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대한주산의학회> PERINATOLOGY (구 대한주산의학회잡지)

PERINATOLOGY (구 대한주산의학회잡지) update

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수록정보
수록범위 : 1권1호(1990)~33권2호(2022) |수록논문 수 : 1,390
PERINATOLOGY (구 대한주산의학회잡지)
33권2호(2022년 06월) 수록논문
최근 권호 논문
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KCI등재

저자 : Byong Sop Lee

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 33권 2호 발행 연도 : 2022 페이지 : pp. 73-81 (9 pages)

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Despite recent advances in prenatal diagnosis and newborn treatment strategies, the survival rate of congenital diaphragmatic hernia (CDH) has not changed much in the range of 60% to 80% over the past 20 years. Obstetricians, pediatricians, and pediatric surgeons play a pivotal role in prognosis prediction, perioperative stabilization, and diaphragmatic repair, respectively. The two cardinal underlying pathologies are lung hypoplasia and persistent pulmonary hypertension, which sometimes lead to early mortality and long-term cardiopulmonary sequelae even after timely treatment in the newborn period. The observed/expected lung-to-head ratio in antenatal ultrasound is a strong predictor of mortality, and provides guidance in family counseling on critical decisions such as in utero transfer and extracorporeal membrane oxygenation (ECMO). In the CDH, the efficacy of pulmonary vasodilators including inhaled nitric oxide is unclear, and hemodynamic support should be individually tailored based on invasive monitoring and echocardiography as well. ECMO plays a definite role as a last resort to rescue CDH. However, the implementation of ECMO can be a miraculous life-saving bridge to a surgical correction, but rather can be a meaningless life-sustaining machine. Controversy continues over the timing and technique of surgical repair to reduce mortality and postoperative recurrence. Although late death of CDH is rare after hospital discharge, a significant proportion of patients experience a wide range of long-term burden of associated morbidities including feeding difficulties, pulmonary dysfunction, reduced exercise capacity, and neurodevelopmental impairment. Recent clinical trials on fetal tracheal occlusion therapy are promising in that it turns out to improve the survival rate of severe CDH.

KCI등재

저자 : Min-a Kim , Young-han Kim

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 33권 2호 발행 연도 : 2022 페이지 : pp. 82-88 (7 pages)

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Pregnant women and newborns are vulnerable to several pathogens and are at high risk of exposure to various infectious diseases. Part of this increased susceptibility in pregnant women is due to pregnancy-related hormones that interact with the immune response. Maternal vaccination is an effective strategy for protecting the mothers as well as their infants and newborns against vaccine-preventable infections acquired at birth via transplacental transfer of maternal antibodies. At present, vaccines routinely recommended for pregnant women are the influenza and Tdap vaccines. A single dose of influenza vaccine is recommended for all pregnant women during the influenza season, which should be repeated during each pregnancy and the Tdap vaccine is recommended during every pregnancy, between 27 and 36 weeks of gestation. In addition, since pertussis infection in newborns or infants is often caused by family members and caregivers who come in direct contact with the baby, obstetrician-gynecologists should encourage the administration of the Tdap vaccine to these individuals at least 2 weeks before coming into contact with the newborn. In addition to influenza and Tdap vaccines, some vaccines such as hepatitis A and B vaccines can be used to protect from infectious diseases through vaccination in high-risk conditions or practices, such as travel to endemic areas, exposure, and during outbreaks. Maternal immunization is an important public health strategy to protect pregnant women and their babies. Healthcare providers should confidently promote vaccination during pregnancy as they are regularly trained to advise women on the latest immunization information.

KCI등재

저자 : Yoo Jinie Kim , Seung Han Shin , Ee-kyung Kim , Han-suk Kim

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 33권 2호 발행 연도 : 2022 페이지 : pp. 89-95 (7 pages)

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Objective: We aimed to investigate whether preterm infants with postnatal cytomegalovirus (CMV) infection have unfavorable hearing and neurodevelopmental outcomes. We also tried to find the difference between symptomatic and asymptomatic group of preterm infants with CMV infection.
Methods: Preterm infants born before 32 weeks' gestation between January, 2014 and October, 2020 with urine CMV polymerase chain reaction-positive 2 weeks after birth were enrolled. Those who presented more than one of symptoms including thrombocytopenia, neutropenia, hepatitis, cholestasis, and pneumonitis were classified as a symptomatic group. Hearing status and neurodevelopmental outcomes were compared between symptomatic and asymptomatic groups by using results of auditory brainstem response threshold and Bayley Scales of Infant and Toddler Development, third edition (Bayley-III) performed at 8 to 12 and 18 to 24-months corrected age, respectively.
Results: Among 553 live births, 32 patients (5.8%) were diagnosed as postnatal CMV infection. Of 32 patients, 20 (62.5%) were classified as a symptomatic group. The incidence of respiratory distress syndrome was significantly higher in symptomatic group (95.0 vs. 58.3%, P=0.018). Composite scores of cognitive, language, and motor domains of Bayley-III was comparable between 2 groups. Total of 2 patients showed mild hearing impairment and one of each was included in the group.
Conclusion: No significant difference in short-term outcome was observed between symptomatic and asymptomatic groups. Postnatal CMV infection in preterm infants resulted in mild degree of auditory impairment and no unfavorable neurodevelopmental outcome. Further study with large study population is needed to confirm the consequences of postnatal CMV infection among preterm infants.

KCI등재

저자 : Sujung Oh , Ji Hye Jo , Subeen Hong , Hyun Sun Ko , In Yang Park , Hyesung Hwang

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 33권 2호 발행 연도 : 2022 페이지 : pp. 96-101 (6 pages)

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Objective: This study demonstrates sonographic features of such ovarian masses and share treatment process for those that require surgery during pregnancy.
Methods: This retrospective study includes females diagnosed with ovarian masses during pregnancy at The Catholic University of Korea, Seoul St. Mary's Hospital from 2009 to 2020. The study population was categorized into 2 groups depending on the need for surgery based on gestational age at the time of detection of ovarian masses, sonographic findings, and delivery outcomes. From the group that had surgery, outcomes were analysed according to the gestational age at surgery and the surgical indications.
Results: Of the 114 females with ovarian masses found during pregnancy, 49 (43.0%) underwent surgery during pregnancy, and 65 (57.0%) did not require surgery. Ovarian masses were found in the first trimester in 82 cases (71.9%). The risk factors for surgery were maternal age (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.72-0.98), gestational age at the time of detection (OR, 0.85; 95% CI, 0.76-0.94), the size of the mass (OR, 1.06; 95% CI, 1.03-1.09), and ascites (OR, 18.09; 95% CI, 1.83-178.78). In females undergoing surgery during pregnancy, 45 (91.8%) had laparoscopic surgery, and 20 (40.8%) were treated surgically after 1st trimester. The most common cause of surgery was mass torsion (n=22, 44.9%).
Conclusion: The risk of ovarian surgery is higher during pregnancy when the mass is identified at an earlier gestational age, the masses are larger, or ascites is detected. Laparoscopic surgery is recommended even after the first trimester.

KCI등재

저자 : Ji Hye Bae , Ji-hee Sung , Yejin Kim , Hye Jung Cho , Yun-sun Choi , Suk-joo Choi , Soo-young Oh , Cheong-rae Roh

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 33권 2호 발행 연도 : 2022 페이지 : pp. 102-105 (4 pages)

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Pigmentary demarcation lines (PDLs) are rare pigmentary diseases with abrupt transition lines between areas of deeper pigmentation and areas of lighter or normal pigmentation. Among several types, type B PDL involves the posterior medial part of the lower extremities and is commonly associated with pregnancy. In South Korea, only a few cases of type B PDL during pregnancy is reported; however, here we present a case of recurrent type B PDL during pregnancy. The patient experienced 2 pregnancies with pigmentary changes in the posterior thigh from the late second trimester; the pigmentation faded and disappeared a few months after delivery in both pregnancies. Most PDLs are asymptomatic and are spontaneously relieved. It will be helpful for obstetricians to recognize this condition and reassure patients.

KCI등재

저자 : Han-rok Do , Sun-young Lee , Myo-jing Kim , Chae-ku

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 33권 2호 발행 연도 : 2022 페이지 : pp. 106-109 (4 pages)

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3M syndrome is a rare disease characterized by severe growth retardation, characteristic facial morphology, and skeletal abnormalities. Approximately 65% of patients with 3M syndrome have mutations in the cullin-7 (CUL7) gene. We report a rare case of early diagnosis of 3M syndrome in a newborn with Hirschsprung disease. A female infant was born at 38 weeks and 3 days of gestation with a birth weight of 2,510 g. The patient had a large forehead, round face, short extremities, and a small body. The patient had abdominal distension and delayed meconium passage for over 48 hours. Hirschsprung disease was diagnosed, and the patient underwent surgical treatment. Next-generation sequencing analysis of the patient showed a CUL7 gene mutation, which suggested a diagnosis of 3M syndrome. We confirmed a compound heterozygous CUL7 gene mutation by genetic testing of the parents. In the future, the patient needs to be repeatedly assessed for growth, development, and skeletal deformities and will be treated with growth hormone therapy at an outpatient clinic.

KCI등재

저자 : Yejin Kwon , Hanna Moon , Yeonseong Jeong , Young-han Kim

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 33권 2호 발행 연도 : 2022 페이지 : pp. 110-115 (6 pages)

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An incarcerated gravid uterus is a rare obstetrical complication that requires close monitoring to ensure fetal and maternal well-being and to plan a successful delivery. Most patients present with vague anatomic pressure-related symptoms, such as pelvic discomfort and urinary symptoms, in the early 2nd trimester. Initial presentation in the 3rd trimester is scarce, and asymptomatic cases are even rarer. In this case report, we present an asymptomatic patient who was referred at 30 weeks of gestation with an initial impression of placenta previa totalis. She was not a candidate for uterine reduction; therefore, after a close follow-up period, she underwent planned cesarean section at 36 weeks of gestation. Because of its rare frequency and related obstetrical complications, early clinical suspicion and diagnosis are critical for management until delivery and establishing a successful delivery strategy.

KCI등재

저자 : Yoon Suk Choi , Yoon Young Jeong , Jin Young Bae , Ji Eun Jeong , Seong Yeon Hong , Hyun Jin Ko

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 33권 2호 발행 연도 : 2022 페이지 : pp. 116-120 (5 pages)

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Cystinuria is an inherited disorder that causes urolithiasis owing to a defect in the reabsorption of cystine in the kidneys. A fetal hyperechoic colon revealed on ultrasound before 36 weeks of gestation may suggest cystinuria, and a high positive predictive rate of 89% has been reported. A 31-year-old female patient was referred to Daegu Catholic University Hospital at 30 weeks of gestation for a fetal echogenic bowel. The fetal colon had homogenously increased echogenicity as much as that of the fetal iliac bone, upon prenatal ultrasonography; otherwise, there was no evidence of fetal structural anomalies. The baby was born at 37 weeks and 3 days of gestation. Postnatal urinary amino acid analysis revealed 4,425 mol/g cystine (normal range, 212-668 μmol/g). Diagnostic exome- sequencing revealed a c.1976A>C mutation in the SLC3A1 gene. From the time of weaning, sodium intake or animal protein diet can be restricted; however, since it is not consumed during the newborn period, the progress was observed at the outpatient clinic without any other restrictions. The baby visited an outpatient clinic at 1 month of age with no urolithiasis. Since cystine urolithiasis generally appears in the first 2 decades, there is an advantage in receiving preventive treatment if diagnosed in advance using prenatal ultrasound findings. Therefore, if hyperechoic colon findings are found on prenatal ultrasonography, it is desirable to conduct postnatal examinations for cystinuria.

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