Peripartum Cardiomyopathy: 12 Cases / 대한산부인과학회지

OBJECTIVE: Our objective was to describe the clinical characteristics, diagnosis and treatment of 12 cases of peripartum cardiomyopathy (PPCM). METHODS: We retrospectively reviewed 12 cases of PPCM diagnosed by clinical and echocardiographic criteria between Jan 1997 and Dec 2004. RESULTS: The incidence of PPCM was 1 in 576 deliveries. The most common clinical and laboratory findings were dyspnea (100%), pulmonary edema (83.3%), and tachycardia (83.3%). The mean left ventricular ejection fraction (EF) was 34.2% (range, 23-44.6%), and the mean fractional shortening (FS) on echocardiography was 15.9% (range, 10.2-23%). Eight patients (67%) were diagnosed after delivery, and four patients (33%) were diagnosed before delivery. The mean interval from the onset of symptoms to evaluation with echocardiography was 72 hours (range, 7 hr-10 day). Suspicion and evaluation of PPCM was delayed in discharged women, our period of inexperience, and during the antepartum period. We did not observe any mortality case in our study population. Six patients improved, while three patients showed persistent ventricular dysfunction at follow-up echocardiography. CONCLUSION: All of our patients represented with the symptoms and sings of congestive heart failure, although which were similar to those of late pregnancy. Therefore, we suggest that PPCM should be considered and evaluated, whenever peripartum dyspnea, pulmonary edema, and tachycardia especially develop.

Expression of HER-2/neu Oncoprotein in Epithelial Ovarian Cancer / 대한산부인과학회지

OBJECTIVE: To evaluate the significance of the expression of HER-2/neu oncoprotein as a prognostic factor, we retrospectively examined its overexpression rates in epithelial ovarian cancer and their relationships with prognostic factors. METHODS: Immunohistochemistry for Her-2/neu oncoprotein was performed on formalin-fixed, paraffin-embedded tissues from 45 epithelial ovarian cancer operated between 1999 and 2002. We analyzed relationships between the overexpression of HER-2/neu oncoprotein and prognostic factors including age, histologic type, surgical stage, residual tumor > or =2 cm, and recurrence. RESULTS: The rate of overexpression of HER-2/neu oncoprotein in epithelial ovarian cancer was 31.1% (14/47). The overexpression of HER-2/ neu oncoprotein showed associations with residual tumor > or =2 cm (p=0.049) and recurrence (p=0.029) in univariate analysis. But, there were no associations between the overexpression of HER-2/neu oncoprotein and overall survival. CONCLUSION: The overexpression of HER-2/neu oncoprotein was associated with residual tumor and recurrence in univariate analysis, but appeared to have no prognostic significance for overall survival of epithelial ovarian cancer. Further and larger prospective studies using multivariate analysis are necessary to establish the clinical applicability of these observations.

Prenatal Ultrasonographic Diagnosis of Klippel-Trenaunay-Weber Syndrome / 대한산부인과학회지

Klippel-Trenaunay-Weber syndrome is a rare congenital disorders which is characterized by the presence of multiple hemangiomata, arteriovenous fistulas and unilateral limb hypertrophy. There has been some reports that Klippel-Trenaunay-Weber syndrome was diagnosed at birth or infant, but the prenatal diagnosis was very difficult in pregnant women who have not family history. Recently, the prenatal diagnosis of Klippel-Trenaunay-Weber syndrome has been occasionally reported according to improvement of prenatal ultrasound. We recently experienced two cases of Klippel-Trenaunay-Weber syndrome. So we report our cases with brief review of literature.

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.

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.

A prevalence of chlamydia trachomatis infection in early pregnancy / 대한산부인과학회잡지

OBJECTIVE: In this study, we investigated the prevalence of Chlamydia trachomatis infection and evaluated its risk factors in early pregnancy. METHODS: From April, 2004 to July, 2004, in antenatal care center, endocervial swabs were obtained in the 100 pregnant women during first trimester. After then, Chlamydia trachomatis infection was screened by DNA hybridization test which detects Chlamyidal r-RNA. All data were collected from review of each patient's medical record, including age and obstetric history. Associations between variables were studied using chi-square test. RESULTS: The prevalence of Chlamydia trachomatis infection was 9.0% (9/100) in early pregnancy. There were no significant differences in mean age between Chlamydial infection group and non-infection group (29.9 vs 30.2). In Chlamydial infection group, there was a high peak prevalence among the late thirties (21.4%) and the early twenties (16.7%) was the next. We couldn't find any statistical significances in age, parity and gravida among Chlamydial infection groups. CONCLUSION: The prevalence of Chlamydial infection is high in early pregnancy and Chlamydial infection has a deleterious effect on pregnancy outcome. Therefore, the screening test for Chlamydia trachomatis may be recommended at first antenatal visit. And early diagnosis and treatment may offer the benefit to prevention of obstetrical complication and neonatal infection.