Late postpartum eclampsia 11days after delivery without preeclampsia: A case report / 대한산부인과학회지

Eclampsia, defined as peripartum seizure activity commonly associated with hypertension, proteinuria and edema. Historically, eclampsia was believed not to occur more than 48 hours after delivery and late postpartum eclampsia was thought to be uncommon. However, recent evidence suggests that its incidence is increasing. In addition, clinical signs of late postpartum eclampsia may differ from that occurring during the pregnancy. In case of late postpartum eclampsia, headache and visual disturbance may precede seizure but classic preeclampsia signs as edema, proteinuria, and hypertension are not presented until shortly before seizure onset. So it should be needed that patient education about prodromal symptoms of late postpartum eclampsia, including headache, visual disturbance, and abdominal pain at the time of hospital discharge. We described a case of eclampsia occurring 11days after delivery without preeclampsia symptom including a review of the literature.

Three cases of vaginal evisceration after laparoscopic hysterectomy / 대한산부인과학회지

Vaginal evisceration is a rare but life threatening complication of gynecologic surgery. Most of them occur after abdominal or vaginal hysterectomy. The incidence after laparoscopic hysterectomy is unknown. The incidence of evisceration in the patients undergoing laparoscopic hysterectomy in our hospital was 0.1 %. The rapid recovery after laparoscopic hysterectomy, compared with abdominal hysterectomy, is widely acknowledged. Swift return to everyday activities and early resumption of intercourse could predispose to rupture of vaginal vault. Upon discharge, patients undergoing laparoscopic hysterectomy should be given careful instructions to avoid coitus until complete healing of vaginal vault. We described three cases of vaginal evisceration after laparoscopic hysterectomy including a review of the literature.

A case report of Extragonadal endodermal sinus tumor occurring in the appendix and mesentery / 대한산부인과학회지

Endodermal sinus tumor (EST) is a rare malignant germ cell tumor arising usually in the gonads such as the testis or ovary. However, 10-15% of EST cases may arise in the extragonadal sites, such as sacrocoxygeal area, mediastinum, vagina, brain and retroperitoneum in a frequent occurring order. To our knowledge there are only 2 case reports of extragonadal EST, one originating from the omentum in 1998, and another which was localized in the pelvis in 2003. We report one case of extragonadal sinus tumor which arose in appendix and mesentery in the 19-year-old female with a review of the literature.

The factors influencing pregnancy after surgery in infertile patients with severe endometriosis / 대한산부인과학회지

OBJECTIVE: Endometriosis is assumed to be one of the causes of infertility, although the mechanism remains unclear. The purpose of this study was to determine the prognostic factors for the fertility in women with severe endometriosis. METHODS: Clinical data of 78 consecutive infertile patients who had taken surgery for stage III and IV endometriosis were retrospectively analyzed in two groups: A- pregnant after surgery (n=43, 55.1%): B- non-pregnant after surgery (n=35, 44.9%). All patients were treated with GnRHa after surgery. Each group were compared age, BMI, duration of infertility, stage of endometriosis, size and number of endometrioma, peritoneal implant outside the pelvic cavity, peritubal adhesion, ovarian adhesion and cul-de-sac obliteration. RESULTS: Among these factors, duration of infertility (p=0.03), peritoneal implant (p=0.01), tubal adhesion (p=0.04) and ovarian adhesion (p=0.02) were significantly different. However, patients' age, BMI, size and number of endometrioma, cul-de-sac obliteration and stage of endometriosis did not showed significantly different. CONCLUSION: We concluded that the duration of infertility and tubal and ovarian adhesion are important factors for predicting pregnancy after surgery in severe endometriosis.