Uterine Torsion in Third Trimester Pregnancy / 대한주산의학회잡지

The preoperative diagnosis of uterine torsion is very difficult due to the rarity of this disorder and its nonspecific clinical course. A primigravida woman visited our hospital with severe abdominal pain at 34 weeks of gestation. Emergency cesarean section was carried out due to development of fetal distress and severe abdominal pain. During the cesarean section, we noticed the uterus was rotated 180 degrees and the torsion was corrected after the delivery by making a vertical incision at the posterior uterine wall. High degree of suspicion and prompt management are important factors contributing to good prognosis of uterine torsion.

Uterine Torsion in Third Trimester Pregnancy / 대한주산의학회잡지

The preoperative diagnosis of uterine torsion is very difficult due to the rarity of this disorder and its nonspecific clinical course. A primigravida woman visited our hospital with severe abdominal pain at 34 weeks of gestation. Emergency cesarean section was carried out due to development of fetal distress and severe abdominal pain. During the cesarean section, we noticed the uterus was rotated 180 degrees and the torsion was corrected after the delivery by making a vertical incision at the posterior uterine wall. High degree of suspicion and prompt management are important factors contributing to good prognosis of uterine torsion.

Complete septate uterus, obstructed hemivagina, and ipsilateral adnexal and renal agenesis in pregnancy

Most cases of double uterus with obstructed hemivagina and ipsilateral renal agenesis were diagnosed at adolescents after menarche. This is the first reported case of complete septate uterus with obstructed hemivagina and ipsilateral renal agenesis in addition to ipsilateral agenesis of fallopian tube and ovary in which the diagnosis was delayed until pregnancy. The pregnancy was uneventful in spite of intermittent vaginal spotting. During the cesarean section, the septum of the uterus was resected and about a 3-cmx3-cm window was made on the vaginal septum to allow an opening for the obstructed vaginal discharge. We followed the patient up for one and half years, and she has not had symptoms such as dysmenorrhea or abnormal vaginal bleeding.

Gene Expression Pattern of Human Chorion-Derived Mesenchymal Stem Cells during Adipogenic Differentiation

PURPOSE: The aim of this study was to identify the adipocyte-specific gene expression patterns in chorion-derived mesenchymal stem cells during adipogenic differentiation. MATERIALS AND METHODS: Chorionic cells were isolated from the third trimester chorions from human placenta at birth and identified morphologically and by fluorescence-activated cell sorting analysis. After inducing adipogenic differentiation for 28 days, cells at days 3, 10, 21 and 28 were analyzed by Oil red O staining and RNA extraction in order to assess the expression levels of adipocyte marker genes, including CCAAT-enhancer binding protein alpha (C/EBPalpha), peroxisome proliferator-activated receptor gamma (PPARgamma), fatty acid binding protein 4 (FABP4) and Glycerol-3-phosphate dehydrogenase (GPD2). Cells not induced for differentiation were compared with the induced cells as a control group. RESULTS: Chorion-derived cells showed the same pattern as fibroblasts, and expressed CD73, CD105, and CD166 antigens, but not CD45, CD34, and HLA-DR antigens. On day 3 after differentiation, cells began to stain positively upon Oil red O staining, and continuously increased in lipid granules for 4 weeks. The expression level of C/EBPalpha increased 4.6 fold on day 3 after induction, and continued to increase for 4 weeks. PPARgamma was expressed at a maximum of 2.9 fold on day 21. FABP4 and GPD2 were significantly expressed at 4.7- and 3.0-fold, respectively, on day 21, compared to controls, and further increased thereafter. CONCLUSION: Human chorion-derived mesenchymal stem cells exhibited the sequential expression pattern of adipocyte marker genes during differentiation, corresponding to adipogenesis.

Korean-Specific Parameter Models for Calculating the Risk of Down Syndrome in the Second Trimester of Pregnancy

The purpose of the current study was to propose a Korean-specific parameter set for calculating the risk of Down syndrome in the second trimester of pregnancy and to determine the screening performances of triple and quadruple tests in Korean women. Using the data on triple or quadruple screening from three hospitals in Korea during 7 yr, we re-converted the concentrations of four serum markers to multiple of median values according to gestational age and maternal weight. After re-calculating the risk of Down syndrome in each pregnancy by multiplying maternal age-specific risk by the likelihood ratio values for the serum markers, screening performances and optimal cut-off values of triple and quadruple tests were analyzed. Among 16,077 pregnancies, 23 cases had Down syndrome (1.4/1,000 deliveries). Compared to the previous program, the tests with new parameters had improved screening performance. The triple and quadruple tests had detection rates of 65.2% and 72.7%, respectively, at a false-positive rate of 5%. The optimal cut-off value for the quadruple and triple tests was 1:250. We have presented a Korean-specific parameter set for Down syndrome screening. The proposed screening test using this parameter set may improve the performance of Down syndrome screening for Korean women.

Pathologic Differences between Placentas from Intrauterine Growth Restriction Pregnancies with and without Absent or Reversed End Diastolic Velocity of Umbilical Arteries

BACKGROUND: Abnormal umbilical artery Doppler velocimetry is one of the important findings of intrauterine growth restriction (IUGR) and IUGR is associated with high perinatal morbidity and mortality. In addition, this abnormal Doppler velocimetry is correlated with placental insufficiency. The aim of this study was to determine the pathologic differences in the placentas from IUGR pregnancies with and without the absent or reversed end diastolic velocity (AREDV). METHODS: Among the cases that had undergone prenatal follow-up in our institute, a retrospective slide review was conducted for 18 cases of IUGR with AREDV and 17 cases with IUGR that had normal end-diastolic flow of the umbilical artery. RESULTS: The birth weight and the other clinical parameters were not different among the two groups. Grossly, the placental weight percentiles were significantly smaller in AREDV group when they were adjusted according to gestational age. Histologically, chronic deciduitis, mural hypertrophy of the decidual arteries, an intimal fibrin cushion of the large fetal vessels, increased syncytial knots, villous agglutinations, avascular villi, villous stromal-vascular karyorrhexis, and acute atherosis were more frequently found in the AREDV group and their presence showed statistical significance. CONCLUSIONS: These findings suggest that pathologic abnormalities due to fetal and maternal vasculopathies in the placenta may be the cornerstone for inducing AREDV in the umbilical artery.

The perinatal outcome of monoamniotic twin pregnancies / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to determine the perinatal outcome in monoamniotic twin pregnancies and to review the recently published literature about the topic. METHODS: This retrospective study examined the records of prenatally diagnosed monoamniotic twin pregnancy casese in our institution between January 1997 and April 2010. RESULTS: Among 1,112 twin pregnancies, there were 15 (1.3%) monoamnionic twins, including 2 conjoined twin pregnancies. Twelve (80%), 9 (60%), 5 (33.3%), and 4 pregnancies (26.7%) delivered after 20, 30, 32, and 34 weeks, respectively. Among 12 pregnancies that continued after 20 weeks of gestation, three cases showed one-fetal death and one, both-fetal death. The perinatal mortality rate (from 20 weeks of gestation to 28 days after birth) was 37.5%. The incidence of lethal anomalies and congenital heart anomalies was 20% and 23.3%, respectively. The mean gestational age at delivery was 31.4+/-4.53 weeks; 16 of 18 neonates (84.2%) were admitted to the neonatal intensive care unit (NICU). Three neonates expired on the first day after birth. The mean duration of the NICU stays for 13 live neonates was 32.0+/-29.3 days (range, 3 to 114 days). The main causes of perinatal deaths were preterm birth, congenital anomalies, pregnancy loss before 20 weeks, and intrauterine fetal demise that might have resulted form cord entanglement. CONCLUSION: Perinatal mortality in monoamniotic twins was still very high and the survival rate after 32 weeks of gestation is approximately one-third. Further studies are needed to improve the perinatal mortality.

Thoraco-omphalopagus conjoined twins diagnosed at 14 weeks of gestation / 대한산부인과학회지

Conjoined twins are very rare and the mortality rate of the fetus is extremely high. Early prenatal diagnosis is crucial, as it provides the opportunity for the mother and father to help in recognizing the conjunction of the twins and to help medical team in defining the prognosis of conjoined twins. We present a case of thoraco-omphalopagus conjoined twins diagnosed by two-dimensional and three-dimensional transabdominal sonography at 14(+2) weeks of gestation.

A successful pregnancy in patient with pulmonary hypertension associated with systemic lupus erythematosus / 대한산부인과학회지

Pulmonary hypertension is a rare and potentially life-threatening complication of Systemic lupus erythematosus (SLE), and 5 cases has been previously documented in pregnancy. Four cases died after delivery and only one case was alive. We describe the case of a 28-year-old pregnant woman with pulmonary hypertension related to SLE with no previous history of immunologic disease including SLE. Diagnosis was made at 22 weeks of gestation. Medication including prednisolone and hydroxychloroquinone was commenced immediately and continued throughout the pregnancy. On fetal sonogram, the fetal growth was 3~10 percentile and diastolic notch of uterine arteries was noted. However, a healthy baby girl weighing 2,400 g was born in planned vaginal delivery at gestation week 38. There were no postpartum complications.

Clinical course and obstetrical outcomes of 94 pregnancies in Korean patients with systemic lupus erythematosus (SLE) / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to assess the maternal and fetal outcomes in pregnant women with systemic lupus erythematosus (SLE) and to evaluate clinical and laboratory markers for preterm birth and lupus flares. METHODS: 94 pregnancies of 60 patients were retrospectively evaluated from Jan 1997 to Sep 2004. We used clinical and laboratory data from the medical records and statistics analysis by Chi-square test, using SPSS 15.0 V. RESULTS: Pregnancy resulted in 74 (78.7%) live births, 11 (11.7%) spontaneous abortions, 2 (2.1%) therapeutic abortion, and 4 (4.2%) stillbirths. Thirty-seven cases (47.4%) were delivered by cesarean section. Obstetric complications included 17.9% of preterm births, 26.9% of preeclampsia, and 20.5% of IUGR. There were 31 (39.7%) uncomplicated cases among the pregnancies over 20 gestational weeks. There were 12 of transient neonatal lupus, 2 of neonatal death due to prematurity, and 51 of normal births. Low C4, myocarditis, pleural effusion prior to pregnancy, activity at conception, antiphospholipid antibody syndrome were significantly associated with preterm birth. The maternal long-term effect of pregnancy was poor, because 44.7% were in deterioration of cardiovascular, hematologic or renal function after delivery. Lupus nephritis, proteinuria, hematuria, and activity at conception were significantly associated with lupus flare during pregnancy. CONCLUSION: Pregnant women with active SLE at conception should be intensively monitored with maternal and fetal surveillance. It is essential to control disease activity during pregnancy. However, adequate pregnancy follow-up and delivery care by multidisciplinary effort with experience in management of patients with SLE resulted in a better outcome of lupus pregnancy.

Perinatal outcome of term pregnancies with meconium-stained amniotic fluid / 대한주산의학회잡지

PURPOSE: The purpose of this study was to compare the obstetric and perinatal outcome between two groups with or without meconium staining of amniotic fluid (MSAF) at term birth in one-year consecutive population at our delivery unit. METHODS: Pregnancy complication including nonreassuring fetal heart rate pattern, intrauterine growth retardation, oligohydramnios, hydramnios and preeclampsia between the two groups were retrospectively documented by review of medical record. To evaluate the perinatal outcome, apgar score at 1min and 5min, and umbilical artery blood gas analysis were also analyzed. Student T test and chi square test were used for statistic analysis. RESULTS: The study population consisted of 687 full-term neonates with presence (n=89) and absence (n=598) of MSAF. Gestational age at delivery was significantly higher in the MSAF group (p12.0 mEq/L) was not increased. The incidence of non reassuring fetal heart rate pattern was also increased in the MSAF group (4.5% vs 1.0%, p=0.03). However there was no significant difference in 1 min and 5 min Apgar score. CONCLUSION: Although MSAF is associated with the risk of non reassuring fetal heart rate pattern and fetal acidemia, the metabolic acidemia and low apgar score at 5minutes was not significantly increased compared with clear amniotic fluid group. Delivery of pregnancy with MSAF should be managed under the careful fetal heart rate monitoring.

Expression of Tissue Tissue-transglutaminase-2 (TGM2) and Cyclo-oxygenase (COX) in the Fetal Membrane of Preterm Birth / 대한주산의학회잡지

BACKGROUND: Preterm labor accounts for one third of preterm deliveries. However, the causes and the mechanism of preterm labor are still under investigation. The purpose of this study was to investigate the changes of tissue transglutaminase 2 (TGM2) and cyclo-oxigenase I,II in the fetal membrane of patients with preterm birth compared with patients with term delivery. METHODS: Fetal membrane were obtained from women with preterm birth due to preterm labor (n=3) and from the women with term delivery (n=3) after each vaginal birth. The expression of TGM2, COX I & II were assessed by RT-PCR and immunoblotting analysis of the amnion and chorion. Nonparametric statistics were used for analysis. RESULTS: In the amnion in patients with preterm delivery, the expression of TGM2, COX I and COX II mRNA were increased by 2.3-fold, 2.7-fold, 1.3-fold, respectively, compared to term delivery with labor. The protein expression of TGM2 and COX I in these patients was increased in 1.9-fold and 2.1-fold but COX II protein expression showed no significant change, compared to term delivery with labor. In the chorion in patients with preterm delivery, the expression of TGM2, COX I and COX II mRNA showed no significant change, compared to term delivery with labor, but the protein concentration was significantly increased in 14.6-fold, 1.4-fold and 1.3-fold respectively, compared to term delivery with labor. CONCLUSION: This study shows that TMG2 and COX I are expressed more in the fetal membrane at preterm delivery caused by preterm labor, compared to term delivery with labor. These data suggests that the mechanism of preterm labor might be different form term labor.

The effect of oligohydramnios on the adverse perinatal outcome and clinical characteristics in uncomplicated term pregnancies / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to assess the effect of the isolated oligohydramnios on the perinatal outcome in uncomplicated term pregnancies. METHODS: We used data from Jan 2002 to Dec 2005 in all uncomplicated pregnancies between 37 and 41weeks and 6 days of gestation with a singleton fetus, underwent monitoring with serial determination of AFI. Oligohydramnios was defined by ultrasonographic determination of AFI < or =5 cm. Exclusion criteria were PROM, maternal medical complications and fetal anomalies detected by prenatal ultrasound. We investigated the mode of delivery, birth weight, birth weight <10th percentile, 1 and 5 min Apgar score, umbilical cord pH and base excess, and meconium stained amniotic fluid (MSAF). We also assessed the predictive value of obstetric factors associated with adverse perinatal outcome. We used statistics analysis by Chi-square test, independent-samples T test using SPSS 14.0 V. RESULTS: 2,491 patients met our inclusion criteria. Oligohydramnios was diagnosed in 8.63% (215/2,491). There was significantly difference in cesarean section for fetal distress between those with oligohydramnios vs. normal AFI (43.8% vs.4.1%). Patients with oligohydramnios had significantly lower SGA (15.3% vs. 5.7%), lower Apgar score at 1 min<7 (7.9% vs. 3.3%), and higher rate of MSAF (31.2% vs. 18.4%) than those with normal AFI. There were musculoskeletal abnormalities in 10/215 (4.6%) and urogenital abnomralites in 53/215 (24.6%). CONCLUSION: Isolated oligohydramnios in uncomplicated term pregnancies is associated with an increased adverse perinatal outcome. Nulliparity, advanced maternal age, MSAF, SGA, and lower BPP were significantly associated with the adverse perinatal outcomes.

Polymorphisms of matrix metalloproteinase-1 and -2 genes in the pregnant women with preterm premature rupture of membranes / 대한산부인과학회지

OBJECTIVE: To elucidate whether polymorphisms of matrix metalloproteinase (MMP)-1 and -2 promotor genes are associated with preterm delivery caused by preterm premature rupture of membranes (PPROM) in Korean pregnant women. METHODS: We conducted a case-control study of korean pregnant women admitted to our labor and delivery unit. PPROM group (n=31) was defined as women whom delivered before 37 weeks of gestation due to PPROM. Control group (n=291) included women who were delivered after 37 weeks of gestation and had no history of preterm delivery. Genomic DNA was extracted from maternal peripheral blood. Polymerase chain reaction (PCR) and direct sequencing were done to determine the genotype of MMP-1 promotor -1607 and MMP-2 promotor -1306 of each participant. Data was analyzed by 2-tailed unpaired t test, x2 test, odds ratio with 95% confidence interval (CI) using SPSS 10.0. RESULTS: The carrier rate of MMP-1*1G was significantly higher in the PPROM group than that in the control group (p=0.020; odds ratio 3.09, 95% CIl 1.14-8.35). The frequency of 1G allele of MMP-1 was also significantly higher in the PPROM group than that in the control group (p=0.011, odds ratio 1.97, 95% CI 1.16-3.36). There was, however, no significant difference in the carrier rate of genotype as well as in the allelic frequencies of MMP-2*T in PPROM group compared with the control group (p=0.430, odds ratio 1.48, 95% CIl 0.56-3.96; p=0.377, odds ratio 1.58, 95% CI 0.57-4.40). CONCLUSION: Our data suggest that polymorphism of MMP-1 promotor -1607 might be associated with PPROM in Korean pregnant women.

Association of polymorphism in the tumor necrotic factor-alpha (TNF-alpha) gene and interleukin-1beta (IL-1beta) gene with preterm delivery / 대한산부인과학회잡지

OBJECTIVE: To elucidate whether polymorphisms of tumor necrotic factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) are associated with preterm delivery caused by preterm labor and preterm premature rupture of membrane (PPROM) in korean pregnant women. METHODS: From August 2002 to October 2003, we recruited 93 pregnant women who delivered before 37 weeks in gestation. In 93 cases, there were 66 cases with preterm labor and 27 cases with PPROM. 288 pregnant women who delivered after 37 weeks in gestation served as controls. Maternal blood was collected and Genomic DNA was extracted from peripheral blood and the relevant genomic region was amplified using polymerase chain reaction (PCR). PCR products were digested with the restriction enzymes, Nco I for TNF-alpha and Ava I for IL-1beta. Data was analyzed by 2-tailed unpaired t test, x2 test, odds ratio with 95% confidence interval using SPSS 10.0. RESULTS: In normal pregnant group, the proportions of TNF-alpha*1/ TNF-alpha*1, TNF-alpha*1/ TNF-alpha*2, and TNF-alpha*2/ TNF-alpha*2 were 91%, 8%, and 1%, respectively. In normal pregnant group, the proportions of IL-1beta*A/IL-1beta*A, IL-1beta*A/IL-1beta*a, and IL-1beta*a/IL-1beta*a were 29%, 40%, and 31%,respectively. The carrier rate of TNF-alpha*2 was significantly different in PPROM group compared with control group (22% vs. 9%, P=0.03), while not in preterm labor group (15% vs. 9%, P=0.138). The allelic frequency of TNF-alpha*2 was significantly different neither in preterm labor group nor in PPROM group compared with control group (0.08 vs. 0.05, P=0.248; 0.11 vs. 0.5, P=0.062, respectively). The carrier rate of IL-1beta*a was significantly different neither in preterm labor group nor in PPROM group compared with control group (68% vs. 71%, P=0.671; 67% vs. 71%, P=0.65, respectively). The allelic frequency of IL-1beta*a was significantly different neither in preterm labor group nor in PPROM group compared with control group (0.44 vs 0.52, P=0.151; 0.52 vs. 0.52, P=0.512, respectively). CONCLUSION: These results suggest that TNF-alpha polymorphism may be, at least in part, associated with PPROM.

Clinical Study for Intrauterine Fetal Death / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate intrauterine fetal death and to elucidate the etiology of intrauterine fetal death. METHODS: This is a clinical study of 153 cases of fetal death in utero (FDIU) among 11,866 deliveries at Holy Family Hospital during Mar. 1995 to Feb. 2002. RESULTS: 1. The average incidence of FDIU was 1.29%. 2. The age distribution of mother with FDIU was between 16 to 45 year old and was highest in the 25 to 29 year old age group (45%). 3. The parity of mothers with FDIU was the highest in nulliparous group (58.5%) and there was a decreased tendency with high parity. 4. There were 80 cases (52.1%) with previous history of abortion and 8 cases (5.2%) with previous history of FDIU. 5. The highest incidence rate of FDIU was shown at 20~24 weeks of gestation (36.6%) and in the fetus weighted less than 1,000 gm (56%), and the sex ratio of male versus female fetus was 1.29:1. 6. The mode of delivery FDIU was labor induction (54.3%), laparotomy (15.2%), spontaneous labor (30.4%). The indication for laparotomy were placental abruption, previous cesarean section state, twin and maternal death. As the gestational age and fetal weight decreased, the mean time interval from start of labor induction to fetal expulsion and the variety of labor induction became increase. 7. The etiology factors of FDIU was unexplained causes (44%), congenital anomaly (17%), cord complication (14%) in order. CONCLUSION: The proper antenatal care should be taken of fetuses on the basis of risk factors of antepartum and intrapartum so that unnecessary intrauterine fetal death might be able to be prevented.

A Case of VACTERL Association Diagnosed by Autopsy / 대한주산의학회잡지

VACTERL association is occuring in conjuction with vertebral anomalies, anal atresia, cardiac abnormalities, tracheoesophageal fistula, renal agenesis and limb defects. Additional abnormalities may include microphthalmia, abnormal lung lobulation and spleen defects. We describe a infant born to consanguineous healthy parents with multiple congenital anomalies of the skeleton and internal organs. A woman at 25 weeks gestaion was transferred to our hospital due to abnormal antenatal sonographic finding(molded calvarium, huge mass in abdomen, hyperechoic intestine and femur bowing). She admitted to our hospital due to decreased fetal movement 3 weeks later. Fetal death in uterus was diagnosed by sonogram. Its phenotype displays imperforated anus, absence of genital organ, absence of utrethral opeining, disunion of maxilla and mandible, varus deformity of bilateral knee joints, widening of interphalangeal space in right foot. The diagnosis was confirmed by clinical features, radiological findings, and autopsy. We reported this case of VACTERL association with review of literatures.

Dyslipidemia in Preeclampsia / 대한주산의학회잡지

No abstract available.

Influence of Hepatocyte Growth Factor on Matrix Metalloproteinase Expression in HT cell line / 대한산부인과학회잡지

OBJECTIVE: This study was performed to investigate the influence of hepatocyte growth factor (HGF) on matrix metalloproteinase (MMP), which are related in the lysis process of tissue during the invasion of trophoblasts. METHOD: HT cell line was treated with recombinant HGF (rHGF) of different concentration (0, 10, 50 and 100 ng/mL) and was cultured for 24 hours to check the changes in the expression of MMP-2 and MMP-9. Also, HT cell line was treated with recombinant HGF 50 ng/mL and was cultured for 24, 36, 48, and 72 hours to check the changes in the expression of MMPs according to the different time span. Total RNA were extracted from each cultured sample and RT-PCR and Western blotting were used to analyze the expression of MMP-2 and MMP-9. RESULTS: MMP-2 mRNA expression with treated rHGF showed increase of 2, 2.5 and 2.2 times with the increase of concentration level of 10, 50 and 100 ng/mL accordingly, while MMP-2 protein expression were increased 1.4 and 1.5 times in 50 ng/mL and 100 ng/mL of rHGF respectively compared with that of normal control. MMP-9 mRNA showed no significant changes in its expression with all different levels of concentration, while MMP-9 protein showed 1.5 times increase with 10 ng/mL rHGF but 0.4 times decrease with 100 ng/mL. MMP-2 mRNA expression treated with recombinat HGF were increased 1.6 times with 24 hour culture and 2.3 times with 36 hour culture. MMP-2 protein showed 1.9 times increase only for the case of 24 hour culture. MMP-9 mRNA expression of recombinant HGF-treated groups was decreased 0.7 times compared with that of control group in 36 hours. MMP-9 protein expression were increased by 1.2, 1.6 and 1.9 times as culture time increase to 36, 48, and 72 hours accordingly, compared with that of normal control. CONCLUSION: This result suggests that the HGF might partially regulate the invasion of trophoblasts through MMP-2 and MMP-9.

Influence of Hepatocyte Growth Factor on Matrix Metalloproteinase Expression in HT cell line / 대한산부인과학회잡지

OBJECTIVE: This study was performed to investigate the influence of hepatocyte growth factor (HGF) on matrix metalloproteinase (MMP), which are related in the lysis process of tissue during the invasion of trophoblasts. METHOD: HT cell line was treated with recombinant HGF (rHGF) of different concentration (0, 10, 50 and 100 ng/mL) and was cultured for 24 hours to check the changes in the expression of MMP-2 and MMP-9. Also, HT cell line was treated with recombinant HGF 50 ng/mL and was cultured for 24, 36, 48, and 72 hours to check the changes in the expression of MMPs according to the different time span. Total RNA were extracted from each cultured sample and RT-PCR and Western blotting were used to analyze the expression of MMP-2 and MMP-9. RESULTS: MMP-2 mRNA expression with treated rHGF showed increase of 2, 2.5 and 2.2 times with the increase of concentration level of 10, 50 and 100 ng/mL accordingly, while MMP-2 protein expression were increased 1.4 and 1.5 times in 50 ng/mL and 100 ng/mL of rHGF respectively compared with that of normal control. MMP-9 mRNA showed no significant changes in its expression with all different levels of concentration, while MMP-9 protein showed 1.5 times increase with 10 ng/mL rHGF but 0.4 times decrease with 100 ng/mL. MMP-2 mRNA expression treated with recombinat HGF were increased 1.6 times with 24 hour culture and 2.3 times with 36 hour culture. MMP-2 protein showed 1.9 times increase only for the case of 24 hour culture. MMP-9 mRNA expression of recombinant HGF-treated groups was decreased 0.7 times compared with that of control group in 36 hours. MMP-9 protein expression were increased by 1.2, 1.6 and 1.9 times as culture time increase to 36, 48, and 72 hours accordingly, compared with that of normal control. CONCLUSION: This result suggests that the HGF might partially regulate the invasion of trophoblasts through MMP-2 and MMP-9.