A case of Listeriosis in early third trimester pregnant woman / 대한산부인과학회지

Although listeria monocytogenes is widely distributed in nature, it rarely causes clinical infection in previously healthy people. However, this microorganism may cause severe infectious disease in pregnant women and newborns due to impaired cell-mediated immunity. Various clinical symptoms have been described such as sepsis, central nervous system infections, endocarditis, gastroenteritis and localized infections. A clinical presentation of listeriosis in an early third trimester pregnant woman and in a preterm infant is emphasized in addition to taking a careful patient history, early empirical administration of antibiotics, aggressive ventilation therapy and also pharmacological support.

A Case of Vasa Previa / 대한산부인과학회잡지

Vasa previa is one of the most unusual and tragic accidents to fetus in obstetrics. This condition is not diagnosed easily because it is rare and unexpected. To improve the perinatal outcome, early detection by ultrasonography is very important during pregnancy. We present a case of vasa previa with velamentous insertion of cord with a brief review of the literatures concerned.

Isolated Oligohydramnios in Low-risk Pregnancy as a Predictor of Adverse Perinatal Outcome / 대한산부인과학회잡지

OBJECTIVE: The aim of our study was to assess whether isolated oligohydramnios is associated with adverse perinatal outcomes in low-risk term pregnancy. METHODS: Women delivered between March 2001 and July 2003, who underwent ultrasonography from 37 to 41(+6) weeks gestation were analyzed. Women undergoing labor induction for oligohydramnios were matched by gestational age and parity to women with normal amniotic fluid index measurements. Oligohydramnios was defined as an amniotic fluid index (AFI) 5.0 cm with respect to maternal age, parity, nulliparity, gestational age at delivery. The study (N=21) and control groups (N=100) had similar the primary outcome (rate of total cesarean delivery and rate of cesarean delivery for fetal distress) as well as the secondary outcome variables such as birthweight, Apgar score8 day. There were no differences between pregnancies with 5th percentile of AFI with respect to maternal age, parity, nulliparity, and the secondary outcome variables such as birthweight, Apgar score8 day. However, pregnancies with 5th percentile of AFI. Rate of cesarean delivery for fetal distress was not significantly different in the two groups. CONCLUSION: We demonstrated that oligohydramnios in low-risk term pregnancy does not affect the increased perinatal morbidity and mortality. Therefore, isolated oligohydramnios may not be a marker for fetal compromise in low-risk term pregnancy, and induction of labor may not be warranted in most cases.

Maternal Circulating Vascular Endothelial Growth Factor in Normal Pregnancies and their Relationship to Platelet Counts / 대한산부인과학회잡지

OBJECTIVE: The aim of the present study was to evaluate changes of vascular endothelial growth factor levels in maternal circulating blood during normal pregnancies and examine their relationship with maternal platelet counts. METHODS: The 33 subjects were selected from healthy normotensive women from the antenatal clinic at Korea University Medical Center, Guro Hospital. Blood samples for VEGF were taken at 7 to 8 weeks' gestation, 16 to 18 weeks' gestation, 24 to 26 weeks' gestation, 30 to 32 weeks' gestation, 37 to 41 weeks' gestation. Serum and plasma were extracted from all samples, and VEGF concentrations were measured in duplicates by competitive enzyme immunoassay. The 23 of them, the platelet counts were performed with an automated blood Coulter counter. RESULTS: Serum VEGF levels during normal pregnancies were mean 6.73 ng/mL at 7-8 weeks' gestation, 7.88 ng/mL at 16-18 weeks' gestation, 7.18 ng/mL at 24-26 weeks' gestation, 8.42 ng/mL at 30-32 weeks' gestation, 14.03 ng/mL at 37-41 weeks' gestation. Plasma VEGF levels were mean 5.50 ng/ mL at 7-8 weeks' gestation, 7.23 ng/mL at 16-18 weeks' gestation, 7.98 ng/mL at 24-26 weeks' gestation, 7.35 ng/mL at 30-32 weeks' gestation, 14.05 ng/mL at 37-41 weeks' gestation. The trends in the mean VEGF levels were similar between serum and plasma, with stable levels until 30 to 32 weeks' gestation, and then the levels were increased. There was no significant difference between serum VEGF levels and plasma VEGF levels (p=0.236) and no correlation between circulating VEGF levels and platelet counts. CONCLUSION: Our data suggests that platelets may not be the origin of elevated VEGF levels in normal pregnancies because there was no correlation between VEGF levels and platelet counts.

Pregnancy and Cerebrovascular Disease / 대한산부인과학회잡지

OBJECTIVE: It is widely believed that pregnancy accounts for a significant impact upon maternal as well as fetal health. Nevertheless, the correlation between pregnancy and cerebrovasular disease has not been fully understood due to few data available in Republic of Korea. METHODS: We have reviewed clinical diagnosis and impressions of 7,879 patients who were admitted inpatients to the Korea University Anam Hospital either for delivery or for pregnancy between 1995 and 2000, retrospectively. Four identified as patients with cerebrovascular disease were analyzed with medical records, results of blood tests and radiologic tests, as well as neurologic findings. RESULTS: In 4 patients with cerebrovascular diseases, we found 2 subarachnoid hemorrhages, 1 intracranial hemorrhage, and 1 cerebral infarction. Among 7,879 inpatients, the incidences of subarachnoid hemorrhage, intracranial hemorrhage, and cerebral infarction were 0.03%, 0.01%, and 0.01% respectively. CONCLUSION: In our study, the incidence of cerebrovascular disease during pregnancy was as low as 0.05%. But cerebrovascular disease was related to maternal and fetal health, therefore much attention should be focused on the precise evaluation of the pregnancy with cerebrovascular disease.

A Case of Intrauterine Pregnancy after Laparoscopic Bilateral Uterine Artery Ligation for Treatment Uterine Myoma / 대한산부인과학회잡지

Uterine artery ligation or embolization is a minimally invasive alternative for treatment of symptomatic leiomyoma. However, the experience with pregnancy management and outcome after ablating uterine blood flow is still unknown. We have recently experienced a case of a woman who had two successful spontaneous intrauterine pregnancies after laparoscopic uterine artery ligation to treat uterine myoma for dysmenorrhea and menometrorrhagia.