Heat Shock Protein 60 and 27 expressions on the trophoblast of preterm birth / 대한산부인과학회지

OBJECTIVE: To compare the distribution and expression of hsp60 and hsp27 in placental trophoblast between preterm and term placenta and to observe hsp immune response in relation to the pathogenesis of preterm birth. METHODS: 22 cases of preterm trophoblast, between 24 weeks and 36 weeks gestation, which were developed spontaneous onset or less than 24 hours after rupture of membrane were obtained. And aged-matched, 22 cases of normal term trophoblast, as control were also obtained after informed consent from each patient. The protein extraction form trophoblast was stained by immunohistochemical methods and was measured by the assay of Western blots. And the density of band using Image-writer were taken and statistical assay were performed as significance <0.05. RESULTS: The expressions of hsp60 and hsp27 in trophoblast of preterm and term placenta were identified by immunohistochemical staining method. The hsp60 had significantly higher expression in trophoblast of preterm birth than in that of term birth (P<0.001) and the hsp27 also had significantly higher expression in trophoblast of preterm birth than in that of term birth (P<0.02) CONCLUSION: The higher expression of hsp60 and hsp27 in trophoblast of preterm birth might be suggested the development of immune response to occur preterm labor Further study are necessary to determine the exact actions of hsp60 and27 in trophoblast and to understand the immune mechanism of preterm birth.

The perinatal outcomes of pregnant women with cardiac disease / 대한산부인과학회지

OBJECTIVES: The aims of the study show the effect of cardiac disease of pregnant women on the perinatal complications and pregnancy outcomes. METHODS: From Jan. 2001 to Nov. 2005, 29 cases of pregnant women with cardiac disease were enrolled and classified by the NYHA (New York Heart Association) classes under the supervision of cardiologist and cardiothoracic surgeon. The average age of all cases is 29.9 years olds and it consists of 13 primigravida and 16 multigravida. For the examination of cardiac function during the pregnancy, the echocardiography was performed. We evaluated the cardiac disease of pregnant woman with the underlying causes, clinical manifestations during the pregnancy, delivery mode, gestational age at birth, birth weight, Apgar score and perinatal complication. RESULTS: All 29 cases with cardiac diseases are composed of 21 cases of NYHA class I (72.7%), 4 case of NYHA class II (13.7%) and 4 cases of NYHA class III (13.7%). There are 11 cases with congenital heart disease (37.9%), 6 cases with acquired heart disease (20.6%), 9 cases with arrhythmia (31.0%), and 3 cases with other cardiac disease (10.3%). Before the pregnancy, 6 cases of 11 cases with congenital heart disease and 5 cases of 6 cases with acquired heart disease performed the corrected cardiac surgery. Echocardiography was performed on 24 cases. It showed average ejection fraction in left ventricle of NYHA class I (13 cases) and NYHA class II, III (8 cases) were 61.5% and 52.6%, respectively. 7 cases of NYHA class I and 1 case of class II was done on the vaginal delivery. 14 cases of class I pregnant woman were performed the cesarean section according to obstetric indications but 3 cases of class II were performed the cesarean section for the prevention of cardiac risks. 4 cases of class III were performed the cesarean section according to obstetrics indications (2 cases) and for the prevention of cardiac risks (2 cases). For gestational age at birth, the average of NYHA class I was 38.1 weeks and the average of NYHA class II, III was 35.4 weeks. The average birth weight showed 3,022 gm in class I and 2,446 gm in class II and class III. Preterm birth were 3 cases (class II; 1 case, class III ; 2 cases). Low birth weight infant were 5 cases (class I; 3 cases, class II 2 cases). Intrauterine fetal death was a case (class I). Congenital abnormalities at birth were not observed in our study. Although no maternal mortality was observed, 2 cases of pulmonary edema caused by cardiomyopathy in NYHA class III and 1 case of Eisenmenger Syndrome caused by PDA in NYHA class II were developed during the labor. CONCLUSION: In this study, the majority of pregnant women with cardiac disease had the congenital heart diseases. It also showed that they can expect good perinatal outcomes by the adequate prenatal care including cardiac surgery before the pregnancy.