Analysis of Pregnancy Outcomes among Interracial Couples in Korea

Although the prevalence of interracial marriages in Korea is increasing, little is known regarding the pregnancy outcomes of interracial couples. The aim of this study was to investigate the differences in pregnancy outcomes between Korean and interracial Korean-foreign couples. Data for infants born in 2011 and 2012 were obtained from the national birth registry of the Korean Statistical Office. The couples were subdivided into Korean father-Korean mother, Korean father-foreign mother, and foreign father-Korean mother groups. Pregnancy outcomes included neonates with low birth weight ( 4,000 g). In 2010 and 2011, 888,447 Korean father-Korean mother, 36,024 Korean father-foreign mother, and 4,955 foreign father-Korean mother neonates were delivered in Korea. After adjustment for parental age, educational level, parity, gestational age at delivery, and neonatal sex, the birth weights were found to be different between groups, with the highest number of foreign father-Korean mother and lowest number of Korean father-foreign mother pregnancies. Based on multivariate logistic regression analysis, the risk of low and large birth weights was higher in the Korean father-foreign mother and foreign father-Korean mother groups, respectively, compared with that in the Korean father-Korean mother group. There are significant differences in pregnancy outcomes including birth weights between Korean and interracial Korean-foreign couples.

A case of vulvar hematoma with rupture of pseudoaneurysm of pudendal artery

Vulvar hematomas are uncommon outside of the obstetric population and may be the result of trauma to the perineum. Vulvar hematomas most often present with low abdominal pain and urologic and neurologic symptoms. The vulva has rich vascularization that is supplied by the pudendal artery, a branch of the anterior division of the internal iliac artery. We describe a rare case of a 15-cm-sized vulvar hematoma with the suggested rupture of a pseudoaneurysm of the left pudendal artery without trauma injury. A 14-year-old girl presented with sudden pain and swelling in her left labium and was successfully treated with selective arterial embolization and surgical evacuation. We provide a literature review and discuss patient treatment and management strategies.

Hepatitis A virus infection during pregnancy in Korea: Hepatitis A infection on pregnant women

OBJECTIVE: Although there is a large body of data on acute hepatitis A virus (HAV) worldwide, data regarding the occurrence of HAV during pregnancy is limited. It is commonly acknowledged that HAV is not associated with severe outcomes or complications during pregnancy. In contrast, there are several reported cases of vertical HAV transmission. Moreover, it has been recently reported that HAV infection during pregnancy is associated with gestational complications. In Korea, the incidence of HAV infection has increased from 317 cases in 2002 to 13,117 cases in 2009. However, HAV infection during pregnancy is rarely reported in Korea. METHODS: This study was conducted as a retrospective cohort series of pregnant women presenting to Korea University Medical Center between January 2000 and October 2009 in whom a diagnosis of HAV infection was made. RESULTS: During study period, there were 12 cases of HAV in pregnant women, including two cases with preterm contraction, two cases with cholestatic hepatitis, and one case with fetal ascites and intra-abdominal calcification. CONCLUSION: HAV infection during pregnancy is associated with high prevalence of maternal and fetal complications. Because the incidence of HAV infection in women of reproductive age is increasing, a further focus on preventing HAV infection during pregnancy is warranted.

Comparison of the Seeplex HPV4A ACE and the Cervista HPV assays for the detection of HPV in hybrid capture 2 positive media / 부인종양

OBJECTIVE: To validate the efficacy of Seeplex HPV4A ACE for the detection of high-risk (HR) human papillomavirus (HPV) and HPV 16 and/or HPV 18 genotypes as compared to the PCR method and the Cervista HPV assays in cervical swab samples. METHODS: Besides liquid-based cytology, additional 97 cervical swab samples were collected for HPV genotyping by HPV4A ACE, Cervista HPV assays, and PCR method. To check the statistical differences, we also conducted the paired proportion test, Cohen's kappa statistic, and a receiver operating characteristic curve. RESULTS: Seeplex HPV4A ACE and the Cervista HPV HR showed substantial agreement with PCR for detection of HR HPVs (88.3%, kappa=0.767 and 81.7%, kappa=0.636, respectively). Seeplex HPV4A ACE also showed substantial agreement with the Cervista HPV 16/18 test (89.5%, kappa=0.628). Additionally, the sensitivity and specificity of Seeplex HPV4A ACE and Cervista HPV HR were 91.4% vs. 84.5% and 73.4%, vs. 72.7%, respectively, when those higher than low-grade squamous intraepithelial lesions were regarded as abnormalities. HPV genotyping for HPV 16/18 detected cervical intraepithelial neoplasias (CINs) better than HR HPV tests (66.7% vs. 24.6% by HPV4A ACE, 52.6% vs. 25.9% by Cervista HPV assays in CIN II or more, relatively). CONCLUSION: Seeplex HPV4A ACE is an effective method as the PCR and the Cervista HPV assays for the detection of HR HPVs and for genotyping of HPV 16 and 18.

Relationship between Metabolic Syndrome and Bone Mineral Density in Middle-aged Women / 대한폐경학회지

OBJECTIVES: To determine the relationship between metabolic syndrome (MS) and bone mineral density (BMD) in middle-aged women. METHODS: Three hundred eight premenopausal women were included in this study, including 268 women without MS and 40 women confirmed to have MS according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. Clinical markers including anthropometric parameters, the serum lipid profile, and glucose level were determined and analyzed with the BMD at the lumbar spine and femoral neck. RESULTS: There was no significant difference in femoral neck or lumbar BMD between the controls and women with MS. In correlation tests, the body mass index (BMI) showed a significant association with the femoral (r = 0.209, P < 0.001) and lumbar BMD (r = 0.176, P = 0.002). In addition, the waist circumference (WC) was also significantly correlated with the femoral (r = 0.142, P = 0.012) and lumbar BMD (r = 0.113, P = 0.048). CONCLUSION: The BMI and WC showed a significant positive association with the femoral and lumbar spine BMD in premenopausal women. Further studies with a large population will be needed to elucidate the combined effect of MS on BMD in middle-aged women.

Analysis of failed arterial embolization for postpartum hemorrhage / 대한산부인과학회지

OBJECTIVE: To investigate what factors are associated with a failed arterial embolization for postpartum hemorrhage (PPH) and to attempt to estimate efficacy of arterial embolization. METHODS: Between 2004 and 2008, 60 patients at Korea University Medical Cencter underwent arterial embolization to control obstetrical hemorrhage. In all cases, arterial embolization was performed because of intractable hemorrhage unresponsive to conservative management. Medical records and angiographic results were reviewed. Arterial embolization failure was defined as the requirement for subsequent surgical procedure to control PPH with the procedure, and its results. RESULTS: Arterial embolization was attempted in 60 of deliveries. Failures occurred in 7 of 60 cases (11.7%) and in 4 of 7 cases (57.1%) of abnormal placentation (placenta previa totalis with or without placenta accrete or increta). Comparison of the failed and successful arterial embolization groups showed no differences in maternal characteristics, clinical status, and angiographic finding. Amount of total transfusion in failed arterial embolization group were larger than successful group although hemoglobin before embolization was not different. CONCLUSION: The only factor significantly associated with failed arterial embolization was an abnormal placentation. Arterial embolization is a safe and highly effective method to control PPH.