A Case of Fetal Anesthesia with Fentanyl for Thoracentesis of Fetal Pleural Effusion / 대한산부인과학회지

Fentanyl is an opiate-like, pain-killing drug. It was found in the 1950s and prescribed from the 1960s. Fentanyl shows its effect by acting on opiate-like receptors. This case was a case of a 24-year-old primiparous woman who was referred from local clinic due to fetal pleural effusion in the left lung on antenatal ultrasonographic examination at 32 weeks of gestational age. The amount of pleural effusion increased and fetal heart deviated to the right side. We injected fentanyl 2 microgram intramuscularly into the fetal left thigh under ultrasound-guide for fetal anesthesia at 34 weeks of gestational age. After 5 minutes, we inserted 22 gage spinal needle to the left pleural cavity and aspirated 50 mL pleural fluid under ultrasound-guided. After aspiration, follow-up was performed oat one week interval and there was no more pleural fluid until delivery. At gestational age 41 weeks, the fetus was delivered vaginally as a 3.2 kg, healthy male baby. This is a case of fentanyl injection to fetus as a fetal anesthesia during thoracentesis for fetal pleural effusion at gestational age 34 weeks, we think that fentanyl is useful drug for fetal anesthesia.

The Study about the change of Fetal Adrenal Gland Hormone during Pregnancy and Labor / 대한산부인과학회잡지

OBJECTIVE: Fetal adrenal gland hormone was known to have close association with fetal weight and labor pain in response to fetal stress. Our purpose was to analyze the correlation between cortisol, DHEA-S in cord blood and obstetric status of fetuses. METHODS: We collected cord blood samples from 60 neonates immediately after delivery of baby. Six cases were complicated by intrauterine growth restriction and fourteen patients were complicated by preeclampsia. We measured cortisol, DHEA-S levels by using the RIA commercial Kits for the ELISA. We performed statistic analysis of the data on the SPSS computer program. RESULTS: Cortisol was significantly higher in intrauterine growth restriction (23.4 +/- 16.2 microgram/dL) statistically than control group (13.7 +/- 9.5 microgram/dL) (P=0.022). Cortisol and DHEA-S had negative correlation each other (P=0.025). DHEA-S was significantly lower in intrauterine growth restriction (1202.2 +/- 1005.9 ng/ mL) than control group (1714.8 +/- 978.6 ng/mL) (P=0.01). DHEA-S had increased with advancing gestational age (P=0.03) and fetal weight (P=0). CONCLUSION: Cord blood cortisol level and DHEA-S level has close association with intrauterine growth restriction and negative correlation with each other.

Comparative Analysis of Multiplex PCR and Hybrid Capture System in the Detecttion of Human Papillomavirus in the Uterine Cervix / 대한산부인과학회잡지

OBJECTIVE: To compare the multiplex-PCR and hybrid capture methods for detection of Human papillomavirus (HPV) in uterine cervical swab samples. METHODS: This study determined the HPV infection and its risk group (subtype) in uterine cervical swab samples of 91 Korean women by HPV hybrid capture I and multiplex-PCR method. RESULTS: The prevalence of HPV infection determined by muliplex-PCR was more higher than by hybrid capture method I. Of 65 women with nonspecific uterine cervical lesions, the frequence of HPV-positivity was 14/65 (12 low-risk and 2 high-risk HPV) by hybrid capture method I and was 37/65 (34 low-risk and 3 high- risk HPV) by multiplex-PCR method, respectively. The frequence of high-risk HPV was 2/6 in LSIL, 7/14 in HSIL, 4/6 in uterine cervical cancer by hybrid capture method I, and was 2/6 in LSIL, 8/14 in HSIL, 4/6 in uterine cervical cancer by multiplex-PCR method. CONCLUSION: These results suggest that multiplex-PCR is more sensitive, simple and cost-effective technique than Hybrid-capture I in the detection of HPV infection in the uterine cervix.

Comparison of Use of Ultrasonic Surgical and Bipolar Coagulator System on Laparoscopic Assited Vaginal Hysterectomy / 대한산부인과학회잡지

OBJECTIVE: This study was to evaluate the effectiveness and value of Ultrasonic surgical system on Laparoscopic assited vaginal hysterectomy (LAVH). METHODS: Retrospective study of 42 cases of LAVH with bipolar coagulator and 85 cases of LAVH with ultrasonic surgical system in Dept of OB/GYN, Chosun University Hospital from January 2001 to December 2002 was carried out and postoperative results were compared between 2 methods. Statistical analysis was performed using x2 test and student t-test as appropriate. Statistical significance was defined as p<0.05. RESULTS: The mean age of patients (bipolar coagulator vs ultrasonic surgical system) was 49+/-3 vs 48+/-4 years. The mean operating time was 54+/-13 min vs 37+/-6 min. The mean weight of uterus was 320+/-135 g vs 315+/-121 g. The mean hemoglobin drop was 2.42+/-0.85 g/dL vs 1.97+/-0.74 g/dL. CONCLUSION: In case of LAVH of myoma or adenomyosis using bipolar coagulator or ultrasonic surgical system. The advantages of ultrasonic surgical system were shortening of operation time, less bleeding during operation and less smoke caused by high temperature coagulation.