ABSTRACT
Intramural pregnancy implanting in the previous cesarean section scar is one of the rarest form of an ectopic pregnancy and probably the most dangerous form because of its risk of rupture and hemorrhage. For its sonographic diagnosis, the gestational sac should be in the anterior wall of uterine isthmic portion, there should be no myometrium between bladder and gestational sac, and it should be verified that uterine cavity and cervix should be isolated from gestational sac. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are desirable. We have recently experienced a case of intramural pregnancy implanting in the scar of cesarean section, treated with systemic methotrexate injection. So, we report this case with a brief review of the literature.
Subject(s)
Animals , Female , Humans , Mice , Pregnancy , Cervix Uteri , Cesarean Section , Cicatrix , Diagnosis , Fertility , Gestational Sac , Hemorrhage , Methotrexate , Myometrium , Pregnancy, Ectopic , Rupture , Ultrasonography , Urinary BladderABSTRACT
OBJECTIVE: To investigate the necessity of colposcopically directed biopsy for more accurate detection of cervical neoplasm. METHODS: Cytology and colposcopically directed biopsy were performed in 114 patients and the patients were subsequently underwent conization or hysterectomy from January, 1998 to December, 2001. RESULTS: The complete diagnostic agreement of cytology with permanent biopsy was 57.9% (66 of 114) and the diagnostic agreement within one degree was 80.6% (92 of 114). The complete diagnostic agreement of colposcopically directed biopsy with permanent biopsy was 62.3% (71 of 114) and the diagnostic agreement within one degree was 85.1% (97 of 114). The difference between two tests was statistically significant (p<0.001). CONCLUSION: We concluded that colposcopically directed biopsy can reduce the false negative rate of cytology for screening test of cervical neoplasm. The difference between colposcopically directed biopsy and permanent biopsy was caused by inappropriate resection of the lesion and unskilled physician.
Subject(s)
Humans , Biopsy , Conization , Diagnosis , Hysterectomy , Mass Screening , Uterine Cervical NeoplasmsABSTRACT
Umbilical cord stricture is a very rare cord abnormality that cause intrauterine fetal death. An extreme focal deficiency of Wharton's jelly is suggested as a cause of cord stricture, and was most commonly occurred at the fetal end of umbilical cord. Antenatal detection of umbilical cord stricture is very difficult. We experienced a case of the intrauterine fetal death due to umbilical cord stricture, and we report this case with a brief review of literatures.
Subject(s)
Constriction, Pathologic , Fetal Death , Umbilical Cord , Wharton JellyABSTRACT
Actinomycosis is a rare disease in human and has variable clinical features, which make the diagnosis difficult. Actinomycosis may be confused with malignancy and other inflammatory diseases because of its infiltrative nature and its tendency to invade normal anatomic barriers. We have experienced a case of abdominal actinomycosis combined with ovarian mucinous cystadenocarcinoma and report this case with brief review of literatures.
Subject(s)
Humans , Actinomycosis , Cystadenocarcinoma, Mucinous , Diagnosis , Ovarian Neoplasms , Rare DiseasesABSTRACT
Ovarian remnant syndrome is a rare condition which develops when functional ovarian tissue is left in situ after intended bilateral oophorectomy. It produces clinically significant syndrome, namely chronic pelvic pain and dysmenorrhea. Although the true incidence of this syndrome is unknown, an apprant increase in incidence has been reported. We have experienced a case of ovarian remnant syndrome showing chronic pelvic pain and palpable abdominal mass after difficult gynecologic operation. So, we report this case with a brief review of literatures.
Subject(s)
Female , Dysmenorrhea , Incidence , Ovariectomy , Pelvic PainABSTRACT
OBJECTIVES: From February 1995 to April 1998, those patients who had visited for evaluation of infertility, shown abnormal endometrial pattern on hysterosalpingography underwent resectoscopic operation. We evaluated about its therapeutic effect, recurrence rate of uterine adhesion and effectiveness of its assisted method. METHOD: We have reviewed 45 cases of intrauterine adhesion, classified as a central type, marginal type and multiple type. We used 26F resectoscope made in Storz for operation and inserted Lippes loop or pediatric foley catheter for prevention of readhesion. For promoting reepithelialization, conjugated estrogens(premarin) 5mg daily for 30 - 50 days were given and then 10mg of medroxyprogesterone acetate(provera) were added daily for the last 10 days. We evaluated the uterine cavity condition preoperatively and postoperatively by using hysterosalpingography. RESULT: In 45 cases, 41 cases were followed up postoperatively. 21 cases were markedly improved, 12 cases were improved and 8 cases were not improved or recurred on hysterosalpingography. In 41 cases, for prevention of readhesion 20 cases were used pediatric foley catheter and 5 cases(25%) were recurred. 21 cases were used Lippes loop and 3 cases(14%) were recurred. Pregnancy outcome was as follows;15 cases were pregnant and 10 cases delivered a viable infant, 3 cases aborted spontaneously, 1 case was ectopic pregnancy and laparoscopic salpingectomy was done, 1 case was ongoing pregnancy. CONCLUSION: This report suggests that resectoscopic operation is very effective in the treatment of intrauterine adhesion(therapeutic rate of 81%) and that the use of Lippes loop seems like to have the less recurrence rate than the use of pediatric foley catheter in prevention of postoperative readhesion, but more experience and further follow-up are necessary to obtain more detailed conclusions.