH-glycerol groups (P<0.05), however, there was no difference between the two freezing methods. CONCLUSION: These results suggest that EG may be advantageous comparing with the conventional cryoprotectants, PROH and glycerol in slow freezing method for mouse embryo cryopreservation. In terms of freezing method, vitrification is better than slow freezing.
Subject(s)
Animals , Female , Humans , Mice , Pregnancy , Blastocyst , Cell Count , Cryopreservation , Culture Media , Embryonic Development , Embryonic Structures , Ethylene Glycol , Freezing , Glycerol , Morula , Propylene Glycol , Survival Rate , VitrificationABSTRACT
OBJECTIVE: Birth weight of the newborns is the major factor affecting maternal, childhood mortality and morbidity. The purpose of this study was to identify the effects of maternal weight gain and Body Mass Index (BMI) gain by trimester of pregnancy on birth weight of newborns. METHODS: The data of 73 women who delivered at our institute from March 2004 to June 2004 were analyzed. Maternal weight gain and BMI gain during pregnancy was calculated. Statistical analysis was done. RESULTS: The standardized woman in 1.6 m height had total 12.5 kg weight gain during pregnancy. The BMI was calculated. Women with total BMI gain over 4.88 were grouped in over BMI group. The BMI gain by trimester and gestational age of pregnancy were analyzed. Maternal BMI gain in the 3rd trimester of pregnancy influences more strongly newborns' weight than does in the 1st or 2nd trimester. CONCLUSION: We considered that maternal BMI gain during each trimester of pregnancy was a marker of newborns' weight gain.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , Body Mass Index , Gestational Age , Mortality , Parturition , Weight GainABSTRACT
The aim of this study was to establish a multi-center birth defects monitoring system to evaluate the prevalence and the serial occurrence of birth defects in Korea. Ten medical centers participated in this program. A trained nurse collected relevant records from delivery units and pediatric clinics in participating hospitals on a monthly basis. We observed 1,537 cases of birth defects among 86,622 deliveries, which included live births and stillbirths. The prevalence of birth defects was 1.8%, and the sex distribution of the birth defect cases was 55.2% male and 41.6% female. The highest proportion of birth defects was in the cardiovascular system (17.5%), followed by birth defects involving in the genitourinary system (15.6%). Chromosomal anomalies were detected 30.0 per 10,000 births. Of these chromosomal anomalies, Down syndrome was most frequently observed. This study led to an establishment of a multi-center active monitoring system for birth defects. To better understand the serial occurrence of birth defects in Korea, it is necessary to increase the number of participating hospitals and to launch on a nation-wide multi-center study.
Subject(s)
Child , Female , Humans , Male , Pregnancy , Congenital Abnormalities/epidemiology , Chromosome Aberrations , Korea/epidemiology , Population Surveillance , Pregnancy OutcomeABSTRACT
OBJECTIVE: To evaluate patients with adnexal masses that were managed surgically during pregnancy and their effect on fetal outcome. METHODS: The data were reviewed concerning pregnant women who required surgery at Samsung Cheil hospital between January 1996 to December 2001. Among 50,126 deliveries, 255 cases of ovarian tumors were evaluated for clinical aspects, histologic patterns, and obstetrics and fetal outcome. RESULTS: 1. The prevalence of ovarian mass in pregnancy was 0.5% (255 cases in 50,126 deliveries). 14 cases of malignant tumors were founded. 2. The maternal mean age was 28.7+/-3.6 years old, mean gavida was 1.8+/-1.1, and mean parity was 0.3+/-0.5. 3. The mean gestational weeks of diagnosis was 11.9+/-8.6 weeks. Prenatal operations were performed in 160 cases, and 95 cases of ovarian masses were operated at delivery time by cesarean section. 4. In the group of prenatal operation, preterm delivery and caesarian section rate were decreased at operation before 23 gestational weeks (P<0.05). 5. In 42 cases, Emergency operations were done. Mean delivery weeks was 36.7+/-7.2 weeks and was earlier than elective operation group (P<0.05). 6. The mean size of ovarian mass was 9.5+/-3.8 cm. The pathologic features of the 255 lesions were as follows: 98 benign cystic teratomas, 43 mucinous cystadenomas, 31 endometriomas, 20 serous cystadenomas, 14 simple cysts, 14 paraovarian cysts, 6 follicular cysts, 5 corpus luteal cysts, 5 theca luteal cysts, 3 hydrosalpinx, 2 fibromas, and 14 malignant tumors. 7. The 231 patients for whom the outcome of pregnancy was available, 18 (7%) gave birth before 37 weeks of gestation, while 3 (1.2%) experienced spontaneous abortions, 2 artificial abortions, and 1 hysterotomy. CONCLUSION: Most adnexal masses identified by sonography during pregnancy were small, simple cysts that did not pose a risk a pregnancy. However the percentage of malignant tumors or tumors of low malignant potential was 1.8 fold greater than previously reported. Surgical intervention at <23 weeks of gestation might have not been adverse outcomes.
Subject(s)
Female , Humans , Pregnancy , Abortion, Spontaneous , Cesarean Section , Cystadenoma, Mucinous , Cystadenoma, Serous , Diagnosis , Emergencies , Endometriosis , Fibroma , Follicular Cyst , Hysterotomy , Obstetrics , Parity , Parturition , Pregnant Women , Prevalence , TeratomaABSTRACT
OBJECTIVE: To evaluate planned pregnancy rate and associated factors related planned pregnancy. METHODS: We surveyed 1,396 cases from May 2002 to December 2002. The cases were derived from the Maternity school. They filled out questionnaire including planned pregnancy, medico-social-economic status. Then, we assessed the planned pregnancy rate with associated medico-social-economic state, through the prospective study. RESULTS: The planned pregnancy rate is 51.4%. The major factor which affected the planned pregnancy rate is the income of the family. The association with the planned pregnancy rate and the parity, age, and educational attainment of the women are not statistically significant. In unplanned group, exposure to alcohol, X-ray and medication is significantly increased in early pregnancy. CONCLUSION: The planned pregnancy can prevent induced abortion and reduce the birth defects due to early exposure to teratogen. Therefore it is important to make an effort to raise the planned pregnancy rate.
Subject(s)
Female , Humans , Pregnancy , Abortion, Induced , Congenital Abnormalities , Family Planning Services , Parity , Prospective StudiesABSTRACT
OBJECTIVE: To evaluate the relationship between increased nuchal translucency (NT) and abnormal pregnancy outcomes. METHODS: From January 1999 to December 2001, The 298 fetuses of increased nuchal translucency (>or=2.5 mm) in period of 10-14 weeks gestation were reviewed retrospectively. Amniocentesis and high resolution ultrasonography during second trimester were done for all cases. We analyzed septation within NT, karyotypes, structural anomalies, and adverse pregnancy outcomes such as spontaneous abortion, intrauterine fetal death and preterm delivery. RESULTS: The mean age of the patients was 30.5 +/- 3.5 years. The mean gestational age and CRL were 12.5 +/- 0.95 weeks and 6.5 +/- 1.15 mm. We observed 18 (6%) cases of abnormal karyotypes. 7/46 (15.2%) fetuses with internal septation had abnormal karyotype and 11/252 (4.4%) fetuses without internal septation had abnormal karyotype (p=0.013). Among the 280 fetuses with normal karyotype, 8 (2.8%) fetuses had structural anomalies and 18 (6.4%) fetuses had adverse pregnancy outcomes. The chromosomal abnormality and structural anomaly were significantly increased in the group of nuchal translucency thickness above 3.5 mm (p=0.001). CONCLUSION: Increased nuchal translucency is related with chromosomal abnormality and abnormal pregnancy outcomes.
Subject(s)
Female , Humans , Pregnancy , Abnormal Karyotype , Abortion, Spontaneous , Amniocentesis , Chromosome Aberrations , Fetal Death , Fetus , Gestational Age , Karyotype , Nuchal Translucency Measurement , Pregnancy Outcome , Pregnancy Trimester, Second , Retrospective Studies , UltrasonographyABSTRACT
Because of the widespread use of amniocentesis, the prenatal recognition of sex chromosome abnormality (SCA) has become increasingly common. Recent literature provided an insight into the understanding of the natural history and prognosis for individuals with SCA. Our study was designed to review the parental decision on pregnancy with SCA. Over the last 10 yr, we diagnosed 38 cases (0.50%) with SCA out of 7,498 prenatal cases. We reviewed the records and the results of the pregnancies. We included the cases (n=25) of apparently normal anatomic fetus to analyze the factors influencing parental decision. We excluded 13 cases with obvious anomaly or presumably bad outcome. Fifteen (60%) couples continued their pregnancies and ten (40%) terminated theirs. Nine couples (64%) out of fourteen mosaicism cases continued their pregnancies. All five pregnancies assisted by reproductive technique continued their pregnancies. More pregnancies were continued when counseling was done by an MD geneticist rather than by an obstetrician. A significant trend was observed with a higher rate of pregnancy continuation in recent years. The genetic counseling is important to give appropriate information to the parents. Establishing guidelines and protocols will help both obstetricians and parents to make a decision.
Subject(s)
Female , Humans , Male , Pregnancy , Chromosome Aberrations , Decision Making , Genetic Counseling , Parents , Prenatal Diagnosis , Sex ChromosomesABSTRACT
The major aneuploidies diagnosed prenatally involve the autosomes 13, 18, 21, and sex chromosomes X and Y. Fluorescence in situ hybridization (FISH) allows rapid analysis of chromosome copy number in interphase cells. We retrospectively reviewed 130 amniotic fluid interphase FISH analyses from January 1997 to December 2001. The review was done in order to assess the role of interphase FISH among the patients who were at the risk of fetal aneuploidies. The sample was considered to be aneuploid when 70% of or more than the total number of hybridized nuclei displayed the same abnormal hybridization pattern for a specific probe. All of 130 cases but one met the criteria. The results were considered as informative and they were obtained in 24-48 hr. The overall detection rate for aneuploidies was 100% (2 cases of trisomy 21, 2 cases of trisomy 18, and 1 case of Turner syndrome). In comparison to cytogenetics, the rates of both sensitivity and specificity were 100%. The experiment demonstrates that FISH can provide a rapid and accurate clinical method for prenatal identification of chromosome aneuploidies. The experiment can also serve as an adjunctive test to help cytogenetics to reduce significant amount of emotional stress of patients and physicians through early decision making process.
Subject(s)
Adult , Female , Humans , Male , Pregnancy , Amniocentesis , Amniotic Fluid/cytology , Aneuploidy , Chromosomes, Human/genetics , In Situ Hybridization, Fluorescence/methods , Interphase , Prenatal Diagnosis/methods , Retrospective Studies , Time FactorsABSTRACT
OBJECTIVE: The aim of this study was to evaluate the efficacy of laparoscopic uterosacral nerve ablation (LUNA) in infertile women with chronic pelvic pain and endometriosis. METHOD: Prospective randomized study was performed in 20 infertile women with endometriosis and chronic pelvic pain, who had undergone of laparoscopic uterosacral nerve ablation at Samsung Cheil hospital between April and September, 1998. Statistical analysis was perfomed using by DBSTAT (ver. 2.0). RESULT: The pelvic pain score of pre-operation was 3.72+/-1.07 (mean+/-SD) and it was significantly decreased to 1.83+/-0.85 at 1 month later and 1.93+/-0.92, 1.69+/-0.60, 1.56+/-0.62, 1.56+/-0.81 each in second, third, fourth and fifth month after operation. There was no correlation between pelvic pain and stage of endometriosis. Pregnancy rate was 65% after LUNA (twelve deliveries, one pregnancy is ongoing at IUP 24 weeks). CONCLUSION: Laparoscopic uterosacral nerve ablation would be effective for infertile women with endometriosis and pelvic pain.
Subject(s)
Female , Humans , Pregnancy , Endometriosis , Pelvic Pain , Pregnancy Rate , Prospective StudiesABSTRACT
OBJECTIVE: The aim of this study was to evaluate the efficacy of laparoscopic uterosacral nerve ablation (LUNA) in infertile women with chronic pelvic pain and endometriosis. METHOD: Prospective randomized study was performed in 20 infertile women with endometriosis and chronic pelvic pain, who had undergone of laparoscopic uterosacral nerve ablation at Samsung Cheil hospital between April and September, 1998. Statistical analysis was perfomed using by DBSTAT (ver. 2.0). RESULT: The pelvic pain score of pre-operation was 3.72+/-1.07 (mean+/-SD) and it was significantly decreased to 1.83+/-0.85 at 1 month later and 1.93+/-0.92, 1.69+/-0.60, 1.56+/-0.62, 1.56+/-0.81 each in second, third, fourth and fifth month after operation. There was no correlation between pelvic pain and stage of endometriosis. Pregnancy rate was 65% after LUNA (twelve deliveries, one pregnancy is ongoing at IUP 24 weeks). CONCLUSION: Laparoscopic uterosacral nerve ablation would be effective for infertile women with endometriosis and pelvic pain.
Subject(s)
Female , Humans , Pregnancy , Endometriosis , Pelvic Pain , Pregnancy Rate , Prospective StudiesABSTRACT
Congenital myotonic dystrophy is a severe and early-onset form of myotonic dystrophy (DM) with a prevalence of 2.5-5.5/100,000 live births. Expansion of the trinucleotide CTG repeat in the 3 untranslated region of the DM gene, which is located at a chromosome 19q13.3 is a common mutation in DM. Clinical features are generalized hypotonia (floppy infant), respiratory and feeding difficulty, and the neonatal mortality rate is approximately 40%. We experienced a case of recurrent congenital myotonic dystrophy, and report with a review of related literatures. Women with recurrent neonatal hypotonia or ultrasonographic evidence of hypotonia, including positional abnormalities of the extremities and idiopathic polyhydramnios, should be offered testing for the genetic studies for myotonic mutation, such as PCR (Polymerase chain reaction) analysis and Southern blot analysis.
Subject(s)
Female , Humans , Infant , Blotting, Southern , Diagnosis , Extremities , Infant Mortality , Live Birth , Muscle Hypotonia , Myotonic Dystrophy , Polyhydramnios , Polymerase Chain Reaction , Prenatal Diagnosis , Prevalence , Untranslated RegionsABSTRACT
Congenital myotonic dystrophy is a severe and early-onset form of myotonic dystrophy (DM) with a prevalence of 2.5-5.5/100,000 live births. Expansion of the trinucleotide CTG repeat in the 3 untranslated region of the DM gene, which is located at a chromosome 19q13.3 is a common mutation in DM. Clinical features are generalized hypotonia (floppy infant), respiratory and feeding difficulty, and the neonatal mortality rate is approximately 40%. We experienced a case of recurrent congenital myotonic dystrophy, and report with a review of related literatures. Women with recurrent neonatal hypotonia or ultrasonographic evidence of hypotonia, including positional abnormalities of the extremities and idiopathic polyhydramnios, should be offered testing for the genetic studies for myotonic mutation, such as PCR (Polymerase chain reaction) analysis and Southern blot analysis.
Subject(s)
Female , Humans , Infant , Blotting, Southern , Diagnosis , Extremities , Infant Mortality , Live Birth , Muscle Hypotonia , Myotonic Dystrophy , Polyhydramnios , Polymerase Chain Reaction , Prenatal Diagnosis , Prevalence , Untranslated RegionsABSTRACT
OBJECTIVE: To evaluate the recent trend of indication for pregnancy termination. METHOD: From 1993 to 2000, 1,087 cases of termination out of 61,842 cases of deliveries in Samsung cheil hospital were analyzed. We reviewed retrospectively the data-base and charts of delivery, and analyzed the indication for pregnancy termination. RESULTS: Among 61,842 cases of deliveries, indications of pregnancy termination were fetal structure anomalies in 399 cases (0.7%), IUFD in 261 cases (0.4%), PROM in 215 cases (0.4%), chromosomal anomalies in 138 cases (0.2%), anhydroamnios in 32 cases (0.05%), rubella infection of mother or fetus in 24 cases (0.04%), and others in 20 cases (0.03%). Autopsy was performed in 242 cases of fetal anomalies (60.7%), 116 cases of UIFD (44%), and 59 cases of fetal chromosomal abnormalities (43%). The cases of chromosomal anomaly as indication of termination increased and rubella infection of mother or fetus decreased recently, and it is statistically significant r=0.95(P=0.00) and r=-0.73(P=0.04). The fetal weight terminated due to PROM is significantly decreased (Y=517-26 x year P=0.002). CONCLUSION: The indications of termination for fetal chromosomal abnormalities were increased, but for rubella infections were decreased. In cases of PROM, the terminated fetal weight were significantly decreased. However, no change was observed in cases of fetal anomaly, IUFD,and PROM.
Subject(s)
Humans , Pregnancy , Autopsy , Chromosome Aberrations , Fetal Weight , Fetus , Mothers , Retrospective Studies , RubellaABSTRACT
A case of intermediate differentiated Sertoli-Leydig cell tumor with elevated Alpha-fetoprotein (AFP) levels occurred in a 15-year-old girl. No germ cell component and no heterologous elements were identified. Secretion of AFP by Sertoli-Leydig cell tumor has rarely been mentioned previously, and its mechanism is difficult to explain. We present this case with review of related literatures.