The Maternal and Fetal Adrenal Effect of 1 cycle Dexamethasone on women with Preterm Labor / 대한산부인과학회잡지

OBJECTIVE: The aim of this study was to determine whether 1 cycle of dexamethasone administration to women at risk of preterm delivery causes adrenal suppression METHODS: Nonpregnant ten control subjects were checked baseline cortisol and stimulated cortisol level after low-dose (1 microgram) ACTH stimulation test. Ten women at risk of preterm delivery had two weekly low-dose (1 microgram) ACTH stimulation tests with the first one at admission. Immediately after the first ACTH stimulation test, we gave each women a 5 mg dexamethasone dose intramuscularly and repeated it 12 hours later for two days. Serum cortisol levels were measured before (baseline) and 30 minutes after ACTH administration. RESULTS: All ten subjects had normal baseline and stimulated cortisol levels for the first ACTH stimulation test. The adrenal suppressed Group was composed of 5 patients. But the remainders was not suppressed. Mean baseline serum cortisol levels decreased from 38.52 microgram/dL (before dexamethasone) to 33.26 microgram/dL (1 week after 1 cycle of dexamethasone) in adrenal suppressed Group. The mean stimulated cortisol levels also decreased from 46.40 microgram/dL (before dexamethasone) to 45.02 microgram/dL (1 week after 1 cycle of dexamethasone) in adrenal suppressed Group. CONCLUSIONS: Antenatal administration of 1 cycle dexamethasone produced slightly adrenal suppression, but no adrenal insufficiency, in some women at risk of preterm delivery and may be harmless to maternal and fetal adrenal function.

A Case Of Acute Misoprostol Toxicity / 대한산부인과학회잡지

Misoprostol (Cytotec) is a prostaglandin E1 analog used in prevention of nonsteroidal anti-inflammatory drugs induced gastric ulcer and has a uterotonic effect. It has been used to terminate pregnancy at any stage by promoting uterine contractions and for ripening the cervix before induced labor or abortion. Recently, it is known to reduce postpartum hemorrhage. Very little experience has been reported acute misoprostol toxicity in contrast with its usages. We have experienced a case of acute toxicity of misoprostol used for management of postpartum hemorrhage. We report this case with a review of literatures.

A Case Of Acute Misoprostol Toxicity / 대한산부인과학회잡지

Misoprostol (Cytotec) is a prostaglandin E1 analog used in prevention of nonsteroidal anti-inflammatory drugs induced gastric ulcer and has a uterotonic effect. It has been used to terminate pregnancy at any stage by promoting uterine contractions and for ripening the cervix before induced labor or abortion. Recently, it is known to reduce postpartum hemorrhage. Very little experience has been reported acute misoprostol toxicity in contrast with its usages. We have experienced a case of acute toxicity of misoprostol used for management of postpartum hemorrhage. We report this case with a review of literatures.

Two Cases of Amnioinfusion for the Midtrimester Oligohydroamnios / 대한산부인과학회잡지

Reduced amniotic fluid volume generally leads to a poor perinatal outcome, especially when it is observed in the second trimester. The recent obstetric literatures have been reporting on various applications of amnioinfusion in the diagnostic, prophylactic and therapeutic management of oligohydroamnios. We experienced two cases of amnioinfusion, which were used to diagnose or to manage the midtrimester oligohydroamnios and we report them with a brief review.