Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 5 de 5
Filter
Add more filters











Database
Language
Publication year range
1.
Yonsei Med J ; 61(2): 154-160, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31997624

ABSTRACT

PURPOSE: Recently, obstetric massive transfusion protocols have shifted toward early intervention. This study aimed to develop a prediction model for transfusion of ≥5 units of packed red blood cells (PRBCs) during cesarean section in women with placenta previa. MATERIALS AND METHODS: We conducted a cohort study including 287 women with placenta previa who delivered between September 2011 and April 2018. Univariate and multivariate logistic regression analyses were used to test the association between clinical factors, ultrasound factors, and massive transfusion. For the external validation set, we obtained data (n=50) from another hospital. RESULTS: We formulated a scoring model for predicting transfusion of ≥5 units of PRBCs, including maternal age, degree of previa, grade of lacunae, presence of a hypoechoic layer, and anterior placentation. For example, total score of 223/260 had a probability of 0.7 for massive transfusion. Hosmer-Lemeshow goodness-of-fit test indicated that the model was suitable (p>0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89-0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70-0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability. CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.


Subject(s)
Blood Transfusion , Cesarean Section , Models, Biological , Placenta Previa/therapy , Adult , Calibration , Female , Humans , Logistic Models , Maternal Age , Multivariate Analysis , Nomograms , Pregnancy , Probability , ROC Curve , Retrospective Studies , Young Adult
2.
Obstet Gynecol Sci ; 62(5): 344-351, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31538078

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of scheduled ramosetron injections for controlling postoperative nausea and vomiting (PONV) after single-port access total laparoscopic hysterectomy (SPA-TLH). METHODS: Ninety patients who underwent SPA-TLH at the Korean National Health Insurance Service Ilsan Hospital between June 2013 and July 2014 were enrolled in this prospective, randomized, double-blinded, placebo-controlled study. The patients were divided into 2 groups as follows: the ramosetron group (0.3 mg intravenously [IV]; n=45) and the placebo group (normal saline IV; n=45). Both groups received their respective injections 12 and 24 hours post surgery. The incidence and severity of PONV (numerical rating scale, 0-10), and the use of rescue antiemetics post surgery were evaluated. RESULTS: Demographic and perioperative statistically significant differences were not observed between the 2 groups. The incidence of PONV in the ramosetron and placebo groups was 46.7% and 51.1%, respectively (P=0.51). We found significant differences in the severity of PONV between the 24- to 48-hour postoperative periods in both groups (ramosetron group, P=0.04 and placebo group, P=0.03). The use of rescue antiemetics was significantly lower in the ramosetron group than in the placebo group (P=0.02). CONCLUSION: After general anesthesia, scheduled injections of ramosetron 12 and 24 hours after SPA-TLH reduced the severity of PONV and the use of rescue antiemetics. Administration of ramosetron can be considered not only immediately after SPA-TLH but also during the first 24-hour recovery period. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02011659.

3.
Obstet Gynecol Sci ; 61(4): 489-496, 2018 Jul.
Article in English | MEDLINE | ID: mdl-30018903

ABSTRACT

OBJECTIVE: To describe the clinical outcomes of frozen-thawed embryo transfer (FET) with artificial preparation of the endometrium, using a combination of estrogen (E2) and progesterone (P4) with or without a gonadotropin-releasing hormone agonist (GnRHa), and the modified natural cycle (MNC) with human chorionic gonadotropin (hCG) trigger. METHODS: In this retrospective study, we evaluated 187 patients during 3 years (February 2012-April 2015). The patients were allocated to the following treatment groups: group A, comprising 113 patients (181 cycles) who received GnRHa+E2+P4; group B, comprising 49 patients (88 cycles) who received E2+P4; and group C, comprising 25 patients (42 cycles) who received hCG+P4. The inclusion criteria were regular menstrual cycles (length 24-35 days) and age 21-45 years. RESULTS: The primary outcome of the study - implantation rate (IR) per embryo transferred - was not statistically different among the 3 groups. Similar results were found for the IRs with fetal heartbeat per embryo transferred (68/181 [37.6%] in group A vs. 22/88 [25.0%] in group B vs. 14/42 [33.3%] in group C) and for the live birth rates (LBRs) per embryo transferred (56/181 [30.9%] in group A vs. 18/88 [20.5%] in group B vs. 11/42 [26.2%] in group C). CONCLUSION: Although the pregnancy outcomes were better in the hormone therapy with GnRHa group, hormone therapy FET with GnRHa for pituitary suppression did not result in significantly improved IRs and LBRs when compared with hormone therapy FET without GnRHa or MNC FET.

4.
J Obstet Gynaecol Res ; 38(1): 108-12, 2012 Jan.
Article in English | MEDLINE | ID: mdl-21827576

ABSTRACT

AIM: Toll-like receptor 4 (TLR-4) is the major receptor used for recognition of specific gram negative bacteria by the host immune system. The role of TLR-4 has been revealed in preterm parturition. This study aims to demonstrate the immunohistochemical expression of TLR-4 with regard to histological layers and anatomical regions of the human fetal membranes. MATERIAL AND METHODS: Fetal membranes were obtained from the uterine fundus and low segment. Immunohistochemical staining for TLR-4 and hematoxylin and eosin stain were performed. RESULTS: The chorion expressed significantly higher levels of TLR-4 than the amnion (P=0.001). There was no difference in the expression of TLR-4 between the uterine fundus and the uterine low segment (P=0.942). There was no significant difference in TLR-4 expression according to the presence of histological chorioamnionitis (P=0.444). TLR-4 expression decreased significantly with the progression of gestation (P=0.002). CONCLUSIONS: The level of expression of TLR-4 did not differ according to anatomic location, but did differ according to the histological layer of the human fetal membranes and gestational age. These results suggest that TLR-4 may be involved in preterm parturition.


Subject(s)
Extraembryonic Membranes/metabolism , Premature Birth/metabolism , Toll-Like Receptor 4/metabolism , Uterus/metabolism , Adult , Cross-Sectional Studies , Female , Gestational Age , Humans , Immunohistochemistry , Infant, Newborn
5.
Am J Reprod Immunol ; 48(2): 70-6, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12389595

ABSTRACT

PROBLEM: The mechanism through which vascular endothelial growth factor (VEGF) regulation occurs at the feto-maternal interface is poorly understood. The aim of this study was to investigate the effects of various cytokines on VEGF expression and secretion by trophoblast cells. METHOD OF STUDY: We investigated the effects of cytokines on VEGF expression in human first trimester trophoblast cell line by analyzing VEGF messenger RNA (mRNA) by reverse transcription-polymerase chain reaction and VEGF protein secretion by enzyme linked immunosorbent assay. RESULTS: The trophoblast cells expressed VEGF mRNA constitutively and the main subtypes were identified as VEGF121 and VEGF165. When cultured in the presence of interferon (IFN)-gamma, interleukin (IL)- 1beta, tumor necrosis factor (TNF)-alpha, IL-2, or IL-10, VEGF mRNA expression was found to be significantly increased by IL-1beta, IFN-gamma and TNF-alpha but to be unaffected by IL-2 and IL-10. Moreover, VEGF secretion was most significantly increased by IFN-gamma treatment. CONCLUSION: These results suggest that IL-1beta, IFN-gamma, and TNF-alpha may regulate the production of VEGF in early gestational trophoblasts.


Subject(s)
Cytokines/physiology , Endothelial Growth Factors/genetics , RNA, Messenger/biosynthesis , Trophoblasts/metabolism , Cell Culture Techniques , Cytokines/pharmacology , Enzyme-Linked Immunosorbent Assay , Female , Gene Expression Regulation , Humans , Interferon-alpha/physiology , Interferon-beta/physiology , Interleukin-1/physiology , Interleukin-10/physiology , Interleukin-6/physiology , Pregnancy , Pregnancy Trimester, First , RNA, Messenger/genetics , Trophoblasts/cytology , Trophoblasts/drug effects
SELECTION OF CITATIONS
SEARCH DETAIL