Effect of electroacupuncture on lung dysplasia in rats with intrauterine growth restriction induced by maternal food restriction / 中国针灸

OBJECTIVE@#To investigate the protective effect of electroacupuncture (EA) at "Zusanli" (ST 36) in pregnant rats on lung dysplasia of newborn rats with intrauterine growth restriction (IUGR) induced by maternal food restriction.@*METHODS@#Twenty-four female SD rats were randomly divided into a control group, a control+EA group, a model group and a model+EA group, 6 rats in each group. From the 10th day into pregnancy to the time of delivery, the rats in the model group and the model+EA group were given with 50% dietary restriction to prepare IUGR model. From the 10th day into pregnancy to the time of delivery, the rats in the control+EA group and the model+EA group were treated with EA at bilateral "Zusanli" (ST 36), once a day. The body weight of offspring rats was measured at birth, and the body weight and lung weight of offspring rats were measured on the 21st day after birth. The lung function was measured by small animal lung function detection system; the lung tissue morphology was observed by HE staining; the content of peroxisome proliferator activated receptor γ (PPARγ) in lung tissue was detected by ELISA.@*RESULTS@#Compared with the control group, the body weight at birth as well as the body weight, lung weight, lung dynamic compliance (Cdyn) and PPARγ at 21 days after birth in the model group were significantly decreased (@*CONCLUSION@#EA at "Zusanli" (ST 36) may protect the lung function and lung histomorphology changes by regulating the level of PPARγ of lung in IUGR rats induced by maternal food restriction.

An Audit of Pregnancies complicated by Intrauterine Growth Restriction at Lautoka Hospital

Introduction@#IUGR is an obstetrical complication that is difficult to identify in order to allow intervention to lessen morbidity and mortality. The Lancet series on stillbirths highlighted the causes of stillbirths globally, identifying IUGR as one of the five major causes. IUGR has accounted for almost a third of all still births at Lautoka Hospital over the past three years. The aim of this study was to audit all pregnancies complicated by IUGR, the contributing risk factors and their outcomes at Lautoka Hospital from 1st January to 31st December 2016. @*Aim@#To conduct a retrospective audit of pregnancies complicated by IUGR at Lautoka Hospital from 1st January 2016 to 31st December 2016.@*Method@#This is a retrospective descriptive audit using clinical notes, conducted on 170 women diagnosed with IUGR in 2016. @*Results@#There were 4,131 deliveries during the study period; 191 patients of whom were diagnosed with IUGR of which 170 folders were retrieved. The Incidence rate of those diagnosed with IUGR during this period was 4.3%. Seventy percent of women with IUGR had low to normal Body Mass Index (BMI) and booked in the late second to third trimester. The risk of developing IUGR was significantly increased in Fijians of Indian Descent (FID) (RR 4, CI 2.9-5.3, p-value <0.0001); in primigravida (RR 4.1, CI 3.5 – 4.7, p-value <0.0001); and those with previously Low Birth Weight baby (LBW) (< 2500g) (RR 2.3, CI 1.67 – 3.26, p-value <0.0001). Anaemia or hypertension diagnosed during pregnancy significantly increased the risk of developing IUGR (RR 1.7, CI 1.3-2.40, p-value 0.0002) and (RR 2.6, CI 1.75 – 4.05, p-value <0.0001) respectively. Women with IUGR have a 6 times higher chance of having a Still Birth (SB) (RR 6.1, CI 3.78-9.92, p-value <0.0001); higher risk of Induction of Labour (RR 4.2, CI 3.65-5.64, p-value <0.0001) and caesarean section delivery (RR 2.1, CI 1.54-2.85, p-value <0.0001). Seventy eight percent of still births were delivered beyond 37 weeks, a possible delay, which could have been avoided potentially improving the SB rate. SB risk was significantly higher in those diagnosed at or > 37 weeks gestation compared to those with an earlier diagnosis (RR 1.61 95% CI 1.11 – 2.35, p value 0.05). @*Conclusion@#IUGR contributes significantly to still births. There were delays in diagnosis and appropriate surveillance to allow timely delivery at Lautoka Hospital, which could have reduced the still birth rate.

A case of mosaic ring chromosome 13 syndrome / 소아과

The clinical features of ring chromosome 13 include mental and growth retardation, CNS anomalies, facial dysmorphism, cardiac defects, genital malformations, limb anomalies, skeletal deformities and anal malformations. Although many cases of ring chromosome 13 have been reported worldwide, only 6 cases have been reported in Korea, and the latter cases were not mosaic but pure ring chromosome 13. Here we report a case with mosaic ring chromosome 13. The baby boy was born at 37 weeks of gestation by induced vaginal delivery due to intrauterine growth restriction (IUGR). He was the second baby of a 28-year-old hepatitis B carrier mother and a 32-year-old father. There was no family history of chromosomal anomalies. The baby was a symmetric IUGR with a birth weight of 1,860 g, length of 44.8 cm, and head circumference of 29.4 cm. The physical examination revealed microcephaly, trigonocephaly, flat occiput, large ears, short neck and dysmorphic facial features, including microophthalmia, hypertelorism, antimongoloid slanting palpebral fissures, a flat nasal bridge, and micrognathia. The karyotype of this patient performed by peripheral blood lymphocytes was 46,XY,r(13)(p13q34)/45,XY,-13/46,XY,dic r(13;13)(p13q34;p13q34). The baby showed failure to thrive, hypotonia, and developmental delay. We report the first case of mosaic ring chromosome 13 in a male baby in Korea and compare this case with other Korean cases of non-mosaic ring chromosome 13.

Prenatal diagnosis of a de novo ring chromosome 11

A 36-year-old pregnant woman was referred for amniocentesis at 19.5 weeks gestation because of advanced maternal age and evidence of increased risk for Edward syndrome in the maternal serum screening test. Cytogenetic analysis of the cultured amniotic fluid cells revealed mosaicism for ring chromosome 11: 46,XX,r(11)[65]/45,XX,-11[16]/46,XX[34]. Parental karyotypes were normal. A targeted ultrasound showed intrauterine growth restriction (IUGR). Cordocentesis was performed to characterize the ring chromosome and to rule out tissue specific mosaicism. Karyotype was confirmed as 46,XX,r(11) (p15.5q24.2)[229]/45,XX,-11[15]. And a few new form of ring were detected in this culture. The deletion of subtelomeric regions in the ring chromosome were detected by fluorescent in situ hybridization (FISH). The pregnancy was terminated. The fetal autopsy showed a growth-retarded female fetus with rocker bottom feet. We report a case of prenatally detected a de novo ring chromosome 11.