Clinical significance of Urinary protein fractional analysis in Severe preeclampsia / 대한산부인과학회지

OBJECTIVE: To determine whether severity of proteinuria or urinary protein fractional analysis correlates with adverse maternal and fetal outcomes in women with severe preeclampsia. METHODS: Thirty-six women diagnosed of severe preeclampsia from January, 2002 to April, 2003 were studied. The correlation between proteinuria or urinary albumin fraction, and maternal mean arterial pressure, neonatal birth weight, 1 minute apgar score were analyzed statistically. Thirty-six patients were divided into two groups according to the pattern of urinary protein fraction. One group was a selective proteinuria group if the albumin fraction was over 70%, and another was a non-selective proteinuria group if the fraction was below 70%. The maternal and neonatal outcomes were compared between the two groups. RESULTS: Significant positive correlation was observed between proteinuria and mean arterial pressure, between urinary albumin fraction and neonatal birth weight. Negative correlation was significantly present between proteinuria and neonatal birth weight, 1 minunte apgar score, between proteinuria and albunin fraction. Increased proteinuria, higher mean arterial pressure, higher serum uric acid level, lower creatinine clearance, lower neonatal birth weight, and lower 1 minunte Apgar score were observed in the non-selective proteinuria group than those in the selective proteinuria, although there was no statistical significance. CONCLUSION: With increasing proteinuria and decreasing albumin fraction, there is increased risk of adverse maternal and fetal outcome. Proteinuria fractional analysis by electrophresis might provide useful information regarding the prediction of pregnancy outcomes.

A clinical study of torsion of ovarian tumors in pregnancy / 대한산부인과학회잡지

OBJECTIVE: To evaluate optimal management of an ovarian tumor in pregnancy METHODS: This study includes 89 cases of an ovarian tumor in pregnancy that required surgery at Catholic Medical Center, Kangnam St. Mary's hospital, Holy Family hospital of the Catholic University Medical College from January, 1990 to December, 2001. We collected 36 cases from 48 pregnant women who underwent emergency operation. And 53 cases were pregnant women who underwent elective operation. The student t-test and x2 test were used for statistical analysis. A P value of <0.05 was considered significant. RESULTS: The most common size of torsion of an ovarian tumor during pregnancy was 6-10 cm and the incidence was the most frequent during the first trimester of pregnancy. Pregnant women with torsion of an ovarian tumor who underwent emergency operation compared with those who underwent elective operation, the risk of preterm delivery were significant. But there were no fetal deaths reported, also there were no difference in the birth weight or the method of delivery. CONCLUSION: The torsion of an ovarian tumor dose not have a serious affect on the overall pregnancy. If the early diagnosis of the ovarian tumor is made and the malignancy is ruled out, it seems likely that the conservative care is better than the invasive method of operation during the second trimester of pregnancy just to prevent from preterm labor due to emergency operation of ovarian tumor.

Prenatal Sonographic Finding of A Case of Hydrometrocolpos / 대한산부인과학회잡지

Cloacal anomalies are very rare congenital malformations with the incidence of 1/50,000-250,000 births. Hydrocolpos involves the dilatation of the vagina due to obstruction of the genital tract, leading to accumulation of secretions. Because of wide spectrum of abnormal anatomy involving urogenital and gastrointestinal systems, prenatal diagnosis is difficult. As ultrasound becomes more and more reliable, prenatal diagnosis is possible as early as in the second trimester. The presence of prenatally detected hydro (metro) colpos warrants a systematic evaluation of fetal and neonatal anatomy to rule out a large variety of possibly associated malformations or syndromes. We present a case of urogenital sinus maldevelopment which was initially presented as a fetal ascites.