Acute Sciatic Nerve Palsy after Sleeping in a Sitting Position: Case Report

STUDY DESIGN: A case report. OBJECTIVE: We wanted to present the clinical manifestation and imaging findings of a rare case of acute sciatic nerve palsy with a foot drop similar to lumbar disc herniation developed after sleeping for 8 hours in a sitting position in inebriated condition. SUMMARY OF LITERATURE REVIEW: Sciatic nerve palsy as a complication from being operated in a sitting position have been reported, but here have not been any reported cases of after-sleep sciatic nerve palsy. STUDY SUBJECT AND METHODS: Sixty eight year old male admitted to hospital due to acute onset of right foot drop, subsequent walking difficulty, and numbness of the right calf and foot. Symptoms began after 8 hours of sleeping in a sitting position. Pelvic MRI exam revealed sciatic neuropathy, and also electrophysiological exam revealed sciatic nerve palsy. RESULTS: The subject patient's conditions started improving after 6 weeks and he was able to walk again on his own. CONCLUSION: Sciatic nerve injury by prolonged pressure around the buttocks or posterior thighs, albeit rare, can develop and may cause foot drop, parethesia and sciatica.

Transvaginal ultrasonographic detection of fetal abnormalities in the first trimester / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate the efficiency of transvaginal ultrasonography for detection of fetal anomalies in first trimester. METHODS: This cohort included pregnant women between 9~14 weeks of gestation from April 2000 to April 2002 at department of Obstetrics and Gynecology, Sanggye Paik hospital, Inje university. Besides ACOG (1993) criteria, we scan nuchal translucency, FHR, cranium, abdominal wall and nuchal lesion using transvaginal sonography. If the anatomical survey was normal, the women underwent routine 18~24 weeks anomaly scans. RESULTS: 20 fetuses were identified as having 21 anomalies. Central nervous system anomaly (38%: 8/21) was the most frequent type of malformation. The other detected anomalies were isolated disorders of the lymphatic system 28% (6/21: two cystic hygromas and four nuchal edema), cystic hygroma associated with hydrops 14% (3/21), abdominal wall defects 14% (3/21), skeletal dysplasia 5% (1/21). Of the 20 fetuses that was diagnosed, 14 patients had elective first-trimester abortion, two had spontaneous fetal deaths, four were delivered at term. CONCLUSION: Besides offering the possibility of early termination, first trimester sonography has the advantage of identifying a transient sonographic sign, nuchal edema, which can be used as a marker in screening for fetal chromosomal abnormalities.

Effects of Oligohydramnios on Perinatal Outcome and Latency Period in Patients with Preterm Premature Rupture of Membranes / 대한주산의학회잡지

OBJECTIVES: To examine the effects of the oligohydramnios on perinatal outcome and latency period in patients with preterm premature rupture of membranes. METHODS: We performed a retrospective analysis of 98 singleton pregnancies complicated by preterm premature rupture of membranes, with delivery between 26 and 35 weeks' gestation. Amniotic fluid index was determined using transabdominal ultrasound at admission. All medical records of mothers and neonates were reviewed. Oligohydramnios was defined as amniotic fluid index less or equal to 5.0 cm and latency period was defined as time interval from membrane rupture to delivery. Chi-spuare test, Fisher's exact test, Student-t test, Mann-Whitney U test were used for statistical analysis. RESULTS: 1) Of the 98 patients, 59 patients(60%) were oligohydramnios group(AFI5.0). Both groups were similar with respect to selected dermographics, gestational age at rupture of the membranes, chorioamnionitis, 1 min Apgar score and 5 min Apgar score. Patients with oligohydramnios demonstrated a lower gestatoinal age at birth and lower birth weight. There were no statistically significant correlations in neonatal morbidity and perinatal mortality between both groups. 2) For comparing latency period, we excluded deliveries of Cesarean section or induction. Comparing the remained group(25 patients), median of latency period in oligohydramnios group were 41.5 hours and median of latency period in non-oligohydramnios group were 44 hours. There were no statistically significant correlations in oligohydramnios and latency period. CONCLUSION: There were no significant effects of the oligohydramnios on poor perinatal outcome and latency period in patients with preterm premature rupture of membranes

A Case of Heterotropic Pregnancy After In Vitro Fertilization / 대한산부인과학회잡지

Heterotropic pregnancy is defined as coexistent intrauterine and ectopic pregnancy. The natural incidence is 1 per 30,000 pregnancies, but in case of ovulation induction and in vitro fertilization, it is 1 per 100 pregnancies. Heterotropic pregnancy is increased with pelvic inflammatory disease and the use of various ovulation induction method. Because heterotropic pregnancy is clinically difficult to early diagnosis, close monitoring of pregnancy is important to prevent a deleterious delay in the treatment of ectopic pregnancy, maternal morbidity, and fetal loss. We experienced a case of heterotropic pregnancy diagnosed by ultrasonography in a 32-year-old woman, who complained of vaginal spotting and low abdominal pain after in vitro fertilization and report the case with brief review of literature.