Acute fatty liver of pregnancy: A case report / 대한산부인과학회지

Acute fatty liver of pregnancy are relatively rare but extremely dangerous, because they may quickly develop into a fulminant disease and become a serious life-threatening disorder for mother and fetus in the third trimester. Therefore, early diagnosis, prompt delivery and intensive supportive care the cornerstones in the management of acute fatty liver of pregnancy. Clinical findings in acute fatty liver of pregnancy vary because it may occur with varying degrees of clinical severity and in conjunction with other third trimester symptoms, making early diagnosis difficult. However, careful history and physical examination, in conjunction with compatible laboratory and imaging results, are often sufficient to make the diagnosis, and liver biopsy is rarely indicated. We have experienced a case of acute fatty liver of pregnancy presenting as early hepatic encephalopathy, renal failure which developed during the third trimester. We diagnosed acute fatty liver of pregnancy based on clinical presentation and laboratory abnormalities. Despite of prompt delivery and adequate supportive care management, this severe complication of pregnancy has had an adverse outcome for mother.

Inguinal hernia of ovary and fallopian tube in adult woman / 대한산부인과학회지

Anomalous presence of fully developed female reproductive organs in the inguinal canal is extremely rare. But, early recognition and reduction of an ovary is thought to be important to prevent strangulation of the hernia and necrosis of the ovary. Ultrasound scan diagnose positively the presence of ovaries in the majority of cases. So we advise ultrasound scan must be performed routinely in those female with inguinal hernia. We experienced a case of inguinal hernia of ovary and fallopian tube in a fully developed adult woman. So we present it with a brief review of literature.

A Clinical, Pathologic and Prognostic Features of Adnexal Masses Operated on during Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate retrospective data concerning patients with adnexal masses that were managed surgically during pregnancy and their effect on fetal outcome. METHODS: Data were reviewed concerning pregnant women who required surgery at our hospital from January 1991 to December 2000 for an adnexal mass. RESULTS: In the recent 10 years at our hospital a total of 47 pregnant women aged 27.9+/-3.6 years were diagnosed with adnexal masses that required surgery. The masses were removed at 12.3+/-3.7 weeks of gestation and maximum diameter was 8.4+/-2.3 cm. The pathologic features of the 47 lesions were as follows : 17 mature cystic teratomas, 14 epithelial origins (12 serous cystadenoma, 2 mucinous cystadenoma), 9 functional cysts, 4 endometriotic cysts, 2 paraovarian cysts, 1 malignant neoplasm. Of the 41 patients for whom the outcome of pregnancy was available, 2 (4.2%) gave preterm birth before 37 weeks, while 4 (8.5%) experienced spontaneous abortion. There were not any perinatal death for the 43 infants. CONCLUSION: Although our studies are smaller for confirmation, so larger studies are required, but our results suggest that an adnexal mass may be associated with an adverse fetal outcome. Surgical intervention at<22 weeks of gestation might not have been related to the adverse fetal outcomes.