• 제목/요약/키워드: fetal death

검색결과 101건 처리시간 0.027초

Clinical significance of sonographic soft markers: A review

  • Kim, Mi Sun;Kang, Sukho;Cho, Hee Young
    • Journal of Genetic Medicine
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    • 제15권1호
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    • pp.1-7
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    • 2018
  • Sonographic findings with little or no pathological significance, known as soft markers, are often found in aneuploidy fetuses. After normal screening for the aneuploidy in first trimester, there are no uniform recommendations regarding when to disregard or put on clinical significance in isolated soft markers. Associations between some soft markers and adverse pregnancy outcomes including intrauterine fetal death, preterm birth, fetal growth restriction, and congenital infection have been reported in euploidy fetuses. The present article aims to review recent literatures about the clinical significance of soft markers after normal first trimester combined screening or noninvasive prenatal testing, and propose a simple clinical summary for management of specific soft markers in pregnancies.

효율적인 병원보건관리를 위한 태아건강분류 모델 (Design of Fetal Health Classification Model for Hospital Operation Management)

  • 전제란
    • 디지털융복합연구
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    • 제19권5호
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    • pp.263-268
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    • 2021
  • 본 연구에서는 병원에서 실질적인 태아분만 시스템에 관리를 위한 태아건강분류모델을 설계하는 것을 목적으로 한다. 출산 중 사망자 수는 2017년을 기준으로 295,000명인 산모 사망률과 유사하다. 이러한 사망의 94%는 환경에 의해 발생하므로 대부분 예방할 수 있다. 따라서 본 논문에서는 랜덤 포레스트(Random Forest)를 이용하여 Cardiotocograms(CTG) 검사에서 추출한 2개의 데이터(태아의 심박수, 태아의 움직임, 자궁 수축 등)로 태아의 건강을 예측하는 모델을 제안하였다. 본 연구에서 제안된 모델은 태아분만 보건운영 시스템을 안정적으로 관리하기 위해 태아분만에 대한 데이터의 분포가 불균형한 이상 데이터를 갖는 항목을 찾아 표준편차의 상한 및 하한의 임계값을 설정하여 이상값을 제거하여 정확도를 높혔다. 또한 태아의 건강상태를 나타내는 클래스의 비율이 불규칙함으로, 데이터 리샘플링을 이용하여 소수의 클래스를 복제하여 클래스의 균형을 맞추었다. 그 결과 정확도가 4~5% 향상되어 97.75%로 나타났다. 이에 예측 모델을 통해 발생 할 수 있는 태아의 사망과 병을 사전에 정확히 예측하여 우선적으로 관리함으로써 효율적인 태아 보건운영과 태아 사망 및 병 예방에 기여할 수 있을 것이라고 기대한다.

Changes in the neonatal and infant mortality rate and the causes of death in Korea

  • Chung, Sung-Hoon;Choi, Yong-Sung;Bae, Chong-Woo
    • Clinical and Experimental Pediatrics
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    • 제54권11호
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    • pp.443-455
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    • 2011
  • Neonatal mortality rate (NMR) or infant mortality rate (IMR) are the rate of deaths per 1,000 live births at which babies of either less than four weeks or of one year of age die, respectively. The NMR and IMR are commonly accepted as a measure of the general health and well-being of a population. Korea's NMR and IMR fell significantly between 1993 and 2009 from 6.6 and 9.9 to 1.7 and 3.2, respectively. Common causes of infantile death in 2008 had decreased compared with those in 1996 such as other disorders originating in the perinatal period, congenital malformation of the heart, bacterial sepsis of newborns, disorders related to length of gestation and fetal growth, intra-uterine hypoxia, birth asphyxia. However, some other causes are on the increase, such as respiratory distress of newborn, other respiratory conditions originating in the perinatal period, other congenital malformation, diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism. In this study, we provide basic data about changes of NMR and IMR and the causes of neonatal and infantile death from 1983 to 2009 in Korea.

Analysis of increased nuchal translucency: Chorionic villi sampling and second-trimester level II sonography

  • Park, Ji Eun;Park, Ji Kwon;Cho, In Ae;Baek, Jong Chul;Kang, Min Young;Lee, Jae Ik;Shin, Jeong Kyu;Choi, Won Jun;Lee, Soon Ae;Lee, Jong Hak;Paik, Won Young
    • Journal of Genetic Medicine
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    • 제11권2호
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    • pp.56-62
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    • 2014
  • Purpose: To assess the outcomes of increased fetal nuchal translucency (NT), to aid in prenatal counseling and management in our practice. Materials and Methods: We retrospectively reviewed the medical records of patients who underwent first trimester fetal karyotyping using chorionic villi sampling (CVS) and second trimester level II sonography for a fetal NT thickness ${\geq}3.0mm$ between 11 weeks and 13 weeks 6 days' gestation, at Gyeongsang National University Hospital. Pediatric medical records and a telephone interview were used to follow-up live-born children. Exclusion criteria included incomplete data and CVS for other indications. Results: Seventy cases met the inclusion criteria (median NT thickness, 4.7 mm; range, 3.0-16.1 mm). Twenty-nine cases (41.4%) were aneuploid. The prevalence of chromosomal defects increased with NT thickness: NT 3.0-3.4 mm, 16.7%; NT 3.5-4.4 mm, 27.3%; NT 4.5-5.4 mm, 66.7%; NT 5.5-6.4 mm, 37.5%; NT ${\geq}6.5mm$, 62.5%. The most common karyotype abnormality was trisomy 18 (n=12), followed by trisomy 21 (n=9). In chromosomally normal fetuses (n=41), fetal death occurred in 2 cases (4.9%), and structural malformations were found in 11 cases (26.8%). In chromosomally and anatomically normal fetuses (n=28), one child had neurodevelopmental delay (3.6%). Twenty-eight infants who had a prenatal increased NT were alive and well at follow-up (40%). Conclusion: Outcomes of increased fetal NT might help inform prenatal counseling and management. The high prevalence of chromosomal defects associated with increased fetal NT implies that CVS should be performed in the first trimester, particularly considering the stress associated with an uncertain diagnosis.

쌍생아 (Twins)

  • 이오경
    • Clinical and Experimental Pediatrics
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    • 제48권7호
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    • pp.685-690
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    • 2005
  • Recently, twinning rate increases in Korea since the early 1990s by delayed marriage and prevailing of assisted reproductive technology. But twin and higher-order multiples are at increased risk for perinatal and neonatal mortality over 5 fold despite of dramatic improvement of perinatal and neonatal care. Because twins are born more prematurely and have lower birth weights than singleton. In addition, twins are at increased risk for cerebral palsy mainly in monochorionic twins due to co-twin fetal death, twin to twin transfusion and congenital anomaly. So, this article reviews the factors contributing to the mortality and morbidity of the twins and the efforts to decrease the neonatal mortality of twins.

Cyanidin-3-glucoside inhibits amyloid β25-35-induced neuronal cell death in cultured rat hippocampal neurons

  • Yang, Ji Seon;Jeon, Sujeong;Yoon, Kee Dong;Yoon, Shin Hee
    • The Korean Journal of Physiology and Pharmacology
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    • 제22권6호
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    • pp.689-696
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    • 2018
  • Increasing evidence implicates changes in $[Ca^{2+}]_i$ and oxidative stress as causative factors in amyloid beta ($A{\beta}$)-induced neuronal cell death. Cyanidin-3-glucoside (C3G), a component of anthocyanin, has been reported to protect against glutamate-induced neuronal cell death by inhibiting $Ca^{2+}$ and $Zn^{2+}$ signaling. The present study aimed to determine whether C3G exerts a protective effect against $A{\beta}_{25-35}$-induced neuronal cell death in cultured rat hippocampal neurons from embryonic day 17 fetal Sprague-Dawley rats using MTT assay for cell survival, and caspase-3 assay and digital imaging methods for $Ca^{2+}$, $Zn^{2+}$, MMP and ROS. Treatment with $A{\beta}_{25-35}$ ($20{\mu}M$) for 48 h induced neuronal cell death in cultured rat pure hippocampal neurons. Treatment with C3G for 48 h significantly increased cell survival. Pretreatment with C3G for 30 min significantly inhibited $A{\beta}_{25-35}$-induced $[Zn^{2+}]_i$ increases as well as $[Ca^{2+}]_i$ increases in the cultured rat hippocampal neurons. C3G also significantly inhibited $A{\beta}_{25-35}$-induced mitochondrial depolarization. C3G also blocked the $A{\beta}_{25-35}$-induced formation of ROS. In addition, C3G significantly inhibited the $A{\beta}_{25-35}$-induced activation of caspase-3. These results suggest that cyanidin-3-glucoside protects against amyloid ${\beta}$-induced neuronal cell death by reducing multiple apoptotic signals.

소아암 환아의 영적 케어

  • 신민선
    • 호스피스학술지
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    • 제5권2호
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    • pp.54-63
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    • 2005
  • The purpose of this study is to examine the requirement for child life support specialist and fetal education for children with cancer. This research presented was composed with three chapters : First chapter, I presented the purpose, scope and definitions of this research. Second chapter, I defined about hospice care service for children with cancer and kind of pediatric cancer. And general characteristics of children with cancer, a understanding character of death and dietary therapy. Lastly, I defined and investigated about spiritual care. Third chapter, I concluded with some of findings and final suggestions based on the results. According to the developmental stages children with cancer are disability of communication competence and more dependence on their parents, therefore parents' decision making were more difficulty. And parents with a child who suffers from a cancer needs a counseling in order to discover the meaning of life. Parents' psychological experience about the caring for their child suffering from pediatric cancer was equal to broken hearts due to shadow of the child's death from time to time. In other words a parents with a child who suffers from a cancer needs comprehensive services such as hospice, consultor as well as wide experienced pediatrician and nurse. Child life support specialist can help them recover and improve their o주 potential strength in behalf of overcoming their difficulties. And pastoral counseling can help them reduce the fear and anxiety about unknown world and death. The systematically developed a school-based counseling program would help children adjust to the difficulties after a perfect cure because of children adjusted to school well when they have good peer relationships.

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3세대에 걸친 60Hz 전자파 노출이 마우스에 미치는 영향

  • 김윤원;이진상;장인애;최영희;강성하;정경천;김윤명;조민기
    • 전자공학회지
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    • 제28권2호
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    • pp.90-104
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    • 2001
  • 최근까지 동물 또는 사람이 극저주파 전자기장에 평생 또는 여러 세대에 걸쳐 노출되었을 경우, 나타나는 생체영향에 관한 연구는 거의 없다. 본 연구에서는 마우스에 60Hz 전자파를 1세대부터 3세대까지 지속적으로 노출시켜 나타나는 영향을 실험하였다. 실험동물은 5주령인 BALB/c 마우스를 1주일간 적응시킨 후 사용하였다. 실험군은 5kV/m, 30kV/m, 0.5mT 그리고 1.5mT의 4개군으로 나누었으며, 대조군은 1군으로 실험하였다. 생후 6주부터는 위에서 정해진 양의 전자파를 20-22주간 지속적으로 실험동물에 조사하고 동일조건의 암수 마우스를 교미시켰으며, 임신 후에도 사망 또는 부검시까지 동일한 조건으로 계속 조사하였다. 2세대와 3세대는 임신적부터 사망 또는 부검시까지 동일한 조건으로 계속 조사하였다. 1, 2 그리고 3세대 마우스들은 질병에 의한 사망 직전 또는 생후 46주, 66주 그리고 생후 49주에 부검한 뒤, 혈액학적 및 생화학적 검사 그리고 조직병리학적 검사를 실시하였다. 2세대 태아에서는 조기사망(early fetal death), 성장기사망(late fetal death) 그리고 뇌노출(excencephaly) 및 선천성 심장기형을 포함하는 선천이상이 발견되었는데, 이는 대조군에 비해 2-4배 높았다. 1, 2세대에서는 생식기인 고환(testis)과 난소(ovary)의 무게가 감소하였으나 2세대에서는 아무런 변화를 보이지 않았다. 실험군인 30kV/m, 0.5mT 그리고 1.5mT 전 실험군인 30kV/m, 0.5mT 그리고 1.5mT 전자파에 노출된 1세대와 2세대 마우스에서는 프종(lymphoma), 선암종(adenocarcinoma), 기저상피세포증(basal cell epithelioma), 편평상 피두유종(squamous papilloma) 그리고 선종(adenoma) 등이 발견되었으나, 3세대에서는 발견되지 않았다. 60Hz 전자파는 태아 및 생식기에 영향을 미치고, 또한 종양을 유발할 가능성이 있다. 그러나 3세대는 전자파 환경에 점차 적응을 하는 것으로 보인다. 그러나 몇몇 국제기구에서 정하여 놓은 안전한계치의 전자파가 생체에 장기간 노출되었을 경우에 나타날 수 있는 생체영향을 확인하기 위해서는 많은 연구가 필요하다.

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A Rare and Often Unrecognized Brain Meningitis and Hepatopneumonic Congestion are a Major Cause of Sudden Death in Somatic Cloned Piglets

  • 박미령;조성근;임여정;박종주;김진회
    • 한국동물번식학회:학술대회논문집
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    • 한국동물번식학회 2003년도 학술발표대회 발표논문초록집
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    • pp.18-18
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    • 2003
  • In human, sudden infant death syndrome(SIDS) is synonyms for the sudden, unexpected and unexplained death of an infant. The incidence of SIDS has been estimated to be from 1 to 3%. Cloning has a relatively high rate of late abortion and early postnatal death, particularly when somatic cells are used as donors of nuclei and rates as high as 40 to 70% have been reported. However, the mechanisms for SIDS in cloned animals are not known yet. To date, few reports provide detailed information regarding phenotypic abnormality of cloned pigs. In this study, most of the cloned piglets were alive at term and readily recovered respiration. However, approximately 82% of male cloned piglets (81/22) died within a week after birth. Significant findings from histological examinations showed that 42% of somatic cloned male piglets died earlier than somatic cloned female piglets, most probably due to severe congestion of lung and liver or neutrophilic inflammation in brain, which indicates that unexpected phenotypes can appear as a result of somatic cell cloning. No anatomical defects in cloned female piglets were detected, but three of the piglets had died by diarrhea due to bacterial infection within 15 days after birth. Although most of male cloned piglets can be born normal in terms of gross anatomy, they develop phenotypic anomalies that include leydig cell hypoplasia and growth retardation post-delivery under adverse fetal environment and depigmentation of hair- and skin-color form puberty onset. This may provide a mechanism for development of multiple organ system failure in some cloned piglets. Th birth weights of male cloned pig in comparison with those of female cloned piglets are significantly reduced(0.8 vs 1.4kg) and showed longer gestational day(120 vs 114). In conclusion, brain meningitis and hepatopneumonic congestion are a major risk factor for SIDS and such pregnancy in cloned animals requires close and intensive antenatal monitoring.

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Arsenic Toxicity in Male Reproduction and Development

  • Kim, Yoon-Jae;Kim, Jong-Min
    • 한국발생생물학회지:발생과생식
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    • 제19권4호
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    • pp.167-180
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    • 2015
  • Arsenic is a toxic metalloid that exists ubiquitously in the environment, and affects global health problems due to its carcinogenicity. In most populations, the main source of arsenic exposure is the drinking water. In drinking water, chronic exposure to arsenic is associated with increased risks of various cancers including those of skin, lung, bladder, and liver, as well as numerous other non-cancer diseases including gastrointestinal and cardiovascular diseases, diabetes, and neurologic and cognitive problems. Recent emerging evidences suggest that arsenic exposure affects the reproductive and developmental toxicity. Prenatal exposure to inorganic arsenic causes adverse pregnancy outcomes and children's health problems. Some epidemiological studies have reported that arsenic exposure induces premature delivery, spontaneous abortion, and stillbirth. In animal studies, inorganic arsenic also causes fetal malformation, growth retardation, and fetal death. These toxic effects depend on dose, route and gestation periods of arsenic exposure. In males, inorganic arsenic causes reproductive dysfunctions including reductions of the testis weights, accessory sex organs weights, and epididymal sperm counts. In addition, inorganic arsenic exposure also induces alterations of spermatogenesis, reductions of testosterone and gonadotrophins, and disruptions of steroidogenesis. However, the reproductive and developmental problems following arsenic exposure are poorly understood, and the molecular mechanism of arsenic-induced reproductive toxicity remains unclear. Thus, we further investigated several possible mechanisms underlying arsenic-induced reproductive toxicity.