Neonatal and maternal infectious morbidity between single and multiple courses of antenatal betamethasone treatment in patients with preterm premature rupture of membranes / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare the neonatal and maternal infectious morbidity between single and multiple courses of antenatal betamethasone treatment in patients with preterm premature rupture of membranes. METHODS: One hundred seventy patients who delivered neonates between 28 and 34 weeks' gestation after preterm premature rupture of membranes from January 1992 to July 2000 were reviewed retrospectively. Patients were divided into 3 groups on the basis of the following betamethasone exposures: (1) none (control subjects), (2) betamethasone 4 mg IM, IV simultaneously and then 4 mg IV q 8 hours for 24 hours (single course) and (3) weekly administration after initial single course (multiple courses). All included patients received prophylactic antibiotics for group B streptococci. The statistical analyses were done using x2 test, Fisher's exact test and one way analysis of variance (ANOVA). Multiple logistic regression analysis was performed to determine the confounding effect of the multiple variables those were considered as risk factors for neonatal sepsis. RESULTS: This study included 67 patients in the control group, 60 patients in the single course group, and 43 patients in the multiple courses group. The latency (p=.0001) was significantly longer in the patients exposed to multiple course than the patients in the control group and those in the single course group. No significant difference was demonstrated in the incidence of neonatal sepsis (p=.881) and postpartum endometritis (p=.619) among the three groups. Neonatal sepsis was significantly associated with clinical chorioamnionitis (p=.022). CONCLUSION: According to our data, multiple courses of antenatal betamethasone treatment in patients with preterm premature rupture of membranes was not associated with the increased incidence of neonatal sepsis and postpartum endometritis.

Clinical Efficacy of High-risk HPV DNA Test Using Hybrid Capture System in Cervical Epithelial Cells / 대한부인종양콜포스코피학회잡지

Human papillomavirus(HPV) has implicated in the development of cervical cancer. Several studies has suggested a strong correlation between HPV 16, 18 and cervical intraepithelial neoplasia(CIN). For detecting and typing HPV DNA in cervical tissues, recently the chemiluminescent molecular hybridization assay method has been widely used. This study was performed to determine the usefulness of hybrid capture assay for detecting high-risk HPV in cervical epithelial cells, and to compare the correlation among cervical cytology, biopsy finding and HPV infection, and to determine whether the addition of the hybrid capture assay to cytologic test would improve the ability to identify significant lesions. This study included 267 patients who visited the colposcopic clinic of the department of obstetrics and gynecology, Chonbuk University Hospital from May, 1997 to October 199S. Pap smears hybrid capture assays, and colposcopically directed biopsy were performed concurrently on al1 women. The results obtained were as follow; l. Using hybrid capture assay, the detection rate of high-risk HPV of all patients was 37.1%(99/267). There was no statistical significance in the detection rate of HPV between the age groups. 2. The false negative rate of Pap Smear was 53.3% and showed significant discrepancies between the cytologic and histologic diagnosis. 3. According to the cytologic diagnosis, the detection rates of high-risk HPV were 7.1% in normal, 25.3% in ASCUS or LSIL, and 61.6% in HSIL. In each cytologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 4. According to the histologic diagnosis, the detection rates of high-risk HPV were 0.1% in normal, 11.1% in CIN I, and 72.7% in CIN II or CIN III. In each histologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 5. According to the comparison of histologic diagnosis between positive and negative results of high-risk HPV test due to each cytology, there was no statistical significance in the incidence rate of cervical neoplasia, Above results suggest that high-risk HPV test using hybrid capture assay may be a useful method in supplement the pitfalls of cervical cytology. This test might also have prognostic value in the management of patients with CIN.