Early prediction of birth weight percentile and large for gestational age fetuses using gestation-adjusted projection of estimated fetal weight / 대한산부인과학회잡지

OBJECTIVE: To evaluate the accuracy of predicted birth weight percentile and large for gestational age(LGA) fetuses by the gestation-adjusted projection method using estimated fetal weight. METHODS: From 462 low-risk pregnancies with singleton fetus, fetal biometry including fetal biparietal diameter(BPD), head circumference(HC), abdominal circumference(AC), and femur length(FL) was made from 30 weeks of gestation until term. Estimated fetal weight(EFW) by combinations of fetal biometry were made by Campbell, Hadlock1, Hadlock2, and Shepard formulas respectively. The diagnostic accuracy according to 4 formulas was assessed by correlation between EFW percentile and birth weight percentile, prediction of LGA fetuses, and prediction error(percentile difference between birth weight and EFW). RESULTS: The mean gestational age on ultrasound and on birth, and birth weight were 33.21 +/- 2.08(30-40) weeks, 38.43 +/- 1.72(30-42) weeks, and 3.14 +/- 0.47(0.99-4.38) Kg, respectively. The diagnostic accuracies of gestation-projection method using EFW were similar result to predict birth weight percentile and LGA fetuses according to 4 formulas. Correlation between EFW percentile and birth weight percentile(correlation coefficient, r) were Campbell: 0.644(p <0.001), Hadlock 1: 0.682(p <0.001), Hadlock 2: 0.681(p <0.001), Shepard: 0.638(p <0.001), respectively. Youden's index(sensitivity + specificity - 1) in prediction of LGA fetuses were Campbell: 0.532, Hadlock1: 0.525, Hadlock2: 0.520, Shepard: 0.549, respectively. Prediction error were Campbell: 18.14+/-16.56, Hadlock1: 16.19+/-14.35, Hadlock2: 16.10+/-14.29, Shepard: 19.68+/-17.00, respectively. The prediction error was increased according to increasing of lapse time(p <0.001), gestational weeks on ultrasound, and estimated fetal weight percentile, and decreasing birth weight percentile(p <0.001)(R square=0.411, (p <0.001). But, amniotic fluid index did not affect to prediction error(p=0.199). CONCLUSION: Our study presented relatively accurate prediction for birth weight percentile and LGA fetuses from remote sonographic examination. If LGA fetuses was suspected by antenatal ultrasound, adequate therapy and periodic observation are recommended for good perinatal outcome.

Fetal Cardiotocogram for Prediction of Adverse Neonatal Outcome in Thick Meconium Stained Pregnancy / 대한산부인과학회잡지

No abstract available.

A case of Varicella Infection during Pregnancy / 대한산부인과학회잡지

The varicella during pregnancy is rare. The incidence of varicella among pregnant women is about 5 in 10,000 pregnancies. In 1947, Laforet and Lynch were the first to describe an association between maternal varicella infection in early pregnancy and congenital anomalies in the offspring. the existence of a syndrome was first postulated by Srabstein et al(1974), Brunell(1983), Kotchmar(1984), and recently Higa et al.(1987) described most of the malfomations associated with maternal varicella infection. Varicella-Zoster viurs(VZV) infections acquired during pregnancy may result in serio us disease for both the mother and the fetus. The effects on maternal health can range from a mild chikenpox exanthem to servere life-theatenig illness often complicated by viral pneumonitis. The fetus may remain unaffected, but VZV infection during early pregnancy has been associated with a congeital syndrome including muliplie defects of the skin, limb, eyes, and brain. We reports our experience with a varicella during pregnancy with a brief literature review.