삼태임신에서 융모막성에 따른 주산기 결과

경규상,이미영,이희영,현민경,원혜성,이필량,김암,심재윤 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

How much have the perinatal outcomes of triplet pregnancies improved over the last two decades?

경규상,심재윤,오수영,원혜성,이필량,김암,윤성철,강푸른나래,최석주,노정래 대한산부인과학회 2019 Obstetrics & Gynecology Science Vol.62 No.4

ObjectiveThis study was conducted to demonstrate the temporal trends in perinatal outcomes of triplet pregnancies over thelast two decades. MethodsThe medical records of patients with triplet pregnancies at two Korean tertiary-care hospitals from 1992 to 2012 wereretrospectively reviewed in regard to maternal and neonatal outcomes. The study was divided into two periods foranalysis: period I (1992–2001) and period II (2003–2012). ResultsOver a 21-year period, 65 women with triplet pregnancies and 185 neonates were analyzed. Period II, whencompared with period I, was associated with improved maternal outcomes, characterized by a decreased incidenceof preeclampsia (31.8% vs. 2.3%, P=0.002) and anemia (68.2% vs. 30.2%, P=0.003) during pregnancy. Regardingneonatal aspects, the composite morbidity of period II was significantly decreased compared with that of period I,as assessed with a generalized estimating equation for logistic regression (26.2% vs. 8.1%, P=0.03). Multivariableanalysis revealed that the gestational age at delivery and the period were significantly associated with the compositeneonatal morbidity (P<0.001 and 0.007, respectively). ConclusionImproved neonatal morbidity was associated with a higher gestational age at delivery and with the more recentdecade.

Delayed postpartum hemoperitoneum due to uterine artery pseudoaneurysm rupture

경규상,문지연,채송화,홍승화,강민호,정은환 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.3

A 30-year-old woman experienced severe abdominal pain 8 days after vaginal delivery. The patient was diagnosed with hemoperitoneum due to rupture of the left uterine artery pseudoaneurysm, which was confirmed via ultrasound with color Doppler and computed tomography scans. This patient was treated with bilateral uterine artery embolization to maintain fertility. A uterine artery pseudoaneurysm that causes delayed postpartum hemorrhage can occur after cesarean section or vaginal delivery. A uterine artery pseudoaneurysm can be fatal, so its detection and diagnosis are critical. Herein, we report a case of delayed postpartum hemoperitoneum due to uterine artery pseudoaneurysm rupture.

임상 ; 제왕절개 후 질식분만 실패의 원인 및 예측인자의 연구

경규상 ( Kyu Sang Kyoung ),조아라 ( A Ra Cho ),이영미 ( Young Mi Lee ),박민아 ( Min Ah Park ),정은환 ( Eun Hwan Jeong ),지일운 ( Ill Woon Ji ) 대한주산의학회 2007 Perinatology Vol.18 No.4

목적: 이번 연구의 목적은 제왕절개 후 질식분만의 성공률을 높이는데 도움을 주기위해 성공예측 인자와 실패의 원인을 분석하였다. 방법: 1997년 1월부터 2005년 12월까지 이전에 제왕절개 수술을 했던 임부 중 본원에서 질식분만을 시도했던 193명을 대상으로 하였다. 성공군과 실패군 사이에 임부의 나이, 재태연령, 입원시 자궁경부의 개대, 임부의 BMI, 신생아 몸무게, 질식 분만한 과거력, 이전 제왕절개의 이유 등 질식분만의 성공여부에 영향을 줄 수 있다고 생각되는 변수를 비교하였고, 실패군에서는 그 원인을 조사하였다. 결과: 93명 중 153명(79%)이 성공하였으며 40명(21%)이 실패하였다. 자궁파열이나 산모 및 태아의 사망 또는 심각한 합병증은 발생하지 않았으며, 두 대조군 사이에 임부의 나이나 재태연령은 차이가 없었고, 입원할 때 자궁경부의 개대가 많이 될수록, 임신전과 분만전의 임부의 BMI가 낮을수록, 신생아 몸무게가 적을수록 성공률이 의미 있게 높았다. 실패의 원인은 임부의 요구, 분만진행 장애, 태아심박동 양상의 이상변화, 유도분만 실패 등이 있었으며, 임부의 요구가 19명(47.5%)으로 가장 많은 부분을 차지했다. 결론: 본 연구에서 유의한 차이를 보인 인자들은 제왕절개 후 질식분만의 성공예측 인자로 사용될 수 있을 것이며, 응급 제왕절개의 합병증에 대해 미리 충분히 설명하거나 진통 중에 통증 조절을 적절하게 함으로써 임부의 요구에 의한 제왕절개 후 질식분만의 실패를 줄일 수 있을 것이다. Objective: The purpose of this study was to determine the factors associated with successful vaginal birth after cesarean section (VBAC), and to analyze the causes of failed VBAC. Methods: This study was performed based on 193 pregnant women who tried vaginal delivery after cesarean section in Chungbuk National University Hospital from January 1997 to December 2005. Maternal age, gestational age, cervical dilatation at admisson, maternal body mass index (BMI), neonatal bodyweight, history of prior vaginal delivery, and indication of prior cesarean section were retrospectively analyzed between the successful group and the failed group of women who tried labor. The causes of the failed trial were analyzed. Results: Seventy nine percent (153/193) was successful in the trial of VBAC and 21% (40/193) failed. There were no difference in maternal age or gestational age between two groups. The success rate was significantly higher when cervical dilatation at admission was more extended, BMI of pregnant women before pregnancy and birth was lower, and birthweight of newborn was lower. Maternal request was the major cause of failure (47.5%), and others were failure to progress, non-reassuring fetal monitoring and failed induction. Conclusion: The factors that had significant differences in this study can be used as predictor of successful VBAC. And failed trial of VBAC due to maternal request can be decreased by adequate explanation regarding the complication of emergency operation, and enough pain control during labor.

산전 초음파로 진단된 선천성 가로막 탈장 1례

지일운, 연현경, 최진영, 경규상, 홍승화, 정은환, 김학순 충북대학교 의학연구소 2019 忠北醫大學術誌 Vol.29 No.1

본문 참고

자연 소실된 태아 심방 조동 증례 보고

지일운, 연현경, 최진영, 경규상, 홍승화, 정은환, 김학순 충북대학교 의학연구소 2018 忠北醫大學術誌 Vol.28 No.1

본문 참고

수술 중 컴퓨터단층촬영을 통해 진단된 임신 중 자연적으로 발생한 자궁동맥 파열 증례 보고

김수진,김예솔,경규상,김승호,이명화,조혜연,경민선,강정배 대한주산의학회 2023 Perinatology Vol.34 No.1

A 35-year-old pregnant woman, para 0, who had previous medical history of lymphoma, visited to our hospital at 18 weeks and 2 days of gestation with chief complaint of suprapubic pain. Small amount of abdominal fluid collection was seen on initial ultrasonography and normal appendix on magnetic resonance imaging. However, after 6 hours later, she underwent emergency diagnostic exploratory laparoscopy due to aggravating abdominal pain and hypotension. Bleeding focus was hardly found due to its location and enlarged uterus, intraoperative enhanced computed tomography (CT) scan was done and left uterine artery was identified as the site of bleeding. Spontaneous rupture of a uterine artery in pregnancy is rare and can cause fatal consequence but clinical signs and symptoms were not specific. Some bleeding sites would be difficult to find in diagnostic exploration and may cause more blood loss and worse obstetric complications. Contrast-enhanced CT can clearly confirm bleeding site comparing with other modality. Therefore, preoperative contrast CT scan can be performed to obtain better outcome.

임상 ; 임신성 당뇨병 발생의 위험인자

조아라 ( A Ra Cho ),경규상 ( Kyu Sang Kyeung ),박민아 ( Min Ah Park ),이영미 ( Yung Mi Lee ),정은환 ( Eun Hwan Jeong ) 대한주산의학회 2007 Perinatology Vol.18 No.4

목적: 임신성 당뇨병의 발생과 관련이 있는 위험인자를 조사하고, 선별검사의 범위를 한정시킨 현행 의료급여고시의 타당성을 검토하기 위함이다. 방법: 1999년 6월부터 2006년 3월까지 임신 22주에서 39주 5일까지의 충북대학교병원 산부인과에서 선별검사를 시행한 임부 1,091명을 대상으로 하였다. 50 g 경구 당부하 검사를 시행하여 1시간 후 혈당이 140 mg/dL 이상인 임부에서 100 g 경구 당부하 검사를 하였고 미국 국립 당뇨병 연구회의 진단기준(1994)을 이용하여 2개 이상 양성인 경우 임신성 당뇨병으로 진단하였다. 임신성 당뇨병의 위험인자로는 임부의 연령, 비만, 임신 후 과도한 체중증가, 기형아나 거대아, 자궁 내 태아사망의 분만력, 주산기 사망, 당뇨병의 가족력, 고혈압과 임신중독증, 당뇨병의 기왕력을 조사하였다. 결과: 고령, 주산기 사망, 자궁 내 태아사망의 분만력, 당뇨병의 가족력, 임신중독증이나 임신성 당뇨병의 기왕력 등의 위험인자가 있는 임부는 임신성 당뇨병의 발생율과 거대아 출산의 확률이 의미있게 높았다. 또한 임신성 당뇨병 군에서 신체질량지수가 의미있게 증가되어 있었고 50 g 당부하 검사수치가 증가하였다. 그러나 위험인자가 없는 임부에서도 임신성 당뇨병이 발생하는 것을 보여주었다. 결론: 위험인자가 있는 임부는 임신성 당뇨병의 발생에 유의하여야 하지만, 예상치 않은 임신성 당뇨병을 조기에 발견하여 치료함으로써 임신결과를 향상시키기 위해서는 위험인자가 없더라도 모든 임부를 대상으로 선별검사를 하는 것이 훨씬 좋을 것으로 보인다. Objective: The purpose of this study was to identify the prevalence of risk factors related to Gestational Diabetes Mellitus (GDM). Methods: We retrospectively analyzed medical records of 1,091 pregnant women who had a 50 g oral glucose tolerance test (OGTT) at performed at the department of Obstetrics and Gynecology, Chungbuk National University Hospital from June, 1999 to March, 2006. The 1-hour plasma glucose level higher than 140 mg/dL was considered as a positive screening result. Patients with positive results underwent a 100 g OGTT as the diagnostic test for GDM, and more than 2 positive results were diagnosed as GDM, according to the American National Diabetes Data Group (NDDG) guideline. We investigated age, prevalence of obesity, weight gain, history of fetal anomaly, fetal death in uterus (FDIU), macrosomia, preeclampsia, GDM and familial history of diabetes mellitus, as the risk factors of GDM. Results: Elderly gravida, history of FDIU, perinatal death, preeclampsia, and GDM, familial history of diabetes mellitus were the risk factors of GDM and macrosomia to a statistically significant degree. We found out that BMI and 50 g OGTT results were increased in GDM group. However, there was a pregnant woman with no risk factors who had been diagnosed with GDM. Conclusion: Although the pregnant women with risk factors should be managed carefully to detect GDM, we also suggest all pregnant women to take screening test even if they have no risk factors, to improve pregnancy outcomes by detecting and treating unexpected GDM early in pregnancy.

단일 융모막 쌍태아에서 한쪽 태아의 터너 증후군 증례 보고

장정희 ( Jeong Hui Jang ),경규상 ( Kyu Sang Kyeong ),홍덕호 ( Deok Ho Hong ),홍승화 ( Seung Hwa Hong ),지일운 ( Il Woon Ji ),정은환 ( Eun Hwan Jeong ) 대한주산의학회 2014 Perinatology Vol.25 No.4

Monochorionic twins with discordant karyotypes are rare and mostly caused by post-zygotic mitotic nondisjunction. A 32 year old nulliparous woman at 11 weeks of gestation with spontaneous twin pregnancy wasreferred to our hospital. An amniocentesis was performed in both amniotic sacs at 15 weeks of pregnancy. Onefetus in monochorionic twin pregnancy was diagnosed with Turner syndrome with cystic hygroma, and theother fetus was normal. Because of high mortality rate in abnormal fetuses, the umbilical cord coagulation wasperformed using radiofrequency ablation to prevent the damage of co-twin that may be caused by the demiseof one fetus. After delivery, chorionicity of placenta was ascertained by pathologic exam. Postnatal findings ofphysical exam, abdominal and brain sonography were normal in the surviving neonate.

전방 전치태반 임신에서 태반 절개를 통한 제왕절개 분만의 안정성

홍덕호,김유진,장정희,경규상,정은환 대한산부인과학회 2015 대한산부인과학회 학술대회 Vol.101 No.-