The relationship of maturation value of vaginal epithelium and bone mineral density in postmenopausal women / 대한산부인과학회잡지

OBJECTIVE: To assess the relationship between vaginal cytology and bone mineral density in postmenopausal women. METHODS: In 93 postmenopausal women, vaginal cytology smears were taken for maturation index, serum estradiol level and bone mineral density were also taken. the percentage of each cell type found By vaginal cytology was multiplied to its specific value:superficial cells, 1.0; intermediate cell, 0.6; parabasal cell, 0.2 and modified to maturation value. Bone mineral density was measured at lumbar spine using DEXA. RESULTS: The mean bone mineral density was 0.88+/-0.14g/cm2. Mean maturation value was 50.53+/-20.74 and it was related with age and bone mineral density. CONCLUSION: Maturation value of vaginal epithelial cell represents the influence of estrogen on bone mineral density.

The Effect of transdermal estrogen on pulsatility index of internal carotid artery in postmenopausal women - Effect of estrogen on arterial tone / 대한산부인과학회잡지

OBJECTIVES: To evaluate the effect of transdermal estrogen on arterial tone. METHODS: In 30 postmenopausal women, doppler ultrasound was used to assess blood flow characteristics in internal carotid arteries. As the pulsatility index(PI) represents impedance to blood flow distal to the point of sampling, pulsatility index of internal carotid artery was measured from the flow velocity waveform. Patients were studied pretreatment and at weeks 8, 12, and 24 of treatment with transdermal estradiol 50microgram/day. RESULTS: Blood pressure was not changed during transdermal estrogen replacement therapy. Serum estradiol was increased from 13.4+/-13.7pg/ml to 55.8+/-32.8pg/ml with week 8 of treatment and it was maintained until week 24. The mean pulsatility index was fallen to 0.1+/-0.1 during week 8 of therapy and a significant reduction in PI was maintained until week 24(p=0.0001). CONCLUSION: We believe that transdermal estrogen replacement therapy affects on the arterial tone and prevents cardiovascular disease in postmenopausal women.

Computerized analysis of fetal heart rate after acoustic stimulation / 대한산부인과학회잡지

OBJECTIVES: The objectives of this study is to compare the differences of fetal heart rate (FHR) variables between preterm and term pregnancies after acoustic stimulation using computerized analysis of fetal heart rate. METHODS: Eighty-two normal pre-term and term pregnancies entered to this study after conventional 20-minutes nonstress test(NST) and 10-minutes acoustic stimulation test (AST). Acoustic stimulations were performed using Fetal Acoustic Stimulator (Model 146, Corometrics, US). We analyzed the FHR response after acoustic stimulation using our on-line computerized FHR analysis system, HYFM-I & II software. The changes of loss of signal, baseline FHR, variability, number of fetal movements, and number of FHR accelerations were analyzed numerically. RESULT: The mean baseline FHR was increased in term pregnancies from 141+/-7.0bpm to 152.7+/-9.7bpm, and in preterm pregnancies from 144.6+/-6.8bpm to 156.8+/-10.2bpm, respectively. The mean baseline FHR was significantly increased in both term and preterm pregnancies (p<0.01. paired t-test). The variability of FHR was increased in term pregnancies from 18.2+/-6.4bpm to 22.6+/-5.0bpm and in preterm pregnancies from 17.8+/-5.5bpm to 22.7+/-5.9bpm, respectively. The variability of FHR was also significantly increased in both term and preterm pregnancies. (p<0.01. paired t-test) CONCLUSION: The mean baseline FHR and the variability of FHR was significantly increased both preterm and term pregnancies. But the difference of each FHR variables between preterm pregnancies and term pregnancies was not statistically significant in this study.

The change of bone mineral density according to the duration of hormone replacement therapy and the characteristics of the patients in postmenopausal women / 대한산부인과학회잡지

OBJECTIVES: A retrospective study was performed to clarify the change of lumbar bone mineral density(BMD) according to the duration of hormone replacement therapy(HRT) and the other factors such as age, years since menopause(YSM) and initial BMD in postmenopausal women. METHODS: From January, 1995 to December, 1998 we measured lumbar bone mineral density in 100 postmenopausal women in the department of obstetrics and gynecology, Inha University Hospital. These women had been followed for 2 years after taking HRT. We investigated whether there were any relation between the duration of HRT, age, YSM, initial BMD and change of BMD. RESULTS: Lumbar BMD was increased 2.06% after one year of HRT(p=0.0001) but there was no change of BMD at the 2nd year of HRT(p=0.847). The response to HRT was greatest in those who were oldest(r=0.209 ; p=0.039) and furthest YSM(r=0.209; p=0.039), and consequently among those who had the lowest BMD(r=0.590 ; p=0.0001). CONCLUSION: The bone mass was increased upto 2.06% at the 1st year of HRT but no more progressive increase was occurred. It suggest that intensive HRT is needed at 1st year of therapy. The risk of fracture is not decreased to that of the healthy population inspite of HRT, so the earlier therapy is necessary to prevent osteoporotic fracture despite of intervention.

Control of Postpartum Bleeding by Rectal Misoprostols: A Report of 3 Cases / 대한산부인과학회잡지

Postpartum hemorrhage is an important cause of maternal mortality and morbidity. Especially uterine atony is the most common cause of postpartum hemorrhage. Conventional method to control postpartum uterine atonic bleeding is based on the use of oxytocin and ergot preparations. Prostaglandin F2alpha analogue such as carboprost can be used to promote contraction when these agents fail to produce uterine contraction. Prostaglandin E1 analogue, misoprostol has uterotonic effect by oral or vaginal administration. They are used to induce labor and first or mid trimester abortion. In postpartum uterine atonic bleeding, misoprostols cannot be used via oral or vaginal route. Recently we have experienced that postpartum uterine atonic bleedings unresponsive to conventional methods were controlled by rectal misoprostols. So we report these cases with a brief review of literatures.

Screening of high risk pregnancy using maternal serum triple markers / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to determine whether abnormal triple marker in the second trimester may be associated with adverse pregnancy outcomes. METHODS: Between November 1996 and April 1998, we evaluated 1,158 pregnant women undergoing second trimester triple marker screening tests who delivered at our hospital. The pregnancy outcomes of 48 women with false positive screens were compared with 1,158 screen negative controls. The pregnancy outcomes were obtained from hospital delivery records. RESULTS: Women with abnormal triple marker showed increased risks for low birth weight(p<0.01). But there was no significant differences between study and control groups with respect to preterm labor, pregnancy induced hypertension, oligohydroamnios, premature rupture of membrane, placenta previa, abruptio placenta, fetal death in utero. CONCLUSION: Abnormal triple marker in the second trimester was associated with low birth weight.