ABSTRACT
OBJECTIVE: To compare the effectiveness of oral misoprostol with vaginal misoprostol administration in mid-trimester pregnancy termination after pretreatment with serial laminarias tenting. METHODS: This study was made in 50 patients for mid-trimester pregnancy termination at Department of Obstetrics and Gynecology, Chonbuk National University Hospital from January 1999 through December 2002. Twenty five women received misoprostol orally in a dose of 200 micro gram every hour for 3 doses followed by 400 micro gram every 4 hours after serial laminarias tenting. Twenty five women received misoprostol vaginally in a dose of 400 micro gram every 4 hours after serial laminarias tenting. Side effects of drug, induction to delivery interval, delivery numbers within 24 hours, curettage numbers for retained placenta, and the length of hospital stay were compared. RESULTS: The mean time of induction to delivery interval was significantly shorter in the vaginal group (15.5 +/- 12.7 vs 24.2 +/- 14.3 hours, p<0.01). The length of hospital stay was also shorter in the vaginal group (38.9 +/- 13.1 vs 47.2 +/- 14.5 hours, p<0.01). The number of patients delivered within 24 hours was more in the vaginal group (92 vs 72%, p<0.05). The side effects of misoprostol were slightly more common in the oral group than the vaginal group without statistical significance. CONCLUSION: We suspect that after serial tenting of laminarias, intravaginal misoprostol appears to be more safe and effective than oral misoprostol for mid-trimester termination.
Subject(s)
Female , Humans , Pregnancy , Curettage , Gynecology , Laminaria , Length of Stay , Misoprostol , Obstetrics , Placenta, RetainedABSTRACT
The acardiac twin, or twin reversal of arterial perfusion (TRAP) sequence is encountered in approximately 1% of monozygotic twins with an incidence of one in 35,000 births. The problem results from vascular anastomoses between the arterial and venous circulation of normal "pump" twin and that of recipient "perfused" acardiac twin. The recipient twin may display severe and lethal anomalies, including acardia and acephalus. The pump twin is structurally normal. Mortality of about 50-75% in cases without treatment is due to heart failure, prematurity or cord entanglement. We report a case of acardiac twin diagnosed by ultrasound prenatally.
Subject(s)
Humans , Heart Failure , Incidence , Mortality , Parturition , Perfusion , Twins, Monozygotic , UltrasonographyABSTRACT
Multicystic dysplastic kidney (MCDK) is one of the most common causes of an abdominal mass in infants and it is the cystic anomaly most frequently identified antenatally by prenatal ultrasonography. The incidence of bilateral MCDK incidence is 1 in 5,000-10,000 births, but the prognosis is very poor due to association with other anomalies as well as chromosomal abnormalities. Recently, we performed prenatal diagnosis on a 26-year-old primigravida after a detection of oligohydramnios with bilateral MCDK on fetal ultrasonographic examination at 24 weeks gestation. Chromosomal analysis of the amniotic fluid cell cultures revealed a 46, XX, t(15;17)(p3;p12) karyotype. Bilateral MCDK was confirmed after autopsy, therefore we report this case with a review of brief literatures.