The efficacy of umbilical artery blood flow velocity waveform to predict the perinatal outcome of term pregnancies with small for gestational age / 대한산부인과학회지

OBJECTIVE: To investigate whether umbilical artery Doppler blood flow velocity waveform is effective in predicting perinatal outcome of term pregnancies with small for gestational age (SGA). METHODS: A total of 381 patients at 37~41 weeks of gestational age (GA) who received antenatal umbilical artery Doppler blood flow test and delivered singleton SGA infants. The ratio of peak-systolic to end-diastolic (S/D) blood flow velocities in the umbilical artery was measured in each patient. The patients were divided into a normal group (n=307) with a S/D ratio equal to or less than 3.0, and an abnormal group with a S/D ratio of greater than 3.0 (n=74). These groups were comparatively analysed with respect to maternal characteristics and neonatal outcomes. Results: There were no significant differences between the two groups in mean maternal age, gestational age at the time of delivery, and cesarean section rate due to fetal distress. There was significantly increased incidence of hypertensive disorders in pregnancy in the abnormal S/D ratio group. And the abnormal S/D ratio group showed lower neonatal birthweight, higher incidence of admission to neonatal intensive care unit (NICU), and longer stay in neonatal intensive care unit. According to linear regression, in pregnancies complicated by SGA, abnormal S/D ratio was still a risk factor for low birthweight even after controlling for the incidence of hypertension. Conclusion: In term pregnancies accompanied by SGA, abnormal umbilical artery S/D ratio is an independent predictor of neonatal birth weight, incidence of admission to NICU, and NICU stay.

The efficacy of umbilical artery blood flow velocity waveform to predict the perinatal outcome of term pregnancies with small for gestational age / 대한산부인과학회지

OBJECTIVE: To investigate whether umbilical artery Doppler blood flow velocity waveform is effective in predicting perinatal outcome of term pregnancies with small for gestational age (SGA). METHODS: A total of 381 patients at 37~41 weeks of gestational age (GA) who received antenatal umbilical artery Doppler blood flow test and delivered singleton SGA infants. The ratio of peak-systolic to end-diastolic (S/D) blood flow velocities in the umbilical artery was measured in each patient. The patients were divided into a normal group (n=307) with a S/D ratio equal to or less than 3.0, and an abnormal group with a S/D ratio of greater than 3.0 (n=74). These groups were comparatively analysed with respect to maternal characteristics and neonatal outcomes. Results: There were no significant differences between the two groups in mean maternal age, gestational age at the time of delivery, and cesarean section rate due to fetal distress. There was significantly increased incidence of hypertensive disorders in pregnancy in the abnormal S/D ratio group. And the abnormal S/D ratio group showed lower neonatal birthweight, higher incidence of admission to neonatal intensive care unit (NICU), and longer stay in neonatal intensive care unit. According to linear regression, in pregnancies complicated by SGA, abnormal S/D ratio was still a risk factor for low birthweight even after controlling for the incidence of hypertension. Conclusion: In term pregnancies accompanied by SGA, abnormal umbilical artery S/D ratio is an independent predictor of neonatal birth weight, incidence of admission to NICU, and NICU stay.

The association of the cervical intraepithelial neoplasia and human papillomavirus viral load / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to determine the relationship between the cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) DNA load and to evaluate the efficacy of viral load in prediction of histologic severity. METHODS: The cervical cytology and Hybrid Capture II tests for HPV detection were performed in 2411 women visited our hospital, from August 2003 to October 2004. A total of 259 consecutive women underwent cervical colposcopy directed biopsy and operations with confirmed final histologic diagnoses were included. Viral load was measured by Hybrid Capture II system expressed as relative lights unit (RLU) ratio of specimens and controls. RESULTS: There was no significant difference of CIN 1, CIN 2, CIN 3, SCC group and control group in the clinical characteristics. The higher the viral load, the higher stage of CIN was shown. HPV viral load test showed sensitivity of 82.9%, specificity of 37.7%, positive predictability of 60.0%, negative predictability of 66.2% in detecting CIN, while 94.4%, 34.3%, 67.5%, 80.8% in detecting HGSIL. The viral loads were categorized into four groups (negative, low, intermediate, high) for analysis and it was shown that higher viral load group tended to exist CIN more frequently (odds ratio=1, 1.8, 3.4, 3.5). In addition, viral load was more strongly associated with the risk of HGSIL than that of LGSIL (odds ratio=1, 6.7, 9.0, 9.6). CONCLUSION: We found that the higher HPV viral load is significantly associated with the higher stage of CIN. The measurement of HPV DNA load is useful for predicting the severity of lesions of the uterine cervix and making decision of treatment plans.