Min Hyoung Kim

Perinatal Outcome in Twin Pregnancies Complicated by Gestational Diabetes Mellitus: A Comparative Study

The purpose of this study is to compare perinatal outcomes of twin pregnancies complicated by gestational diabetes (GDM) with those unaffected by GDM. A total of 1,154 twin pregnancies who delivered at Cheil General Hospital, between January 1998 and December 2002 were recruited to participate in a retrospective analysis. Out of these twin pregnancies, 37 women were had GDM. Four pregnancies exposed to GDM were excluded due to the loss of medical records; therefore 33 twin pregnancies exposed to GDM were enrolled. We matched the GDM pregnancies with pregnancies unaffected by GDM in a 1:2 ratio; therefore there were 33 GDM/66 without GDM who delivered during the study period. Our findings show that there were no significant differences including birth weight, Apgar score, respiratory distress syndrome, meconium aspiration pneumonia, transient tachypnea of new born, hyperbilirubinemia, hypoglycemia, hypocalcemia and congenital anomalies. Therefore, well controlled GDM may not increase perinatal complications in twin pregnancies. Careful pregnancy management and fetal surveillance in twin pregnancies is important to decrease perinatal complications and maintain a sound pregnancy and healthy offspring.

Outcomes of subsequent pregnancies after uterine compression sutures for postpartum hemorrhage.

OBJECTIVE: To estimate the association between uterine compression sutures for postpartum hemorrhage and subsequent pregnancy outcomes. METHODS: We reviewed the medical records of 336 women who received uterine compression sutures to control postpartum hemorrhage during their first delivery at a single medical center between 2006 and 2011. Of these, 42 women who became pregnant again and received care through our hospital were included in this study. One hundred thirty-nine pregnant women matched for age and parity who did not receive uterine compression sutures during a previous cesarean delivery served as the control group. We compared subsequent pregnancy outcomes and operative findings during repeat cesarean delivery between the two groups. RESULTS: There were four (9.5%) miscarriages and one (2.4%) tubal pregnancy in the compression suture group compared with 14 (10.1%) miscarriages and two (1.5%) tubal pregnancies in the control group (P=.92 and P=.68, respectively). In the compression suture group, 34 (81.0%) women delivered at term and two (4.7%) women had preterm deliveries. In the control group, 114 (82.0%) women delivered at term and seven (5.0%) women had preterm deliveries (P=.88 and P=.60, respectively). The rate of pelvic adhesions on repeat cesarean delivery was significantly higher in the compression suture group than in the control group (34.3% compared with 17.5%, P=.03). CONCLUSIONS: Subsequent pregnancy outcomes were similar for women who did and those who did not receive uterine compression sutures during their prior delivery, whereas uterine adhesions at repeat cesarean delivery were more prevalent in women who received uterine compression sutures. LEVEL OF EVIDENCE: II

Fragile X carrier screening in Korean women of reproductive age

Objective To estimate the distribution of the FMR1 alleles and the prevalence of the premutaion (PM) and full mutation (FM) of the FMR1 gene in Korean women of reproductive age. Methods Using polymerase chain reaction and Southern blot, 5829 women of reproductive age were screened (low-risk group n = 5470 and high-risk group n = 359) and 11 prenatal diagnoses were completed between September 2003 and December 2011. Results Of the 5829 women screened, normal FMR1 alleles (11,607) had a bimodal distribution with most alleles having 29 (37.87%) and 30 (31.87%) CGG repeats. Of the 5470 women in the low-risk group, 7 PM were identified, giving a PM carrier frequency of 1:781; none of the women had Fragile X syndrome. We also identified 38 intermediate alleles, with a reported incidence of 1:143. Of the 11 prenatal diagnoses, five were normal, five had a premutation, and one had a full mutation allele. Conclusions The carrier frequency is 1/781 (0.13%) in Korean women of reproductive age. This is lower than among Caucasians, but relatively higher than in other Asian populations. Although there may be a founder effect, these results might be valuable in understanding Fragile X syndrome in Koreans and Asians as a whole.

Threshold of Nuchal Translucency for the Detection of Chromosomal Aberration: Comparison of Different Cut-offs

This study evaluated the sensitivities and false positive rates of the screening test using ultrasonographic measurement of thickness of nuchal translucency (NT) with different cut-offs for chromosomal aberration in a Korean population. We included 2,570 singleton pregnancies undergoing ultrasound between 11 weeks and 14 weeks of gestation in this study. We analyzed the sensitivities of NT alone for screening chromosomal aberration using three cut-offs -2.5 mm, 3.0 mm, and 95th percentile for each crown rump length (CRL). There were 31 chromosomal aberrations (1.2%) including 12 cases of trisomy 21. The numbers of chromosomal aberrations that were detected by NT with different cut-offs of 2.5 mm, 3.0 mm and the 95th percentile CRL were 22, 18 and 23, respectively. At a threshold of 2.5 mm, the sensitivity and the false positive rate for total chromosomal aberrations were 67.7% and 6.3%, respectively. At 3.0 mm, those were 54.8% and 3.5%, respectively. At the 95th percentile CRL, those were 70.9% and 5.8%, respectively. The use of CRL-dependent cut-offs for nuchal translucency improves the detection of chromosomal aberrations when compared to fixed cut-offs in a Korean population.

ORIGINAL ARTICLE: Transforming Growth Factor-Beta1 Gene Polymorphisms in Korean Patients with Pre-eclampsia: TGF-β1 GENE POLYMORPHISM IN PRE-ECLAMPSIA

Citation Kim SY, Lim JH, Park SY, Yang JH, Kim MY, Kim MH, Ryu HM. Transforming growth factor‐beta1 (TGF‐β1) gene polymorphisms in Korean patients with pre‐eclampsia. Am J Reprod Immunol 2010; 63: 291–298