ABSTRACT
OBJECTIVE: The authors have aimed to compare the efficacy of the computed tomography with other study methods, and to investigate if replacement by computed tomography is possible METHODS: From January 1998 to December 2002, 203 cervical cancer patients underwent pre-staging studies including computed tomography. The positive predictive values, negative predictive values, sensitivity, specificity of each method of study were compared. RESULTS: 1. Compared computed tomography with intravenous pyelonephrography. Each values of computed tomography for hydronephrosis or non visualization of kidney were sensitivity 91.7%, specificity 97.8%, positive predictive values 84.6%, negative predictive values 98.9%. 2. Compared computed tomography with cystoscopy. Each values of computed tomography for bladder invasion were sensitivity 90%, specificity 95.8%, positive predictive values 52.9%, negative predictive values 99.4%. 3. Compared computed tomography with sigmoidoscopy. Each values of computed tomography for rectal invasion were sensitivity 80%, specificity 94.4%, positive predictive values 26.6%, negative predictive values 99.4%. CONCLUSION: Rather than routine examination for staging of invasive cervical cancer in all patients, it is more ideal to first take a non invasive technique. then perform on intravenous pyelonephrography, cystoscopy and sigmoidoscopy only in patient showing positive findings of hydronephrosis or non visualization of kidney, bladder or rectal invasion on computed tomography.
Subject(s)
Female , Humans , Cervix Uteri , Cystoscopy , Hydronephrosis , Kidney , Sensitivity and Specificity , Sigmoidoscopy , Urinary Bladder , Uterine Cervical NeoplasmsABSTRACT
Selective termination can be used to preserve normal fetus from the other fetus with chromosomal, structural abnormality in multifetal pregnancy. This case is about twin pregnant patient who had undergone in vitro fertilization and embryo transfer. In 18 weeks of gestation, we found that one of the fetus had cranical encephalocele and was in concern for the termination by using ultrasound guided intrcardiac injection of 2.5 ml of potassium chloride solution. After performing this procedure the other healthy female newborn was naturally delivered at 38 weeks gestation with weight of 2.8 kg.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Pregnancy , Embryo Transfer , Embryonic Structures , Encephalocele , Fertilization in Vitro , Fetus , Potassium Chloride , Pregnancy Trimester, Second , Pregnancy, Twin , Twins, Dizygotic , UltrasonographyABSTRACT
Spontaneous umbilical cord hematoma is a rare cause of fetal distress and intrauterine fetal death. The perinatal mortality rate approaches 50%. Various causes of the cord hematoma have been suggested as congenital abnormalities, short cord, trauma, cord around neck, torsion, syphilis, or postmature pregnancy. We have experienced one case of the fetal distress from umbilical cord hematoma, which is presented with a brief review of the literatures.