Birth Weight Distribution of Twins According to Gestational Age / 대한산부인과학회잡지

OBJECTIVE: To establish intrauterine growth curve for the birth weight of twins on the basis of gestational age. METHODS: The medical records of twin gestations delivered between 1980 and 2001 were reviewed. 610 Twin pairs (1,220 infants) were comprised our study population. The newborns were grouped according to gestational age and the median, 10th, 50th, and 90th percentile birth weight for each gestational week were calculated. Intrauterine growth curve of twins was compared with that of singletons of Wonju Christian Hospital. We studied the differences of birth weights of twins as sex, parity, chorionicity in twins. RESULTS: The birth weights of twins fall below that of singleton after 32-33 weeks. The 50th percentile for twins falls below the 10th percentile for singleton after 37 weeks, and 90th percentile for twins falls below the 50th percentile for singleton. The mean birth weight in male twin infant was heavier than in female twin infant through all gestational week. The mean brith weight in multiparity was heavier than in nulliparity through all gestational week. The mean birth weight in dichorionic twins was heavier than in monochorionic twins through all gestational week. CONCLUSION: We presented twin specific birthweight curve on the basis of gestational age. The growth pattern of twins was different from that of singleton. We recommend the twin specific birthweight curve in the management of twin gestations.

The role of Interferon-gamma on the Expression of Class I Human Leukocyte Antigens in a Human First Trimester Trophoblast Cell Line / 대한산부인과학회잡지

Precise mechanism which the fetus can escape from mother's immune rejection is not well understood yet during last 50 years. The clarification of immune mechanism at the feto-maternal interface is very important, because this can be a common pathogenesis of various pathologic conditions including spontaneous abortion and habitual abortion. The pivot of this mechanism is cross-talk between the expression of HLA-C, E, G on the extravillous cytotrophoblasts and their receptors on decidual NK (natural killer) cell. The mechanism through which HLA-C, E, G regulation on the extravillous trophoblast is poorly understood. The IFN-gamma is known to be harmful to the successful maintenance of early pregnancy. OBJECTIVE: To clarify whether the IFN-gamma could be involved in the regulation of the HTR-8/SVneo human first trimester cell line. METHODS: We investigated the effects of IFN-gamma only or with other cytokines on the HLA-C, E, G transcripts in human first trimester trophoblast cell-line by using Reverse Transcription Polymerase Chain Reaction (RT-PCR). RESULTS: The trophoblast cells expressed HLA-C, E constitutively. When cultured in the presence of IFN-gamma only or with other cytokines, HLA-C, E transcripts were not significantly affected. CONCLUSION: These results suggest that harmful IFN-gamma to maintain early pregnancy may affect through another mechanism besides regulation of HLA-C, E on the extravillous cytotrophoblasts at the feto-maternal interface.

Post In vitro Fertilization and Embryo Transfer, Second Trimester Selective Termination in Dizygotic Twin Pregnancy Due to Fetal Cranial Encephalocele / 대한산부인과학회잡지

Selective termination can be used to preserve normal fetus from the other fetus with chromosomal, structural abnormality in multifetal pregnancy. This case is about twin pregnant patient who had undergone in vitro fertilization and embryo transfer. In 18 weeks of gestation, we found that one of the fetus had cranical encephalocele and was in concern for the termination by using ultrasound guided intrcardiac injection of 2.5 ml of potassium chloride solution. After performing this procedure the other healthy female newborn was naturally delivered at 38 weeks gestation with weight of 2.8 kg.