Surgical way of pregnancy termination for patients with placenta previa during midtrimester / 局解手术学杂志

Objective To investigate the effect of rivanol induction on pregnancy termination for patients with placenta previa during midtrimester.Methods From January 2010 to December 2015,16 patients of placenta previa underwent pregnancy termination induced by rivanol during midtrimester were regarded as the observation group, and 22 patients with normal placental position were regarded as the control group.The delivery time,amount of postpartum hemorrhage within 24 hours,one-time success rate of induced abortion,caesarean due to massive haemorrhage and postoperative infection of the two groups were recorded to analyze the clinical effect of rivanol.Results There was no statistically significant differences in the success rate,delivery time and caesarean due to massive haemorrhage between the two groups(P>0.05).The amount of intrapartum and postpartum hemorrhage in the observation group was more than that of the control group,with a statistically significant difference(P<0.05),but it was less than 500 mL,which did not significantly increase the related risk for patients.Conclusion Induced abortion by rivanol is a simple,safe and effective method for patients with placenta previa during midtrimester with fewer side effects and less trauma,which is the preferred method for such patients.

A comparative study of ethacridine lactate with vaginal misoprostol versus vaginal misoprostol alone for mid trimester abortion

Introduction: Mid-trimester termination of pregnancy is one of the most controversial areas of gynaecological practice. It has moral, emotional, social and technical issues. There is continuous need for termination of pregnancy in second trimester, more recently due to increase in the use of antenatal diagnostic procedures. The objective of the present study is to compare acceptability, safety, efficacy, complications and induction-abortion interval of ethacridine lactate with vaginal misoprostol versus vaginal misoprostol alone for mid trimester abortion Materials and methods: This was a comparative study s200 women of 13-20 weeks pregnancy were randomized in two groups. Out of these 100 patients were selected at random for intravaginal misoprostol 400 μg stat followed by 200 μg misoprostol P/V 4th hourly and 100 cases for extra amniotic ethacridine lactate instillation with tablet misoprostol 400 μg Stat followed by tablet misoprostol 200 μg 4th hourly. The relative efficacy, induction- abortion interval, complications of each was studied. Results: The patients studied belong to all categories of marital status, married, and unmarried, widowed. The age ranged from 15-34 years. The gestational age from 14-20 weeks most of them were primi para. Mean induction abortion interval with misoprostol is 15.2 hours while that of emcredil with misoprostol is 16.44 hours. Success rate with misoprostol is 94% while that of emcredil with misoprostol is 95%. Incomplete abortion with misoprostol 2% while that of emcredil with misoprostol 1%. No major complications are noted in both the methods. Yashvardhini Siddareddy, Himabindu Sangabathula. A comparative study of ethacridine lactate with vaginal misoprostol versus vaginal misoprostol alone for mid trimester abortion. IAIM, 2017; 4(6): 38-44. Page 39 Conclusion: Misoprostol is safer, more effective and acceptable than ethacridine for mid trimester termination of pregnancy

Maternal Characteristics, Short Mid-Trimester Cervical Length, and Preterm Delivery

We aimed to determine the maternal characteristics (demographics, an obstetric history, and prior cervical excisional procedure) associated with a short mid-trimester cervical length (CL, defined as a CL of ≤ 25 mm) and whether having a short cervix explains the association between these maternal characteristics and spontaneous preterm delivery (SPTD, defined as a delivery before 34 weeks). This is a single-center retrospective cohort study of 3,296 consecutive women with a singleton pregnancy who underwent routine CL measurement between 20 and 24 weeks. Data were collected on maternal age, weight, height, parity, obstetric history (nulliparity; a history of at least 1 SPTD; and at least 1 term birth and no preterm birth [low-risk history group]), and prior cervical excisional procedure. In the multivariate regression analysis, an obstetric history, prior cervical excisional procedure, and gestational age at measurement were the variables significantly associated with short CL. In contrast, maternal weight, height, age, and parity were not significantly associated with short CL. By using the likelihood of SPTD as an outcome variable, logistic regression indicated that short CL and obstetric history, but not prior cervical excisional procedure, were significantly associated with SPTD after adjustment for potential confounders. A history of SPTD and prior cervical excisional procedure were associated with an increased risk of a short mid-trimester CL. A history of SPTD, but not prior cervical excisional procedure, is associated with an increased risk of SPTD, independent of a short CL.

A Case of Idiopathic Acute Hepatitis with Complications in Mid-Trimester Pregnancy

Although liver diseases in pregnancy are rare, they can seriously affect mother and fetus. Although any type of liver disease can develop during pregnancy, it is difficult to identify features of liver disease in pregnant women because of physiological changes. Physiologic changes of pregnancy can be confounding with the symptoms of liver diseases. It can not only complicate mother's life but also burden life of fetus to growth restriction. We describe an uncommon case of acute hepatitis with disseminated intravascular coagulation and clinical chorioamnionitis coincidentally in mid-trimester pregnancy. She experienced the development of acute hepatitis of unknown causes. She presented with fever, maternal tachycardia, and fetal tachycardia. We decided termination of pregnancy because of 16 weeks' gestation. After termination, she was managed about acute hepatitis. So we report our case with a brief reviews of the literature.

Concentrations of cytokines in the mid-trimester amniotic fluid of normal pregnancy / 医学研究生学报

Objective The concentration of cytokines in the amniotic fluid ( AF) may reflect the immune state of maternal-fetal interface .This study aimed to investigate the level of inflammation -related cytokines in the mid-trimester AF of normal pregnant women. Methods This study included 263 pregnant women undergoing mid-trimester genetic amniocentesis , and all of them had normal pregnancy outcomes .Using MILLIPLEX MAP and Luminex, we measured the concentrations of interleukin IL-10, IL-1β, IL-6, monocyte chemotactic MCP-1, and tumor necrosis factor TNF-αin the AF collected from the women at 18-22 +6 weeks′gesta-tion.We analyzed the correlation of their concentrations with maternal age , gestational age , and fetal gender by rank sum test . Results The median concentrations of IL-10, IL-1β, IL-6, MCP-1, and TNF-αin AF at mid-trimester were 7.91, 0.97, 78.15, 1 135.57, and 8.47 pg/mL, respectively.The levels of IL-10 and IL-1βwere higher in the pregnancies with male fetuses than in those with female fetuses (8.54 and 1.18 pg/mL vs 7.72 and 0.85 pg/mL, P=0.043 and 0.008).Maternal age or gestational week at the mid-trimester exhibited no influence on the concentrations of the 5 cytokines. Conclusion The levels of IL-10, IL-1β, IL-6, MCP-1 and TNF-αremain stable in AF at mid-trimester and the former 2 are higher in pregnancies with male fetuses .

A case of heterotopic pregnancy: 16 weeks of intrauterine pregnancy with fetal Edwards syndrome and tubal pregnancy, following IVF-ET / 대한산부인과학회지

Heterotopic pregnancy is defined as coexistence of intrauterine and ectopic pregnancy. The reported incidence of heterotopic pregnancy, which is normally rare, is particularly high (1%) after IVF treatment. It is important to have a high index of suspicion for the occurrence of heterotopic pregnancies because only 40% to 84% of cases can be diagnosed with transvaginal ultrasound at the initial presentation. Edwards syndrome occurs in 8,000 newborns and the incidence is much higher in elderly gravidas. We report a case of heterotopic pregnancy following IVF-ET resulting in 16 weeks of intrauterine pregnancy with fetal Edwards syndrome, and tubal pregnancy with a brief review of literature.

The normal range of amniotic fluid alpha-fetoprotein in singleton midtrimester pregnancy of Korean women / 대한산부인과학회지

OBJECTIVE: To determine normal range of amniotic fluid alpha-fetoprotein (AFAFP) in midtrimester singleton Korean pregnant women whose pregnancy and neonatal outcomes were uneventful. METHODS: AFAFP levels were measured in midtrimester pregnancy during amniocentesis from May 1995 to September 2006 at tertiary referral center. Normal ranges were obtained from 954 singleton pregnancies in which pregnancy and neonatal outcomes were normal. RESULTS: Median values of AFAFP in midtrimester pregnancy were 15,800 ng/mL, 13,903.9 ng/mL, 11,408.7 ng/mL, 9,690.1 ng/mL, 6,923.4 ng/mL, 6,330.0 ng/mL, 5,295.3 ng/mL, 4,421.2 ng/mL, 3,162.5 ng/mL at 16 week, 17 week, 18 week, 19 week, 20 week, 21 week, 22 week, 23 week, and 24 week. CONCLUSION: The normal range of AFAFP level in each gestational week in Korean women could be a good reference for prenatal diagnosis of various disorders.

Cytogenetic and Clinical Analysis in 3,537 Cases of Midtrimester Amniocentesis / 대한주산의학회잡지

OBJECTIVE: To analyze the incidence of chromosomal abnormalities according to age and indications in midtrimester amniocentesis performed for prenatal genetic diagnosis. METHODS: We retrospectively analyzed the results of 3,537 cases of midtrimester prenatal genetic amniocentesis which were performed from 1994 to June 2006 in the cytogenetic laboratory at Pusan National University Hospital. RESULTS: Of the 3,537 midtrimester amniocentesis cases, the most common maternal age group was 25~29 years old (32.8%), followed by 30-34 years old (32.1%) and 35~39 years old (24.3%). The indications for amniocentesis were abnormal triple test (42.6%), advanced maternal age (31.8%), family history of chromosomal abnormality (7.0%), in the respective order. The overall incidence of chromosomal abnormalities was 5.0%, of which numerical abnormalities and structural abnormalities were 2.4% and 2.6%, respectively. Chromosomal abnormalities were most frequently found in the maternal age over 45 (16.7%), followed by 40~44 years old (6.3%) and 25~29 years old (5.6%). According to the indications of amniocentesis, chromosomal abnormalities were found in patients with habitual abortion (21.2%), previous history of chromosomal abnormality (14.3%), abnormal finding on ultrasonography (11.5%) and advanced maternal age (5.7%), in the respective order. CONCLUSION: In this study, in addition to although abnormal triple test and advanced maternal age as important indications of midtrimester amniocentesis for prenatal diagnosis, other indications such as habitual abortion, previous history of chromosomal abnormality and abnormal finding on ultrasonography should be considered important as indications of midtrimester amniocentesis.

Clinical and cytogenetic analysis of midtrimester amniocentesis / 대한산부인과학회지

OBJECTIVE: To analyze clinical data based on prenatal genetic amniocentesis. METHODS: We analyzed retrospectively maternal age, gestational age, indications, cytogenetic results and complications, based on a total of 496 cases of midtrimester prenatal genetic amniocentesis performed at Sungkyunkwan University School of Medicine, Kangbuk Samsung hospital from March 2000 to May 2005. RESULTS: The most common age of total subjects was between 35-39 years (37.1%). The indications of amniocentesis were abnormal maternal serum marker (39.72%), advanced maternal age (35.89%), abnormal ultrasonographic finding (5.04%), combined old age and abnormal maternal serum marker (4.23%), in order. Since 2000, the number of amniocentesis due to abnormal ultrasonographic finding was increased. The overall incidence of chromosomal abnormalities were 6.05% (30/496). There was no significant difference between maternal age and abnormal fetal karyotype. According to indications, there was 7.11% (14/197) of chromosomal abnormalities in abnormal maternal serum screening group, 1.69% (3/178) in advanced maternal age group and 22.22% (6/27) in abnormal ultrasonographic finding group. CONCLUSION: Abnormal maternal serum marker and advanced maternal age were the most common indication. There were frequent chromosomal abnormalities in combined old age and abnormal maternal serum marker group and abnormal ultrasonographic finding group.

Cytogenetic Analysis in 3,503 Cases of Midtrimester Amniocentesis: CUMC Experience (II) / 대한산부인과학회잡지

OBJECTIVE: To analyze chromosomal abnormalities according to patient's age and indications of patients in midtrimester amniocentesis for prenatal genetic diagnosis. METHODS: We retrospectively analyzed 3,503 cases of midtrimester prenatal genetic amniocentesis cases which were done in the cytogenetic laboratory at Kangnam St. Mary's Hospital, Catholic University Medical College. RESULTS: In 3,503 cases, the most common maternal and gestational age distributions were 35 to 39 years old and 17 to 17 week 6 days (32.2% and 21.5%, respectively). Abnormal maternal serum markers was the most common indication for amniocentesis (46.4%), and followed by advanced maternal age (40.3%) and abnormal ultrasonographic findings (3.2%). The overall incidence of chromosomal abnormalities was 180 cases (5.1%), of which numerical abnormalities and structural abnormalities were 78 cases (2.2%) and 102 cases (2.9%), respectively. Among the autosomal abnormalities, Down syndrome was most common (33 cases, 0.9%), and followed by Edward syndrome (17 cases, 0.5%). Among the sex chromosomal abnormalities, 45,X was the most common (6 cases, 0.2%). Chromosomal abnormalities were most frequently noted in the maternal age 18-19 years old (14.3%), 40 to 44 years old (7.0%), 25 to 29 years old (6.1%), 30 to 34 years old (5.2%), and followed by 20 to 24 years old (4.1%). On the other hand, chromosomal abnormalities were most frequently noted in abnormal ultrasonographic findings (12.4%), previous history of aneuploidy (8.3%), and followed by family history of aneuploidy (7.0%). CONCLUSION: This study suggested that although advanced maternal age is still important indication in midtrimester amniocentesis for prenatal diagnosis, abnormal maternal serum markers and ultrasonographic findings might be also important as indications. Therefore, they should be considered in prenatal genetic counseling.

A Comparative Study of Oral and Vaginal Misoprostol Administration in Mid-trimester Pregnancy Termination / 대한산부인과학회잡지

OBJECTIVE: To compare the effectiveness of oral misoprostol with vaginal misoprostol administration in mid-trimester pregnancy termination after pretreatment with serial laminarias tenting. METHODS: This study was made in 50 patients for mid-trimester pregnancy termination at Department of Obstetrics and Gynecology, Chonbuk National University Hospital from January 1999 through December 2002. Twenty five women received misoprostol orally in a dose of 200 micro gram every hour for 3 doses followed by 400 micro gram every 4 hours after serial laminarias tenting. Twenty five women received misoprostol vaginally in a dose of 400 micro gram every 4 hours after serial laminarias tenting. Side effects of drug, induction to delivery interval, delivery numbers within 24 hours, curettage numbers for retained placenta, and the length of hospital stay were compared. RESULTS: The mean time of induction to delivery interval was significantly shorter in the vaginal group (15.5 +/- 12.7 vs 24.2 +/- 14.3 hours, p<0.01). The length of hospital stay was also shorter in the vaginal group (38.9 +/- 13.1 vs 47.2 +/- 14.5 hours, p<0.01). The number of patients delivered within 24 hours was more in the vaginal group (92 vs 72%, p<0.05). The side effects of misoprostol were slightly more common in the oral group than the vaginal group without statistical significance. CONCLUSION: We suspect that after serial tenting of laminarias, intravaginal misoprostol appears to be more safe and effective than oral misoprostol for mid-trimester termination.

Cytogenetic Analysis in 785 Cases of Midtrimester Amniocentesis Using In Situ Coverslip Culture / 대한산부인과학회잡지

OBJECTIVE: Amniocentesis is the most commonly used invasive method for prenatal diagnosis of genetic disorders. We performed this study to analyze the indications, distributions of maternal age and cytogenetic results of midtrimester amniocentesis. METHODS: We retrospectively analyzed 785 cases of midtrimester prenatal genetic amniocentesis which were performed in the cytogenetics laboratory using in situ coverslip culture at Dong-A University Hospital from January 1995 to March 2003. RESULTS: Amniocentesis was practiced mostly from 15 weeks to 20 weeks of gestational ages. Requested indications of amniocentesis were abnormal maternal serum screening (421, 53.7%), advanced maternal age (233, 29.7%) and abnormal ultrasonographic finding (61, 7.8%) in the order of decrease. The overall incidence of chromosome abnormalities was 5.1% (40 cases), and it contains 27 cases (3.4%) of numerical abnormalities and 13 cases (1.7%) of structural abnormalities. Among autosomal abnormalities Down syndrome was most common (13 cases) and followed by Edward syndrome (2 cases). Of the sex chromosomal abnormalities, three cases of Turner syndrome and three cases of Kleinefelter syndrome were found. Chromosomal abnormalities were most frequently noted in the maternal age of 30 to 34 years old (14 cases, 35.0%), 25 to 29 years old (12 cases, 30.0%), followed by 35 to 39 years old (7 cases, 17.5%). The frequency of pseudomosaicism were 5 cases (0.6%). CONCLUSION: Maternal serum screening, advanced maternal age and antenatal ultrasonographic finding must be important screening methods for amniocentesis which is considered to the most effective diagnostic procecdure for prenatal cytogenetic studies. I conclude that the karyotyping analysis of midtrimester amniocentesis is efficacious method for detection of chromosomal aberration and genetic counselling for parents.

Clinical Analysis of 501 Cases of Mid-trimester Genetic Amniocentesis / 대한산부인과학회잡지

OBJECTIVE: To analyze the change of indications and chromosomal abnormalities according to pateint's age and indications in midtrimester genetic amniocentesis. METHODS: This study reviewed 501 prenatal genetic amniocentesis cases from June 1995 to April 2004 which were done at Presbyterian Medical Center. We analized the changes of the indication, age distribution and chromosomal results according to maternal age and indications of amniocentesis. RESULTS: In 501 cases, the most common maternal and gestational age distributions were 30-34 years old and 17 weeks (32.54% and 25.98%, respectively). Abnormal maternal serum markers were the most common indications for amniocentesis (46.9%), and followed by old age (24.96%), combined old age and abnormal maternal serum screening (14.38%), ultrasonographic abnormality (4.60%). The overall incidence of chromosomal abnormalities were 3.79% (19 cases), of which numerical abnormalities and structural abnormalities were 1.79% (9 cases) and 2.0% (10 cases), respectively. In autosomal disorders, Down syndrome 4 cases, translocation 3 cases, mosaicism 2 cases, deletion 1case were diagnosed. In sex chromosomal disorders, Turner syndrome 1 case and mosaicism 2 cases (Turner syndrome 1 case, Triple X chromosome 1 case) were diagnosed. No statistic significance was found among different age groups. Those who had ultrasonographic abnormalities were found to have correlation with chromosomal abnormalities than other indications. CONCLUSION: Among the several indications for prenatal cytogenetic diagnosis, ultrasonographic abnormalities and abnormal maternal serum markers might be important indications. Especially, ultrasonographic abnormalities could be the most predictive markers for abnormal fetal karyotypes.

A Clinical Study of Midtrimester Amniocentesis / 대한주산의학회잡지

OBJECTIVE: The objective of this study was to analyze the distributions of maternal age, the indications, cytogenetic results and the safety of 334 cases of midtrimester amniocentesis. METHODS: We reviewed retrospectively 334 cases of midtrimester genetic aminiocentesis which were performed in Pusanpaik Hospital, Inje University from February 1996 to January 2003. The distributions of maternal and gestational age, the indications, chromosomal results, the correlation between age and results of chromosomal analysis, the correlation between the indications and results of chromosomal analysis, and the risks and complications of the procedure were analyzed. RESULTS: The most common indication for amniocentesis was abnormal results of maternal serum screenings (46.4%) and which was followed by advanced maternal age (>or=35) (40.1%), previous history of fetal congenital or chromosomal abnomalies (6.3%), abnormal ultrasonographic findings (3.9%). The overall incidence of chromosomal aberration was 2.4% (8 cases) and which was composed of 0.9% (3 cases) of numerical aberrations and 1.2% (4 cases) of structural aberration and 0.3% (1 case) of both numerical and structural aberration. Although there was no statistical significance, the chromosomal aberrations were more commonly detected in the patients aged before 35 years old than in the patients aged above 35 years old (3.5% vs 0.8%) (P>0.05). The incidence of chromosomal aberrations according to indications had no statistical significance (P>0.05). There were three cases (0.9%) of complications, one case of pregnancy loss (0.3%) and 2 other procedure-related complications (1 case of amniotic fluid leakage and 1 case of vaginal bleeding). CONCLUSION: Midtrimester amniocentesis is relatively effective and safe invasive diagnostic procedure for prenatal cytogenetic studies. Although advanced old age (>or=35) is still important indication in midtrimester amniocentesis, abnormal results of maternal serum marker, ultrasonographic findings, and other abnormal conditions might be important indications because of many cases of chromosomal aberrations detected in younger age.

Ultrasound Measurement of Korean Fetal Growth Parameters by Gestational Age in Midtrimester Pregnancy / 대한산부인과학회잡지

OBJECTIVE: This study was done to formulate Korean fetal biometry charts of midtrimester presenting percentile values as a function of gestational age. METHODS: The relationships between the ultrasound measurement of 5 fetal parameters (biparietal diameter, head circumference, abdominal circumference, femur length, transverse cerebellar diameter) and nuchal skinfold thickness and menstrual age were determined by a cross-sectional study. The study group consisted of 215 normal healthy pregnant Korean women with known last menstrual period and regular menstrual period who had been performed genetic amniocentesis at our hospital and for whom complete pregnancy outcome information was available. All ultrasound examination was performed by one expert examiner. For each of the 5 parameters, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles were determined. RESULTS: Ready-to-use fetal measurement charts in midtrimester are presented in a format giving the percentile values as a function of gestational age. CONCLUSION: These fetal biometry charts, obtained from midtrimester, Korean women can be used as a reference value.

Cytogenetic Aberration Analysis of Midtrimester Amniotic Fluid / 대한산부인과학회잡지

OBJECTIVE: To analyze cytogenetic results of prenatal genetic amniocentesis. METHODS: From January 1997 to December 2000, We analyzed 1,390 cases of midtrimester amniocentesis which were done at Gil medical center of Gachon medical school according to its indications and maternal age. RESULTS: Chromosomal aberrations were found in 88 cases (6.3%). Of all our chromosomal aberrations, 29 cases (2.1%) of normal variants and 59 cases (4.2%) of abnormal karyotypes were found. 37 cases of autosomal numerical abnormal karyotypes and 7 cases of sex chromosomal abnormal karyotypes were diagnosed. In abnormal karyotype group, the incidence was high after 40 years of maternal age and in abnormal ultrasound findings, but no such correlations were found in normal variant group. CONCLUSION: In analysis of midtrimester amniocentesis, it would be better to analyze separately abnormal karyotype group and normal variant group.

A Review of Prenatal Cytogenetic Analysis in 2942 Midtrimester Amniocentesis / 대한산부인과학회잡지

OBJECTIVES: To analyze 2942 cases of prenatal genetic amniocentesis with their cytogenetic results. METHODS: This study reviewed 2942 genetic amniocentesis results which were perfomed at Ilsin Christian Hospital from 1993 to 1999, as prenatal genetic diagnosis for the possibility of chromosomal abnormality of fetus. Age distribution, gestational weeks, indications of amniocentesis and cytogenetic results were the key factors for the analysis. RESULTS: Maternal ages were ranged from 20 to 45, mostly 25-39. Of indications of prenatal genetic amniocentesis, abnormal maternal serum marker was the most common(57.9%) and followed by advanced maternal age(29.3%). The frequency of abnormal karyotypes was 3.1%(90/2942). Down syndrome(trisomy 21) and inversion of chromosome were found at 0.8%(24/2942) and 1.0%(30/2942). The incidence of abnormal karyotype according to indication had statistical significance in family history and abnormal ultrasonographic findings.(p<0.001) CONCLUSIONS: Midtrimester genetic amniocentesis is an important diagnostic tool in prenatal genetic diagnosis. In addition to the maternal serum markers and maternal ages, complete family history takings and ultrasonograms should be considered in prenatal genetic counseling.

Cytogenetic Analysis in 1,565 Cases of Midtrimester Amniocentesis: CUMC Experience(I) / 대한산부인과학회잡지

OBJECTIVES: To analyze chromosomal abnormalities according to patient's age and indications of patients in midtrimester amniocentesis for prenatal genetic diagnosis. METHODS: We retrospectively analyzed 1,565 cases of midtrimester prenatal genetic amniocentesis cases which were done in the cytogenetics laboratory at Kangnam St. Hospital, Catholic University Medical College from November1997 to May 2000. RESULTS: In 1,565 cases, the most common maternal and gestational age distributions were 35 to 39 years old and 17 to 17+6 weeks (32.78% and 21.47%, respectively). Abnormal maternal serum markers were the most common indication for amniocentesis (43.64%), and followed by advanced maternal age (40.45%) and abnormal ultrasonographic findings (3.64%). The overall incidence of chromosomal abnormalities was 4.47% (70 cases), of which numerical abnormalities and structural abnormalities were 1.86% (29 cases) and 2.61% (41 cases), respectively. Among the autosomal abnormalities, Down syndrome was most common (10 cases, 0.65%), and followed by Edward syndrome (9 cases, 0.59%). Among the sex chromosomal abnormalities, both of 47,XXX and 47,XXY were most common (3 cases, 0.20%, respectively). Chromosomal abnormalities were most frequently noted in the maternal age of 25 to 29 years old (5.10%), 30 to 34 years old (4.82%), 40 to 44 years old (4.31%), and followed by 35 to 39 years old (3.90%). On the other hand, chromosomal abnormalities were most frequently noted in abnormal ultrasonographic findings (7.02%), previous history of aneuploidy (5.88%), and followed by advanced maternal age (3.95%). CONCLUSION: This study suggested that although advanced maternal age is still important indication in midtrimester amniocentesis for prenatal diagnosis, abnormal maternal serum markers and ultrasonographic findings might be also important as indications. Therefore, they should be considered in prenatal genetic counseling.

Two Cases of Amnioinfusion for the Midtrimester Oligohydroamnios / 대한산부인과학회잡지

Reduced amniotic fluid volume generally leads to a poor perinatal outcome, especially when it is observed in the second trimester. The recent obstetric literatures have been reporting on various applications of amnioinfusion in the diagnostic, prophylactic and therapeutic management of oligohydroamnios. We experienced two cases of amnioinfusion, which were used to diagnose or to manage the midtrimester oligohydroamnios and we report them with a brief review.

A Clinical Study of 1,064 Cases of Midtrimester Genetic Amnicentesis / 대한산부인과학회잡지

Midtrimester genetic amniocentesis has been a gold standard for prenatal diagnosis in antenatal care since last 25 years. After the triple serum marker test was introduced as a prenatal screening method for Down syndrome, the frequency of genetic amniocentesis was increased. OBJECTIVE: To determine the complication, risk of amniocentesis and detection rate of chromosomal abnormality. MATERIAL AND METHODS: A retrospective clinical analysis of 1,064 midtrimester genetic amnicentesis in IL Sin Christian Hospital antenatal clinic from Jan 1995 to Dec 1997. Chi square test was used for the statistical analysis and p value < 0.05 was considered significant. RESULTS: Amnicentesis were significantly increased in the age of 35-39 yrs and 40yrs over. And also the incidence of chromosomal abnormality was higher than younger age group. The indications of amnicentesis were screen positive of triple marker test(43%), advanced maternal age(20.8%), abnormal beta-hCG level, past history of chromosome abnormality or malformed baby and abnormal alpha-FP level in order. Total number of chromosomal abnormalities was 30 and the incidence of chromosomal abnormalities was 2.8%(30/1,064). The complications were developed in 13 cases and fetal loss rate was 0.78%(9/1,064). CONCLUSION: The detection rate of chromosomal abnormality in midtrimester amnicentesis for prenatal diagnosis was high and relatively safe procedure but, we should be attention to more careful manipulation.