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이영,송승규,김수평,이종건,김은중,김사진,이귀세라,허수영,강규섭,남정,김용옥 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10
1996년 1월 1일부터 1997년 12월 31일까지 가톨릭대학교 성가병원에서 분만한 산모 4388명 중에서 임신 24∼28주에 50 gm 경구당 부하검사를 시행한 1384명에서 140 mg/dl 이상의 양성 반응을 보여 100 gm 경구당 부하검사를 시행하였던 223명을 대상으로 정상군이 158명(17명 누락), 치료받지 않은 Coustan군이 26명(2명 누락) 그리고 치료받은 NDDG 기준의 임신성 당뇨군이 39명(3명 누락)으로 후향적으로 조사하여 다음과 같은 결과를 얻었다. 1. NDDG기준에 의한 임신상 당뇨의 빈도는 2.8%였 으며 Coustan기준을 사용한다면 4.9%로 50% 이상의 임신성 당뇨 빈도의 증가를 보였다. 2. NDDG군은 정상군에 비하여 처음 제왕절개술 및 총 제왕절개술, 조산 등에서 높은 빈도를 질식 분만에서는 낮은 의의 있는 차이를 보였으나 Coustan군에서는 조 산의 빈도만 높았다. 3. Coustan군에서 NDDG군에 비하여 과체중아, 거대아, 질식 분만, 제왕절개술, 조산 및 산과적 합병증에 대한 유의적인 차이는 없었다. 이상의 결과로 100 gm 경구당 부하검사에서 Caustan 기준으로 역치 값을 낮추는 것은 거대아 및 산과적 이환율을 낮추는 것 없이 임신성 당뇨 진단에 있어 과다 진단을 초래할 것으로 생각된다. Objective: To determine the incidence of gestational diabetes mellitus and relationship between birth weight and mode of delivery by two sets of 3-hour glucose tolerance test criteria, those recommended by the National Diabetes Data Group (NDDG) and Carpenter and Coustan criteria (Coustan). Methods: Between January 1996 and December 1997 from Holy Family hospital of Catholic Medical College , a total of 1384 pregnant women were screened for a plasma glucose of 140mg/dl or greater.223 positive subjects received a 3-hour glucose tolerance test interpreted by the two criteria.Data are presented for 158 (17 were lost of F-U) positive screen, negative glucose tolerance test subjects; 26 (2 were lost of F-U) subjects with untreated Coustan criteria; and 39 (3 were lost of F-U) subjects with treated GDM by NDDG. Results: 1. Gestational diabetes mellitus incidence was 4.9% overall based on the Coustan criteria and 2.8% by the NDDG criteria. 2. Primary & total cesarean delivery, and preterm delivery in NDDG were increased significantly, Episiotomy was decreased when compared with normal group, but preterm delivery in Coustan was increased significantly. 3. There were no significant differences in episiotomy, macrosomia, large baby, cesarean deliveries, and pregnancy outcomes between the women with not-treated Caustan group and treated NDDG. Conclusions: Our results indicate that the criteria of Carpenter and Caustan would overdiagnose Gestational Diabetes Mellitus without improving perinatal and pregnancy outcomes.
김도강,김수평,노덕영,신진웅,장병우,변태섭,서천옥,이희중,강규섭 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10
Objective: This report was undertaken to determine the present status of cesarean hysterectomy which was originally devised to prevent postcesarean infection and hemorrhage, and its conditions have gradually been widened to include many conditions in which removal of the uterus is necessary or desirable. Material & method: 53 cases of cesarean hysterectomy performed at Taejon St, Mary`s Hosp. from Jan. 1992 to Aug. 1997, was discussed and evaluated retrospectively. Results: There were 19, 823 deliveries during this period. Cesarean hysterectomy was performed in 53 cases of 8, 558 cesarean sections [0.56%] and 11, 265 normal spontaneous vaginal deliveries [0.04%], an total indication of 0.28%. In total subjects of 53 cases in this series, the subject were 31 cases of uterine atonic bleeding, 9 cases of adhesive placenta, 6 cases of placenta previa, 5 cases of uterine myoma with pregnancy and 2 cases of uterine rupture. All patients who had cesaren hysterectomy received transfusion from 1 pint to 40 pints. The post operative complications were atonic bladder, disseminated intrav ascular coagulopathy, febrile morbidity and wound infection. There was one maternal death due to acute, severe homorrhage and DIC. Conclusion: Postoperative complications still remain the main causes of maternal mortality. Therefore careful prenatal care, momentary judgement of right operation time, fresh blood transfusion and reduction of operation time are very important.
정상 임신과 비정상 임신의 초기 혈중 CA - 125 수치에 관한 연구
노덕영(Duck Yeong Ro),김도강(Do Kang Kim),김수평(Soo Pyung Kim),문희봉(Hee Bong Moon),강규섭(Gyu Sub Kang),황지영(Jee Young Hwang),신봉영(Bong Young Shin),장병우(Byeung Woo Jang) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11
N/A A prospective study was initiated to compare maternal serum concentration of CA-125 during the first trimester of normal and abnormal pregnancies. Serum specimens were obtained from 87 women with a normal intrauterine pregnancy and 47 women with abnormal pregnancies which were ended in spontaneo abortion or pathologically confirmed to be missed abortion. In normal pregnancies, the mean serum CA-125 concentrations were increased significantly from amenorhea 6 weeks (139.838.7 IU/ml), and were higher statistically than the values tested in the same weeks of abnormal pregnancies. In abnormal pregnancies serum CA-125 concentations were relatively lower than those of normal pregnancies. But these differences were not statistically significant except the values tested in amenorhea 6weeks. So serum levels of CA-125 may not be proved useful in monitoring of early pregnancies outcome.