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KMID : 0358419960390122375
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Korean Journal of Obstetrics and Gynecology
1996 Volume.39 No. 12 p.2375 ~ p.2384
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Fetal Biophysical Profile, Umbilical Artery Doppler Velocimetry and Perinatal Outcome in Small for Gestational Age Fetuses
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선진규
김재익/양정형/김대화/기광수/임헌정
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Abstract
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In Korea, Cancer of the uterine Cervix is the most common gynecologic malignacy and leading cause of death in women. Cytologic screening for cancer of the cervix, specifically precancerous lesions, is generally accepted as being effective in
reducing
both incidence and mortality for cervical cancer. Due to the absence of a nation-wide mass screening program and national cancer registry program, the prevalance rate of cervical cancer and cervical intraepithelial neoplasia in the normal
population has
not been exactly evaluated in our country.
The purpose of this study is to investigate the efficacy of the cevical cytology as a screening tools for the cervcal cancer and to roughly estimate the prevalence of cervical cancer group of women visited our health care center.
Review of the cytologic smears from January 1, 1991 to December 31, 1993 revealed 14,505 cases with 484 abnormal cytology.
@ES The results were as follows ;
@EN 1. Of the women screened were the age of 20 years, 29.2% < 40 years, 33% <50 years, 25.1% >60, 9.0% <70, 0.8% ≥70 respectively.
2. Abnormal cytology rate was 3.34% including 2.50% of class II, 0.56% of class III, 0.24% of class IV and 0.24% of class V.
3. 3. Abnormal cytology rate increased with age. The proportion of women with abnormal cytology was highest in those age of years(5.1%). Class III was highest between ages 30 and 49 and class IV, V in those age of 60 years(1.0%).
4. 4. At the histopathologic evaluation of the biopsy specimens from the women with class III(40/81), 45(65.3%) had findings cocsistent with CIN(Cervical intraepithelial neoplasia) I or worse. Among the histopathologically evaluated women with
class
IV, V(29/41), 28(97%) had lesions worse than mild dysplasia ; 5 of these were found to have invasive cancer.
5. The prevalence rates of carcinoma in situ and invasive cancer for the past 3 years were 0.23%(33/14,505) and 0.03%(5/14,505).
6.
@EN In a prospective study of 89 women who delivered Small-for-Gestational-Age fetuses with singleton pregnancies after 30 week's gestation, fetal biophysical assessment and umbilical artery resistance index were performed within 72 hours before
delivery.
Patients with abnormal fetal biophysical profile and umbilical artery RI had a significantly higher rate of preterm delivery, cesarean section for fetal distress, low Apgar score, significant neonatal morbidity, perinatal death, and admission to
Neon-Intensive-Care-Unit than patients with normal tests.
It was 87.6% vs. 84.3% that over all efficiency of tests to predict adverse perinatal outcome. Multiple logistic regression analysis indicated that abnormal artery RI and fetal biophysical profile were significant independant predictors for the
development of adverse perinatal outcome beyond the risk of preterm baby(odds ratio-119, p=0.0000 ; odds ratio=34.0, p=0.00001).
In this study, we can suggest that umbilical artery RI & fetal biophysical profile are useful independant predictor of adverse perinatal outcome with similar efficacy in Small-for-Gestational- fetuses.
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KEYWORD
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