• Clinical and Experimental Reproductive Medicine
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• 제30권1호
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• pp.39-45
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• 2003

Objective : To identify the factors affecting the complete fetal loss following multifetal pregnancy reduction (MFPR). Design: Retrospective clinical study. Methods : A total of 256 consecutive treatments of MFPR in IVF-ET cycles performed between 1992 through 2000 in Samsung Cheil hospital were analyzed. MFPR was done around 8 weeks of gestation by transvaginal ultrasono-guided aspiration in multiple pregnancies and reduced to singleton or twins. Stepwise logistic regression was performed to identify the factors affecting the final outcome of pregnancy after MFPR. Dependent variable was complete fetal loss and the independent variables were maternal age, paternal age, initial number of gestational sac (iGSNO), initial number of fetal heart beat, the number of remaining live fetus after MFPR, and chorionicity. Results: The total survival rate was 87.9%, and total fetal loss rate after MFPR was 12.1%. Total fetal loss occurred within four weeks from MFPR procedure was 1.95%. Total loss occurred after four weeks of procedure and before 24 gestational weeks was 8.2%. Seventy nine percent (202/256) of pregnancies delivered after 34 weeks of gestation. The survival rate of pregnancies reduced to singleton was significantly higher than that of pregnancies reduced to twins (93.5% vs. 86.7%, p<0.05). The mean ($\pm$SEM) gestational age at delivery was $36.2{\pm}1.0$ and $34.1{\pm}0.5$ weeks for pregnancies reduced to singletons and twins, respectively (p=0.065). Logistic regression analysis revealed that the maternal age, the number of initial gestational sac (iGSNO), and the number of remaining live fetus after MFPR significantly affected the rate of total fetal loss (Z = 0.174'age + 0.596'iGSNO + 1.324'remaining fetuses -12.07), (p<0.05). Conclusions: MFPR seems to be a relatively safe and efficient method to improve the obstetric outcome in high order multiple pregnancy. Because the maternal age, the number of initial gestational sac and the remaining live fetuses after MFPR affect the total fetal loss rate, restriction of the number of transferred embryos according to the age and MFPR to singleton fetus could be considered for the better obstetric outcome in IVF pregnancy.

• International Journal of Oral Biology
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• 제30권3호
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• pp.105-110
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• 2005

Periodontitis is a chronic infectious disease that leads to the destruction, one of the major cause of tooth loss in human. Osteoclast Differentiation Factor(ODF), also called as Receptor activator of NF-${\kappa}B$ ligand(RANKL), a surface-associated ligand on bone marrow stromal cells and osteoblasts, activates its cognate receptor RANK on osteoclast progenitor cells, which leads to differentiation of these mononucleated precursor cells. Osteoprotegerin(OPG), a decoy receptor, is released from stromal cells and osteoblasts to inhibit the interaction between RANKL and RANK. The experiment for the effect of pregnancy on gingival health showed greater gingival inflammation and edema during pregnancy, despite similar plaque index. There should be many factors affecting the periodontal health in pregnancy. In this experiment, we examined the direct effects of sex hormones(estrogen and progesterone) on the ODF/OPG expression in human gingival fibroblasts and periodontal ligament cells at the serum concentration of pregnancy. The ratio was high in the 1st trimester of pregnancy by estrogen and in the late 2nd trimester by progesterone. Therefore, the local periodontal destruction might be accelerated by these hormonal effect on the periodontal cells.

• 대한한방부인과학회지
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• 제21권4호
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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.

• 대한간호학회지
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• 제22권2호
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• pp.157-173
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• 1992

The purposes of study were to investigate the prenatal psychological adaptation and the perception of birth experience, and to identify the relationship between them. The subjects consisted of 162 women who visited the obstetrical outpatient clinic for prenatal examinations and who delivered the in babies at SNUH during the period from June 20 to August 10, 1990. The tools used for measurement were Lederman's Prenatal Self Evaluation Questionnaire and Marut & Mercer's scale of the Perception of Birth. The results are summarized as follows : 1. The orders and item means of psychosocial adaptation in pregnancy were the Acceptance of pregnancy(1.58). Identification of motherhood role(1.63). Relationship with husband(1.65) and Relationship with mother(1.67). The preparation for labor, concern for wellbeing of self and baby, and fear of pain, helplessness and loss of control were found to be less adaptive. 2. The level of the perception of the birth experience was mid-range(item mean : 3.22). The score of the perception of birth experience for primiparas was higher than for multiparas. However there was not a significant difference the groups. There were significant differences in the perception of the birth experience between certain general characteristics, namely, sex of the baby(p＜0.05), type of delivery(p＜0.005), and type of anesthesia(p＜0.005). 3. There were significant differences in the perception of the birth experience between the groups below the mean and above the mean of concerti for wellbeing of self and baby, Fear of pain, Helplessness and loss of control, Relationship with husband and Identification of motherhood role (p＜0.05). The perception of the birth experience was predicted by Fear of pain, Helplessness and loss of control (11%), Type of Delivery(6%), Concern for wellbeing of self and baby(3%), Preparation for labor(1%), sex of baby(1%), Relationship with mother(1%), Parity(1%) and Identification of motherhood role(1%). The Childbirth education should be revised to improve the psychosocial adaptation in pregnancy.

• Clinical and Experimental Reproductive Medicine
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• 제47권2호
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• pp.122-129
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• 2020

Objective: The survival of a semi-allogeneic fetus depends on several immunological mechanisms, and it has been suggested that recurrent pregnancy loss (RPL) could develop as a result of one or more immunological abnormalities. Methods: Compatibility between partners for human leukocyte antigen (HLA) genotypes and the relationships between maternal killer-cell immunoglobulin-like receptor (KIR) and paternal HLA-Bw4/Bw6 and HLA-C1/C2 supra-groups were investigated in 25 couples with RPL in comparison to healthy couples with children. HLA and KIR genotyping was performed using polymerase chain reaction with sequence-specific primers and/or sequence-specific oligonucleotides. Results: HLA class I incompatibility between partners, especially in HLA-B alleles, was more common in the RPL group (p= 0.01). HLA-C2 homozygosity was more frequent in the male partners of RPL couples than in other groups (p= 0.03). The KIR2DL5 gene frequency was significantly higher in both the female and male partners of RPL couples, whereas the KIR2DS3 gene frequency in male partners of RPL couples was significantly reduced (p= 0.03). The presence of KIR2DL3 in women with RPL was correlated with the presence of HLA-C2 alleles in their spouses (p= 0.03). Conclusion: Our data from a Turkish population suggest that male HLA-C2 homozygosity may play an important role in RPL. Additionally, an incidental match between male HLA-C2 and female HLA-C1 ligand KIR receptors might perturb the balance between activatory and inhibitory KIR-ligand interactions during pregnancy in couples affected by RPL. The roles of orphan KIR2DL5 and orphan KIR2DS3 in RPL remain obscure.

• Clinical and Experimental Reproductive Medicine
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• 제47권1호
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• pp.68-76
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• 2020

Objective: Since sperm abnormalities are known to be a major reason for recurrent pregnancy loss (RPL), any defects in DNA structure and chromatin condensation can place embryos at risk in the early stage of development and implantation. As antioxidants such as vitamin C may play a protective role against the destruction of protamine genes in sperm chromatin, this study was conducted to evaluate the effects of vitamin C on chromatin and the expression of protamine genes in the male partners of couples with RPL. Methods: Twenty male partners of couples with RPL were selected as the intervention group and received vitamin C supplementation (250 mg daily for 3 months). Healthy fertile men (n = 20) were included as controls. Sperm chromatin, DNA integrity, and the expression levels of protamine genes were evaluated before and after treatment. Results: Significant differences were found in sperm morphology, protamine deficiency, and apoptosis between the two groups and before and after vitamin C administration. A significant change was found in mRNA levels of PRM1, PRM2, and the PRM1/PRM2 ratio after treatment. Conclusion: Daily oral administration of vitamin C may improve human sperm parameters and DNA integrity by increasing protamine gene expression levels in the male partners of couples with RPL. The beneficial effects of vitamin C supplementation as an antioxidant for the male partners of couples with RPL could lead to improved pregnancy outcomes in these cases.

• 한국수정란이식학회지
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• 제30권1호
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• pp.51-57
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• 2015

This study was aimed to determine the biometry of genital organs, incidence of gynecological disorders and pregnancy loss in Black Bengal goat (Capra hircus). Genitalia of 118 does were collected from local abattoirs. Biometric parameters of genital organs were measured and gross and histopathological examinations were carried out for detection of abnormalities. For gravid uterus, age of the fetus was determined by measuring crown-rump length. There was no significant difference in the length, width and weight of right and left ovaries (P>0.05). However, the number of follicles between left ($5.3{\pm}2.3$) and right ovaries ($7.4{\pm}2.7$) varied significantly (P<0.05). The mean length of right fallopian tube and uterine horn were not varied with those of left fallopian tube and uterine horn. The length of uterine body, cervix and vagina were $1.3{\pm}0.1cm$, $3.3{\pm}0.5cm$ and $6.8{\pm}1.3cm$, respectively. Overall, 29 (24.6%) genitalia had abnormalities. Fifteen genitalia (12.7%) had ovarian abnormalities including ovaro-bursal adhesions (6.8%), parovarian cyst (5.1%) and follicular cyst (0.9%). Uterine abnormalities were found in 12 genitalia (10.2%) and predominant uterine lesion was endometritis (6.8%) followed by adenomyosis (1.7%), hemorrhagic lesion on endometrial surface (0.9%) and cyst in broad ligament (0.9%). In addition, cyst in fallopian tube (0.9%) and vagina (0.9%) were recorded. The proportion of slaughtered pregnant goats was 15.3% (18/118). The pregnancy wastage was highest in the first month (50.0%) followed by second (33.3%) and third (16.7%) month. It can be concluded that ovaro-bursal adhesions, parovarian cyst and endometritis are the gynecological disorders of major concern in Black Bengal goat.

• Clinical and Experimental Reproductive Medicine
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• 제51권1호
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• pp.75-84
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• 2024

Objective: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. Methods: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). Results: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. Conclusion: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

• 여성건강간호학회지
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• 제14권1호
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• pp.44-55
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• 2008

Purpose: This study was done to assess the personal experiences of the coping process during pregnancy for single mothers. Methods: The participants were 17 single mothers who had stayed in a social welfare facility. Data was collected with an in-depth unstructured interview. Data analysis was done by the grounded theory method. Results: One-hundred twelve concepts and 49 sub-categories were confirmed in the analysis. The sub-categories were grouped into 19 categories; escape from a miserable family, wrong meeting, openness of sex, defenseless state of pregnancy, inevitable result of pregnancy, heartbreak by herself, closure, isolation, difficult situation of being alone, stigma, supporting & protecting, helplessness, seeking, empowering, feeling of loss, conflict, facing issues, assuring a fresh start and becoming-mature. "Being driven over the edge of a cliff" was the key phenomenon which the single mothers experienced during the process of pregnancy. Conclusion: The above results will help nurses assessing single pregnancy mothers' needs and developing a nursing intervention program for supporting them. Therefore, nurses will be able to stop them from "being driven over the edge of cliff". A more vigorous nursing intervention is suggested for the research of the vulnerable classes of medical health care including single pregnant mothers.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.781-784
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• 2014

Background: Although the cause in most cases of childhood leukemia is not known, the contribution of environmental risk factors in the context of genetic predisposition has been reported with inconsistent results. The aim of this study was to examine association of childhood leukemia with maternal factors especially during pregnancy, to help in avoiding risk factors. Materials and Methods: This case-control study included children younger than 18 years diagnosed with leukemia from 2008 to 2012. Controls were randomly selected and individually matched to cases with respect to age, sex, and residency. All variables were compared between cases and control to determine any significant association with leukemia. Results: Statistically significant associations between risk of childhood leukemia with mother's education (p=0.001), occupation (p=0.0005) and pesticides exposure (p=0.005) during pregnancy were found. However, there were no significant links with maternal age (p=0.090), history of fetal loss (0.85), history of radiography during pregnancy (p=0.400), history of drug intake (p=0.689) and infection (p=0.696) during pregnancy. Conclusions: The results showed increased risk of leukemia in children whose mothers were working in agriculture and were exposed to pesticides during pregnancy. The further study needs to be investigated to know association of various maternal risk factors with leukemia which remained unknown in this study.