• Title/Summary/Keyword: gestational age

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Esophageal Atresia with Tracheoesophageal Fistula : A 20 Year Experience of 51 Cases (식도기관루를 동반한 선천성 식도폐쇄 -20년간 51례 치료경험-)

  • Han, Jae-Hyun;Chung, Jae-Hee;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.14 no.1
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    • pp.1-11
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    • 2008
  • The aim of this study is to analyze the outcomes of the esophageal atresia with tracheoesophageal fistula over the last 2 decades. The records of 51 patients born between 1987 and 2006 were reviewed. Twenty-seven patients were male. Mean values of the age, gestational age and birth weight were 2.9 days, 296 days and 2.7kg, respectively. All patients had Gross type C anomalies. Thirty-one patients (60.7 %) had one or more associated congenital anomalies and the most common anomaly was cardiac malformation. In 48 cases, primary anastomosis was done and staged operation was done in one case. Circular myotomies in the proximal esophagus were performed in 9 cases. Postoperative complication developed in 26 cases (54 %): pulmonary complication in 12 cases, anastomotic leakage in 10 and anastomotic stricture in 10, recurrent trachoesophageal fistula in one and tracheomalasia in 2 cases. Reoperation was carried out in 2 patients with anastomotic leaks, the remaining leaks were managed non operatively. Three of the strictures were reoperated upon and the others were successfully managed by balloon dilatations. Overall mortality rate was 15.6 %. Mortality rate of the second 10 years (8 %) period decreased significantly compared to that of the first 10 years (23 %) period.

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A Study of the Factors Influencing on Postpartum BMI Change in Some Postpartum Women (일부 산모에서 산후 BMI 변화에 영향을 미치는 요인 분석)

  • Park, Jung-Kyoung;Kim, Tae-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.4
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    • pp.139-149
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    • 2008
  • Purpose: The purpose of this study was to examine the relationships between variety pregnancy related factors and postpartum BMI change. Methods: Analyzing the BMI of 125 postpartum women in oriental medical hospital of O O university from March, 2008 to May, 2008. Age, pregnancy period. type of delivery, parity, pregravida(PG) BMI, weight and BMI gain during pregnancy, gestational maximum(GMx) BMI were recorded. BMI also checked on each postpartum 7days(P7d), 14days(P14d), 90days(P90d), And we distinguished into Sasang Constitution by QSCC II. Results: The following results were obtained: 1. Age. pregnancy period were not correlated to postpartum BMI change. 2. PG BMI were lower in normal delivery group than caesarean delivery group. 3. PG BMI was lower in primipara group than multipara group. Weight and BMI gain during pregnancy. P90d BMI were lower in multipara group. 4. PG, GMx, P7d, P14d, P90d BMI were significally high in Taeumin. 5. PG BMI were correlated to GMx, P7d, P14d, P90d BMI. 6. Weight and BMI gain during pregnancy were correlated to GMx BMI and P7d, P14d, P90d BMI, BMI loss. Conclusion: This results suggested that weight and BMI gain during pregnancy have the best relationship with postpartum weight change.

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Risk factors for respiratory distress syndrome in full-term neonates

  • Kim, Jin Hyeon;Lee, Sang Min;Lee, Young Hwan
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.187-191
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    • 2018
  • Background: Respiratory distress syndrome (RDS) is a one of the most common cause of respiratory morbidity and mortality in neonates. This study was conducted to investigate the risk factors for RDS in full-term neonates. Methods: We conducted this retrospective study using medical records. The study group included 80 full-term neonates diagnosed with RDS and hospitalized in the neonatal intensive care unit between January 2012 and December 2016, at Yeungnam University Hospital. We analyzed sex, gestational age, birth weight, delivery method, maternal age, number of pregnancy, history of abortion, and complication of pregnancy. The control group included 116 full-time neonates who were hospitalized with jaundice during the same period. Results: The incidence of full-term RDS was more common in males (odds ratio [OR], 3.288; 95% confidence interval [CI], 1.446-7.479), cesarean section (OR, 15.03; 95% CI, 6.381-35.423), multiparity (OR, 4.216; 95% CI, 1.568-11.335). The other factors rendered no significant results. Conclusion: The risk factors for RDS in full-tern neonates were identified as male sex, cesarean section, and multiparity. Further studies involving more institutions are needed to clarify the risk factors for RDS in full-term infants.

Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants

  • Jeon, Ga Won
    • Clinical and Experimental Pediatrics
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    • v.65 no.4
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    • pp.182-187
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    • 2022
  • We frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older children or adults. The production of megakaryocytes (megakaryopoiesis) and platelets (thrombopoiesis) is mainly regulated by thrombopoietin (TPO). Increased TPO levels during infection or inflammation can stimulate megakaryopoiesis, resulting in thrombopoiesis. TPO concentrations are higher in newborn infants than in adults. Levels increase after birth, peak on the second day after birth, and start decreasing at 1 month of age. Initial platelet counts at birth increase with gestational age. Thus, preterm infants have lower initial platelet counts at birth than late-preterm or term infants. Postnatal thrombocytosis is more frequently observed in preterm infants than in term infants. A high TPO concentration and low TPO receptor expression on platelets leading to elevated plasma-free TPO, increased sensitivity of megakaryocyte precursor cells to TPO, a decreased red blood cell count, and immaturity of platelet regulation are speculated to induce thrombocytosis in preterm infants. Thrombocytosis in newborn infants is considered a reactive process (secondary thrombocytosis) following infection, acute/chronic inflammation, or anemia. Thrombocytosis in newborn infants is benign, resolves spontaneously, and, unlike in adults, is rarely associated with hemorrhagic and thromboembolic complications.

Iron Status Indices of Maternal, Umbilical Cord, Placenta and Birth Weight (임신말 모체.제대혈 및 태반의 철분함량과 신생아체중)

  • 배현숙;이금주;이민숙;이주예;신용미;안홍석
    • Korean Journal of Community Nutrition
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    • v.7 no.5
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    • pp.686-695
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    • 2002
  • The purpose of this study is to assess the maternal iron status during pregnancy and to evaluate the relationships bet-ween the iron indices of maternal, umbilical cord serum, placenta and pregnancy outcomes. Venous bloods samples were drawn from 54 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth. And also, placental tissues were extracted. We investigated the difference of the iron status indices of maternal, umbilical cord serum and placental tissue between two gestational age group (PT group, NT group : preform delivery and normal term delivery at 34.9wk and 39.0wk of mean gestational length, respectively) and also assessed correlations of iron status indices of maternal, umbilical cord serum and placenta tissue. And lastly, we related between birth weight and iron status indices of maternal, umbilical cord serum and placental tissue. The concentrations of maternal serum ferritin and of placental iron were significantly higher in NT group (32.1 $\pm$ 21.1 ng/ml, 68.5 $\pm$ 16.7 $\mu$g/g), than those of NT group (20.8 $\pm$ 11.6 ng/ml, 53.2 $\pm$ 17.4 $\mu$/g) respectively (p<0.001). However the serum ferritin of umbilical cord were significantly higher in NT group (PT : 109.4 $\pm$ 65.7 ng/ml, NT : 147.0 $\pm$ 56.8 ng/ml) than those of PT group (p<0.05). Our results showed that a negative association between birth weight (r=-0.361) and maternal serum ferritin and that a positive association between birth weight and umbilical cord serum ferritin (r=0.261). Despite not a significant difference, there was tendency that highest concentration of maternal serum ferritin was associated with the lowest birth weight. These findings indicate that birth weight of newborn is dependent of multiple factors such as maternal iron status during pre-pregnancy, body size, general nutritional status. Although for women who enter pregnancy with low iron stores, enough intakes of iron during pregnancy could produce undesirable pregnancy outcome. Therefore we suggest for successful pregnancy outcome and delivery differential iron supplementation program will be carried out individual pregnant women on the basis of pre-pregnancy nutritional status.

Association Between Gestational Diabetes Mellitus and Subsequent Risk of Cancer: a Systematic Review of Epidemiological Studies

  • Tong, Gui-Xian;Cheng, Jing;Chai, Jing;Geng, Qing-Qing;Chen, Peng-Lai;Shen, Xin-Rong;Liang, Han;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4265-4269
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    • 2014
  • Purpose: This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. Materials and Methods: We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. Results: A total of 9 articles documented 5 cohort and 4 case-control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Conclusions: Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.

Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study

  • Han, Ae-Ra;Kim, Hye-Ok;Cha, Sun-Wha;Park, Chan-Woo;Kim, Jin-Yeong;Yang, Kwang-Moon;Song, In-Ok;Koong, Mi-Kyoung;Kan, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.2
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    • pp.103-108
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    • 2011
  • Objective: To investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups. Methods: Women with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese PCOS group, obese-PCOS group, non-obese tubal factor group, and obese tubal factor group, with obesity defined by a body mass index over 25 kg/$m^2$, and reviewed focusing on the basal characteristics, ART outcomes, and adverse pregnancy outcomes. Results: There was no difference among the groups' the clinical pregnancy rate or live birth rate. Regarding adverse pregnancy outcomes, the miscarriage rate, multiple pregnancy rate, and prevalence of preterm delivery and pregnancy induced hypertension were not different among the four groups. The incidence of small for gestational age infant was higher in the PCOS groups than the tubal factor groups ($p$ <0.02). On the other hand, the morbidity of gestational diabetes mellitus (GDM) was not high in the non-obese PCOS group but was in the obese groups. And in the obese PCOS group, the newborns were heavier than in the other groups ($p$ <0.02). Conclusion: Non-obese PCOS presents many differences compared with obese PCOS, not only in the IVF-parameters but also in the morbidity of adverse pregnancy outcomes, especially in GDM and fetal macrosomia.

Adrenal and thyroid function in the fetus and preterm infant

  • Chung, Hye Rim
    • Clinical and Experimental Pediatrics
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    • v.57 no.10
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    • pp.425-433
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    • 2014
  • Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

A Morphological Study on the Development of the Placenta of the Golden Hamster (Mesocricetus auratus) (Golden Hamster (Mesocricetus auratus) 의 태반형성(胎盤形成)에 관한 형태학적(形態學的) 연구(硏究))

  • Lee, Cha Soo
    • Korean Journal of Veterinary Research
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    • v.13 no.2
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    • pp.111-118
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    • 1973
  • The placentation in the golden hamster (Mesocricetus auratus) and the morphological changes occuring in its placenta from implantation to parturition have been observed by light microscope. The results obtained were summarized as follows. 1. The development of the placenta in the fertilized ovum implanted on the day 5 of gestation was described with increasing gestational age. 2. On the day 8 of gestation, the chorioallantoic placenta was formed by fusion of the allantois to the chorion of ectoplacental cone. 3. On the day 13 of gestation, Reichert's membrane with the parietal yolk sac disappeared in a circumscribed area antimesometrially.

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Bilateral Submammary Skin Incision for Open Heart Surgery (유방하 피부절개를 통한 개심술)

  • 김기봉
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1095-1098
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    • 1988
  • Congenital cystic adenomatoid malformation[CCAM] is a rare disease that cause respiratory distress in the newborn and infants, but is one of the two causes along with lobar emphysema. This malformation has the pathologic characteristics which can be differentiated from other forms of diffuse cystic disease, i.e. CCAM is marked proliferation of the terminal bronchioles and that can enlarge rapidly by air trapping in cystic areas. The CCAM has a clinical importance because of rapid worsening respiratory distress, with tachypnea, subcostal retraction and cyanosis. This is a strict surgical condition and after operation[lobar, segmental resection or pneumonectomy] the symptoms relieved obviously. We experienced 6 cases of CCAM from July, 1980 to September, 1987 at the Department of Cardiovascular and Thoracic Surgery, Severance Hospital, College of Medicine, Yonsei University. The male patients were two and female patients were four. The age distribution was from premature to 10 year old. One of them was 27 weeks gestational premature female who was borne dead. The other 5 patients were performed on thoractomy[1 case pneumonectomy and 5 cases lobectomy]. The postoperative courses were good and no complications were seen.

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