A Case of Pulmonary Embolism After Cesarean Delivery / 대한산부인과학회잡지

During the past 50 years, the maternal mortality ratio has decreased dramatically. The leading causes of maternal deaths were pulmonary embolism, the complications of the pregnancy-induced hypertension, hemorrhage, the complications of the ectopic pregnancy and infection. Pulmonary embolism is one of the most fatal maternal complications that abruptly happen and rapidly progress, and has been a major cause of maternal death recently. Early detection of pulmonary embolism is difficult, because there is not any specific clinical symptoms and signs. We have experienced a case of a fatal pulmonary embolism which was diagnosed by lung perfusion scan on postoperative 1 day after cesarean delivery and managed with heparin therapy. We report this case with a brief review of literatures.

The Efficacy of Lamellar Body Counts for Prediction of Perinatal Outcome / 대한산부인과학회잡지

OBJECTIVE: This study is aimed to evaluate whether lamellar body count (LBC) in amniotic fluid could be used as a predictor of neonatal morbidity as well as respiratory distress syndrome (RDS) and to determine the value of lamellar body count that maximizes sensitivity and specificity. METHODS: We conducted a prospective clinical outcome study. Amniotic fluid was obtained from 39 pregnant women at various gestational ages (29 to 36 weeks) from March 1, 2002 to February 28, 2003. They delivered within 72 hours of amniocentesis, excluding 6 cases of contaminated amniotic fluid. A LBC was performed on each specimen. The frequencies of RDS, minor and major morbidity of newborn in different LBC cutoff value were analyzed. Statistic analysis was done by Chi-square test. RESULTS: LBCs increased with gestation (r=0.533, p<0.05). The LBC cutoff value that best agreed with RDS (sensitivity 36.4%, specificity 93.8%), minor morbidity (sensitivity 100.0%, specificity 50.0%) and major morbidity (sensitivity 45.5%, specificity 81.3%) was 30,000/ l. CONCLUSION: These results indicate that LBC might be useful as a predictor of neonatal morbidity as well as respiratory distress syndrome.

Clinical Analysis of Ovarian Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The frequency of ectopic pregnancy has been recently increased by various causes. Especially in ovarian pregnancy, definitive preoperative diagnostic criteria have not been established. This study is aimed to focus on helpful clinical characterstics which can later on serve as diagnostic key points in case of suspicious ovarian pregnancy. METHODS: The study included 23 patients pathologically diagnosed with ovarian pregnancy from January 1991 to December 2002 in Kangnam St. Mary Hospital. We analyzed the age at diagnosis, pregnancy and delivery history, presence of underlying disease, clinical symptoms, therapeutic methods, human chorionic gonadotropin level, and sonographic findings for these patients. RESULTS: The average age at diagnosis was 31.6 year and 39.1% of the patients were older than the age of 35. More than half of the patients had the history of multiple pregnancy (52.2%). The common clinical symptoms were lower abdominal pain (95.6%) and vaginal bleeding (21.8%). Ipsilateral ovarian wedge resection was performed at the most frequent rate (78.3%) and ipsilateral adnexectomy was done at second most frequent rate (21.7%). HCG level was measured on 19 cases showing various individual difference. Most common sonographic findings included the fluid stasis surrounding the ovarian pregnancy lesions and ipsilateral ovary enlargement (91.3%). CONCLUSION: This study showed that ovarian pregnancy should be suspected in young woman. Of the age between 25 and 30 years, with symptom of lower abdominal pain, nulliparity, havior history of pelvic adhesion, pelvic inflammation, and showing sonographic findings of fluid collection around ovary or enlarged ovary.