A Case of Limb-body Wall Complex / 대한산부인과학회잡지

Limb-body wall complex, also known short umbilical cord syndrome and body stalk anomaly, is a complex set of disruptive abnormalities consisting of failure of ventral body wall to close, short umbilical cord, disruption of lateral body wall, distinctive scoliosis of spine, limb defects, facial defects and cranial defects. This disorder has similar findings to amnioitic band syndrome. but limb-body wall complex appears severe scoliosis of spine, herniation of internal organs, absent or short umbilical cord. Recently, we present a case of limb-body wall complex which found at 32+1 weeks. A case was diagnosed with ultrasonography, so we report a case of limb-body wall complex with brief review of literature.

Normal Variation and Predictive Value for Pregnancy Outcome of Fetal Heart Rate in the Early First Trimester / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to define the normal variation of fetal heart rate (FHR) and to analyze whether first-trimester fetal heart rate (FHR) are useful in predicting pregnancy outcome. METHODS: We prospectively studied 162 singleton pregnancies with gestational ages ranging from 5 to 10 weeks between Mar. 1999 and Jan. 2003 visting our hospital. Color doppler sonography was used to calculate the fetal heart rate in beats per minute as the mean of 3 waves. RESULTS: The following results were obtained. 1. Overall, 149 pregnancies reached viability and 13 resulted in fetal loss before 13 weeks' gestation. 2. A significantly higher number of viable pregnancies, compared with fetal losses, had FHR within one (73.1% compared with 38.5%, p<0.001) and two (94.6% compared with 69.2%, p<0.001) standard deviations of the mean for viable pregnancies at corresponding gestational ages. 3. A significant correlation was seen between gestational age and fetal heart rate (p<0.001). The regressing equation for heart rate was as follows: heart rate = 3.40 X gestational age (days)-30.15 (r = 0.87). 4. There was no significant difference in the fetal heart rates between male and female embryos during this early stage of pregnancy. CONCLUSION: First-trimester FHR can be helpful to predict pregnancy outcome. Women with FHR outside the reference range from the mean for viable pregnancies at corresponding gestational ages may be at risk for eventual pregnancy loss.

A Study of Successful Prognostic Factors in Vaginal Birth after Cesarean Sections / 대한산부인과학회잡지

OBJECTIVE: Recently, with rising rates of repeat cesarean sections, enormous amount of the studies about trial of labor after cesarean section have been reported to decrease the rate of cesarean section. The purpose of this study is to provide data regarding the safety and the successful prognostic factors of VBAC (vaginal birth after cesarean section). METHODS: This retrospective study was performed based on 194 pregnant women who tried vaginal delivery after cesarean section at Eulji University Hospital from March 1997 to February 2002. The age of mother, gestational age, estimated fetal body weight by ultrasonography, neonatal body weight, cervical effacement, cervical dilatation, Bishop score, the number of previous vaginal delivery, and spontaneous labor were analyzed between successful group (177 patients) and failure group (17 patients) with trial of labor. Student T-test and Chi-square test were used for statistical analysis. RESULTS: 177 cases (91.24%) in 194 cases succeeded in VBAC and 17 cases (8.76%) failed. There was no maternal death or uterine rupture in the cases of trial of labor. The gestational age, estimated fetal body weight by ultrasonography, neonatal body weight, cervical effacement, cervical dilatation, Bishop score, the number of previous vaginal delivery, spontaneous labor had notable differences between the successful group and the failure group. But, There was no significant difference in maternal age. CONCLUSION: The trial of labor after cesarean section is relatively safe method of delivery if it is performed under strict indication. Above findings can be used as possible prognostic factors for the success of VBAC and may reduce the risk and complication of VBAC. The following studies with large populations and performed by multi-centers will be needed for the evaluation of safety and successful prognostic factors of VBAC.