A Clinical Report of Pregnancy Induced Hypertension according to the Severity / 대한주산의학회잡지

The aim of present study was to establish the baseline data for pregnancy induced hypertension (PIH). From November 2000 through October 2001, a total of 212 women diagnosed as PIH and delivered at Samsung Cheil Hospital were included in this study. We reviewed the obstetric and neonatal records, then analyzed the incidence, maternal complications, and neonatal outcomes according to the severity of PIH. The incidence of PIH was 2.6% (mild and severe form was 59% and 41%, respectively). In maternal age, parity, number of fetus (singletone or multiple pregnancy), and gestational diabetus, there was no significant different incidence between mild and severe form of PIH. But, the women with severe PIH delivered more frequently at 21~28 and 33~36 gestational weeks than in mild form (p<0.05). Among fetuses with intrauterine growth restriction (IUGR), a group with birth weight below the population 5 percentile was more frequent in severe than in mild form of PIH (p0.05). As to maternal, fetal and neonatal complications of PIH, maternal anemia, preterm labor, and IUGR were more frequently founded in severe form of PIH than in mild. We could not found significant different frequency in other complication (disseminated intravascular coagulation, abruptio placenta, pulmonary edema, low apgar score, meconium stained, respiratory distress syndrome, and intracranial hemorrhage) between mild and severe form of PIH.

A clinico-pathological analysis of microinvasive cervical cancer / 대한산부인과학회잡지

OBJECTIVE: To evaluate correlation the of histological variables and the clinical features of microinvasive cervical cancer with the depth of invasion and to establish the adequate therapeutic modality. METHODS: One hundred and thirty-seven patients with microinvasive cervical cancer diagnosed by FIGO (1994) staging were reviewed, who were treated by conization, type I hysterectomy, type II hysterectomy and type III hysterectomy, in Gil Medical center from January 1997 to December 2001. We divided the depth of invasion to three groups of less than 1 mm, 1-3 mm and 3-5 mm. RESULTS: The age of the 137 women ranged from 24 to 71 years (mean age 47.4 years). The number of patients with FIGO stage IA1 and IA2 were 112 and 24, respectively. Of surgically treated 135 patients, lymph node involvement was present in 1 patient with a depth of invasion of less than 1 mm, 2 patients with 1-3 mm and 1 patient with 3-5 mm. Lymph-vascular space involvement was present in 3 patients with 1-3 mm, 4 patients with 3-5 mm. Transient bladder dysfunction was the most common complication after surgical procedures, occupying 5.6%. Other surgical complications included lymphedema (3.6%), wound complication (3.6%), ureter injury (1.1%), lymphocele (1.1%), anal incontinence (1.1%) and dyspareunia (1.1%). CONCLUSION: A management should be individualized. Patients with a depth of invasion of less than 1mm and clear resection margin may be managed by conization. Further follow-up study for a necessity of lymphadenectomy for the group with the depth of invasion of 1-3 mm irrespective of lymph-vascular space involvement is demanded.

Clinical Characteristics of Intrauterine Fetal Death / 대한주산의학회잡지

OBJECTIVE: To analyze the clinical characteristics of intrauterine fetal death. METHODS: A retrospective cross sectional analysis was done on 269 cases of intrauterine fetal death, among 44,453 deliveries over 20 weeks of gestation or weighs more than 500gm, at Ghil Hospital, Gacheon Medical School from April 1994 to December 2001. RESULTS: The incidence of intrauterine fetal death was 0.06$. The average maternal age was 28 +/- 4.6 years old. There were 52 cases(19.3%) with previous history of spontaneous abortion and 3 cases(1.1%) with previous history of intrauterine fetal death. There were 28 cases(10.4%) of fetal anomaly, and of which central nervous system defect, hydrops fetalis, abdominal anomaly were common. The maternal disease was accompanied by 69 cases(25.7%) and most common maternal disease was preeclampsia. In 74 cases(27.5%), we could not find the suspected cause of intrauterine fetal death. The suspected causes of intrauterine fetal death were intrauterine growth retardation(13.8%), cord complication(12.6%), preeclampsia(11.5%), fetal anomaly(10.4%), and placental abruption(8.2%). There were 12 cases(4.5%) of peripartum maternal complications. CONCLUSION: Intrauterine growth retardation and cord complications were the most common suspected causes, we could not find the cause of intrauterine fetal death in 74 cases(27.5%) out of 269 cases.