A Case of Aplastic Anemia in Pregnancy Refractory to Platelet Transfusion / 대한산부인과학회지

Aplastic anemia is a rare complication of pregnancy that is associated with significant maternal and fetal morbidity and mortality. The relationship between aplastic anemia and pregnancy is not yet clear. Aplastic anemia in pregnancy is difficult to manage because the risk of bleeding and infection is high, especially in refractory to platelet transfusion. There is no therapeutic guide-line and prognosis for aplastic anemia in pregnancy refractory to platelet transfusion. We recently experienced one case of aplastic anemia in pregnancy refractory to platelet transfusion without no peripartum complication. So we report this case with brief review of the literature.

Chronological Pattern of the Frequencies and Indications for Cesarean Section: Analysis of 6,051 Cesarean Section Cases at Busan Paik Hospital for 24 Years, 1980-2003 / 대한산부인과학회지

OBJECTIVE: To evaluate chronological pattern of the frequencies and indications for cesarean section performed at one university hospital for 24 years. METHODS: This study was carried out retrospectively based on the clinical records of 6,051 patients who had cesarean sections among total 28,836 delivery cases at our hospital from January, 1980 to December, 2003 to show the frequencies and indications for cesarean section. RESULTS: The relative frequencies of cesarean section among total delivery cases for 24 years was 21.0%. The frequencies was 16.6% in the 1980s, 21.9% in the 1990s and 34.3% in the 2000s, which shows a tendency to marked increment. The common indications of cesarean section for 24 years was previous cesarean section (40.9%) followed by abnormal presentation (16.3%), dystocia (12.2%), fetal distress (7.9%), placenta previa (6.8%). Repeat cesarean section showed increasing frequencies from 1980 to 1992 and dropped again from 2002. Dystocia and abnormal presentation showed decreasing frequencies, but multiple pregnancy, placenta previa and other indications showed increasing frequencies, especially in late 1990s and 2000s. CONCLUSION: The frequencies for cesarean section was increasing, especially from 1990s. There are many changes in indications for cesarean section. Recent changes was decreasing frequencies for repeat cesarean section, increasing for multiple pregnancy, placenta previa and other indications. This might be related to low birth rate and high elderly mother's proportion.

A Case of Arthrogryposis Multiplex Congenita Diagnosed by Prenatal Ultrasonography / 대한산부인과학회지

Arthrogryposis multiplex congenita is congenital disorder that characterized by multiple joint contractures. Although there are characteristic morphologic features, most of cases are diagnosed at birth and cases diagnosed by prenatal ultrasonography are rare. We describe a case of fetal arthrogryposis multiplex congenita seen prenatally with sonographic feature of multiple joint contractures including clubhands, clubfeet, and absent fetal movements in late second trimester. This report is the first case of arthrogryposis multiplex congenita that diagnosed by prenatal ultrasonography in Korean literature.

A Case of Conservative Management of Ectopic Pregnancy Embedded in the Myometrium of Previous Cesarean Section Scar / 대한주산의학회잡지

Intramural pregnancy, implanted in the previous cesarean section scar, is one of the rare and dangerous forms of ectopic pregnancies, because a delay in either diagnosis or treatment can lead to uterine rupture, hysterectomy, or significant maternal morbidity, due to severe hemorrhaging. With the development of transvaginal ultrasound and MRI, early diagnosis and conservative treatment of intramural pregnancy is possible. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are desirable. We experienced a case of intramural pregnancy developed in the previous cesarean section scar and successfully treated it with conservative management. So we report this case with a brief review of literature.