• Title/Summary/Keyword: High-risk pregnancy

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Thrombolytic Therapy for Prosthetic Mitral Valve Thrombosis of Pregnant Patient -A Case Report- (임신중 발생한 인공승모판 혈전증의 혈전 용해제를 이용한 치료 -치험 1례 보고-)

  • 김영대
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.858-861
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    • 1994
  • Prosthetic valve thrombosis is rare but it is one of fatal complication after heart valve surgery. Improvements of the valve design and the material have decreased the frequency of thrombosis but have not eliminated completely. And some cases of prosthetic valve thrombosis during pregnancy were reported inspite of adequate anticoagulation therapy.Urgent surgical intervention is indicated for prosthetic valve thrombosis but it is associated with high operative risk, therefore medical thrombolytic therapy such as urokinase or streptokinase therapy is regarded as an alternative therapy. This is a case report of the successful thrombolytic therapy for valve thrombosis in a pregnant patient after mechanical mitral valve replacement.

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Development of Discriminant Model of PIH Pregnant using Decision Tree

  • Park, Young-Sun;Choi, Hang-Suk;Lee, Young-Koun;Cha, Kyung-Joon;Lee, Sung-Hoon;Park, Moon-Il
    • 한국데이터정보과학회:학술대회논문집
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    • 2004.04a
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    • pp.141-149
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    • 2004
  • The various methods have been studied to develop discriminant model for Pregnancy Induced Hypertension(PIH) as high risk pregnant. In this study, we adapt the approximate entropy which is the non-linear chaotic measuring method. Then, we develop the system to discriminant PIH pregnant using QUEST with S-PLUS.

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Clinical implications of coronavirus disease 2019 in neonates

  • Kim, Do-Hyun
    • Clinical and Experimental Pediatrics
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    • v.64 no.4
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    • pp.157-164
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    • 2021
  • Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, a small number of coronavirus disease 2019 (COVID-19) cases in neonates have been reported worldwide. Neonates currently account for only a minor proportion of the pediatric population affected by COVID-19. Thus, data on the epidemiological and clinical features of COVID-19 in neonates are limited. Approximately 3% of neonates born to mothers with COVID-19 reportedly tested positive for SARS-CoV-2. Current limited data on neonates with COVID-19 suggest that neonatal COVID-19 shows a relatively benign course despite a high requirement for mechanical ventilation. However, neonates with pre-existing medical conditions and preterm infants appear to be at a higher risk of developing severe COVID-19. The greatest perinatal concern of the COVID-19 pandemic is the possibility of vertical transmission, especially transplacental transmission of SARS-CoV-2. Although direct evidence of the vertical transmission of SARS-CoV-2 is lacking, its possibility during late pregnancy cannot be ruled out. This review summarizes available case studies on COVID-19 in neonates and introduces what is currently known about neonatal COVID-19 with focus on its vertical transmission.

Integrated Test for Screening in Down Syndrome as a Predictor of Adverse Pregnancy Outcomes (임신합병증 예측에 있어 다운증후군 통합 선별검사 지표의 의의)

  • Park, Sang-Won;Kang, Jin-Hee;Lee, Kyong-Jin;Jun, Hye-Sun;Kang, Myoung-Seo;Huh, Ji-Young;Cha, Dong-Hyun
    • Journal of Genetic Medicine
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    • v.6 no.1
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    • pp.74-80
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    • 2009
  • Purpose: To assess the value of first-trimester pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and second-trimester alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin-A in predicting pregnancy complications other than fetal aneuploidy. Materials and Methods: A retrospective study in 3,121 singleton pregnancies with integrated testing was performed at Kangnam CHA hospital between January 2005 and December 2006. Baseline characteristics, pregnancy outcomes, and serum marker levels were obtained by review of the medical records. We analyzed the data to identify associations between the integrated screening markers and adverse pregnancy outcomes. Statistical analyses were performed with the SPSS program. Results: In preterm labor and preeclampsia, high AFP, hCG, and inhibin-A levels and low PAPP-A and NT levels were found to be significantly correlated (P<0.05). Elevated second-trimester inhibin-A levels were associated with preeclampsia (odds ratio 2.843), low birth weight (odds ratio 1.446), and preterm labor (odds ratio 1.287), and while decreased first-trimester PAPP-A levels were associated with preeclampsia (odds ratio 0.51) and preterm labor (odds ratio 0.75). Conclusion: First- and second-trimester maternal serum markers screening can be used for predicting high-risk pregnancies.

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The use of Intravenous Albumin for the Prevention of Ovarian Hyperstimulation Syndrome in Patients at High Risk in in Vitro Fertilization (과배란유도에 의한 난소과자극증후군 발생 고위험군에 있어서 알부민 정맥투여요법의 효과에 관한 연구)

  • Moon, Shin-Yong;Roh, Jae-Sook;Lee, Kyung-Soon;Suh, Chang-Suk;Kim, Seok-Hyun;Choi, Young-Min;Shin, Chang-Jae;Kim, Jung-Gu;Lee, Jin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.22 no.2
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    • pp.171-181
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    • 1995
  • Ovarian hyperstimulation syndrome(OHSS) is one of the well-known complication of controlled ovarian hyperstimulation(COH). Though there have been numerous measures to prevent the occurrence of OHS, it has not been completely preventable until now. The fluid shift from the intravascular space to the third space is due to decreased oncotic pressure of the serum. The objective of this study was to evaluate if IV administration of 20% albumin in those patients with OHSS risk can make prevention of severe OHSS. We retrospectively analysed 70 patients undergoing IVF-ET who had serum peak estradiol($E_2$) level of >2,500 pg/ml and/or the number of oocytes retrieved over 20. The treatment group(n=39) received albumin while the control group(n=31) did not. After 40 grams of human albumin diluted in 1,000 ml of 0.9% sodium chloride solution, the treatment group received half of the fluid during oocyte retrieval, the remainder in the recovery suite. The results were as follows; There were significant differences in the levels of serum peak $E_2$ and number of oocytes retrieved between the two groups(p<0.05). However, there were no significant differences in the incidence of OHSS and pregnancy rate or multifetal pregnancy rate. In conclusion, administration of albumin to OHSS risk patients did not reduce the rate of OHSS in IVF-ET. However, if we consider the fact that there were differences in the level of peak serum $E_2$ and oocyte numbers, further prospective study may be needed.

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Inter-hospital Comparison of Cesarean Section Rates after Risk Adjustment (위험도 보정을 통한 병원간 제왕절개 분만율의 비교)

  • Lee, Sang-Il;Ha, Beom-Man;Lee, Moo-Song;Kang, Wee-Chang;Koo, Hee-Jo;Kim, Chang-Yup;Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.337-346
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    • 2001
  • Objective : To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. Methods Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. Results : The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. Conclusions : Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.

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Initial Risk Assessment of Acetanilide in OECD High Production Volume Chemical Program

  • Park, Hye-Youn;Park, Yoonho;Sanghwan Song;Kwon, Min-Jeoung;Koo, Hyun-Ju;Jeon, Seong-Hwan;Na, Jin-Gyun;Park, Kwangsik
    • Toxicological Research
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    • v.18 no.1
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    • pp.13-22
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    • 2002
  • In Korea, 2,320 tonnes of acetanilide were mostly wed as intermediates for synthesis in phar-maceuticals or additives in synthesizing hydrogen peroxide, varnishes, polymers and rubber. Only small amount of 120 kg were wed as a stabilizer for hydrogen peroxide solution for hair colouring agents in 1998. Readily available environmental or human exposure data do not exist in Korea at the present time. However, potential human exposures from drinking water, food, ambient water and in work places are expected to be negligible because this chemical is produced in the closed system in only one company in Korea and the processing factory is equipped with local ventilation and air filtering system. Acetanilide could be distributed mainly to water based on EQC model. This substance is readily biodegradable and its bioaccumulation is low. Acute toxicity of acetanilide is low since the L $D_{50}$ of oral exposure in rats is 1,959 mg/kg bw. The chemical is not irritating to skin, but slightly irritating to the eyes of rabbits. horn repeated dose toxicity, the adverse effects in rats were red pulp hyperplasia of spleen, bone marrow hyperplasia of femur and decreased hemoglobin, hematocrit and mean corpuscular hemoglobin concentration. The LOAEL for repeated dose toxicity in rats was 22 mg/kg/day for both sexes. Acetanilide is not considered to be genotoxic. In a reproductive/developmental toxicity study, no treatment-related changes in precoital time and rate of copulation, impregnation, pregnancy were shown in all treated groups. The NOAELs for reproduction and developmental toxicity (off-spring toxicity) are considered to be 200 mg/kg bw/day and 67 mg/kg bw/day, respectively. Ecotoxicity data has been generated in a limited number of aquatic species of algae (72 hr- $E_{b}$ $C_{50}$; 13.5 mg/l), daphnid (48hr-E $C_{50}$ > 100 mg/l) and fish (Oryzias latipes, 96hr-L $C_{50}$; 100 mg/l). Form the acute toxicity values, the predicted no effect concentration (PNEC) of 0.135 mg/1 was derived win an assessment factor of 100. On the basis of these data, acetanilide was suggested as currently of low priority for further post-SIDS work in OECD.in OECD.D.

The degree of paternal attachment to neonate (아버지의 신생아에 대한 애착정도)

  • 김지영
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.330-340
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    • 1995
  • This study was conducted to find out the degree of paternal attachment to neonate, and to identify factors affecting paternal attachment. The main purpose was to make the base data for nursing intervention to improve parternal attachment. The subjects of this study were 20 fathers whose partners have delivered premature neonate and 30 fathers whose partners have delivered normal neonate in 3 university hospitals in Seoul. Data were collected from Feb. 10 to Apr. 10 1994 by self report questionaires. The instrument for this study was based on 7 kinds of characteristics of paternal attachment by Greenberg St Morris(1974), and developed by re-searcher The statistical methods for data analysis were percentage, mean, standard deviation, 1-test, ANOVA with S.P.S.S. program. The conclusions are as follows. 1. Fathers had the high degree of paternal attachent to neonate, but were afraid of active touch. 2. The factors that affect paternal attachment were delivery odor, past experience about own father except delivery pattern, pregnancy plan, sex of nonate. 3. There were not significant correlations between paternal attachment and early visual contact frequency of father-neonate. 4. In the degree of paternal attachment, though normal neonate father showed somewhat higher result than premature neonate father, there was not statistically significant difference between two groups(t=-1.83, P=0.076). But in the character of tactail awarness there were significant differences between two groups, hence nursing interventions are needed to help the premature neonate's father bring early tactile con-tact. Pother research about factors affecting paternal attachment to neonate and high risk neonate as well as low birth weight neonate is reguired.

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The Paternal Attachment to Neonate in One Hospital (일 병원 신생아 아버지의 부성애착)

  • Oh, Jin-A;Oh, Young-A;Nam, Young-Hui
    • Korean Parent-Child Health Journal
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    • v.8 no.2
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    • pp.137-146
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    • 2005
  • This study was conducted to find out the paternal attachment to neonate, and to identify factors affecting paternal attachment. The purpose was to make the base data for nursing intervention to improve paternal attachment. The subjects of this study were 93 fathers whose partners have delivered normal neonate in 1 hospital in Busan. Data were collected from Sep. 1th to Oct. 31th 2005 by a self-report questionnaire. The instrument for this study was based on 7 kinds of characteristics of paternal attachment by Greenberg & Morris(1974), and modified by researchers. The statistical methods for data analysis were percentage, mean, standard deviation, t-test, ANOVA with SPSS program Ver 10. The conclusions are as follows. Fathers had the high degree of paternal attachment to neonate. But, there were not significant correlations between paternal attachment and the father's demographic characteristics, pregnancy plan, delivery pattern, delivery order, sex of neonate and past experience. Also there were not significant correlations between paternal attachment and early visual contact frequency of father-neonate. Further research about factors affecting paternal attachment to neonate and high risk neonate as well as low birth weight neonate is required.

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Noninvasive prenatal test for the pregnancy with Turner syndrome mosaicism 45, X/47, XXX: A case report

  • Kim, Ji Hye;Lee, Gun Ho;Cha, Dong Hyun;Cho, Eun-Hae;Jung, Yong Wook
    • Journal of Genetic Medicine
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    • v.12 no.2
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    • pp.118-122
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    • 2015
  • Noninvasive prenatal test (NIPT) is a novel screening method for the diagnosis of fetal chromosomal aneuploidies. NIPT is based on technology that detects cell-free fetal DNA in maternal plasma and analyzes it with massively parallel sequencing technology to determine whether the fetus is at risk of trisomy 21, trisomy 18, trisomy 13 or sex chromosome abnormalities (SCAs). NIPT has been reported to have sensitivity of 99% and a false positive rate of less than 1% for detecting trisomy 21 and trisomy 18. Although extension of the application of NIPT to other SCAs has been attempted, there are concerns in extending NIPT to SCAs because of maternal or fetal mosaicism, undetected maternal SCAs, and multiple pregnancies. Recently, we assessed a pregnancy with the rare Turner syndrome mosaicism 45, X/47, XXX, which was reported as 45, X with NIPT. We present the case here and briefly review the current literatures on NIPT in testing for fetal monosomy X. To the best of our knowledge, this is the first report of the 45, X/47, XXX mosaicism in Korea to be reported as 45, X by NIPT with whole genome sequencing. This case report will provide valuable information for counseling women who want to undergo NIPT.