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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.
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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.
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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
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.
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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.
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자궁내막증 환자의 임상증상에 따른 난포액과 복강액내 prostaglandin E2 및 F2a 농도비교
이종철 ( Jong Cheol Lee ),경규상 ( Kyu Sang Kyoung ),조아라 ( A Ra Cho ),박민아 ( Min Ah Park ),이영미 ( Young Mi Lee ),홍승화 ( Seung Hwa Hong ),박연진 ( Yeon Jin Park ),지일운 ( Ill Woon Ji ),정은환 ( Eun Hwan Jeong ),김학순 ( H 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.8
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이미영,원혜성,이경아,경규상,심재윤,이필량,김암 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-
To report our short experience with fetoscopic laser surgery (FLS) in management of twin-twin transfusion syndrome (TTTS). Retrospective analysis of fetuses with TTTS who were treated with FLS between October 2011 and March 2012. Seven patients underwent FLS at the median age of 20.5weeks (range, 17.5-24.1 weeks). Most of the cases were at Quintero stage 3 and there were 2 cases with the anterior placenta. The median duration of coagulation time was 27min (range, 16-80 min) and the median number of coagulated anastomoses was 7.5 (range, 4-10). The survival rate of at least 1 twin was 71.4%. The median gestational age at delivery was 36.0 weeks (range, 25.5-38.1 weeks). Except one extremely preterm infant, the remaining survivors are doing well without any complications. From our results, FLS was not so difficult and carried the good perinatal outcomes. Parents of fetuses diagnosed with severe TTTS should be counseled carefully about the benefits as well as complications of FLS.
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