Pregnancy Outcomes after Peri-conceptional Medication Exposure; 10 Years Experience: Study for Application of Reproductive Toxicity Information / 대한주산의학회잡지

PURPOSE: In Korea, pregnancy termination is frequently reported among women who took medications for an acute or chronic disease during pregnancy, for fear of teratogenic risk. We have previously shown that a service providing evidence-based information is helpful for women who week counseling to make a rational decision regarding their pregnancies. This study aimed to evaluate whether termination of pregnancy based on such perceptions, is justified using the 'DRug Exposure and risk Assessment in Moms' (DREAM) registry. METHODS: The study included 5,032 consenting pregnant women from the clinic and call center at the Korean Motherisk Program, from November 1999 to October 2008. The DREAM registry recorded the pregnancy outcomes (preterm birth, low birth weight, intrauterine fetal death, and congenital anomaly) of 3,328 women. RESULTS: Among women exposed to medications, time of exposure ranged from 3.5-4.6 weeks of gestation. There were 1,308 different drugs prescribed to these women. The drug most frequently prescribed was acetaminophen followed by chlorpheniramine maleate, and pseudoephedrine. There were 4.7% (n=156/3,328) women who underwent a voluntary abortion for fear of birth defects. We compared frequency of birth defects between exposed women and unexposed pregnant women in our institution during gestation. The frequency of major congenital malformations was 2.5% (n=74/2,977) in exposed group and 2.9% (n=75/2,573) in unexposed group (P=0.32). There was no statistically significant difference between exposed and control group in the rate of preterm births, intrauterine fetal death and low-birth weight babies. CONCLUSION: We did not observe increased risk of congenital malformations and adverse pregnancy outcomes in a population of pregnant women exposed to a variety of medications. Therefore these medications are not considered teratogen.

Osteopontin expression on benign and malignant ovarian tumors / 대한산부인과학회잡지

OBJECTIVE: To understand the expression pattern of osteopontin on various histologic types of ovarian tumors. METHODS: We performed an immunohistochemical study on 90 paraffin embedded tissues including 80 ovarian epithelial tumors and 10 normal ovaries. We also performed a semiquantitative study of osteopontin mRNA on 12 fresh ovarian tumors, 2 normal ovaries and SKOV3 cell line. SAS 8.2 program was used for statistical analysis and Fisher's Extract test and Cochran-Mantel-Haenszel Statistics for analysis of the relationship between expression of osteopontin and histologic types. RESULTS: Among 55 carcinomas, over 50% of tumor cells expressed osteopontin in 14/14 clear cell, 11/ 12 endometrioid, 11/16 serous, and 5/15 mucinous types. The expression degrees were well correlated with the histologic types of carcinomas (p=0.002). Among 25 benign tumors, over 10% of tumor cells showed in 11/15 serous and 3/10 mucinous types (p=0.008). However, the degree of osteopontin expression was not related to the tumor grades or stages of ovarian cancer. Semiquantitative study for osteopontin mRNA showed 5-6 times higher in SKOV3 cell line as well as in serous adenocarcinomas, compared with the normal ovaries. However, there was no increase of osteopontin mRNA in benign or malignant mucinous tumors. CONCLUSION: Our findings suggest that the expression of osteopontin is not only present in ovarian cancers, but also in benign ovarian tumors.