• Clinical and Experimental Pediatrics
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• v.50 no.3
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• pp.268-271
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• 2007

Purpose : Premature narrowing of the foramen ovale is rare but serious clinical entity. Prenatal narrowing or obstruction of the foramen ovale shows symptoms such as right heart failure, fetal hydrops, triscupid regurgitation, left heart obstructive disease, and supraventricular tachycardia. This study aimed to assess the prenatal diagnosis and postnatal clinical course of restrictive foramen ovale in utero in otherwise normal heart. Methods : The subjects were five patients diagnosed with restrictive foramen ovale in utero from January 2001 to June 2005 at Chungnam National University Hospital. The diagnostic criteria was defined when the maximum diameter in a 4-chamber view is less than 2.5 mm and there is a continuous doppler velocity at the foramen ovale of more than 0.6m/s. Results : At the time of diagnosis of restrictive foramen ovale, gestation age was 34~37 wks, and chief complaints were fetal arrhythmia(2 cases), pericardial effusion, Ebstein anomaly and subaortic stenosis. Two cases which were diagnosed fetal hydrops and supraventricular tachycardia delivered by emergent cesarian section. Five cases were found to have right heart dilatation on echocardiogram after birth, but right heart dilatation became normalized at day 7 after birth and the clinical courses were not eventful. Conclusion : Identifying an obstructed foramen ovale in the fetus warrants the further search for additional cardiac and extracardiac anomalies, which may alter the prognosis. Delivery should be induced if possible in cases of foramen ovale obstruction with signs of cardiac decompensation.

• Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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• 2007.11a
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• pp.760-763
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• 2007

We studied how linear and nonlinear heart rate dynamics differ between normal fetuses and uncomplicated small-forgestational age (SGA) fetuses, aged 32-40 weeks' gestation. We analyzed each fetal heart rate time series for 20 min and quantified the complexity (nonlinear dynamics) of each fetal heart rate (FHR) time series by approximate entropy (ApEn) and correlation dimension (CD). The linear dynamics were analyzed by canonical correlation analysis (CCA). The ApEn and CD of the uncomplicated SGA fetuses were significantly lower than that of the normal fetuses in all three gestational periods (32-34, 35-37, 38-40 weeks). Canonical correlation ensemble in SGA fetuses is slightly higher than normal ones in all three gestational periods, especially at 35-37 weeks. Irregularity and complexity of the heart rate dynamics of SGA fetuses are lower than that of normal ones. Also, canonical ensemble in SGA fetuses is higher than in normal ones, suggesting that the FHR control system has multiple complex interactions. Along with the clear difference between the two groups' non-linear chaotic dynamics in FHR patterns, we clarified the hidden subtle differences in linearity (e.g. canonical ensemble). The decrease in non-linear dynamics may contribute to the increase in linear dynamics. The present statistical methodology can be readily and routinely utilized in Obstetrics and Gynecologic fields.

• Asian-Australasian Journal of Animal Sciences
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• v.22 no.12
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• pp.1633-1639
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• 2009

This study investigated the effect of maternal undernutrition during late pregnancy on the growth and development of ovine fetal visceral organs. One hundred Mongolian ewes were mated at a synchronized oestrus and divided into three groups and offered 0.175 MJ ME $kgw^{-0.75}\;d^{-1}$ (Restricted Group1; RG1), 0.33 MJ ME $kgw^{-0.75}\;d^{-1}$ (Restricted Group2; RG2) and ad libitum access to feed (Control Group; CG) during late pregnancy (90 days). Selected animals in each group were slaughtered immediately at d 90 of pregnancy and after parturition (neonatal lambs), and major visceral organs were removed and weighed separately. The results indicated that the weights of lung (p<0.01), spleen (p<0.01), heart (p<0.05), liver (p<0.05) and abomasum (p<0.01) in RG1 were significantly lighter than those of CG. For RG2, only the weights of the lung (p<0.05) and spleen (p<0.01) were significantly lighter than those of CG; when expressed as a percentage of body weight, significance was retained in the spleen (p<0.01) for both restricted groups, but the percentage of brain in RG1 was significantly higher than that in CG (p<0.01). For lung and spleen, the amount of DNA was significantly lower (p<0.01) in both groups of restricted neonatal lambs compared to CG; however, there was a significant difference only between RG1 and CG for protein: DNA ratio (p<0.01). The DNA content of kidney, abomasum and jejunum were decreased (p<0.05) in RG1 neonatal lambs, but protein: DNA ratio in the liver was decreased compared with that of CG (p<0.05). The plane of maternal undernutrition during late pregnancy had a significant effect on the growth and development of fetal visceral organs, which altered ontogeny of fetal organ growth and development. These perturbations in fetal visceral development may have significant implications on postnatal growth and adult health.

• Journal of Biomedical Engineering Research
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• v.16 no.2
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• pp.175-182
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• 1995

Despite the simplicity of processing, a conventional autocorrelation function (ACF) method for the precise determination of fetal heart rate (FHR) has many problems. In case of weak or noise corrupted Doppler ultrasound signal, the ACF method is very sensitive to the threshold level and data window length. It is very troublesome to extract FHR when there is a data loss. To overcome these problems, the high resolution pitch detection algorithm was adopted to estimate the FHR. This method is more accurate, robust and reliable than the ACF method. With a lot of calculation, however, it is impossible to process real time FHR estimation. This paper is presented a new FHR estimation algorithm for real time processing and studied the real time FHR monitoring system by high resolution pitch detection algorithm.

• Proceedings of the KOSOMBE Conference
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• v.1991 no.11
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• pp.79-82
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• 1991

Digital FHR monitoring system based on the personal computer combined wi th the digital signal processing (DSP) board was implemented. The DSP board acquires and digitally processes ultrasound fetal Doppler signal for digital rectification, envelope detection, autocorrealtion function calculation and its peak position detection. The personal computer interfaced with the DSP board is in charge of graphic display, hardcopy, data taransmission and on-line analysis of fetal heart rate change including on-line warning system, base-line estmation, acceleration, deceleration and variability. The advantages of PC-DSP based system can be summarized as follows: 1) Minimum hardware realization. 2) Increased flexibility. 3) Total care system.

• Journal of Digital Convergence
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• v.19 no.5
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• pp.263-268
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• 2021

The purpose of this study was to propose a model which is suitable for the actual delivery system by designing a fetal delivery hospital operation management and fetal health classification model. The number of deaths during childbirth is similar to the number of maternal mortality rate of 295,000 as of 2017. Among those numbers, 94% of deaths are preventable in most cases. Therefore, in this paper, we proposed a model that predicts the health condition of the fetus using data like heart rate of fetuses, fetal movements, uterine contractions, etc. that are extracted from the Cardiotocograms(CTG) test using a random forest. If the redundancy of the data is unbalanced, This proposed model guarantees a stable management of the fetal delivery health management system. To secure the accuracy of the fetal delivery health management system, we remove the outlier which embedded in the system, by setting thresholds for the upper and lower standard deviations. In addition, as the proportion of the sequence class uses the health status of fetus, a small number of classes were replicated by data-resampling to balance the classes. We had the 4~5% improvement and as the result we reached the accuracy of 97.75%. It is expected that the developed model will contribute to prevent death and effective fetal health management, also disease prevention by predicting and managing the fetus'deaths and diseases accurately in advance.

• Journal of Korean Clinical Nursing Research
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• v.24 no.1
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• pp.10-22
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• 2018

Purpose: This study was performed to establish the role and to analyze the job of MFICU (Maternal Fetal Intensive Care Unit) nurses using DACUM (Developing a curriculum). Methods: A DACUM workshop was held to define MFICU nurses' role and identify their duties and tasks. A DACUM committee was consisted of 7 nurses, 2 nursing professors and 1 medical doctor and as a result, a survey was developed which contained duties and tasks of MFICU nurse. Pre-test was carried out for the validity, finally collected the data from 97 nurses who worked at 7 MFICU and 10 delivery room. Results: A total of 60 duties, 115 tasks and 822 elements of tasks were defined on the DACUM chart and survey. The importance, frequency and difficulty of the tasks were presented the determinant coefficient (DC), the highest DC duty was 'Manage maternal ventilator' (15.09) and the lowest DC was 'Provide nursing care for leisure to gestation extension mother' (6.52). Twenty-eight tasks were differentiated between MFICU and delivery nurses significantly. And the most important, frequently, difficulty task perceived by MFICU nurse was 'Check fetal heartbeat with electronic fetal heart monitor'. Conclusion: The organized educational program and policy was needed to develop for MFICU nurses.

• BMB Reports
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• v.34 no.6
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• pp.573-577
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• 2001

The mammalian heart is known to undergo significant mechanical changes during fetal and neonatal development. The objective of this study was to define the ontogeny of the ryanodine receptor/$Ca^{2+}$ release channel and SERCA that play the major roles in excitation-contraction coupling. Whole ventricular homogenates of fetal (F) (19 and 22 days in gestation), postnatal (N) (1 and 7 days postnatal), and adult (A) (5 weeks postnatal) Sprague-Dawley rat hearts were used to study [$^3H$]ryanodine binding and oxalate-supported $^{45}Ca^{2+}$ uptake. For the ryanodine receptor, the major findings were: (1) The ryanodine receptor density, as determined by maximal [$^3H$]ryanodine binding ($B_{max}$), increased 3 fold between the F22 and A periods ($0.26{\pm}0.1$ vs. $0.73{\pm}0.07$ pmoles/mg protein, p<0.01), whereas there was no significant change during the F22 and N1 development phases ($0.26{\pm}0.1$ vs. $0.34{\pm}0.01$). (2) Affinity of the ryanodine receptor to ryanodine did not significantly change, as suggested by the lack of change in the $K_d$ during the development and maturation. For SERCA, changes started early with an increased rate of $Ca^{2+}$ uptake in the fetal periods (F19: $8.1{\pm}1.1$ vs. F22: $19.3{\pm}2.2$ nmoles/g protein/min; p<0.05) and peaked by 7 days (N7) of the postnatal age ($34.9{\pm}2.1$). Thus, we conclude that the quantitative changes occur in the ryanodine receptor during myocardial development. Also, the maturation of the $Ca^{2+}$ uptake appears to start earlier than that of the $Ca^{2+}$ release.

• Advances in pediatric surgery
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• v.6 no.1
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• pp.1-9
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• 2000

Despite of advances in perinatal management and treatment modalities congenital diaphragmatic hernia(CDH) remains a frustrating problem. Although the sheep has proven to be a reliable experimental model for the production of intrauterine CDH, the rabbit may have some advantages. These include lower cost, smaller body size, year-round availability, high number of fetuses per pregnancy, and short gestational period. To evaluate the feasibility of the rabbit model of CDH, twenty-seven pregnant New Zealand rabbits were utilized. Hysterotomy and an operative procedure for creating a diaphragmatic defect on gestational day 24 or 25, in two fetuses of each pregnant rabbit were performed. In one fetus of one cornu of the uterus, the left fetal diaphragm was excised through an open thoracotomy(DH group). In another fetus in the other cornu, CDH was created and the trachea clipped(Surgiclip, USSC, Norwalk, Conn., USA) (TL group). Delivery was by Cesarean section on 30 days of gestation. Among twenty- seven pregnant rabbits, 12 in the DH group and eight in the TL group were born alive. The most common herniated organ was the left lobe of the liver. In thee DH group, the lungs were hypoplastic with decreased lung weight/body weight ratio, reduced numbers of alveoli, thicker media of the pulmonary arteries, and immature alveoli. In TL group, the alveoli were more mature and did not differ from the control animals. In conclusion, (1) pulmonary hypoplasia develops in the fetal rabbit diaphragmatic hernia model and (2) simultaneous tracheal ligation prevents pulmonary hypoplasia.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.136-146
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• 1996

Studies on normal human embryos and on malformed human hearts have been two main sources of the information on the developmental cardiology, Recent advances in the biological technology has opened a new era and descriptive embryology is being shifted into dynamic developmental biology. In this review, we discuss the current understanding on the cardiac embryology relevant to clinical practices of pediatric cardiology. Classical cardiac embryology starts with understanding on five segments of a straight heart tube : the sinus venosus, the primitive atria, the embryonic left ventricle, the embryonic right ventricle and the truncus arteriosus. Key steps in the normal morphogenetic process are the complex spiral septation of ventriculoarterial junction and two jumping connections : between the embryonic right atrium and embryonic right ventricle, and between the embryonic left ventricle and the aorta. Only after these two steps are successfully completed, the third fetal stage tak s place, when myocardial growth and remodeling take place There are two outstanding progresses on the cardiac embryology during recent five-year period. One is immunohistochemical mapping of the conduction system in the developing heart and the other is the understanding on the neural crest cell migration followed by molecular detection of the microdeletion of chromosome 22. A balanced progress of classical morphological studies, modern biological technics and advanced clinical medicine is an urgent task for doctors and scientists dealing with children with sick hearts.