A Case of False Positive Amniotic Fluid Acetylcholinestserase in One Fetus of Twin Pregnancy conceived by Intracytoplasmic Sperm Injection and Zygote Intrafallopian Tube Transfer / 대한주산의학회잡지

Maternal serum alpha-fetoprotein(MSAFP) has been a world wide screening test for open neural the tube defect. But elevation of MSAFP is related to not only neural tube defect, but also incorrect gestational age, congenital anomalies such as congenital nephrosis, esophageal and intestinal obstruction, low birth weight, oligohydroamnios, fetal death and chromosomal anomalies. If MSAFP is elevated, gestational age, congenital anomalies such as neural tube defect, multiple pregnancy and fetal death must be evaluated by ultrasound. When the ultrasound is nondiagnostic, amniotic fluid AFP(AFAFP) levels are measured and if AFAFP is elevated, presence or absence of aetylchoineststarase(AChE) is determined to rule out the false positive of amniotic AFP. Amniotic AChE test yielded detection rate of open spina bifida of 99%, 98% for anecephaly and a false-positive rate of 0.34%. We report a case with elevated AFAFP and positive amniotic AChE result in one fetus of the twin pregnancy conceived by ICSI and ZIFT, but in which targeted ultrasound findings were normal, maintained the pregnancy to term and normal twin was delivered by elective cesarean section.

Acute Leukemia and Myelodysplasitc Syndrome During Pregnancy A Single Institutional Experience of 4 Cases / 대한산부인과학회잡지

We have reviewed the medical records of 4 pregnant patients with concomitant acute leukemia at our institution in conjunction with determining the delivery process in order to reduce complications associated with the delivery. Of the 4 patients, three cases were diagnosed as acute leukemia and the other as myelodysplastic syndrome. One experienced an incomplete abortion at gestational age of 10 weeks, after remission induction chemotherapy. The remaining three patients made delivery at full term by Cesarean section. Our observation indicated that Cesarean delivery was advisable for these three patients. Most of the patients had thrombocytopenia or anemia. Before the Cesarean section or dilatation or evacuation, transfusion was undertaken to prevent hemorrhage or severe anemia. In the cases of refractoriness to blood transfusion, a greater amount was transfused. After Cesarean section, some complications were reported such as fever, delayed wound repair, and vaginal bleeding. Based on the our observations, we are of the opinion that pregnant women with acute leukemia or myelodysplastic syndrome can be managed even in those cases where the state of leukemia is not in complete remission or chemotherapy-induced cytopenia is. And the proper measures are timely undertaken to prevent complications associated with delivery.

The Effect of Oral Administration of Postpartum Tonic Agent(MMQ) on Postpartum Anemia, Obesity and Uterine Involution furing Puerperium / 대한주산의학회잡지

OBJECTIVES: The purpose of this study was to evaluation the effect of administration of postpartumtonic agent(MMQ) on postpartum anemia during puerperal period, obesity control and uterine involution. SUBJECTS AND METHODS: From June 2002 to November 2002, twenty women who underwent spontaneous vaginal delivery at department of obstetrics and gynecology, college of medicine, Pochon CHA University ghopital were included in this study. All women were randomly assigned to receive postpartum tonic agent(MMQ, Albiomed Co.Ltd) or placebo two times a day after each meal for four weeks. They were assessed obesity test(BMI), hematologic examination(CBC, reticulocyte count), liver function test(AST/ALT) and ultrasound test at first day and 28th days after delivery. RESULTS: There was no statistically significant difference between the two group in demographic characteristics. No statistically significant difference were found in this study between the two group in hemoglobin, hematocrit, BMI and the size of uterus. There was no adverse effect to the tested drug. CONCLUSION: There was no significant difference in efficacy and safety between MMQ and placebo in the effect of postpartum anemia, obesity control and reduction of recovery perod. The following limitations have to be considered; Iron supplement, variable diet, seaweed ingestion, consumption of herb and small sample ize. Therefore, a extensive prospective study with control of these variables should be required.