A case of choledochal cyst diagnosed and conservatively treated during pregnancy / 대한산부인과학회지

Choledocal cyst are cystic dilatations of the biliary tree varying in location from the ampulla of vater to the intrahepatic bile ducts. The majority of the cases are diagnosed during the first decade of the life but in 20% of patients with choledochal cysts, the diagnosis is not made until adulthood. Although these cysts occur frequently in females, presentation in pregnancy or the postpartum period is rare. Choledochal cysts presenting during pregnancy an increased risk to both the mother and developing fetus. The clinical presentation is often nonspecific, and physical and radiologic examination are limited during pregnancy because of the presence of the gravid uterus. We experienced one case of choledochal cyst during pregnancy and report our experience.

Maternal-neonatal outcome in HELLP syndrome and severe preeclampsia / 대한산부인과학회지

OBJECTIVE: To assess the clinical characteristics, laboratory findings, the maternal and neonatal complications between HELLP syndrome and severe preeclampsia. METHODS: We reviewed the material and neonatal charts of 34 pregnancies complicated by HELLP syndrome and 40 pregnancies complicated by severe preeclampsia managed at our hospital between January, 2001 and December, 2005. We compared the clinical characteristics, laboratory findings, the maternal and neonatal complications between two groups. Results were compared by student T test, chi-square test. RESULTS: Our study showed that in HELLP syndrome patients had the less gestational age at admission, gestational age at delivery, the lower platelet counts, the higher AST, ALT, LDH, and the longer hospitalization period than in severe preeclampsia. Steroid (dexamethasone) use, cesarean delivery rate and MgSO4 use were more frequent in HELLP syndrome than severe preeclampsia. Neonatal birth weight was lower with HELLP syndrome. There was no significant difference in maternal and neonatal complications. CONCLUSION: HELLP syndrome need to be recognized a unique form of severe preeclampsia. It was associated with serious maternal and fetal mortality, the appropriate management would be done by early diagnosis using laboratory tests.

A Standardization Study of Korean DFS (Delivery Fear Scale) in fear of childbirth / 대한산부인과학회지

OBJECTIVE: The study shows that the DFS is a questionnaire that almost effortlessly can be completed within 60-90 seconds during any moment of labor and delivery. The aim of the present study was to test the validity and reliability of the DFS, to identify its factor structure in Korea. METHODS: Review of the medical records from the department of obstetrics and gynecology from January to April 2005, a confirmed 51 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 22 primiparous and 29 multiparous women answered the Delivery Fear Scale (DFS) once during active labor, and the STAI (State-Trait Anxiety Inventory) after delivery. Reliability test to calculate Chronbach alpha and validity test to measure correlation between DFS and STAI was done. Then factor analysis was applied with the method of principal component analysis and varimax rotation. RESULTS: Korean version of DFS proved to be a reliable and valid scale statistically: Cronbach's alpha was 0.7182 in study. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The DFS measures fear during labor and delivery in an effortless and fast away. The development of the Korean version of DFS which is reliable and valid, and consists of three sub-factors may facilitate future research in the field.

A case of Antenatally diagnosed Changing Sonographic Findings of a Twisted Fetal Ovarian Cyst / 대한산부인과학회지

Ovarian cysts are common incidental findings in term infants and, if unusually large, may result in dystocia, torsion, or rupture. We report the case in which serial sonographic examination revealed changing pattern of cystic ovarian mass from hypoechogenic to well defined multiseptated echogenic during pregnancy. Postnatal T2-weighted MR images revealed a multilocular with high signal density. After delivery a laparotomy was performed, and a twisted ovary measuring 6.7x5x4.5 cm was removed. Ovarian torsion was left-sided and had been almost autoamputated. The resected specimens were nontense, thin walled cysts, filled with hemorrhage like fluid. Histological examination demonstrated the presence of lymphangioma with widespread hemorrhage and necrosis. The neonate did well after the procedure.

Factors Associated with Fear during labor / 대한산부인과학회지

OBJECTIVE: Pregnant women have various fears and expectations regarding the impending birth. Fears can influence the course of the delivery and post-partum period. The DFS (Delivery Fear Scale) measures fear during labor and delivery in an effortless and fast away. The aim of this study were to compare DFS score and parity, maternal age, history of abortion, baby gender during an early stage of active labor (cervix dilatation 3-5 centimeters). METHODS: Review of the medical records from the department of obstetrics and gynecology from January 2004 to December confirmed 151 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 86 primiparous and 65 multiparous women answered the Delivery Fear Scale (DFS) once during active labor. Mann-Whitney test was applied to test possible differences between DFS and variable factors. Difference were considered to be statistically significant at p<0.05. RESULTS: Primiparous women had higher scores on the DFS than multiparous women during active labor. But DFS was not associated with maternal age, history of abortion, baby gender during an early stage of active labor. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The understanding of a fear during labor is to support the woman in labor in a way that decrease fear and the development of the DFS may facilitate future research in the field.

Prenatal 3D-ultrasound diagnosis of Otocephaly and Holoprosencephaly-Cyclopia / 대한산부인과학회지

Otocephaly is a rare malformations comprising hypoplasia or absence of the mandible (agnathia), ventromedial displacement and often fusion of external ears (synotia or otocephaly), and hypoplasia of the oral cavity (microstomia) and tongue (hypoglassia). This developmental complex represents a malformation of the first and second branchial arches and occurs sometimes with holoprosencephaly. We present the ultrasound detection of otocephaly and holoprosencephaly with cyclopia in a fetus of 27 gestational weeks 6 days. The use of three-dimensional (3-D) ultrasound made additional diagnostic ultrasound tomograms possible, and the volume reconstructions improved the imaging and the understanding of the condition.

A Case of Vulvar Arteriovenous Hemangioma / 대한산부인과학회잡지

Vulvar ateriovenous hemangioma is a rare pathologic lesion, encountered in Bartholin's glands of vulva. Little has previously described in the litherature. A painless vulvar mass occurred accidently in a healthy women after cesarean delivery. There was no obvious lesion on the skin. Excisional biopsy revealed a vascular lesion in the subcutaneous layer, consistent with arterio-venous hemangioma. The mass was sucessfully treated by excision, and the patients was asymptomatic for five months later. so, we report this case with a brief review of literatures.

Prenatal Sonographic Finding of A Case of Hydrometrocolpos / 대한산부인과학회잡지

Cloacal anomalies are very rare congenital malformations with the incidence of 1/50,000-250,000 births. Hydrocolpos involves the dilatation of the vagina due to obstruction of the genital tract, leading to accumulation of secretions. Because of wide spectrum of abnormal anatomy involving urogenital and gastrointestinal systems, prenatal diagnosis is difficult. As ultrasound becomes more and more reliable, prenatal diagnosis is possible as early as in the second trimester. The presence of prenatally detected hydro (metro) colpos warrants a systematic evaluation of fetal and neonatal anatomy to rule out a large variety of possibly associated malformations or syndromes. We present a case of urogenital sinus maldevelopment which was initially presented as a fetal ascites.