A Case of Primary Cutaneous Endometriosis at the Unbilicus / 대한산부인과학회지

Cutaneous endometriosis seems to be more common in women who have had a pelvic or abdominal operation and primary cutaneous endometriosis is very rare. In our hospital we experienced a 41-year-old woman who complained of the appearance at the umbilicus of a nodule and had not had operation. This nodule was responsible for recurrent pain and increasing in size and it was excised. Pathology findings revealed cutaneous endometriosis. So we present a case of primary cutaneous endometriosis with a brief review of literature.

A Case of Uterine Rupture in the 18th Week of Pregnancy / 대한산부인과학회잡지

Spontaneous uterine rupture during the second trimester of pregnancy is a rare obstetric emergency. When a patient presents with acute abdominal pain and signs of hemorrhagic shock, a number of differential diagnoses must be considered. Early diagnosis and proper management is necessary to decreased the high maternal and fetal morbidity and mortality associated with rupture of uterus. We present a case of spontaneous rupture of the uterus in the 18th week of pregnancy with a brief review of literatures.

A Case of Holoprosencephaly / 대한산부인과학회잡지

Holoprosencephaly is a complex abnormality of the forebrain that is postulated to derive from a failure in the diverticulation of the embryonic prosencephalon. Early antenatal diagnosis of holoprosencephaly is important to find out its severity, to predict its prognosis and to determine proper treatment according to its prognosis and severity. With recent development of high resolution ultrasonography, it is possible to detect a fetus with holoprosencephaly at early antenatal period. We report a case of alobar holoprosencephaly, diagnosed antenatally with its sonographic and autopsy finding.

A clinical study on fetuses and neonates with single umbilical artery / 대한산부인과학회잡지

OBJECTIVE: To evaluate the relationship of single umbilical artery with congenital anomaly, chromosomal anomaly & pregnancy outcome. METHODS: From January 1993 to December 2000, 143 cases of single umbilical artery were observed among 72,194 total deliveries at Ilsin christian hospital. Pregnancy and perinatal outcome data were retrieved by review of the medical records. RESULTS: The incidence of single umbilical artery (SUA) was 0.2% (143 cases). Isolated SUA without any anomaly were 89 cases (62.2%), SUA with anomaly were 42 cases (29.4%) ; with multiple anomaly were 20 (14%) and stillbirth were 12 (8.4%). Cardiovascular & musculoskeletal system anomalies were common congenital anomalies, 35.7% respectively. Among the 86 cases (60.1%) of chromosomal studies, chromosomal anomalies were observed in 4 cases (2.8%) ; 2 cases were Trisomy 18, 2 cases were 45,XX,-13,-14,+t (13q:14q), 46,XY,t(1:9) (q11:q11). No chromosomal anomaly was observed in isolated SUA without any other anomaly. On 74cases with obstetric complication, intrauterine growth restriction (n=27, 20.6%), preterm birth (n=12, 10%), hydramnios (n=11, 8.4%), oligohydramnios (n=7, 5.3%), preeclampsia (n=6, 4.6%), maternal gestational DM (n=5, 3.8%) were observed. CONCLUSION: When a single umbilical artery is identified during antenatal care, careful search such as targeted ultrasonography & fetal echocardiography should be taken for associated anomaly, and chromosomal study should be considered in case of SUA with any anomaly.

A clinical study on the incomptent internal os of the cervix / 대한산부인과학회잡지

OBJECTIVE: This study was performed to evaluate the effect of cervical cerclage and the clinical characteristics in incompetent internal os of the cervix (IIOC). METHODS: A study was conducted on 170 patients with IIOC, 199 cases of IIOC were admitted and treated with McDonald operation or modified Shirodkar operation at department of Obstetrics and Gynecology Il Sin Christian Hospital from January 1. 1994 to December 31. 1998, of this 14 cases were follow up lost, so 185 cases were analyzed. RESULTS: 1) The incidence of IIOC was 0.43%, 1 in 233 deliveries. 2) The mean age of IIOC patients was 30.54yrs old and the most frequent age group was in 30-34yrs old group (43.78%). 3) The average number of gravida and parity before operation were 4.71 and 1.62. & the success rate of operation was low at high gravida & parity. 4) The predisposing factor was previous history of dilation & curettage (43.75%), Cx. laceration after delivery (6.49%), midtrimester termination (4.32%) etc. 5) The operation methods were McDonald operation (91.35%) and modified Shirodkar operation (8.65%) & the success rate of McDonald operation and modified Shirodkar operation were 85.80% and 87.50%. 6) The successful fetal salvage rate was 85.95% and the highest success rate was 87.50% in 14-16 weeks of gestation group. 7) The more cervix dilate, the more failure occurred. 8) The causes of operation failure were premature rupture of membrane (50.00%), preterm labor (34.62%), FDIU, anomaly, APH etc. 9) The delivery methods after operation were vaginal delivery (65.54%), cesarean delivery (34.46%). CONCLUSION: The 14-16th weeks of gestation group & no cervical dilatation have higher success rate indicating that early diagnosis and appropriate timing of operation is associated with a greater operation success rate.

Clinical Characteristics of 4 Cases with Recurrent Cervical Cancer Showing Cardiac Metastasis / 대한산부인과학회잡지

BACKGROUND: The presence of cardiac metastasis from cervical cancer is very rare. Due to the rarity of this condition, clinical characteristics of the patients with cardiac metastasis from cervical carcinoma is not well known. This study is to investigate the clinical profiles and outcomes of patients with cardiac metastasis from the carcinoma of the uterine cervix. MATERIALS AND METHODS: From Jan. 1990 to May 1999, 4 patients with cardiac metastasis from cervical cancer during the course of the disease were registered in Korea Cancer Center Hospital. The clinical characteristics of these patients were reviewed retrospectively. RESULTS: Mean age of patients was 49 years, and median interval from initial diagnosis to recurrence was 27 months. Histologically, all 4 cases were squamous cell type carcinoma. The stage distribution is two patients with FIGO stage II, one with stage I and one with stage III. Clinical symptoms of patients were dyspnea and facial edema in 2 patients, facial edema in one patients, and dyspneas only in one patient. All patients were confirmed histologically by pericardiocentesis. Synchronous metastatic lesions were supraclavicular lymph node, lung parenchyme and paraaortic, mediastinal lymph node. Following pericardiocentesis or pericardiodesis, all patients were improved clinically and survived for mean interval of 5.3 months. CONCLUSIONS: The patients with pericardial metastasis from cervical carcinoma showed a short survival time, but could be managed by pericardiocentesis or pericardiodesis with improvement of clinical symptoms.