Computerized analysis of fetal heart rate in normal term pregnant women categorized by birth weight and fetal sex / 대한주산의학회잡지

PURPOSE: The objective of this study is to compare the difference of each fetal heart rate (FHR) variables between each categorized group according to birth weight and fetal sex using computerized analysis system of fetal heart rate. METHODS: Non stress test (NST) of four hundred normal pregnant women were grouped based on birth weight to 4 groups, <2,500 g, 2,500~<3000 g, 3,000~<3,500 g and above 3,500 g. Fifty male and 50 female babies entered to each group. So, 100 normal pregnant women entered for the study in each group. For collection and analysis of data and values of each variables, our own FHR interpretation sofware, HYFM-II (Windows version 1.0) was used. RESULT: From the comparison between each group classified by each criteria, there were no specific significant differences in baseline FHR, FHR variability (amplitude & mean minute range), signal loss rate, number of fetal movements, the number of FHR acceleration & the number of FHR deceleration those were obtained by our computerized FHR analysis system. CONCLUSION: We confirm that there were no specific differences in each FHR varibles according to birth weight and fetal sex at least in term normal pregnancy.

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.

Variables of Fetal Heart Rate and Neonatal Outcome according to Fetal Sex / 대한산부인과학회잡지

OBJECTIVE: The differences between two fetal sexes have been a matter of great concern from ancient times to present day. This study was initiated to research the varying fetal behaviors which would differ according to the fetal sex. METHODS: With every 1,500 cases of each fetal sex selected, the patterns which the varying factors related to FHR and prognosis of neonates in normal pregnancy were compared by means of Factor Analysis (a linear method). Canonical Ensemble was performed to compare the relationship of intrauterine fetal behavioral developments, and neonatal prognosis of each fetal sex. And whether the different types of the fetal sex would have influence also on the chaotic behavior was analyzed by the methods of linear Power Spectrum of FHR and Approximate Enthropy. RESULTS: The consequences of Factor Analysis showed that it is Apgar score on the factor 1 axis, and signal loss on the factor 2 axis in the case of male babies. In the case of female babies it is Apgar score on the factor 1 axis, and fetal movement on the factor 2 axis. Speaking of the specific value regarding FHR, male babies displayed higher frequency only in terms of fetal movement sign than female babies (p=0.0394). No other differences between two fetal sexes in abnormal findings were indicated (p>0.05). Among the babies at 30~33 weeks' gestation female babies were more likely to reveal higher Canonical Ensemble (male=0.41+/-0.05, female=0.05+/-0.04; p=0.00411), whereas male babies have a higher Approximate Entropy (male=0.926+/-0.01, female=0.871+/-0.01; p=0.0037). However Power Spectrum Analysis indicated that there were no significant differences as I compared LF/HF (p>0.05), the ratio of LF and HF of two fetal sexes, and same result was also drawn by Power Low beta-slope (p>0.05). CONCLUSION: The linear patterns of the FHR signal from the fetus suggest that there is no variables resulting from the type of fetal sex, except for the fetal movement frequency and the height and weight of neonates. The sympathetic and parasympathetic balance of both fetal sexes also showed a similar development pattern. In the mean time the differences which could be visible were made among the male and female babies specifically at 30~33 weeks' gestation. This may correspond to the fact that the lung maturation of the female fetus is completed before the third trimester of pregnancy, and the male fetus after the period, and finally the differences between the fetal sexes generally become insignificant toward term.

A study on the relationship of leptin concentrations in the maternal plasma and cord blood to fetal weight in term normal-pregnant and preeclampsia women / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.

A study on the relationship of leptin concentrations in the maternal plasma and cord blood to fetal weight in term normal-pregnant and preeclampsia women / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.

Comparison of three methods for DNA extraction from amniotic fluid for fetal sex determination by multiplex polymerase chain reaction (PCR).

The objective of this study was to compare three methods used for amniotic fluid DNA extraction. These methods were: Proteinase K/Phenol-Chloroform, Proteinase K/7.5M Guanidine-HCl and DNAzolา BD Reagent. Ten samples of uncontaminated amniotic obtained by amniocentesis performed in mothers with advanced maternal age for detection of fetal chromosome abnormality were studied. Each sample was divided into three tubes, 1 ml placed in each, and DNA extraction was performed by all three methods. The quality and quantity of DNA extracted by each method were compared by electrophoresis on 3% agarose gel and spectrophotometric study at 260 & 280 nm. The DNA obtained was subsequently used for fetal sex determination by multiplex PCR method. The primers used for multiplex PCR were specific for X and Y chromosomes. Accuracy of fetal sex determination was compared with the results from amniocyte culture and the sex at birth. The results showed that DNA extracted by DNAzolาBD Reagent was 100% accurate when used to determine fetal sex by PCR; eight samples on 1st PCR and the other two on repeat PCR. DNA extracted by Proteinase K/7.5M Guanidine-HCl also yielded 100% accuracy in fetal sex determination; seven samples on 1st PCR, two samples on 2nd PCR and one sample needed 3rd PCR. The Proteinase K/Phenol-Choroform method yielded only 90% accuracy and one sample failed to determine fetal sex after having repeated PCR three times. The extraction method which gave the maximum amount of DNA was the Proteinase K/Phenol-Chloroform one but the failed to give 100% accuracy in determining fetal sex. The method which produced the least protein contamination was DNAzolฎBD Reagent and gave 100% accuracy in determining fetal sex with smallest number of PCR reactions. In conclusion, DNAzolฎBD reagent method is relatively rapid for amniotic fluid DNA extraction with high accuracy for fetal sex determination but when large amount of DNA is also needed for other purposes, Proteinase K/Phenol-Chlorofrom is recommended as the method of choice.

Correlation of Leptin Level between Maternal and Umbilical Cord Plasma in Normal Pregnancy and Preeclanpsia / 대한주산의학회잡지

OBJECTIVE: We investigated the effect of preeclampsia, birth weight, fetal sex, maternal body mass index(BMI) on cord blood leptin concentrations. This study is to test whether leptin would be increased in preeclampsia and to test cord leptin concentrations for correlation with maternal leptin concentrations. METHOD: Maternal blood samples were obtained from 56 normal pregnancies and 24 preeclampsia women prior to delivery. Umbilical cord blood were obtained from the all cases studied immediately after delivery. The total leptin levels were determined by radioimmunoassay. RESULTS: Mean maternal leptin level was 16.4+/-6.4ng/ml in normal pregnancy and was 19.4+/-7.9 ng/ml in preeclampsia. Mean cord leptin level was 5.4+/- 3.4ng/ml in normal pregnancy and 4.6+/-3.2ng/ml in preecalmpsia. Mean cord blood leptin level in female fetus was 6.6+/-3.7ng/ml and 4.8+/-2.8ng/ml in male fetus. CONCLUSION: This study shows that there are correlation with leptin level and fetal birth weight, body mass index, and fetal gender. Furthermore, physiologic role and mechanism of leptin of maternal serum and umbilical cord would be studied.

Factors that Influence MSAFP Concentration at Late Normal Singleton Pregnancies / 대한산부인과학회잡지

This study was purosed to investigate maternal and fetal clinical parameters effecting on maternal serum alpha-fetoprotein(MSAFP) levels at late normal singleton pregnancies. The subjects of this study were 171 pregnant women with gestational age of 36 to 42 weeks, and didn`t have any medical or gynecologic diseases. They delivered fetuses within three days after blood test of MSAFP. MSAFP levels were measured by enzyme-immunoassay. The analysed clinical parameters included fetal sex, fetal weight, gestatioal age, maternal age, gravidity, parity, maternal weight and maternal total weight gain during pregnancy. The results were as follows: At uncomplicated late pregnancies, 1. Male fetus bearers had higher MSAFP(mean: 191.8 ng/ml, SD: 80.8 ng/ml, n=79) than female-fetus bearers(mean 153.6 ng/ml, SD 73.0 ng/ml, n=92)(p=0.0014). 2. Multiparas had higher MSAFP(mean: 192.7 ng/ml, SD: 77.9 ng/ml, n=80) than nulliparas(mean: 152.3 ng/ml, SD 75.1 ng/ml, n=91)(p=0.0007). 3. MSAFP did not have correlation with maternal age, maternal weight, maternal total wight gain during pregnancy, gestational age, fetal weight. According to the above results, fetal sex and parity are the factors that influences MSAFP levels at uncomplicated late pregnancies. So MSAFP values should be interpreted with cautions.

Prenatal fetal sex determination from maternal peripheral blood using polymerase chain reaction

We have investigated the use of a nested polymerase chain reaction(PCR) assay with Y-specific sequence from the DYS 14 locus on the short arm of Y-chromosome for prenatal sex determination in the peripheral blood of 22 pregnant women who participated in the antenatal genetic diagnosis program. The sensitivity and specificity of the nested PCR using DYS 14 locus primers(Y1.5,Y1.6, and Y1.7,Y1.8) were 76.4% and 55.5%, respectively. In terms of gestational age, positive predictive values of 66.6%, 66.6%, and 80% were obtained for the first, second, and third trimester respectively. The corresponding negative predictive values were 50%, 50%, and 100% respectively. Male specific band was positive in three of the six cases of female bearing women and male specific band was negative in three of the seven cases of male bearing women during 9-16 gestational weeks showing low sensitivity. But all cases except one show the male specific band during the male fetus and all female fetuses did not show the male specific 198 base pair band during 18 approximately 40 gestational weeks. This study suggests that prenatal sex determination by PCR employing maternal peripheral blood was usually possible in late pregnancy but less reliable in early pregnancy. It seems that if we used a method separating fetal cells from maternal blood and then run PCR on these cells with DYS 14 locus primers we could make a fairly accurate fetal sex determination.