• Journal of Yeungnam Medical Science
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• 제13권1호
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• pp.141-145
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• 1996

Habitual pregnancy loss has been defined as three or more consecutive spontaneous abortions. The rate of recurrent pregnancy loss is 2% to 5% of reproducible women. Half of this failure can be explained by genetic, hormonal, infectious, and anatomic factors. And eighty percent of the unexplained failures are proposed to have an immunologic cause. The antiphospholipid antibodies are characterized by prolonged phospholipid-dependent coagulation test (known as APTT or Russel viper venom), thrombosis, thrombocytopenia, and fetal loss. The association of antiphospholipid antibodies with one or more of these characteristic clinical features has been termed the antiphospholipid syndrome. We have experienced a case of successful live birth after treated a woman with heparin and aspirin who has experienced spontaneous abortion four times with antiphospholipid antibodies and present it with the review of literature.

• Clinical and Experimental Reproductive Medicine
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• 제28권2호
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• pp.105-110
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• 2001

Objective: To evaluate the abnormality of protein S in patients with recurrent spontaneous abortion due to antiphospholipid syndrome. Material and Method: Antigen and activity of protein S were analyzed by enzyme immunoassay and clotting method, respectively. Results: Of 18 patients with antiphospholipid syndrome, 4 patients were found to have no abnormality of protein S. There were 14 cases of protein S abnormality. Among them, there were 8 cases of type 1, 1 case of type 2, and 5 cases of type 3 protein S deficiency. Conclusion: So in the workup of patients with recurrent spontaneous abortion due to antiphospholipid syndrome, the evaluation for protein S is required.

• Clinical and Experimental Reproductive Medicine
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• 제18권2호
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• pp.223-231
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• 1991

During the years 1984 to 1989, in order to determine of chromosome abnormalities are associated with recurrent spontaneous abortions, cytogenetic studies were performed 384 couples. Abnormal karyotypes were found in 51(13.3%) couples. There was no apparent relation with the number of abortions. The abnormalities were as follows: 17(4.4%) balanced translocation; 15(3.9%) mosaicisms; 17(4.4%) pericentric inversion; 2(0.5%) addition or isochromosome. Chromosome abnormalities were observed in 34(67%) of the wives and 17(33%) of the husbands. In addition, we detected polymorphic variants of chromosomes in 89(23.2%) subjects. Reciprocal translocations(13/17) were more common than the robertsonian type(4/17). All of the mosaicisms were associated with the sex chromosomes in 10 females and 5 males subjects. Pericentric inversions were most common in chromosome 9. Compared to previously studied general populations, significantly higher frequencies of translocations, mosaicisms and inversions were found in couples with repetitive spontaneous abortion. This suggests that couples should have chromosome studies after two or more abortions.

• Journal of Preventive Medicine and Public Health
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• 제35권3호
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• pp.197-204
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• 2002

Objectives : To evaluate the association between working conditions and adverse pregnancy outcomes in Korea. Methods : We obtained data on health history, lifestyle, housework and Working conditions, such as shift work, hours standing, working time, job demand, lifting at work and at home, between August and September 2000, from self-reported questionnaires. A group of 344, occupationally active, pregnant women from 51 industries were studied. Of the women studied, 328 women were further interviewed by telephone between November 2000 and September 2001. Result : Compared with daytime work, shift work increased the risk for preform birth (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62) and low birth weight (an adjusted risk ratio of 2.74,95% CI=1.02-2.02). A significantly increased risk was found for prolonged standing, with an adjusted risk ratio of preform births of 6.80 (95% CI=2.01-23.0). There were no significant differences in the incidence of spontaneous abortion between the occupational working conditions, with the enception of a previous history of spontaneous abortion. Conclusion : These findings suggest that maternal working conditions, such as shift work and prolonged standing, contribute significantly to preterm birth and low birth weight.

• 한국산업보건학회지
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• 제22권1호
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• pp.9-19
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• 2012

Objectives: The aim of this study is to critically review the exposure surrogates and estimates used to associate health effects in wafer fabrication workers such as spontaneous abortion and cancer, as well as to identify the limitations of retrospective exposure assessment methods Methods: Epidemiologic and exposure-assessment studies of wafer fabrication operations in the semiconductor industry were collected. Retrospective exposure-assessment methods used in cancer risk and mortality and reproductive toxicity were reviewed. Results: Eight epidemiologic papers and two reports compared cancer risk among workers in wafer fabrication facilities in the semiconductor industry with the risk of the general population. Exposure surrogates used in those cancer studies were fabrication(vs. non-fabrication), employment duration, manufacturing eras, job title (operator vs. maintenance worker) and qualitative classifications of agents without assessing specific agent or job-specific exposure. In contrast, specific operation, job title and agents were used to classify the exposure of fabrication workers, contributing to finding a significant association with spontaneous abortion (SAB). Conclusion: Further epidemiologic studies of fabrication workers using more refined exposure assessment methods are warranted in order to examine the associations between fabrication work, environment, and specific agents with cancer risk or mortality as used in SAB epidemiologic studies.

• Journal of Genetic Medicine
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• 제2권2호
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• pp.59-63
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• 1998

Between 1988-1998, cytogenetic analyses were performed for 1,476 couples and 162 women with recurrent abortions. We applied GTG-banding, high resolution-banding and FISH (fluorescent in situ hybridization) techniques in this study. The frequency of balanced translocations was 3.6% (112/3114). Of them, 74 cases (2.38%) were reciprocal translocations and 38 (1.22%) were robertsonian translocations. Chromosome aberrations were more frequent in women (80 cases) than in men (32 cases). No phenotypical abnormalities were found in all carriers who had experienced recurrent spontaneous abortions or experienced giving birth to malformed offsprings. Prenatal cytogenetic analyses were carried out on 40 subsequent pregnancies for carrier couples with balanced translocation. The fetal karyotypes showed that 13 cases (32.5%) were normal, 25 (62.5%) were balanced translocations, and two (6%) were unbalanced translocations. It is believed that the frequency of chromosomal abnormalities in patients with recurrent spontaneous abortion is higher than that of the normal population. Most of the fetal samples showed normal karyotypes or balanced translocations matching that of one of their parents. Although the incidence of chromosomal imbalance in the fetuses was relatively low in prenatal cytogenetic analysis, individuals with balanced translocations are predisposed to giving birth to malformed offsprings with partial trisomy or monosomy. Therefore, we recommend the cytogenetic and the prenatal cytogenetic analysis for those who experiences recurrent abortion as well as in case they become pregnant, to prevent the birth of offsprings with chromosomal abnormalities.

• Clinical and Experimental Reproductive Medicine
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• 제48권3호
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• pp.203-210
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• 2021

We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

• Clinical and Experimental Reproductive Medicine
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• 제31권3호
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• pp.183-190
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• 2004

Objectives: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. Methods: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. Results: Total homocysteine level was significantly higher in MTHFR 677TT genotype ($9.80{\pm}3.87{\mu}mol/L$) than MTHFR 677CC genotype ($8.14{\pm}1.74{\mu}mol/L$) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA ($8.42{\pm}2.65{\mu}mol/L$) and 1298CC ($6.09{\pm}0.32{\mu}mol/L$; p=0.2058) and, TSER 2R2R ($8.61{\pm}1.68{\mu}mol/L$) and 3R3R ($8.05{\pm}2.81{\mu}mol/L$; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest ($11.47{\pm}4.66{\mu}mol/L$) in individuals with TSER 3R3R ($8.05{\pm}2.81{\mu}mol/L$) and MTHFR 677TT ($9.80{\pm}3.87{\mu}mol/L$) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes ($7.69{\pm}1.77{\mu}mol/L$) had lower plasma homocysteine levels than TSER 2R2R ($8.61{\pm}1.68{\mu}mol/L$) and MTHR 677CC ($8.14{\pm}1.74{\mu}mol/L$) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. Conclusion: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.

• 대한한의학회지
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• 제19권2호
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• pp.17-35
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• 1998

Medication used during pregnancy may affect the growth of fetus and maintenance of pregnancy so that it may cause fetal deformity or abortion. Before 1940 it was recognized that only genetic factor could affect the incidence of fetal deformity and the teratogen was protected by placenta barrier. But since the report that Thalidomide caused phocomelia was announced in l962 and 1962, it was acknowledged that the placenta barrier was imperfect. In oriental medical care, there were so many prescription used during pregnancy for nausea, threatened abortion, recurrent spontaneous abortion and it was acknowledged that those medication did not harm both maternity and fetus. Most of them are composed of the material that was not classified as prohibition during pregnancy. But we thought that it should be demonstrated through objective methods that these materials do not affect the incidence of fetal deformity or abortion and have the effect of preventing abortion and maintenance of pregnancy. As the first step of that study we researched 78 prescription and each materials, their kinds and using frequency, used for illness and symptoms during pregnancy written in Dongeuibokam(東醫寶鑑) so that we got to know the tendency about what materials are used for each illness and symptoms.

• 대한한방부인과학회지
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• 제28권1호
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• pp.128-137
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• 2015

Objectives: Spontaneous pregnancy is a rare event after repeated failure of in vitro fertilization (IVF) or Intrauterine insemination (IUI) treatment. So this paper is to report the natural pregnancy of Gamiseogagjihwang-tang treatments on two infertile patients who were repeatedly failed in IVF or IUI. Methods: One patient was a 35-year-old patient diagnosed with the adenomyosis and contralateral tubal obstruction, treated with 90 cc Gamiseogagjihwang-tang two times per day for 6 weeks after second failure of IVF. The other patient was a 34-year-old patient undergone induced abortion by three times, treated with 90 cc Gamiseogagjihwang-tang two times per day for 4 weeks after second failure of IUI. Results: Through taking Gamiseogagjihwang-tang without assisted reproduction techniques, two cases got pregnant naturally. Conclusions: These cases suggest that Gamiseogagjihwang-tang is effective in treating infertile female after failure in IVF or IUI and inducing spontaneous pregnancy. Therefore, there needs to be more trial on infertile patients treated with Seogagjihwang-tang.