Acute Kidney Injury Arising from Severe Hyperemesis Gravidarum: Case Report with a Review of Literatures

Severe hyperemesis gravidarum is a rare but potentially life-threatening it left untreated. Its serious complications are dehydration, ketosis, alkalosis from loss of hydrochloric acid, hypokalemia, and compromised pre-renal acute kidney injury. We experienced a very rare case of a 20-year-old woman who presented to the emergency department with severe hyperemesis gravidarum associated with a loss of kidney function at 25 weeks' gestation. Her initial serum creatinine and blood urea nitrogen were 5.0 and 45.9 mg/dL, respectively. The patient underwent hemodialysis for three days and achieved a subsequent recovery of renal function. In conclusion, our case indicates that clinicians should be aware of the possibility of acute kidney injury associated with severe hyperemesis gravidarum although rare.

Uterine artery embolization for primary postpartum hemorrhage

Postpartum hemorrhage is the leading cause of severe maternal morbidity and death. A prompt management of uterine artery embolization [UAE] is important for a good outcome. UAE is generally accepted to be a safe and reliable procedure. To estimate critical patient characteristics influencing the success of UAE for the treatment of emergent primary postpartum hemorrhage. This was a cross sectional study that reviewed 121 patients who were diagnosed primary postpartum hemorrhage between February 2002 and December 2009 at a tertiary treatment center among 4,022 deliveries. We evaluated patient clinical characteristics associated with a successful surgical outcome of UAE. The success rate for UAE was 96%. For two cases, UAE complication was associated with fever [>38.5°C]. Five patients had problems that required admission to the intensive care unit [ICU]. To increase the surgical success rate and lower the number of ICU admissions, the decision to treat primary postpartum hemorrhage using UAE should be based on individual patient clinical findings under the direction of obstetrics staff and an interventional radiologist

Evaluation of Risk Factors for the Postpartum Depression with Edinburgh Postnatal Depression Scale (EPDS) Score / 대한주산의학회잡지

PURPOSE: Postpartum depression is one of the serious diseases which can influence on the mother, newborn, and the family if the recognition and treatment is not immediately performed. Currently, there are lots of known factors and diagnostic methods of postpartum depression. We studied the various factors that can affect postpartum depression. METHODS: Participants were 93 mothers who delivered at our hospital between February 1st, 2007 and November 30th, 2007. We recorded their education status, occupation, parity, delivery method, obstetrical or medical problems during pregnancy, breast-feeding period, newborn admission period, and having herb intake after delivery. Relationship between the frequency of postpartum depression and the factors we recorded was studied. RESULTS: Among many factors, the frequency of postpartum depression occurrence was significantly higher in multiparity, and was associated with herb intake after delivery with borderline significance. The frequency of breast feeding was significantly higher in women without postpartum depression. CONCLUSION: Based on the result of this study, obstetricians could support better treatment and prevent postpartum depression by giving more attention to mothers who have risk factors of postpartum depression.

Acute renal failure associated with ureteral stone of the unilateral kidney and uterus didelphys with hemivaginal obstruction / 대한산부인과학회지

The unique clinical syndrome of the uterus didelphys, a unilateral partially or completely obstructed vagina, and ipsilateral renal agenesis is quite rare, and observed on the right side in greater frequency than on the left. The case of fifteen year old girl with uterus didelphys, unilateral partially obstructed vagina and acute renal failure associated with ureteral stone in unilateral kidney is described. Extracorporealshock wave lithotripsy (ESWL) and evacuation of the hematocolpos and excision of the vaginal septum were done. Aware of this relatively rare condition is mainstay of prompt diagnosis which will prevent permanent renal failure and unnecessary and destructive surgery.

A Case of Pregnancy after Burn Injury / 대한주산의학회잡지

Major burn that happened in childhood impedes conception and maintaining pregnancy during child-bearing period. Specially, the burn on abdomen, breast and perineal area have difficulties in maintaining pregnancy and breast feeding in postpartum period. The appropriate treatment of burn in childhood helps to maintain pregnancy. We have experienced a case of pregnancy after major burn injury in childhood. We present this case with a brief review of the literature.

Cornual pregnancy diagnosed at 9 weeks of atypical ultrasonographic findings / 대한산부인과학회지

A cornual pregnancy occurs when the conceptus implants at the cornus of the uterus which is the junction between the fallopian tube and uterine cavity. Cornual pregnancy is a rare form of ectopic pregnancy and its diagnosis is difficult. It accounts for 2 to 4% of tubal pregnancy and rupture usually occurs between 8 weeks and 16 weeks of gestation. The rich vascularity in this location makes the rupture particularly dangerous, resulting in higher maternal mortality. We have experienced a case of unruptured cornual pregnancy at 9 weeks of atypical ultrasonographic findings, which was hourglass appearance. We present this case with a brief review of the literature.

A case of cystic change of adenomyosis in adolescent girl complaining acute pelvic pain / 대한산부인과학회지

Cystic adenomyosis is a rare form of adenomyosis of the uterine myometrium that has been described in older adults. This condition has not frequently been reported in the adolescent girl. The adenomyotic cyst was located within the myometrium of a 15-year-old adolescent girl suffering from acute lower abdominal pain, not dysmenorrhea. After laparoscopic operation, patients's symptoms improved. On pathology finding, the cyst diagnosed adenomyotic cyst. We report a case of adenomyotic cyst of the uterus in adolescent girl with a brief review of literatures.