Han-Sung Kwon

Vaginal fluid β‐human chorionic gonadotropin level in the diagnosis of premature rupture of membranes

Background.u2002 To determine whether the measurement of β‐human chorionic gonadotropin (β‐HCG) level in the vaginal washing fluid could be useful for the diagnosis of premature rupture of membranes.

Abnormal Doppler velocimetry is related to adverse perinatal outcome for borderline amniotic fluid index during third trimester

Aim:u2002 To evaluate the relationship between abnormal Doppler velocimetry and adverse perinatal outcomes in pregnancies with borderline amniotic fluid index (AFI).

Interventional management for complications following caesarean section

OBJECTIVESnThis study aimed to evaluate the efficacy and safety of interventional management for various intractable complications following caesarean section.nnnMETHODSnBetween August 2005 and September 2009, 18 consecutive women were referred to interventional radiology for treatment of complications developing after caesarean section. Complications included vaginal bleeding (n = 14), haemoperitoneum with abdominal wall haematoma (n = 2), caesarean scar pregnancy (CSP) (n = 1) and post-caesarean fluid collection (n = 1).nnnRESULTSn17 women underwent transcatheter arterial embolisation (TAE) with a variety of embolic materials, and two women underwent percutaneous drainage (PCD) for fluid collection and haemoperitoneum. 5 of the 14 women with vaginal bleeding had extravasation of contrast media on angiography; the other 9 had no visible bleeding foci. The two women with haemoperitoneum with abdominal wall haematoma had injury to the inferior epigastric artery from angiography. TAE and PCD were successfully performed in both women. The CSP was successfully managed and the serum β-human chorionic gonadotropin (β-hCG) level finally normalised. Hysterectomy or dilatation and curretage was required in women with placenta accrete and undetectable bleeding foci.nnnCONCLUSIONnInterventional management including TAE and PCD is effective and safe in controlling complications following caesarean section. Use of these procedures can help avoid high-risk surgery, but subsequent procedures including hysterectomy may be required in cases of placental abnormalities and undetectable bleeding foci.

Effect of DJ-1 Downregulation on the Functions of the First Trimester Extravillous Trophoblasts

DJ-1 (PARK7) has been reported to be causative gene of Parkinson disease and also an oncogene. A loss in DJ-1 function can lead to cell death in neurodegenerative disease, or a gain of it can cause unregulated cell survival in cancer, respectively. DJ-1 protein is known to be expressed mainly in trophoblastic cells in the placenta with increased expression in the first trimester compared to later in term. However, its role in trophoblast regulation remains unknown. This study aimed to investigate the effect of DJ-1 regulation on a first trimester extravillous trophoblast cell line, HTR-8/SVneo. The effect of DJ-1 downregulation induced by small-interfering RNA on cell apoptosis, migration, and the pathway to regulate the cell function was assessed. Data of this study showed that DJ-1 downregulation increased apoptosis and reduced migration by regulating matrix metalloproteinase 2 and matrix metalloproteinase 9 in HTR-8/SVneo cells under both ambient and oxidative stress. Changes in cell function were demonstrated to be at least partly dependent on the AKT/S6 kinase beta-1 (S6K1) pathway. In summary, DJ-1 might play a protective role in maintaining trophoblastic cell functions through the AKT/S6K1-based pathway.

Evaluation of ABX Pentra DX 120 and Sysmex XE‐2100 in umbilical cord blood

Cord blood (CB) is an important source of hematopoietic stem cells and reflects the hematologic status of neonates. ABX Pentra DX 120 (Horiba Medical, Montpellier, France) and Sysmex XE‐2100 (Sysmex, Kobe, Japan) were compared in 200 CB specimens.

Uterine artery Doppler velocimetry and maternal weight gain by the mid-second trimester for prediction of fetal growth restriction.

Objective. To investigate whether assessment of maternal weight gain up to mid‐second trimester improves the predictive value of uterine artery Doppler velocimetry (UAD) for the prediction of fetal growth restriction (FGR). Setting. Department of Obstetrics and Gynecology, Yonsei University College of Medicine. Design. Prospective Doppler measurements coupled to retrospective chart review. Population. A total of 10,970 women delivering at the institution. Outcome measures. Maternal weight gain up to mid‐second trimester and Doppler ultrasonography on bilateral uterine arteries between 20 and 24 weeks’ gestation. Low weight gain was defined as <0.2 kg/week and FGR as birthweight of <10th percentile. Results. ith that combined with the measurement of maternal weight gain for the prediction of the FGR. The odd ratios for FGR were 2.56 (95% CI 1.59–4.12) in the group with normal UAD and abnormal weight gain (normal‐abnormal group), 1.91 (95% CI 0.98–3.7) in the abnormal‐normal group and 40.3 (95% CI 16.9–96.4) in the abnormal‐abnormal group. UAD independent of weight gain had a sensitivity of 31.5%, a specificity of 88%, a positive predictive value (PPV) of 24.5% and a negative predictive value (NPV) of 91.2%. When mid‐trimester maternal weight gain was accounted for, the sensitivity of UAD was 64.9%, specificity 64.1%, PPV 73.3% and NPV 93.6%. Conclusion. The diagnostic performance of UAD for FGR improved significantly when the degree of maternal weight gain until the mid‐second trimester was taken into account. Closer antenatal surveillance might be required in women with abnormal uterine Doppler velocimetry if their mid‐second trimester weight gain is poor.

P08.01: A predictive model of large-for-gestational-age infant and internal validation among Korean women with gestational diabetes mellitus: a Korean multicentre study: Poster discussion hub abstracts

had a longer induction-to-delivery duration in comparison with those with non-OP position. Conclusions: Fetal occiput and spine positions are dynamic in a considerable proportion of women undergoing induction of labor. Furthermore, both assessments do not seem to correlate with the mode of delivery. Occiput and spine position assessment prior to induction of labor are unlikely to be clinically useful in women undergoing IOL.

OC10.08: *The risk of preterm birth in vanishing twin: a multicentre prospective cohort study

S. Jisu1, S. Lee1, Y. Han2, M. Kim2, J. Shim3, M. Lee3, S. Oh4, J. Lee5, S. Kim6, D. Cha6, G. Cho7, H. Kwon8, B. Kim9, M. Park10, H. Cho11, H. Ko12, C. Park1, J. Park1, J. Jun1, H. Ryu2, S. Lee1 1Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea; 2Obstetrics and Gynecology, Cheil General Hospital and Women’s Healthcare Centre, Dankook University College of Medicine, Seoul, Republic of Korea; 3Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Centre, Seoul, Republic of Korea; 4Obstetrics and Gynecology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 5Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea; 6Obstetrics and Gynecology, CHA Gangnam Medical Centre, CHA University, Seoul, Republic of Korea; 7Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Republic of Korea; 8Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, Republic of Korea; 9Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Centre, Seoul, Republic of Korea; 10Obstetrics and Gynecology, Ewha Woman’s University, Seoul, Republic of Korea; 11Obstetrics and Gynecology, CHA Bundang Medical Centre, CHA University, Sung Nam, Republic of Korea; 12Obstetrics and Gynecology, Catholic University of Korea College of Medicine, Seoul, Republic of Korea

Incarceration of early gravid uterus with adenomyosis and myoma: report of two patients managed with uterine reduction

Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encountered two unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2 weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterine incarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infant at term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acute urinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chest position. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, the fetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for the fetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain, is important in the early gestation period.

Prospective observations study protocol to investigate cost-effectiveness of various prenatal test strategies after the introduction of noninvasive prenatal testing

BackgroundAmong the non-invasive screening methods for the identification of fetal aneuploidy, NIPT (non-invasive prenatal testing) shows the highest sensitivity and specificity in high-risk pregnancies. Due to the low false positive rate of NIPT, it is assumed that the implementation of NIPT as a primary screening method may reduce the number of invasive fetal tests and result in a similar or lowered cost in the overall detection of Down syndrome. However, most previous studies are based on theoretical economic analysis. This study aims to determine the cost effectiveness of various prenatal test strategies, including NIPT, in real clinical settings in both low risk and high risk pregnancies.Methods/designIn this prospective observational study, women (<u200924xa0weeks) with singleton or twin pregnancies will be enrolled in 12 different healthcare institutions. The participants will be grouped based on the risks of fetal chromosomal abnormalities and will be counseled on the various screening or diagnostic methods, including NIPT, according to the aneuploidy risk. The final decision on screening or diagnostic methods will be made by patients after counseling. Questionnaires regarding factors affecting the decision on prenatal test will be answered by the participants and physicians. The economic analysis on final total costs will be compared according to the various prenatal test strategies.DiscussionThe results of present study are expected to have a significant impact on national policies in determining Korean prenatal screening test strategies and to help in developing novel and effective prenatal screening tests in the future.