Vitamin D status and its association with cardiometabolic risk factors in Korean adults based on a 2008-2010 Korean National Health and Nutrition Examination Survey

Recent studies suggest that vitamin D deficiency and cardiometabolic disorders are becoming increasingly more prevalent across multiple populations. However, there is a lack of comprehensive data for Korean adults. We investigated the vitamin D status, the prevalence of vitamin D deficiency and its association with metabolic syndrome (MS) risk in Korean adults aged 20 years or older. The study subjects (n = 18,305) were individuals who participated in the Korean National Health Examination and Nutrition Survey (KNHANES) in 2008-2010. Vitamin D status (25-hydroxyvitamin D [25(OH)D]) was categorized as or = 30 ng/mL, which are the cut-off points for deficiency, insufficiency and normal limits. A wide variety of cardiometabolic risk factors were compared according to the vitamin D status. Vitamin D deficiency was found in 53.9% of men and 70.5% of women. Mean BMI, systolic BP, HbA1c and low density lipoprotein cholesterol (LDL-C) were highest in the vitamin D deficiency group in both genders. Further, the MS was most prevalent in the vitamin D deficiency group in both genders (12.3%, P = 0.002 in men and 9.2%, P < 0.001 in women). Compared to the vitamin D normal group, the adjusted odds ratio (ORs) (95% confidence interval [95% CI]) for MS in the vitamin D deficiency group were 1.46 (1.05-2.02) in men and 1.60 (1.21-2.11) in women, after adjusting for confounding variables. In conclusion, Vitamin D deficiency is a very common health problem in Korean adults and is independently associated with the increasing risk of MS.

The predictive efficacy of maternal serum CA125 in intrauterine early pregnancy with vaginal bleeding / 대한산부인과학회지

OBJECTIVE: To investigate whether sudden rise or already increased level of maternal serum CA125 predicts spontaneous abortion in early pregnancy with vaginal bleeding. And if so, to decide the CA125 cut-off level for poor pregnancy outcomes. METHODS: The prospective study was performed in forty women presenting with any vaginal bleeding at early pregnancy. Maternal serum CA125 levels were evaluated on the first visit and followed up during the first trimester, or until the time to diagnose abortion. Serial maternal serum beta-hCG and ultrasonographic evaluation were also performed at the same time. RESULTS: There were eventually fourteen abortions and twenty-six ongoing pregnancies. Using receiver-operating characteristic curve, 150 U/mL of serum CA125 was the most useful value for predicting spontaneous abortion. In most of abortion women, the serum CA125 level was increased over than 150 U/mL immediately before the abortion. The twelve of 17 women who were 150 U/mL or more resulted in abortion, while there were just two cases of abortion among 23 women who were less than 150 U/mL. Its positive predictive value was 70.6% and negative predictive value was 91.3% respectively (P<0.01). CONCLUSION: There was a strong correlation between high level of serum CA125 and subsequent spontaneous abortion in early pregnancy. It should be valuable to check maternal serum CA125 added to beta-hCG and ultrasound for predicting pregnancy outcome at the early pregnancy, especially in the cases with vaginal bleeding.

Efficacy and Safety of Cabergoline as First Line Treatment for Invasive Giant Prolactinoma

Although cabergoline is effective in the treatment of micro- and macro-prolactinoma, little is known about its efficacy in the treatment of invasive giant prolactinoma. We investigated the efficacy and safety of cabergoline in 10 male patients with invasive giant prolactinoma. Before treatment, mean serum prolactin level was 11,426 ng/mL (range, 1,450-33,200 ng/mL) and mean maximum tumor diameter was 51 mm (range, 40-77 mm). Three months after initiation of cabergoline treatment, serum prolactin concentrations decreased more than 97% in 9 patients; at last follow-up (mean treatment duration, 19 months), the mean decrease in serum prolactin concentrations was 98%, with 5 patients having normal serum prolactin levels. At first MRI follow-up (3-12 months after initiation of cabergoline), the mean reduction in tumor size was 85+/-4% (range, 57-98%). Cabergoline treatment for more than 12 months caused a greater reduction in tumor size compared to the treatment for less than 12 months (97+/-1% vs. 78+/-7%, P<0.05). These findings indicate that cabergoline treatment led to a significant and rapid reduction in serum prolactin concentrations and tumor size in patients with giant prolactinoma. Therefore, cabergoline represents an effective and well-tolerated treatment for invasive giant prolactinoma.

Endocervicosis presenting as abdominal wall mass / 대한산부인과학회지

Endocervicosis refers to the presence of benign mucinous glands of endocervical type in ectopic site. It is rare and usually detected incidentally by histologic examination. The urinary bladder is the most common site, but peritoneum, small bowel, abdominal scar, outer wall of the cervix, vagina, and lymph nodes have been documented. Because this is the first documented report of endocervicosis arising in the rectus muscle in korea, we report this with a brief review of the concerned literatures.

A case of endometrial actinomycosis of a virgin / 대한산부인과학회지

Actinomyces species are anaerobic or microaerophilic non-spore-forming gram-positive rods that may reach, occasionally, the normal female genital tract. Actinomycosis is uncommon and often presents as a complication of an intrauterine device (IUD). IUD and pessaries facilitate the access of the microorganisms to the pelvis. Almost 85% of cases occur in women who have had an IUD in place for 3 or more years. In fact, the detection rate of Actinomyces in patients with pelvic actinomycosis is as low as 2%. The diseases caused by Actinomyces spp. is often of difficult diagonsis. The diagnosis of actinomycosis can be confirmed by culture. However, it is often difficult to culture Actinomyces. Therefore a diagnosis of actinomycosis can be made from the finding of sulfur granules within inflammatory exudate on histologic examination after surgery. However, it may be possible to diagnose actinomycosis before surgery by the finding of Actinomyces-like organisms on Papanicolaou smears. The endometrial involvement is extremely rare. The authors report an unusual case of endometrial infection by Actinomyces in a 21 year-old female without intercourse, admitted into the institute with menorrhagia. She had received oral pills. Abdominal ultrasonography showed a endometrial thickening. The pre-diagnosis was endometrial hyperplasia. The endometrial biopsy was done. The sample from the endometrium developed actinomycosis. After procedure and treatment, the menorrhagia was disappeared.

The clinical studies on 600 cases of total laparoscopic hysterectomy (TLH) / 대한산부인과학회지

OBJECTIVE: To analyze the clinical characteristics of total laparoscopic hysterectomy. METHODS: Clinical data about 600 cases who received TLH were collected and the hospital stay, operation time and complication were evaluated. RESULTS: The most common indications for TLH were uterine myomas, adenomyosis, severe endometriosis and cervical intraepithelial neoplasia. Mean operating time was 90 minutes (range 35-200 min) and hospital stay was 3 days (range 2 days-10 days). The most important factors for the surgery time were uterine size, assistant's skill and presence of adhesions (obliteration of the cul-de-sac due to severe pelvic endometriosis). Several techniques were used, including bipolar coagulation of the ovarian and uterine vessels, and suture of the stump. A special uterine manipulator (RUMITM uterine manipulator with colpotomizer and pneumooccluder balloon) used in all procedures aided in anatomic definition and performing the circumferential colpotomy. We had two cases of ureteral obliteration by using bipolar coagulator, and 3 cases of bladder injuries during operation which was diagnosed and immediately repaired laparoscopically. We had two cases of ureterovaginal fistula, two cases of postoperative ileus and one case of bowel perforation. But there were no cases of death, thrombophlebitis or other pulmonary complications. CONCLUSIONS: Total laparoscopic hysterectomy can be performed safely and effectively when the surgical team is sufficiently trained. And we believe that total laparoscopic hysterectomy offers benefits to the patients in the form of less post-operative pain, shorter time in hospital.

Trophoblast Apoptosis and BRCA1 Expression in Fetal Growth Restriction Pregnancy / 대한산부인과학회지

OBJECTIVE: To know the role of trophoblast apoptosis and BRCA1 on pregnancy of intra-uterine fetal growth restriction (FGR). BRCA1 is regarded as not only a tumor suppressor gene but regulator of cell growth, proliferation and differentiation. We tested the hypothesis that enhanced trophoblast apoptosis and expression of BRCA1 reduced placental mass, which caused placental dysfunction and FGR. METHODS: Placentas were obtained from women with pregnancies complicated by FGR (n=10) and from women with controlled normal pregnancies at different gestational ages (n=15). After placental sections were isolated, In Situ DNA 3'-end labelling analysis as well as detection of cytokeratin 18 cleavage products for apoptosis were measured by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) assay and counter staining with hematoxylin and eosin. The same sections were examined by means of immunohistochemistry and Western immunoblotting for identifying the expression of BRCA1 protein. RESULTS: TUNEL staining exhibited consistently higher levels of nuclear staining and more cytokeratin 18 cleavage products in trophoblasts from FGR than normal growth pregnancy. In the trophoblasts of FGR, the BRCA1 expression and the staining intensity were more augmented on Western blotting and immunohistochemistry than normal pregnancies. There was no remarkable difference of BRCA1 expression according to gestational ages. CONCLUSION: The expression of BRCA1 and apoptosis is up-regulated in human placental villi from pregnancies complicated by FGR. It suggests that BRCA1 may play a role in trophoblast proliferation and differentiation and be related to the pathophysiologic mechanism of FGR. We speculated that the clinical conditions associated with enhanced BRCA1-mediated apoptosis in trophoblasts and thereby contribute to placental dysfunction and FGR.

Immunological evaluation of ex vivo expanded umbilical cord blood T lymphocytes / 부인종양

OBJECTIVE: The objectives of this study were, first to characterize the immunological differences of the T lymphocytes of umbilical cord blood (UCB) compared to those of adult; second to expand the T lymphocytes in ex vivo condition of a short term culture, and to assess the immunological function of the expanded T lymphocytes. METHODS: The immunophenotypic study of 40 UCB and 10 adult peripheral blood (PB) was performed. The fresh UCB mononuclear cells (MNCs) were isolated. The nonadherent MNC fractions were then cultured with the anti-CD3 antibody with or without Loranthus yadoriki (10 microgram/ml). The MNCs were cultured in the anti-CD3 antibody-coated flasks for 4 days, and then transferred to the non-coated flasks, which were added IL-2 175 U/ml and cultured for another 10 days. Proliferative ability of UCB T lymphocytes, cell surface markers, and cytotoxicity assays of the expanded T lymphocytes were performed. RESULTS: Cell surface markers of the UCB T lymphocytes were different from those of adult T cells. The UCB T lymphocytes cultured with the anti-CD3 antibody 100 ng/ml showed a significant increase in the proliferative ability (p<0.05). After culture in the anti-CD3 antibody coated flask with IL-2, expression of the activated T lymphocytes were increased significantly. The cultured cells exhibited substantial killing activity on the SK-OV-3 target cells compared to the fresh UCB lymphocytes. CONCLUSION: The ex vivo combination of the anti-CD3 antibody and IL-2 significantly enhanced proliferation, activation, and maturation of the UCB T lymphocytes. Moreover cytotoxic potential of expanded UCB T cells was observed.

A Case of Acute Pancreatitis of the Pregnancy / 대한산부인과학회지

Acute pancreatitis is a rarely occurred during pregnancy, with few reports in the literature addressing the problem. Pregnancy complicated by pancreatitis may lead to significant fetal and maternal morbidity and mortality. The disease occurs predominantly in later pregnancy, and rarely during the postpartum period. We report a case of acute alcoholic pancreatitis during pregnancy with a brief review of literature.

Benefits of Antenatal Corticosteroid in Infants Delivered before 33 weeks of Gestation after Premature Rupture of Membranes / 대한산부인과학회잡지

OBJECTIVE: To evaluate the benefits of maternal corticosteroid therapy in infants delivered before 33 weeks of gestation after premature rupture of membranes (PROM). METHODS: This retrospective study included the pregnant women complicated by preterm delivery within 32 weeks of gestation after PROM at the Asan Medical Center between 1997 to 1999. Patients were divided into 2 groups according to the gestational age at delivery, i.e., one group who delivered within 28 weeks of gestation and the other group who delivered between 29 and 32 weeks of gestation. Within each group, we evaluated the effect of maternal dexamethasone therapy on the perinatal and neonatal outcomes based on the medical records. Data were analyzed with pearson's chi-square test, Fisher's exact test, and two sample t-test. p<0.05 was considered statistically significant. RESULTS: One hundred and fifteen pregnancies complicated by preterm delivery within 32 weeks of gestation after premature rupture of membranes were included. Preterm deliveries occurred within 28 weeks of gestation in 48 cases (41.7%) and between 28 and 32 weeks of gestations in 67 cases (58.3%). Antenatal dexamethasone therapy was done in 27 out of 48 mothers (56.3%) who delivered within 28 weeks of gestation and in 47 out of 67 mothers (70.1%) who delivered between 29 and 32 weeks of gestation. Antenatal dexamethasone therapy did not affect the selected perinatal outcome variables (gestational age at delivery, birth weight, Apgar scores, cesarean section rate, and maternal and neonatal WBC counts and serum C-reactive protein concentrations). Incidences of neonatal complications (respiratory distress syndrome, intraventricular hemorrhage, retinopathy of prematurity, and periventricular leukomalacia) between the groups who did and did not received antenatal dexamethasone were not significantly different in pregnancies who delivered within 28 weeks of gestation. However, incidences of respiratory distress syndrome and intraventricular hemorrhage were significantly lower in a group who received antenatal dexamethasone than in a group who did not in pregnancies who delivered between 29 and 32 weeks of gestation (p<0.05). CONCLUSION: Antenatal corticosteroid therapy may be beneficial to the infants delivered between 29 and 32 weeks of gestation after PROM. However, it may have no therapeutic advantage to the group who delivered within 28 weeks of gestation after PROM.

A Case of Lipid Cell Tumor of the Ovary / 대한산부인과학회잡지

Lipid cell tumors of the ovary are the rarest functional ovarian neoplasm, and malignant variants are unusual. Although rare, due to endocrinological activity, these tumors are of great clinical interest. Recently we experienced a case of lipid cell tumor of the right ovary in 21 years old female, who presented with menometrorrhagia and menorrhagia, and reported it with a brief review of literatures.

A Case of Term Delivery in Heterotopic Pregnancy / 대한산부인과학회잡지

Heterotopic pregnancy is that intrauterine pregnancy is accompanied by a coexisting ectopic pregnancy. The incidence of this disease was very rare, but it has been increased considerably with increasing cases of assisted reproductive technologies and tubal injuries resulted from tubal surgery, endometriosis, and PID. These are prerequisites for diagnosis that close monitoring of early pregnancy including serial serum hCG level and transvaginal sonography. We experienced a case of term delivery in heterotopic pregnancy following natural conception, so report this case with brief review of literatures.

A Case of Juvenile Granulosa Cell Tumor / 대한산부인과학회잡지

Granulosa cell tumors costitute 1% to 2% of all ovarian tumors and occur mostly in adult women. Juvenile granulosa cell tumor (JGCT) differs from the adult type in clinical and pathologic features as well as biological behavior. Usually associated with estrogen production, the tumor leads to endocrinologic symptoms such as isosexual precocity in premenarcheal girl and menstrual irregularities or amenorrhea in postpubertal woman. JGCT is diagnosed in early stage with favorable prognosis in most cases while in more advanced stage with grave outcome. The clinical stage at the time of diagnosis is considered the most important prognostic factor. If fertility is desired in the absence of contralateral or pelvic involvement, unilateral salpingo- oophorectomy is justifiable. We experienced a case of JGCT in 22 years old woman who presented with amenorrhea and low abdominal pain, and report this case with a brief review of literatures.

Measurement of Amniotic Fluid Nitric Oxide and Fetal Plasma Growth Factor Levels in Pregnancies Complicated by Intrauterine Growth Restriction with Normal Uterine Artery Doppler Velocimetry / 대한주산의학회잡지

OBJECTIVE: Our purpose was to evaluate the relationship between amniotic fluid nitric oxide(NO) and fetal blood IGF-I, IGFBP-1, and cortisol in pregnancies complicated by intrauterine growth restriction(IUGR), but showing normal uterine artery doppler waveform. METHODS: From July 1999 to March 2000, 18 pregnant women with IUGR and 18 normal pregnancies were studied. Both group showed normal uterine artery doppler waveform. Amniotic fluid samples were collected to measure NO, and fetal blood samples were collected from umbilical vein to measure fetal growth factors. The definition used to identify cases of IUGR depended on three criteria: clinical evidence of suboptimal growth, ultrasonographic evidence of deviation from an appropriate growth percentile, and individualized birth weight ratios <10th percentile. RESULTS: Overall median NO values in amniotic fluid were lower in IUGRs than in controls, but there was no statistical significance. However, IUGR newborns showed significantly lower(p<0.05) concentrations of IGF-I, and greater(p<0.05) concentrations of IGFBP-1 and cortisol than did controls. CONCLUSION: These result suggest that cord blood IGF-I, IGFBP-1, and cortisol, but not amniotic fluid NO may act major regulating factor in idiopathic IUGR without placental insufficiency.

A Significance of Fetal Choroid Plexus Cysts / 대한주산의학회잡지

OBJECTIVE: Choroid plexus cysts(CPCs) are commonly found at a routine ultrasonography. There is, however much debate as to their clinical significance. The aim of this study were to estimate the prevalence of CPCs associated with aneuploidy and to establish the guidelines for prenatal management and parental counseling. METHODS: Between January 1996 and December 2001, 10,917 women who underwent the secondtrimester USG at Asan Medical Center, of them CPCs were noted in 168 fetuses; there were 85 cases of isolated CPCs and 83 cases of the high risk group. All women whose fetuses were diagnosed as having CPCs underwent the targeted USG for survey of the detailed anatomy and followed with the repeat USG after 3-4weeks. We analysed the association of chromosomal abnormality and CPC, according to the size, bilaterality, and shape. RESULTS: The incidence of CPCs was 1.60%(175/10917). The gestational age of the first detection of CPCs was 21.0+/-3.8(mean+/-SD). In the isolated CPCs(85cases) all case except one resulted in normal karyotyping. In the high risk group(83cases), eighteen of trisomy 18, and two of trisomy 21 were detected. Almost all of them had other structural abnormalities on USG. The chromosomal abnormalities was significantly related with CPCs when CPCs are large(>or=10mm), bilateral, and irregular shape. CONCLUSION: The risk of chromosomal abnormalities is elevated when CPCs are associated with other structural abnormalities on USG. Therefore it is recommendable that the fetal chromosomal analysis to be performed, based on the presence of associated abnormal findings on USG, maternal age, and results of the double marker test.

The postnatal outcome and prognostic cut-off value of fetal pyelectasia / 대한산부인과학회잡지

OBJECTIVE: The purpose of our study was to evaluate the postnatal outcome of fetal pyelectasia and to assess the cut-off value for prediction of renal pathologic processes and surgical intervention. MATERIALS AND METHODS: Seventy-seven cases of pyelectasia were identified during the study period (1996 through 2000). Fetuses with antero-posterior pelvic diameter (APPD) >or=7 mm after 28 weeks were included. Postnatal evaluation included renal sonogram, voiding cystourethrogram, and renal flow and function studies. RESULTS: Renal pathologic processes after birth were found in 38 of 77 cases (49%). Ureteropelvic junction obstruction (19 cases, 50%) was the most common, followed by 4 cases of duplicated kidney, 3 cases of ureterovesical junction obstruction, 2 cases of primary vesicoureteral reflux, dysplastic kidney, extrarenal pelvis respectively and 1 case of ureterocele. Surgical intervention was performed in 21 cases (55%); pyeloplasty (13), nephrectomy (including partial) (3), transurethral incision of ureterocele (2), uretero- ureterostomy (1), uretero-cystostomy (2). Using cut-off value derived from receiver operating characteristic (ROC) curve, renal APPD >or=10.5 mm, >or=13.6 mm after 28 weeks gestation could predict the fetuses who would have renal pathologic processes and need surgical intervention, with sensitivity and specificity of 77.5%, 79.4% and 90.5%, 89.3%, respectively. CONCLUSION: It is possible to predict the fetuses who would require appropriate urologic evaluation and surgical intervention after birth, with determining the renal pelvic diameter in the third trimester of pregnancy.

Efficacy of midtrimester amniotic fluid 8-isoprostane measurement in the prediction of severe preeclampsia / 대한산부인과학회잡지

OBJECTIVE: The objective of this study is to investigate whether the amniotic fluid 8-isoprostane levels at the time of genetic amniocentesis is a marker for severe preeclampsia. METHODS: A case-control study was conducted to compare mid-trimester concentrations of amniotic fluid 8-isoprostane in women with normal pregnancies (n=22) and in those who subsequently developed severe preeclampsia (n=22). Amniotic fluid was also obtained by amniocentesis from another women who already developed severe preeclampsia (n=22) after 20 weeks of gestation. The 8-isoprostane levels were measured by enzyme-linked immunoassay. For statistical analysis, nonparametric tests and receiver-operating characteristic curves were used where appropriate. Statistical significance was considered when probability was <0.05. RESULTS: The levels of midtrimester amniotic fluid 8-isoprostane were found to be significantly decreased in the women who subsequently developed severe preeclampsia in comparison with those who underwent normal pregnancies (P<0.05). The levels of 8-isoprostane in preeclamptic amniotic fluid were found to be significantly decreased with respect to that in midtrimester amniotic fluid (P<0.05). No relationship was found between the midtrimester amniotic fluid 8-isoprostane levels and preeclampsia with small-for- gestational-age. After the onset of severe preeclampsia, however, the amniotic fluid 8-isoprostane levels were significantly decreased in women with small-for-gestational-age. The midtrimester amniotic fluid 8-isoprostane level of 170 pg/ml had a sensitivity of 72.7% and a specificity of 63.6% in the prediction of severe preeclampsia. CONCLUSION: The midtrimester amniotic fluid 8-isoprostane levels may predict the later occurrence of severe preeclampsia. This study not only presents a new information that 8-isoprostane is detected in human amniotic fluid, but also provides a convincing evidence that a subclinical process from faulty placentation in early gestation is important for the occurrence of preeclampsia. Further studies are warranted to determine which mechanism causes such decrease in amniotic fluid 8-isoprostane in preeclampsia.

Clinical usefulness of serum alpha-FP and free beta-hCG levels in midtrimester / 대한산부인과학회잡지

OBJECTIVE: The aim of this study was to evaluate the detection rate of the chromosomal abnormalities by screening of maternal serum alpha-FP, free beta-hCG in midtrimester and to evaluate the association of elevated free beta-hCG with neonatal & pregnancy outcome. METHODS: From October 1995 to December 1999, We studied 8,304 pregnant women who delivered in Asan Medical Center. We measured the levels of serum alpha-FP and free beta-hCG in the midtrimester. We reviewed high Down risk group, high NTD risk group and numerous cases of chromosomal abnormalities, retrospectively. To evaluate the association of elevated free beta-hCG with neonatal & pregnancy outcome, we reviewed birth weight, apgar score, gestational age at delivery, presence of PIH or fetal growth restriction. RESULTS: Two hundred ninety eight (3.6%) women were screened as high Down risk pregnancy, 61 (0.7%) women were screened as high NTD risk pregnancy. In the high risk group of chromosomal abnormalities, there were 13 cases of various chromosomal abnormalites, including of six Down syndrome baby. In the low risk group, there were two (0.02%) Down syndrome baby and 8 cases of other chromosomal abnormality. By using maternal serum alpha-FP, free beta-hCG in mid-trimester, 68% of the detection rate of chromosomal abnormalites and 4.1% of false positive rate was reported. The detection rate of Down syndrome is 75% (6/8) and 3.5% of false positive rate, 0.02% of false negative rate were reported. In the aspect of pregnancy outcome, when the free beta-hCG more than 2.5MOM, there were more numerous preterm delivery (8.2% vs 3.8%), IUGR (4.6% vs 1.7%), lower 1 min apgar score than 7 (6.4% vs 2.7%). CONCLUSION: Maternal serum alpha-FP, free beta-hCG is at least useful method as Double markers screening method for fetal chromosomal abnormalites and maybe elevated free beta-hCG level can be useful marker of poor pregnancy outcome such as PIH, low birth weight or preterm delivery.

A Case of Fetus in Fetu: Ultrasonic prenatal diagnosis / 대한산부인과학회잡지

Fetus in fetu is a very rare pathologic feature consisting of a parasitic twin included within the body of the other twin. Fetus in fetu within about 7X6X5 cm sized cystic mass in the fetal retroperitoneum was detected and diagnosed during antenatal ultrasound and confirmed by computed tomography scan postnatally. The mass was removed after birth. The cyst contain yellowish serous fluid with two solid masses. Two solid masses were confirmed fetus in fetu by gross and microscopic pathologic examination. The larger one showed well-developed and organized internal organ.

Cordocentesis for prenatal diagnosis and therapy: experience of 461 cases / 대한산부인과학회잡지

OBJECTIVE: We report our experience with cordocentesis for prenatal diagnosis and therapy. The clinical effect and safety of cordocentesis were evaluated. MATERIALS AND METHODS: From June 1997 to December 2001, cordocentesis was performed on 461 fetuses at Asan Medical Center. The clinical characteristics of the patients and the results of each procedure were reviewed retrospectively. RESULTS: The mean gestational age at the time of cordocentesis was 25.0 weeks. The most common indication was rapid karyotyping (93.3%) and was followed by the risk of fetal infection (3.5%). Of 461 cordocentesis, 452 (98.0%) were done successfully at the first attempt. The procedure-related complications included transient bleeding at puncture site (0.7%), and transient fetal bradycardia (0.2%). There was no procedure-related fetal loss. The other obstetric complications were comparable with those in the general population. CONCLUSION: We conclude that cordocentesis is a useful, safe and effective procedure for fetal diagnosis and therapy.