Knowledge, attitudes, and acceptability about influenza vaccination in Korean women of childbearing age

OBJECTIVE: The aims of the present study were to investigate the women's perspective on influenza infection and vaccination and to evaluate how they influence vaccine acceptability, in Korean women of childbearing age. METHODS: This was a prospective study by random survey of women of childbearing age (20 to 45 years). They were asked to complete a questionnaire assessing their knowledge, attitudes and acceptability of influenza vaccination before and during pregnancy. This study utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2008 and 2012, to analyze the recent influenza vaccination trends. RESULTS: According to KNHANES (2008-2012), influenza vaccination rates in women of childbearing age have increased up to 26.4%, after 2009. The questionnaire was completed by 308 women. Vaccination rate during pregnancy or planning a pregnancy was 38.6%. The immunization rate increased significantly with the mean number of correct answers (P<0.001). Women who received influenza vaccination were more likely to be previously informed of the recommendations concerning the influenza vaccination before or during pregnancy, received the influenza vaccination in the past, and of the opinion that influenza vaccination is not dangerous during pregnancy, with odds ratios of 14.6 (95% confidence interval [CI], 6.44 to 33.33; P<0.0001), 3.6 (95% CI, 1.84 to 6.97; P=0.0002) and 2.7 (95% CI, 1.34 to 5.47; P=0.0057). CONCLUSION: Influenza vaccination rate in women of childbearing age has increased in this study and national data. More information and recommendation by healthcare workers, especially obstetricians, including safety of vaccination, might be critical for improving vaccination rate in women of childbearing age.

Knowledge and Acceptability about Adult Pertussis Immunization in Korean Women of Childbearing Age

PURPOSE: The adult tetanus, reduced diphtheria, and acellular pertussis (Tdap) vaccine has been introduced in order to provide individual protection and reduce the risk of transmitting pertussis to infants. We assessed the knowledge and acceptability of the Tdap vaccine around pregnancy. MATERIALS AND METHODS: This study was a cross-sectional survey of women of childbearing age (20-45 years) who visited obstetrics and gynecologic units of primary, secondary, or tertiary hospitals. They were asked to fill in a questionnaire assessing their knowledge, attitudes, and acceptability of Tdap. RESULTS: The questionnaire was completed by 308 women; 293 (95.1%) had not received information from doctors about Tdap, and 250 (81.2%) did not know about the need for vaccination. A significantly important factor related to subjects' intention to be vaccinated, identified by stepwise multiple logistic regression, was the knowledge (OR 13.5, CI 3.92-46.33) that adult Tdap is effective in preventing pertussis for infants aged 0-6 months. Additionally, 276 (89.6%) considered the recommendation of obstetric doctors as the most influencing factor about Tdap vaccination. CONCLUSION: In Korea, most women of childbearing age seem to be neither recommended nor adequately informed about the vaccination, although our population was not a nationwide representative sample. Information given by healthcare workers may be critical for improving awareness and preventing pertussis.

Non-Type I Cystinuria Associated with Mental retardation and Ataxia in a Korean Boy with a New Missence Mutation(G173R) in the SLC7A9 Gene

Cystinuria is an inherited renal and intestinal disease characterized by defective amino acids reabsorption and cystine urolithiasis. It is unusually associated with neurologic symptoms. Mutations in two genes, SLC3A1 and SLC7A9, have been identified in cystinuric patients. This report presents a 13-yr-old boy with cystinuria who manifested difficulty in walking, ataxia, and mental retardation. Somatosensory evoked potential of posterior tibial nerve stimulation showed the central conduction dysfunction through the posterior column of spinal cord. He was diagnosed non-type I cystinuria by urinary amino acid analysis and oral cystine loading test. We screened him and his family for gene mutation by direct sequencing of SLC3A1 and SLC7A9 genes. In this patient, we identified new missence mutation G173R in SLC7A9 gene.

Polymorphism of Haptoglobin in Patients with Premature Rupture of Membrane

PURPOSE: To investigate whether allelic polymorphism of haptoglobin (Hp) is associated with premature rupture of membrane (PROM), the Hp phenotypes of pregnant women with PROM were analyzed. PATIENTS AND METHODS: The Hp phenotypes of 221 pregnant Korean women (187 control and 34 PROM patients) were determined by benzidine/hydrogen peroxide staining, following native polyacrylamide gel electrophoresis of hemoglobin-mixed sera. The Hp allele frequencies were calculated from the data of Hp phenotypes, and overall association with PROM was evaluated using Pearson Chi-Square test. RESULTS: The polymorphic distribution of the patients cohort who underwent a normal delivery (control group) was similar to that of healthy Koreans. In contrast, however, patients with PROM showed significantly higher occurrence of the Hp 1-1 phenotype than control group (23.5% vs 8.0%). Hp 2-2 phenotype was lower in PROM cohort (38.2%) than in the control group (48.7%). The Hp1 allele frequency in PROM group was significantly higher than that in the control group (0.426 vs 0.297, p = 0.034) with odds ratio of 1.762 (95% CI: 1.038 - 2.991). CONCLUSION: These findings suggest that pregnant Korean women who possess Hp1 allele (expressed as Hp 1-1 phenotype) have higher incidence of PROM than women with Hp2 allele (expressed as Hp 2-2 phenotype). This is the first study that evaluated the significance of Hp polymorphism with respect to the development of PROM.

Umbilical cord artery blood pH analysis at term pregnancy / 대한주산의학회잡지

OBJECTIVE: To assess the gestational age adjusted values of umbilical cord artery blood pH in term pregnancy METHODS: We retrospectively analyzed umbilical arterial blood pH values and obstetric data of 1,918 term singleton deliveries without maternal medical disease, pregnancy induced hypertension and fetal distress during labor periods at Kangnam St. Mary's Hospital, Catholic University medical college between January 2004 and December 2006. Low pH was defined as less than 7.10 as a stationary cutoff value, whereas pH less than (mean -2 standard deviations [SDs]) was used when gestational age was considered. We evaluated the risk of 5 minute Apgar score of less than 7 and meconium staining more than grade II at low pH. RESULTS: A significant negative correlation was found between gestational age and umbilical artery pH (p=0.000). We evaluated the umbilical artery pH value in different delivery mode. Vaginal delivery cases showed negative correlation (p=0.000), but elective cesarean section cases didnt. Low pH patients defined by both criteria of pH less than 7.10 and pH less than (mean -2SD) showed significantly increased risk of 5 minutes Apgar score of less than 7 (pH less than 7.10: p=0. 000, pH less than (mean -2SD): p=0.001) and meconium staining more than grade II (pH less than 7.10: p=0. 001, pH less than (mean -2SD): p=0.001). CONCLUSION: Our results suggest that umbilical cord pH has a negative relation with gestational age during term period.

Clinical Effects of Continuous Transabdominal Amnioinfusion in Preterm Premature Rupture of Membranes : Retrospective Study / 대한주산의학회잡지

OBJECTIVE : To assess the clinical role of continuous transabdominal amnioinfusion in pregnancies with preterm premature rupture of membranes (PPROM) less than 34 weeks of gestation. METHODS : In this retrospective study between January 1999 and December 2003, 76 singleton pregnancies complicated with PPROM less than 34+0 weeks of gestation, were included. Thirty-eight patients consented to undergo the continuous transabdominal amnioinfusion. The control group, matched with the amnioinfusion group by parity and gestational age at rupture of membranes, was managed expectantly. RESULTS : The median intervals from PPROM and delivery (latency period) (8.0+/-7.3 days vs. 1.7+/-2.5 days, p<0.001), the gestational age at delivery (223+/-17.8 days vs. 211+/-18.0 days, p=0.003) and the birth weight (1,853+/-465 g vs. 1,556+/-459 g, p=0.006) were significantly increased in the amnioinfusion group compared to the control group, respectively. In maternal complications, the amnioinfusion group showed higher rate of placental abruption (5.2% vs. 2.6%, p=0.556) than the control group, but were comparable in the rates of cesarean section (44.7% vs. 42.1%, p=0.817) and clinical chorioamnionitis (18.4% vs. 18.4%). The rate of neonatal ventilator care of positive pressure ventilation was significantly decreased in the amnioinfusion group, compared to the control group (15.8% vs. 50.0%, p=0.002). In neonatal morbidity, respiratory distress syndrome was more frequent in the control group compared to the amnioinfusion group, although it did not show statistical significance (34.2% vs. 15.8%, p=0.06). There were no significant differences in rates of Intraventricular hemorrhage (IVH) grade III, IV, neonatal sepsis and neonatal mortality between two groups. CONCLUSION : Our results suggest that, in pregnancies complicated with preterm premature rupture of membranes less than 34 weeks of gestation, the continuous transabdominal amnioinfusion might have improved the neonatal outcome without increasing the perinatal infection rate.

A Case of mesenchymal dysplasia of the placenta / 대한산부인과학회지

Placental mesenchymal dysplasia is a rare condition of pregnancy that present as macroscopic feature of molar change in the placenta and normal karyotype fetus, and has been reported at birth in 15 cases of Beckwith-Wiedmann syndrome and 25 cases of normal fetus in literatures. It may mimic the partial hydatidiform mole, but the mesenchymal dysplasia is different that it may be compatible with a normal fetus. A nulliparous woman was suspected to be a partial mole with a coexistent live fetus in gestational age of 14 weeks because of the partially cystic placenta on ultrasonography examination. She delivered a healthy female vaginally at 36+6 weeks of gestation and the histological examination of placenta established the diagnosis of mesenchymal stem villous dysplasia. We report here an unusual pregnancy.

Minimally Invasive Neuroendoscopic Surgery for Pituitary Apoplexy Diagnosed During Pregnancy / 대한산부인과학회지

Pituitary apoplexy is a life-threatening condition resulting from hemorrhage or necrosis of a pituitary tumor with subsequent compression of the optic nerves and cavernous sinuses. This is the first case report of a patient who experienced pituitary apoplexy due to hemorrhage of pituitary adenoma, which was initially recognized during pregnancy, and submitted to minimally invasive neuroendoscopic transnasal transsphenoidal approach in the third trimester of pregnancy.

Analysis of Gene Expression in the Human Chorion of Preterm Labor Using cDNA Microarray / 대한주산의학회잡지

OBJECTIVE: We used a genome-wide approach to identify differentially expressed genes in patients with preterm delivery caused by preterm labor to improve the understanding of underlying molecular mechanism. METHODS: RNA was isolated from the chorions of patients with preterm delivery caused by preterm labor with intact membranes and term vaginal delivery. cDNA microarray experiments were used to identify differentially expressed genes, and reverse transcriptase-polymerase chain reaction was used in follow-up experiment. RESULTS: cDNA microarray experiments identified significantly increased expression of 104 genes and decreased expression of 102 genes in the preterm cases. 18 genes showed more than 1.5-fold increased expressions in the chorions of patients with preterm delivery by preterm labor than those with term vaginal delivery. In preterm delivery, up-regulated genes were associated with cell adhesion, cell cycle regulation, development, transport, morphogenesis, muscle contraction, signal transduction, and transcription. 15 genes showed more than 1.5-fold decreased expressions in chorions of patients delivered preterm by preterm labor than delivered term by labor. In preterm delivery, down-regulated genes were associated with cell differentiation, development, metabolism, morphogenesis, RNA processing, signal transduction, transcription, and transport. CONCLUSION: This study suggests cDNA microarray technique might provide insights into the molecular basis of preterm delivery caused by preterm labor.

Pregnancy Outcome in Renal Transplant Recipients: A Retrospective Study / 대한주산의학회잡지

OBJECTIVE: The aim of our study was to identify graft, obstetric and maternal outcomes of pregnancies in renal transplant recipients at our center. METHODS: A 14-year retrospective study between January 1990 and December 2003, 224 women 15 to 45 years of age had transplantation and were analyzed the outcomes of pregnancies, obstetric complications and graft function. RESULTS: Thirty-four pregnancies occurred in 21 of 224 patients. The mean age at the time of conception was 29.5 years (21 to 36 years) with a mean interval of 61.9 months (one to 162 months). In the pregnancy outcome, there were the 23 live births (67.6%) included 13 preterm and 10 term deliveries, 3 spontaneous abortions (8.8%), 7 artificial abortions (20.5%) and one case of ectopic pregnancy (2.9%). Obstetric complications were; preeclampsia (39.1%), preterm labor (43.4%), urinary tract infections (38.2%) and gestational diabetes (8.6%). Nine pregnancies within 2 years of transplantation had the permissible obstetric outcomes comparing with the others after 2 years (spontaneous abortion: p=0.77, artificial abortion: p=0.88, live birth: p=0.36). In twelve pregnancies appearing renal dysfunction associated with pregnancy, the abortion rate was increased comparing the others with stable renal function (p=0.006). Pre-pregnancy serum creatinine > or =1.4 mg/dl was associated with increased preterm delivery, but not significant (50.0% vs 28.5%, p=0.30). In graft function, serum creatinine 3~6 postpartum was significantly increased comparing pre-pregnancy levels (p=0.04). Five cases of 7 patients with acute rejection episode associated with pregnancy conceived after 4 years of transplantation. Two-year graft survival after delivery was 95.2% (20/21) and chronic rejection and graft failure was diagnosed in one case at postpartum 14 months. CONCLUSION: These findings suggest that, if the graft function is stable, pregnancy within 2 years after renal transplantation might be safe. Pregnancy does not appear to have adverse effects on long term graft survival.

Search for Differentially Expressed Genes in Preterm Human Placentae and Their Membranes by Annealing Control Primer System / 대한주산의학회잡지

OBJECTIVE: The aim of this study was to investigate the gene expression profiles using GeneFishingTM kit in human placentae and their membranes delivered at preterm caused by preterm labor. METHODS: Specimens were obtained from placenta, chorion, and amnion delivered at preterm and term, respectively. Total RNAs were isolated from each specimen. Thereafter, the profiles of expression genes between preterm and term specimens were compared using a new and accurate reverse transcription-polymerase chain reaction (RT-PCR) that involves annealing control primers (ACPs) to identify the genes expressed differentially and screened by basic local alignment search tool (BLAST) search. RESULTS: Using 20 ACPs, 13 differentially expressed genes (DEGs) were identified and sequenced. 7 of them were expressed up-regulation, while 6 were expressed down-regulation in preterm deliveries. A BLAST searches revealed that 11 were known genes and 2 were unknown genes. Among known genes, up-regulated genes were insulin-like growth factor II associated protein, vigilin, acyl-Coenzyme A dehydrogenase, tissue inhibitor of metalloproteinase 1 (TIMP1), ribosomal protein S26 (RPS26), follistatin-like 1 (FSTL1) and down-regulated genes were two mitochondrial DNAs, ribosomal protein S28 (RPS28), transglutaminase 2 (TGM2), heparin sulfate proteoglycan (HSPG, perlecan). CONCLUSION: This study shows that the ACP system is a good method for the identification of preterm-related genes. Furthermore, this study suggests that further analysis of the differentially expressed genes in preterm we have identified should provide insights into the molecular basis of preterm delivery caused by preterm labor.

Cytogenetic Analysis in Spontaneous Abortion / 대한주산의학회잡지

OBJECT: To analyze the frequency and the types of chromosomal abnormalities in conceptus of spontaneous abortion method: 81 cases of products of conception aborted spontaneously were collected From Nov. 1999 to May, 2004 in the cytogenetic laboratory at Kangnam St. Mary's Hospital, Catholic University Medical College. The cytogenetic results,along with clinical information including gestational age at the time of the miscarriage and maternal age, were compiled in a database. RESULTS: Cytogenetic results were obtained from 76 cases (93.8%), of which 33 cases (43.4%) showed chromosome abnormalities. Of 33 chromosomal abnormalities, 12 cases (36.4%) showed monosomy X, including one case of 46,X,+7 and the other case of 44,X, t(13q14q). Autosomal trisomy was also detected in 12 cases (36.4%). The most frequent autosomal trisomy was that of chromosome 18 (4 cases), which occurred exclusively in old maternal age (37.8+/-7.5 years old). Mosaicism was found in 2 cases. Triploidy was identified in 4 cases. Structural abnormalities were identified in 3 cases. CONCLUSION: This study showed that monosomy X and trisomy were the most common chromosomal abnormalities in spontaneous abortion, and autosomal trisomy was dependant on maternal age.

Efficacy of Methotrexate in Management of Cervical Pregnancy / 대한주산의학회잡지

OBJECTIVES: This retrospective study was performed to evaluate the overall efficacy of methotrexate chemotherapy and to determine its proper management protocol in cervical pregnancy. METHOD: From January 1999 to May 2004, 44 patients of cervical pregnancy admitted in hospitals attached to Catholic University Medical Center. Among those, data of 35 cases received methotrexate therapy were analyzed. Clinical characteristics, route of methotrexate administration, concomitant invasive procedures, complications, and outcomes were analyzed. Analysis was performed by unpaired t-test, Fisher's exact test and Wilcoxon's rank sum test. RESULTS: The overall success rate of methotrexate was 82.9% and there was no significant difference according to viability, although initial beta hCG was significantly increased in viable pregnancy (p=0.0085). Major route of methotrexate was systemic in nonviable pregnancy and combined in viable pregnancy (p=0.035). In all patients who had a combination of systemic and local injection with methotrexate, treatment outcome was successful. Most common complication of methotrexate was liver toxicity, but not serious. CONCLUSION: Our results suggest that methotrexate treatment is effective as a therapeutic modality for early cervical pregnancy, but its administration route might be not related with efficacy. Furthermore, the combination of systemic and local intra-amniotic injection seems to be more effective.

Acute Optic Neuritis in Children : Clinical Features, Visual Outcome, Recurrence Rate, and Subsequent Evolution into Multiple Sclerosis

PURPOSE: Acute optic neuritis is an inflammatory optic neuropathy, and rarely occurs in children. Childhood-onset optic neuritis is different from adult-onset optic neuritis in terms of clinical and prognostic aspects. We investigated the clinical characteristics and visual prognosis related to the steroid therapy in children with acute optic neuritis. In addition, we evaluated the recurrence rate of acute optic neuritis and subsequent evolution into multiple sclerosis. METHODS: The medical records of ten children, who were previously admitted for acute optic neuritis at the Department of Pediatrics of Ajou University Medical Center from January 1995 to April 2004, were retrospectively reviewed. Nine patients were treated with intravenous methylprednisone pulse therapy, 0.5-1.0 g/day, for 3-5 days followed by an oral prednisone therapy. To 30 months after discharge, we followed up a long-term visual prognosis, recurrence rate and subsequent evolution into multiple sclerosis. RESULTS: There were 4 boys and 6 girls and the mean age of onset was 10 years. Bilateral optic neuritis was noticed in 8 children and 9 children presented with papillitis. Etiology of acute optic neuritis was idiopathic in 50% of patients. Of the remaining cases, it was related with acute disseminated encephalomyelitis(30%), sinusitis(10%), and neuromyelitis optica(10%). Orbital MRI showed optic nerve enhancement and/or enlargement and optic disc protrusion in 15 of the 18 examined eyes. Visual evoked potential (VEP) was abnormal in 12 of the 16 examined eyes; P100 response was totally attenu ated in 6 eyes, and in the others the amplitude of P100 response was normal but the latency was delayed. On follow-up VEP at 1 month after steroid pulse therapy, the amplitude of P100 response was normalized in all, but the latency was still delayed in 60% of the patients. A short-term visual acuity after treatment with steroid was normally recovered in 14 of 15 involved eyes. Acute optic neuritis recurred in one of the nine patients who were treated with high dose methylprednisone pulse therapy, but there was no subsequent development of multiple sclerosis during the follow up. CONCLUSION: The most common cause of acute optic neuritis in children is idiopathic, and presents as bilateral papillitis. On this study, a short-term visual prognosis after high dose methylprednisone pulse therapy is extremely good, but there was no significant difference in long-term visual prognosis at 6 months after treatment with steroid. Acute optic neuritis in children does not usually recur, and does not evolve into multiple sclerosis.

A Case of Vesicoallantoic Cyst Diagnosed by Prenatal Ultrasonogram Imaging / 대한주산의학회잡지

Fetal vesicoallantoic cyst is extremely rare anomaly of umbilical cord. This disorder is thought to be a remnant of the extraembryonic portion of the allantois and incomplete obliteration of the vesico-allantoic lumen results in a wide spectrum of urachal anomalies. A 23-years-old primigravida was referred to our hospital at 18 weeks of gestation age because of fetal abdominal cystic mass in basal part of umbilicus. On the ultrasonographic examination, the cystic mass appeared to be in direct communication with the urinary bladder markedly distended. The cytogenetic study by amniocentesis showed normal 46, XY. The fetus was dead at 21 weeks of gestation age. The results of autopsy showed multiple anomalies. We report this rare case with review on similar anomalies of the allantois.

Obstetric Outcome after Threatened Abortion / 대한산부인과학회잡지

OBJECTIVE: Threatened abortion, one of the most common problems of pregnancy, develops 15-20% of pregnant women and progresses into the abortion in 20-50%. It is related to many obstetrical sequelae. We analyzed the prevalence of complication, disruption of pregnancy and the effect of recent treatments. In ultrasonographic examination, we divided all cases into two groups according to existence of hematoma. We compared the difference of two groups about the prognosis of pregnancy and maternal serum concentration of FP. METHODS: A total 88 cases of threatened abortion and 5741 cases of normal pregnancy were studied from Jan., 1999 through Dec., 2003 at St. Paul Hospital in Seoul, Korea. We analyzed age, gestational age of menstruation and ultrasonogram, parity, results of triple test, existence of hematoma, efficacy of treatment. In all cases, we carried out ultrasonic examination with LogiQ-400 (General Electronics Medical System, Tokyo, Japan). We checked the concentration of FP from triple test. RESULTS: The mean gestational age at diagnosis was 9.2 +/- 3.4 weeks. After threatened abortion, successful cases were 71 and mean gestational age at diagnosis was 9.6 +/- 3.6 weeks. In comparison with 17 unsuccessful cases, whose mean gestational age at diagnosis was 6.6 +/- 1.8 weeks, it was thought to be significant differences (p=0.001). The success rates of pregnancy prolongation between groups of different treatments modalities are nearly similar. Existence of hematoma seems to have little impact on prognoses of pregnancy outcome and there were no meaningful differences of maternal serum FP concentration. CONCLUSION: In this study, we could find no difference between the groups those were treated with various methods. We thought that more systematic analysis about the treatment of threatened abortion would be needed. In the cases that were diagnosed threatened abortion at later gestational age, we could find obvious improvement of the pregnancy outcome. So we conclude that gestational age at the diagnosis is potential parameter of prognosis.

Association of the polymorphisms in CYP1A1 and CYP1A2 genes with preterm premature rupture of membranes / 대한산부인과학회잡지

OBJECTIVE: Preterm delivery (PTD) is the leading cause of perinatal mortality and morbidity. However, its etiology and pathogenesis remain unknown in most cases. Recently, some research put forth the hypothesis that PTD results, at least in part, from a genetic predisposition. This study was undertaken to elucidate whether polymorphisms of cytochrome 450 (CYP) 1A1 and 1A2 are associated with PTD caused by preterm premature rupture of membrane (PPROM) in Korean pregnant women. METHODS: From August 2002 to October 2003, in the affiliated hospitals in the Catholic University of Korea, we have collected the samples from the 264 women who delivered after 37 weeks and from 26 women who delivered following spontaneously ruptured membranes before 37 weeks. RESULTS: There was no significant difference in the genotype frequency as well as in the allelic frequency of CYP1A1*m2 in PPROM group compared with the control group (54% vs. 66%, P=0.224; 0.29 vs. 0.40, P=0.111, respectively). The genotype frequency of CYP1A2*C was significantly higher in PPROM group than in the control group (69% vs. 49%, P=0.047). However, the allelic frequency of CYP1A2*C was not significantly higher in PPROM group than in the control group (0.4 vs. 0.275, P=0.45). CONCLUSION: These results suggest that CYP1A2*C may be, at least in part, associated with PPROM.

Outcome of Prenatally Diagnosed Hydronephrosis: One Center Experience

PURPOSE: The detection of hydronephrosis(HN) with antenatal ultrasonography was first reported in the 1970s. Prenatal HN is diagnosed with an incidence of 1:100 to 1:500 on antenatal screening. Recently, the purpose of antenatal screening has changed from simple detection to selection for specific diagnosis-based management. this study is to evaluate the usefulness of antenatal sonography for HN and to investigate the differential causes of HN and their clinical outcomes. PATIENTS AND METHODS: 11,783 live neonates with prenatal ultrasonographic examination at Ajou University School of Medicine, from Sep. 1994 to Aug. 2001 were analyzed. RESULTS AND CONCLUSION: Hydronephrosis (>10 mm) was detected in 119 (1.0%) cases antenatally and among these, 91 were proved to have HN postnatally. Males were three times more affected than females. Additional imaging studies revealed that ureteropelvic junction obstruction was the most common postnatal diagnosis (47%), followed by multicystic dysplastic kidney, vesicoureteral junction obstruction and vesicoureteral reflux. During 20 months' follow-up (3 to 72 months), 58(48%) renal units showed spontaneous resolution and surgical interventions were necessary in 10 (7.4%) of postnatally confirmed hydronephrotic renal units.

Newborn Hearing Screening: 3 Years of Experience

PURPOSE: Hearing loss is one of the most common major abnormalities present at birth, which has an incidence of 1 to 3 per 1,000 newborn infants in the well-baby nursery population, and 2 to 4 per 1,000 infants in the intensive care unit population each year. If early undetected, will impede speech and language. The purpose of this study was to confirm in prevalence of neonatal hearing loss and to establish a common screening method adjusted to our country and to emphasize the importance of early detection. MATERIALS AND METHODS: TEOAE (transient evoked otoacoustic emission) were performed in 5,512 newborn infants in the well-baby nursery. The tests were performed daily until the infant had passed. Failed infants were followed at the outpatient clinic for re-tests. ABRs were performed for the confirmation of hearing loss those who had failed 3 TEOAE tests. RESULTS: The average test durations for right and left TEOAE were 67+/-50 sec and 72+/-56 sec respectively. There was no difference in test durations of the first TEOAE between before 24 hours and after 24 hours of life. 89% of tested infants passed during admission and the rest were followed at the outpatient clinic for the further studies. Eight infants were diagnosed with hearing loss on ABR. Overall time spent for the diagnosis of hearing loss was less than 3 months. CONCLUSION: TEOAE is a simple and useful screening method for the identification of hearing loss in infants. TEOAE must be necessary to universal screening of all infants.