A Case of Bladder Stone and Vesicovaginal Fistula after McDonald Operation / 영남의대학술지

The frequency of a bladder foreign body in the female is lower than in the male, and bladder stones attached to foreign bodies such as non-absorbable suture material are not common. Moreover, vesicovaginal fistulas due to migration or puncture of suture materials into the bladder are rare. In this report, we present a case of bladder stone and vesicovaginal fistula formation in a 29-year-old female patient who had been treated with the McDonald operation for an incompetent internal os of the cervix (IIOC) during pregnancy. The patient was successfully treated by cystoscopic removal of the bladder stone with suture material and conservative treatment for the vesicovaginal fistula.

The Usefulness in the Value of Some Infectious Parameters to Predict the Success of Emergency Cervical Cerclage Operation / 대한산부인과학회잡지

OBJECTIVE: To predict the perinatal outcomes of emergency cervical cerclage operation we analyzed some infectious parameters before and after the operation in patients has incompetent internal os of cervix, and compared their results between one success group and one failed group. METHODS: The 13 patients with emergency cervical cerclage and the 31 patients with elective cervical cerclage included in our study. After emergency cerclage, we investigated some infectious parameters as ESR, CRP, and WBC count, every other day. And we compared these values between success and failed group. We also evaluated the difference of these results between emergency cerclage and elective cerclage operation. RESULTS: 1. There were higher values of ESR and CRP after cerclage operation in failed group than those in success group significantly (p<0.05). 2. There also had shown higher values of WBC count at 3 days after operation in failed group than those in success group significantly (p<0.05). CONCLUSION: The infection is one of the most important factors in successful perinatal outcome after emergency cerclage operation and continuous follow up in ESR, CRP and WBC counts after operation can be used to predict the perinatal outcomes in relation to incompetent internal os of cervix.

A Clinical Study on the McDonald Operation for the Incompetent Internal Os of the Cervix / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to improve the pregnancy outcome and evaluate the prognostic factor after McDonald operation of IIOC patients. METHODS: From January 1, 1995 to December 31, 1999, 230 cases of IIOC were admitted and treated with McDonald operation at department of Obstetrics and Gynecology, Medical college of Catholic university. Among these patients, 187 cases were analyzed. We classified the above patients into 4 groups by gestational weeks of the operation (1st group before 14weeks, 2nd group 14+1-16weeks, 3rd group 16+1-18weeks, 4th group after 18weeks), and we analyzed the mean age of the patients, parity, indications, operation time, delivery methods and fetal survival rate on each groups. RESULTS: The fetal survival rate was 76.08%,and duration of pregnancy was 21.65weeks+/-6.39 in the 1st group, 78.5%, 19.24weeks+/-6.367 in the 2nd group, 88.2%,18.25weeks+/-5.15 in the 3rd group, 75.67%, 12.12weeks+/-7.19 in the 4th group. The 3rd group shows higher fetal survival rate with significantly. CONCLUSION: We can have higher fetal survival rate and prolongation of duration of pregnancy in the IIOC patients when we do the McDonald operation in the 16+1-18th gestation weeks.

A Clinical Study on the McDonald Operation for the Incompetent Internal Os of the Cervix / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to improve the pregnancy outcome and evaluate the prognostic factor after McDonald operation of IIOC patients. METHODS: From January 1, 1995 to December 31, 1999, 230 cases of IIOC were admitted and treated with McDonald operation at department of Obstetrics and Gynecology, Medical college of Catholic university. Among these patients, 187 cases were analyzed. We classified the above patients into 4 groups by gestational weeks of the operation (1st group before 14weeks, 2nd group 14+1-16weeks, 3rd group 16+1-18weeks, 4th group after 18weeks), and we analyzed the mean age of the patients, parity, indications, operation time, delivery methods and fetal survival rate on each groups. RESULTS: The fetal survival rate was 76.08%,and duration of pregnancy was 21.65weeks+/-6.39 in the 1st group, 78.5%, 19.24weeks+/-6.367 in the 2nd group, 88.2%,18.25weeks+/-5.15 in the 3rd group, 75.67%, 12.12weeks+/-7.19 in the 4th group. The 3rd group shows higher fetal survival rate with significantly. CONCLUSION: We can have higher fetal survival rate and prolongation of duration of pregnancy in the IIOC patients when we do the McDonald operation in the 16+1-18th gestation weeks.

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.

A Clinical Study on the Incompetent Internal Os of the Cervix / 대한산부인과학회잡지

OBJECTIVE:Our goal was to evaluate the clinical characteristics and statistical analysis in incompetent internal os of the cervix(IIOC) METHOD: At Department of Obstetrics and Gynecology, Eulgi Hospital and Eulgi university Hospital from January 1, 1991 to December 31, 1997, 296 cases of IIOC were admitted and treated with McDonald operation or modified Shirodkar operation. Of this, 38cases were follow up lost, so 252 cases were analayzed. Diagnostic criteria was previous history of painless cervical dilatation, followed by spontaneous abortion or preterm birth, and acceptance without resistance at the internal os of No. 8 Hegar dilator. RESULT: Incidence of IIOC was 1.61%, 1 in 60 deliveries. Most frequent age group was in 28-30 years old group and mean age was 30 years old. Total number and mean number of gravida was 818 and 3.2. The most common contributing factor was previous artificial abortion(77%), and cervix dilatation(9%), old cervical laceration(4.3%) etc, was followed. Operation methods were McDonald operation(56%) and modified Shirodkar operation(44%). The Success rate of McDonald and modified Shirodkar was 78.1% and 88.1%. Successful fetal salvage rate was 82.5%, and the highest success rate was 86.9% in 14-18th weeks of gestation group. The more cervix dilate, the more failure occured. Causes of operation failure was premature rupture of membrane(54.5%), preterm labor(43.2%) and fetal death in utero(2.3%). Delivery method after operation was vaginal delivery(146cases, 70.9%) and cesarean delivery(60cases, 29.1%). Cause of cesarean delivery was previous cesarean section(43.3%), breech presentation(16.7%), cephalopelvic disproportion(15%), prolonged labor(6.7%), fetal disttess(6.7%), twin(5%), placenta previa(3,3%) and abruptio placenta(3.3%). CONCLUSION: The 14-18th weeks of gestation group & no cervical dilatation group has higher success rate, which indicate early diagnosis and appropriate timing of operation is probably associated with a greater operation

A Clinical Study on the Incompetent Internal Os of the Cervix / 대한산부인과학회잡지

No abstract available.

A Clinical Study on the Incompetent Internal Os of the Cervix / 대한산부인과학회잡지

The 68 cervical cerclage operations of incompetent internal os of the cervix(IIOC) were performed at the Taegu Catholic Medical Center from Jan. 1, 1990 to Dec. 31, 1995. The results of this study were as follows: 1. The incidence of operation for IIOC was 0.23% of total delivery. 2. Highest number of IIOC was observed in the age group of 25 to 29, and the average number of pregnancy before operation was 4.1. 3. The significant contributory factor was previous history of the induced or spontaneous abortion. 4. In all cases, cerclage method was McDonald operation. 5. The average fetal salvage rate after operation was 82.5% and from the 14th week to 16th week of gestation(43 cases), the success rate of operation was 85%. 6. The causes of operation failure were premature labor in 6 cases(55%), premature rupture of membrane in 3 cases(27%) and abortion in 2 cases(18%) in order.