Alcohol Use during Pregnancy and Related Risk Factors in Korea

OBJECTIVE: The number of Korean women of childbearing age who drink alcohol and binge drink has increased remarkably in recent years. In the present study, we examined self-reported rates of alcohol use before and during pregnancy and identified maternal characteristics associated with drinking in pregnancy. METHODS: One thousand pregnant Korean women who visited the Department of Obstetrics and Gynecology (OB/GYN) completed a self-administered questionnaire that sought information on their demographic characteristics and incorporated features of the Alcohol Use Disorder Identification Test (AUDIT)-C to investigate their use of alcohol, including binge drinking, during three time periods ("in the year before this pregnancy," "during this pregnancy," and "in the previous 30 days"). RESULTS: Of these participants, 16.4% reported using alcohol during their pregnancy, 12.2% had used alcohol in the previous 30 days, and 1.7% reported binge drinking during their pregnancy. In the year before pregnancy, 77.1% had used alcohol, and 22.3% had binge drunk. The group using any amount of any alcohol during pregnancy showed a lower educational level, a lower rate of planned pregnancy, a lower level of knowledge relating to the risks of drinking alcohol during pregnancy, and a higher frequency of alcohol drinking in the year before pregnancy when compared with the abstinent group. Low educational level and unplanned pregnancy were revealed to be significant risk factors for alcohol consumption in pregnant women. CONCLUSION: This is the first study to examine any alcohol and binge alcohol drinking during pregnancy in Korea. Clinical attention and monitoring system on alcohol use during pregnancy are necessary in Korea.

Abnormal Liver Function Tests in Pregnancy: A Single Institution Experience / 대한소화기학회지

BACKGROUND/AIMS: Elevated transaminase levels are often detected during pregnancy. Causes are variable and difficult to differentiate. Furthermore, there is no practical guideline for abnormal transaminase levels in pregnancy. The aim of this study was to suggest a strategy for managing elevated transaminase level during pregnancy. METHODS: One hundred and fiftyfive women with elevated transaminase level were included from an antenatal care center between January 1, 2003 and December 31, 2004. Another 221 women with normal transaminase levels were enrolled as control group. We analyzed documented causes, changes in laboratory tests, and pregnancy outcomes. RESULTS: Two groups showed no difference in baseline characteristics except the duration of pregnancy, parity, and albumin level. Of abnormal results, 39.4% occurred between 30 and 40 gestational weeks while 29% occurred between 10 and 20 gestational weeks. Common causes were hyperemesis gravidarum followed by pre-eclampsia, viral hepatitis, and HELLP syndrome. Excluding viral hepatitis, 69 patients showed abnormal results in the first two trimesters and the results were normalized during the follow-up period. AST and ALT levels were 52.9 (+/-49.6) IU/L and 83.3 (+/-77.0) IU/L during the first two trimesters in the patient group. Abnormal results during the third trimester were associated with shorter duration of pregnancy. CONCLUSIONS: Elevated transaminase levels up to 3 to 4 times of the upper normal limit during the first two trimesters could be safely observed with careful history taking and hepatitis viral antigen tests. However, abnormal results in the third trimester were associated with a shorter duration of pregnancy and should be managed carefully.

Obstetrical Outcomes of Idiopathic Thrombocytopenic Purpura in Pregnancy / 대한주산의학회잡지

OBJECTIVE: Idiopathic thrombocytopenic purpura (ITP) frequently occurs in young women. Consequently, clinicians often give medical treatment to pregnant women who are diagnosed with ITP. This study might help to make a clinical guidelines for obstetrical ITP patients and their infants. METHODS: We retrospectively investigated the medical charts of 19 cases of deliveries and 22 neonates which from mothers with the diagnosis of ITP during pregnancy from March 1998 to March 2007. RESULT: Corticosteroid treatment was administrated in 13 cases, high-dose immunoglobulin therapy in 3 cases, and concentrated platelet transfusion in 17 cases during their antenatal care. Ten (45%) vaginal deliveries and twelve (55%) cesarean sections were performed. There were no obstetrical complications associated with their ITP and only four infants with platelet counts below the 150,000/micronLiter were reported after birth. However there were not any signs and symptoms of neonatal complications resulting from their maternal ITP. CONCLUSION : Our results demonstrate that mothers with ITP can successfully deliver healthy infants in most case. Although maternal and fetal bleeding may occur, such a fatal complication is uncommon.

Clinical Features of Pregnancy and Delivery in Patients with Idiopathic Thrombocytopenic Purpura

BACKGROUND: Patients with the condition of idiopathic thrombocytopenic purpura (ITP) may present with, maternal and fetal hemorrhagic complications. Appropriate monitoring and treatment may be important in obstetric management. METHODS: A retrospective chart review was performed for obstetric patients with ITP at Bundang CHA hospital from March 1996 to March 2005. RESULTS: Nineteen women with ITP delivered 22 children in 22 pregnancies. The median age at delivery was 30 years (range, 21~37 years). The median platelet counts before pregnancy, during pregnancy, and at delivery were 44,000/microliter (range, 20,000~225,000/microliter), 40,500/microliter (range, 13,000~335,000/microliter), and 73,500/microliter (range, 40,000~308,000/microliter. Treatment for ITP was done in 14 cases (63.6%) during pregnancy and in 18 cases (81.8%) at delivery. Platelet transfusion was done for one case during pregnancy but, was performed in 17 cases (77.3%) at delivery. Vaginal delivery was done in 10 cases (45%) and a Cesarean section was done in 12 cases (55%). No obstetric complications were observed. The median platelet count of 17 infants was 220,000/microliter (range, 59,000~315,000/microliter). Four neonates were born with platelet counts below 150,000/microliter. No infant showed any clinical signs of hemorrhage and there were not any neonatal complications. CONCLUSION: In our study, obstetric patients with ITP and their neonates were safe with no hemorrhagic complication. However, when compared to the current guidelines, the treatment strategy used in the present study was excessive. Appropriate treatment according to the guidelines is necessary during the obstetric management of patients with ITP.

A Case of Retroperitoneal Mass in Infancy, Fetus in Fetus / 대한산부인과학회잡지

"Fetus in fetus" is a rare pathologic feature consisting of a parasitic twin included within the body of the other twin, which most likely arises from inclusion of a monozygotic, diamniotic twin pregnancy. The exact embryogenesis of fetus in fetus is controversial. Some investigators propose that it is a highly organized teratoma. Since the condition was first described by Meckel in the late 18th centry, approximately 100 cases have been reported in the literature. Most cases present as an abdominal mass during the first year of life, with a few cases being detected prenatally by ultrasound examination. So we report one case of fetus in fetus detected by ultrasound examination prenatally.

A Case of Sirenomelia In One Fetus of Twin Pregnancy / 대한산부인과학회잡지

Sirenomelia is a lethal congenital malformation characterized by single or fused lower limbs associated with other severe genitourinary and lower gastrointestinal tract anomalies. Associated anomalies include malformation of vertebrae and pelvis, oligohydroamnios, renal agenesis, imperforate anus, internal and external genital anomaly and single umbilical artery. Recently, sirenomelia is diagnosed by ultrasound at first trimester or early second trimester. Termination of pregnancy is recommended as soon as diagnosis is made. We report a case of sirenomelia in a monoamniotic twin gestation detected at IUP at 12 weeks which was maintained till IUP at 37 weeks and delivered by cesarean section. On autopsy, typical finding of sirenomelia was noted, whereas the contralateral twin showed no abnormalities.

The Effect of Oral Administration of Postpartum Tonic Agent(MMQ) on Postpartum Anemia, Obesity and Uterine Involution furing Puerperium / 대한주산의학회잡지

OBJECTIVES: The purpose of this study was to evaluation the effect of administration of postpartumtonic agent(MMQ) on postpartum anemia during puerperal period, obesity control and uterine involution. SUBJECTS AND METHODS: From June 2002 to November 2002, twenty women who underwent spontaneous vaginal delivery at department of obstetrics and gynecology, college of medicine, Pochon CHA University ghopital were included in this study. All women were randomly assigned to receive postpartum tonic agent(MMQ, Albiomed Co.Ltd) or placebo two times a day after each meal for four weeks. They were assessed obesity test(BMI), hematologic examination(CBC, reticulocyte count), liver function test(AST/ALT) and ultrasound test at first day and 28th days after delivery. RESULTS: There was no statistically significant difference between the two group in demographic characteristics. No statistically significant difference were found in this study between the two group in hemoglobin, hematocrit, BMI and the size of uterus. There was no adverse effect to the tested drug. CONCLUSION: There was no significant difference in efficacy and safety between MMQ and placebo in the effect of postpartum anemia, obesity control and reduction of recovery perod. The following limitations have to be considered; Iron supplement, variable diet, seaweed ingestion, consumption of herb and small sample ize. Therefore, a extensive prospective study with control of these variables should be required.

One Case of Pulmonary Thromboembolism Suspected during Cesarean Section / 대한주산의학회잡지

No abstract available.

Two Cases of pregnancies Complicated with Liver Cirrhosis / 대한주산의학회잡지

No abstract available.