Molecular Biological Approach to Find Out the Etiology of Hypertensive Disorder in Pregnancy: Analysis of the Polymorphism in the Promoter of Human Angiotensinogen Gene in Korean Population / 대한산부인과학회잡지

OBJECTIVE: We undertook this study to find out general characteristics of hypertensive disorder in pregnancy and to clarify whether polymorphic marker of promoter region of angiotensinogen G(-6)A polymorphism is associated with the development of hypertensive disorder in pregnancy. METHODS: From August 1998 to March 2002, we recruited 230 pregnant women complicated by hypertension in pregnancy. Retrospective chart review was done. They were assigned to each group according to a new classification. Hypertensive groups were divided into two groups: high blood pressure group (High) was defined as having diastolic blood pressure (DBP) higher than 110 mmHg and low blood pressure group (Low) as having DBP lower than 110 mmHg. Maternal blood was collected and DNA was extracted from 161 normotensive and 200 hypertensive Korean pregnant women. Genomic DNA was prepared and the relevant genomic region was amplified using polymerase chain reaction (PCR). PCR products were digested with the restriction enzyme, Mva I, size fractionated on 3% agarose gels containing ethidium bromide. RESULTS: Family history of hypertension was more common in women with chronic hypertension or superimposed preeclampsia than in women with transient hypertension or preeclampsia (p<0.05). No significant difference in genotype distribution was found between diagnostic groups and control. However, among hypertensive disorder in pregnancy, high blood pressure group had AA genotype more frequently than low blood pressure group (p<0.05). CONCLUSION: Family history is more common in women with underlying hypertension. Angiotensinogen AA genotype may be associated with high blood pressure level in hypertensive disorder in pregnancy.

Association of Amniotic Fluid Concentrations of Monocyte Chemotactic Protein-1 with Intrauterine Infections and Perinatal Outcomes in Preterm Labor / 대한산부인과학회잡지

OBJECTIVE: To examine if amniotic fluid (AF) monocyte chemotactic protein-1 (MCP-1) concentrations are useful in the identification of intrauterine infection and pregnancy outcomes in preterm labor with intact membranes. METHODS: The study population consists of 65 patients who received amniocentesis for preterm labor with intact membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. MCP-1 was determined by a sensitive and specific immunoassay. Fisher's exact test, Mann-Whitney U test, receiver operating characteristic curve, survival techniques, logistic regression, and Spearman correlation were used for statistical analysis. RESULTS: (1) Patients with a positive amniotic fluid culture had a significantly higher median AF MCP-1 concentration than those with negative results (median, 9.0 ng/mL; range, 0.45-40.5 ng/mL; vs median, 0.82 ng/mL; range, 0.06-30.1 ng/mL; P1.9 ng/mL had a significantly shorter median interval to delivery, the higher rate of histologic chorioamnionitis, preterm delivery within 2 and 5 days, and the occurrence of congenital proven or suspected sepsis than did those with AF MCP-1 concentration of <1.9 ng/mL after adjustment for gestational age (P<.05). (3) There was strong correlation between AF MCP-1 concentrations and AF interleukin-6 concentrations (r=.881, P<.001). CONCLUSION: AF MCP-1 determinations are useful in the identification of intrauterine infection, preterm delivery, and neonatal infectious complication in preterm labor with intact membranes.

Pregnancies Complicated by Maternal Heart Diseases / 대한산부인과학회잡지

OBJECTIVE: To assess the pregnancy outcomes complicated by maternal heart diseases. METHODS: From 1994 to 2001, medical records of pregnant women who had reached at least 20 weeks of gestation with maternal heart diseases were reviewed. RESULTS: 224 deliveries of 195 women were enrolled in this study. In 117 (52.2%) cases the heart diseases were of rheumatic origin, in 96 (42.9%) cases congenital, and the remaining 11 (4.9%) cases were miscellaneous group that included arrhythmia, cardiomyopathy, and mitral valve prolapse. There were 2 (0.9%) cases of maternal death related to pregnancy. Majority (91.9%) were in New York Heart Association functional classes I, II before, during, and after delivery. Mean gestational age at birth and birth weight were 37.9 weeks and 2883 gm. Perinatal mortality rate was 17.9/1000 and the rate of congenital malformation was 2.7%. Recurrence risk of neonatal congenital heart disease was 2.1%. CONCLUSION: Most complications were developed in the pregnancies complicated by maternal heart diseases with New York Heart Association functional classes III, IV. Functional status of the pregnant women is the important risk factor in maternal and fetal outcomes.

Three Cases of FDG-FET Scan Application in Patients with Metastatic Gestational Trophoblastic Tumor / 대한부인종양콜포스코피학회잡지

Positron emission tomography(PET) is an imaging technique that produces images reflective of tissue biochemistry rather anatomy. The great versatility of PET and its potential of direct noninvasive study of tumor function will make it a very important clinical and research tool in oncology. Recently, whole body PET techniques have been developed which permit imaging of the entire body during a single scanning session promising both in determining the nature of a localized lesion and in defining the systemic extent of malignant disease. FDG-PET scan seems valuable in evaluating patients with GTT resistant to chemotherapy with persistent elevation of beta-hCG levels and localizing the site of a viable tumor. We present three cases of FDG-PET scan in patients with metastatic gestational trophoblastic tumor with a brief review of literatures.

Clinical Feature and Prognosis of Pregnancies in Patients with Takayasu's Arteritis / 대한산부인과학회잡지

No abstract available.

Normal Range of Amniotic Fluid Alpha-Fetoprotein in Midtrimester Korean Pregnant Women / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to determine normal amniotic fluid alpha-fetoprotein level in midtrimester Korean pregnant women whose neonatal outcomes were normal. METHODS: Amniotic fluid alpha-fetoprotein(AFAFP) levels were measured by specific radioimmunoassay (RIA) in midtrimester pregnant women for various indications of amniocentesis from May 1992 to July 1999 at Seoul National University Hospital. Normal ranges were obtained from 640 singleton pregnancies in which neonatal outcomes were normal. RESULTS: Median values of AFAFP in Korean pregnant women were 13,250ng/mL, 12,900ng/mL, 11,150ng/mL, 9,430ng/mL, 8,019ng/mL, 6,800ng/mL, 5,850ng/mL, 5,750ng/mL, 5,210ng/mL, 3,420ng/mL at 15 week, 16 week, 17 week, 18 week, 19 week, 20 week, 21 week, 22 week, 23 week, 24 week, respectively. CONCLUSION: This determination of the median values and the normal range of AFAFP level by each gestational week in uncomplicated Korean women could be used reference values for prenatal diagnosis of various disorders like open neural tube defect.