• Journal of Chest Surgery
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• v.32 no.11
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• pp.1023-1030
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• 1999

This is a retrospective study of 42 pregnancies from 33 women with prosthetic heart valves who were on anticoagulation regimen prior to or during their pregnancy. Material and Method: Of the 17 women with bioprosthesis, 15 had 21 pregnancies following cessation of the anticoagulation therapy which resulted in the delivery of 20 healthy babies and 1 abortion. Remaining 2 had 3 pregnancies maintained with heparin, resulting in 2 healthy babies and 1 spontaneous abortion. Result: Among 16 women with mechanical heart valves, there were 7 pregnancies during which warfarin was used and this was associated with 4 fetal wastages(2 therapeutic abortion, 1 spontaneous abortion and 1 stillbirth with cerebral hemorrhage). However, in pregnancies where heparin was used, there was no fetal wastage. A patient who did not take anticoagulant for the first trimester and took warfarin for the remaining period and a patient who did not take anticoagulant during pregnancy delivered normal babies. There was an other fetal wastage in a patient on anti-platelet therapy for the first trimester and warfarin therapy for the remaining periods. There was 1 minor petechial complication in a heparin administered group. Conclusion: The study indicates that woman with bioprosthetic heart valves can go through pregnancy without undue risks or complications. On the other hand, the use of warfarin during pregnancy in women with mechanical heart valves, was shown to be associated with unacceptable high risk for the fetus. However, in the same group of women, judicious use of heparin during pregnancy was accompanied by a much reduced risk. The safety and adequate therapeutic range of heparin usage under such circumstances are subject to further studies.

• Korea journal of population studies
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• v.19 no.2
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• pp.47-76
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• 1996

This study was carried out to provide the basic information for the implementation of population quality policies by analyzing fetal life. The outcomes and process of all the pregnancies of women with spouses living in Gapyung-gun, Kyunggi province from November 3, 1993 through December 31, 1995 were analyzed. The results of the study are as follows: According to the fetal life table, the estimated probability of pregnancy outcome showed 53.5% of live birth, 14.5% of fetal death, 32.0% of induced abortion, which resulted in 46.5% of pregnancy wastage throughout gestation period. The curve of the estimated probability of pregnancy outcome by gestation weeks showed L shape in case of total pregnancy rate, induced abortion rate and fetal death rate. The estimated probability of fetal death was 21.9% in case that the induced abortion was excluded, which was 7.4% higher than the case that induced abortion was included. The expected duration of pregnancy was 22.9 weeks until the fourth week of gestation and then started to become the highest, 26.6 weeks at the tenth week. At the 11th week, it declined to decrease to 26.4 weeks. This is attributed to the fact that the pregnancy wastage including fetal death and induced abortion occurred in the early period of pregnancy. The establishment of appropriate policies to cope with this situation are needed.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.21-30
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• 1988

To measure the fertility rate and pregnancy wastage of women in rural area, 3,780 married women under 50 years old who were not sterilized either woman or husband in Gunwee county were followed up for 2 years. Seventeen Myun health workers visited these women periodically to check the status of their family planning practice and menstruation. Pregnant women were interviwed for their past obstetric history and followed up to the time of delivery. Family planning was practiced in 51.6% of the 6,826 women-years observed during the period from April 1, 1985 to March 31, 1987. Pregnancy, abortion and delivery covered 7.6% of the observed women-years and family planning was not practiced in 36.5% of the women-years. When sterilized women at the beginning of the study were included, the family planning practice rate was 72.1% which was slightly higher than the national family planning practice rate. However, 28% of the women of 30-39 years old had not practiced family planning although they had 2-3 children and they used more such less effective methods as safe-period method and condom than the women of 20-29 years old. Overall pregnancy rate was 14.3 per 100 woman-years. Women of 25-29 years old had the highest pregnancy rate of 27.4 per ,100 woman-years. Pregnancy wastage including spontaneous and induced abortions and still births was 22.0% of all pregnancies and it increased with the age of women; 15.8% in women less than 30 years old and 43.7% in women of 30 years and over. Women who terminated the pregnancy with induced abortion had more pregnancies, more previous induced and spontaneous abortions and shorter pregnancy interval than those women who terminated with live birth. Pregnant women terminated with a live birth had received 4.2 prenatal cares on the average. Eighty-five percent of deliveries occurred at a medical facility and 15% at home which was substantially lower home delivery rate than the other rural area of Korea. This may be due to the effects of the demonstration project for the primary health care in 1970s in Gunwee county. These findings suggest that family planning service in rural area should be strengthened by promoting the use of more effective contraceptive method among women over 30 years of age.

• Parasites, Hosts and Diseases
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• v.53 no.5
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• pp.605-610
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• 2015

Toxoplasmosis is considered as an important risk factor for bad obstetric history (BOH) and one of the major causes of congenitally acquired infections. The present study aimed to estimate the seropositivity of T. gondii infection and associated risk factors among the attendees of high risk pregnancy and low risk antenatal care clinic of Minia Maternity and Pediatric University Hospital, Minia, Egypt. The study was carried out from April 2013 to April 2014 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. A total of 120 high risk pregnant and 120 normal pregnant females were submitted to clinical examinations, serological screening for anti-Toxoplasma IgM and IgG antibodies by ELISA, and an interview questionnaire. Seropositive cases were subjected to spiramycin course treatment. The results showed that the seroprevalence of toxoplasmosis in high-risk pregnancy group was 50.8%, which was significantly different from that of normal pregnancy group (P<0.05). Analysis of seropositive women in relation to BOH showed that abortion was the commonest form of the pregnancy wastage (56.5%). The high prevalence of T. gondii seropositive cases was observed in the age group of 21-30 years. Post-delivery adverse outcome was observed in 80.3% of high-risk pregnancy group compared to 20% of normal pregnancy group. There was a statistically significant relationship between seropositivity and living in rural area, low socioeconomic level, and undercooked meat consumption (P<0.05). Serological screening for anti-Toxoplasma antibodies should be routine tests especially among high-risk pregnant women.

• Journal of Preventive Medicine and Public Health
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• v.9 no.1
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• pp.65-75
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• 1976

To compare the maternal health status between women in island and land, the study was conducted to adjacent land (kukdong) and island (kyonghodong) areas in Yosoo city during April 1976. The results obtained from 174 interviewee in island and 192 in land areas were the same as follow, 1. General characteristics of both area. Age: Land, group 20-29 year of age was the largest. Island, 30-39 year of age was the largest. Education; Low educated group, less than primary grade (land 88.6%, island 93.1%), was predominant in both area. Occupation of herself; agriculture and labor was the main occupation (land 50%, island 82.2%) in both area. Occupation of husband: labor and fishery was general (81.2%) in land, and agriculture and fishery was general (81.6%) in island. Duration of residence; Land, 25.0% being resided here more than 10 years. Island, 64.3% being resided here more than 10 years. 2. Marriage, Pregnancy, and Present children. Average age at marriage; Land, 20.7 years. Island, 20.9 years. Average frequency of pregnancy; Land, 4.4 times. Island, 4.3 times. Wastage of pregnancies: Land, 236 per 1000 pregnancies. Island, 151 per 1000 pregnancies. Wastage occupied by induced abortion; land, 73.5%. island, 60.5%. Number and sex of present children; Land, 3.3 per family, sex ratio 52.4 to 47.6. Island, 3.6 per family, sex ratio 53.3 to 46.7. 3. Prenatal and postnatal care. Prenatal consutation: Land, 16.1% received by doctor or midwife. Island 9.2% received by doctor or midwife. Complications during last pregnancy; Land, 46.6% complained. Island, 51.1% complained. Return to work within 1 week after delivery; Land, 40.6%. Island, 50.6%. 4. Delivery environment Home delivery; Land, 97.4% Island, 97.3%. Delivery attdended by non medical professions at home; Land, 80.2% Island, 93.7%. Solo home delivery; Land, 13.0%, Island, 12.9%. Delivery attended by layman without taking any disinfective preparations; Land, 48.1%, Island, 49.1%. Material mainly used to cut umbilical cord at home; Land, scissors (97.4%). Island, scissora (98.8%). Cord cutting material used without giving any disinfective preparations; Land, 79.9%, Island, 84.0%. Delivery sheets used at home; Cement bag paper (land 50.0%, island, 31.3%). Vinyl sheets (land,17.5%, island, 27.6%). News paper (land, 3.2%. island, 11.7%). No sheets (land 19.5%. island, 12.9%). etc. Maternal Meal; Seaweed soup with rice was the most general in both area. (land 95.3%, island, 91.4%).

• Journal of Embryo Transfer
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• v.30 no.1
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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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• v.13 no.2
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• pp.137-144
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• 1986

A reveiw of 85 patients with uterine anomalies was made in respect to the incidence, chief complaints, the reason of infertility, fetal wastage rate, pregnancy complications, fetal presentations and obstetric outcome after metroplasty from 1980 to 1985. The results were summarized as follows: 1. Incidence of uterine anomaly was 0.18% among all outpatients (85/48,240). 2. Of the 85 patients, there were 36 with bicornuate deformities (42.3%), 21 septate (24.7%), 18 uterus didelphys (21.2%), 8 arcuate (9.4%) and 2 patients with unicornuate anomalies (2.4%). 3. Uterine anomalies were diagnosed by hysterosalpingogram (54.1%), pelvic examination (14.2%) and other operative procedures. 4. Chief complaints were primary infertility (41.2%), secondary infertility (15.3%), repeated pregnancy loss (12.9%), antenatal care (11.8%) and menstural disturbance (10.6%), etc. 5. Twenty-nine patients with uterine anomalies had primary infertility. The cause of infertility was proved nonuterine in 26 cases and remained unknown in 3 cases. 6. The obstetric outcome of 104 pregnancies was spontaneous abortion in 51.0%, premature delivery in 11.50/0 and fetal loss in 57.7%. 7. Complications of 41 present pregnancies were threatened abortion (22%), premature rupture of membrane (12%) and premature labor (10%), etc. The frequency of abnormal presentation was 35.3% and 64.7% of deliveries was made by Cesarian section. 8. Metroplasty was performed in 13 patients who didn't have a baby because of repeated miscarriage and unknown cause of infertility. Subsequently 8 patients had 9 successful pregnancies: 6 patients had 7 healthy babies and 2 patients are now in pregnancy without any complications.

• Clinical and Experimental Reproductive Medicine
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• v.24 no.3
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• pp.293-300
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• 1997

The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.

• Korea journal of population studies
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• v.14 no.1
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• pp.55-69
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• 1991

The objective of the study is to figure out the status of reproductive health and general characteristics related to maternal health for Korean-Americans living in Los Angeles. We collected data from the married women who wanted no more additional child birth and were attending the Family Planning Clinic of Koryo Health Foundation in Los Angeles during 1988. There were 494 women met the eligibility requirement for this study. The results are summarized below. 1. In the age distribution of the women who desired no more additional child birth, women 30-34 age group constituted the largest proportion at 36.6 percent ; the mean age of women was 35.1915.55. The mean number of child birth was 1.77, and the proportion of the women by number of child birth were 35.2 percent for one children, 50.1 percent for two children 10.5 percent for three children, and 2.6 percent for four children. All of the women experienced pregnancy at least once, and mean number of pregnancy was 3.42. The mean number of total experience of induced abortion was 1.56. and 76.7 percent of these women had experience with induced abortions. To prevent further pregnancies, 90.1 percent of the women were utilizing the contraceptive methods, and the highest proportion by the contraceptive methods was condoms(53.7%), 9.3 percent in spermicides, 8.7 percent in IUDs, 8.7 percent in rhythm method, and 6.9 percent in oral pills. 2. The mean age of women at each stage of reproductive life cycle were 14.74 years at time of menarche, 24.55 years at time of marriage, 26.60 years at time of the first child birth, and 28.75 years at time of the last child birth. In age distribution of the women by birth cohort (Group I : birth cohort 1940-1954, Group H : birth cohort 1955-1970), the mean menar-cheal age of the women was 14.96 years in group I , and 14.53 years in group H . Mean age at time of marriage was 25.01 years in group I and 24.08 years in group H . Mean child birth age of the women by birth cohort was 27.19 years In group I and 26.01 years in Group II for the first child birth and 30.07 years in group I and 27.45 years in group II for the last child birth. The total length of reproductive life cycle from menarche to menopause (presumed to be at 49 of age years) was 34.26 years. The len-gth of phase I (from menarche to marriage) was 9.81 years, while phase H (marriage to first birth) was 2.05 years, and phase Ill (first birth to last birth) was 2. 15 years, and the last phase of reproductive life cycle, phase IV (last birth to menopause) was 20.25 years. The proportion of each phase 10 total length of reproductive life cycle was 28.6 percent, 6.0 percent 6.3 percent, and 59.t percent respectively. In the tendency of each phase in reproductive life cycle by birth cohort (group I , U ), the length of phase I, II , III of birth cohort group II was diminished in comparison with those of birth cohort group I , but the length of phase IV was extended by 2.38 years. 3. Among the women, the mean number of total pregnancy by birth cohort group was 2.01 in group I and 1.10 in Group II, and mean number of child birth was 1.97 in group I and 1.58 in group II. In terms of pregnancy was-tage rate by birth cohort group, among the total pregnancy of birth cohort group I , 51.8 percent of the cases resulted in induced abortions or spontaneous abortions whils 48.2 percent resulted in live births, and 42.2 percent or total pregnancy in group II resulted in pregnancy wastage and 57.8 percent of the cases resulted in live births.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.251-257
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• 1984

Low birth weight baby, defined as the baby born with less than or equal to 2,500g of body weight by WHO has been a great concern in the fold of maternal and child health since the low birth weight is a major cause of high perinatal mortality. Any measure to prevent the low birth weight baby is most desirable not only for saving the life of a baby but also for levelling up the health of the whole society. The authors attempted to figure out how some known maternal risk factors are related to the low birth weight and to measure their strengh of associations in terms of relative risk using hospital birth records. For this study, hospital birth records of 66 low birth weight cases and sex-parity matched 198 normal controls were chosen from Kangnam St. Mary's Hospital, Catholic Medical Center, and the data were analyzed in regards to several maternal factors. The risk factors studied were mother's age, mother's ABO blood type, previous histories of abortion, low birth weight baby, fetal wastage, and maternal diseases represented by anemia, hypertension, proteinuria, and glucosuria. The results obtained in this study were as follows: 1. The mean body weight of the cases and controls were 1,955g and 3,251g, respectively, and the heights were 41cm for cases and 50cm for controls. Mean gestation periods of cases and controls were 34 weeks and 39 weeks, respectively. 2. Young mother(less than or equal to 20 years of age) or old mother(more than or equal to 30 years of age) experienced more frequently the delivery of low birth weight babies than mothers in between 21 and 29 years of age. But the difference was not statistically significant. 3. Mothers whose blood type was O tended to have slighty higher frequency of low birth weight babies while B mothers have lower frequency. But the difference was not statistically significant too. 4. Those mothers who had experienced low birth weight baby in the past tended to give more births of low birth weight babies. This factor is even statistically significant and the relative risk of the prior experience of low birth weight was 6.7. 5. Mothers with experience of fetal losses and mothers of more than two pregnancies had higher frequency of low birth weight than the mothers with no fatal losses and of first pregnancy, but the difference was not statistically significant. 6. Statistically significant higher frequency of low birth weight were found in mothers with hypertension(odds ratio=4.07), anemia(odds ratio=22,33), and proteinuria(odds ratio=2.79). In summary, these study results strongly suggest that in order to prevent the low birth weight, special care should be made when the mother is too young or too old, and when the mother has experienced deliveries of low birth weight and fetal deaths. Medical control for the maternal diseases such as anemia and hypertension is also needed before or during the pregnency.