Clinical analysis of the perinatal pubic bone separation / 대한산부인과학회지

OBJECTIVE: To raise recognition and find out clinical characteristics about pubic bone separation relatively rarely reported. METHODS: Among the total of 40,475 mothers who had delivered livebirths of over 25 weeks gestation between January 1995 and December 2002, we assigned 40,401 mothers without pubic bone separation to control group I and 74 mothers with pubic bone separation to sample group I. We compared maternal age, gestational age, birth weight and parity between the two groups. To conduct subgroup analysis on mothers who had undergone normal vaginal delivery, we randomly selected 37 out of sample group I and assigned them to sample group II. We selected 1,073 out of control group I with a ratio of nullipara-to-multipara and assigned them to control group II. In subgroup analysis, we compared several risk factors between control group II and sample group II. Lastly, clinical characteristics of sample group I were analyzed by Student's T-test, chi-square test. RESULTS: There were no significant differences in maternal age, gestational age, birth weight and parity between control group I and sample group I. Moreover, there were no significant differences in maternal age, gestational age, parity, weight gain, duration of oxytocin use, BPD and labor duration between control group II and sample group II. But, the history of vacuum delivery, macrosomia and long second-stage labor duration were more notable in sample group II than control group II. The severity and distance of pubic bone separation were severe in cases of normal vaginal delivery than those of Cesarean section. CONCLUSION: In conclusion, it will enhance the diagnostic rate for pubic bone separation in perinatal period to widen the understanding of it's clinical characteristics.

A Case of Partial Hydatidiform Mole with a Coexistent Live Fetus / 대한산부인과학회지

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin, and a major risk for persistent trophoblastic tumor. Partial hydatidiform moles appear to be a milder version of complete moles with both normal and cystic villi, focal trophoblastic hyperplsia, a fetus or indication of previous fetal existence, 69 chromosomes with a maternal contribution, and a malignant potential less than described for complete moles. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies. Due to advances in cytogenetics and ultrasonography, now permit the diagnosis of this pregnancy antenatally. However this unusual pregnancy has the risks of malignant change and severe medical complications, so it is a dilemma to decide continuation or termination of pregnancy. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 12 gestational weeks, and confirmed normal karyotype (diploid) of the coexistent fetus. A brief reviews of related literature was done.

Perinatal outcomes in hyperemesis gravidarum patients as compared to normal pregnancy / 대한산부인과학회잡지

OBJECTIVE: To study perinatal outcomes in hyperemesis gravidarum (HG) patients as compared to normal pregnancy. METHODS: We performed retrospective analysis of pregnancy records of obstetric admission during 9-years period (between 1995 and 2003). We identified 77 women who admitted for control of HG after diagnosed as HG and delivered during the study period. Women treated as out-patients for hyperemesis and delivered at other hospital were excluded. Multiple gestation and stillbirth were also excluded from analysis. Subjects were stratified into groups of mild and severe HG according to the presence of at least one of the following criteria: ketonuria, increased hematocrit, and/or abnormal electrolytes. All patients without HG on whom records were available and who delivered during the study period were included as controls. Student T-test, chi square test, Kruskal-Wallis test and Mann-Whitney's U test were used. RESULTS: Among 77 women, 31 patients were diagnosed as having mild HG and 46 patients as having severe; 41205 patients were defined as controls. Maternal age, gravidity, maternal weight gain from preconception to delivery, maternal anemia were not significantly different between hyperemesis patients and control group. Mean birth weight, mean gestational age, neonatal sex ratio, Apgar score, delivery route were not significantly different. Pregnancy outcome variables and maternal characteristics for mild, severe HG and control group were also similar. CONCLUSION: Women with hyperemesis have similar maternal characteristics to the general population and have similar pregnancy outcomes. And there were no significantly difference between mild and severe hyperemesis patients.

Prenatal Diagnosis of A Case of Fetus in Fetu in the Fetal Retroperitoneum / 대한산부인과학회잡지

Fetus in fetu is a very rare congenital abnormality in which one vertebrate fetus is enclosed within the abdomen of another fetus. With advancing ultrasound imaging technique, a few case of prenatal diagnosis is reported recently. A case of fetus in fetu with 6 X 6 X 4 cm sized cystic mass in the fetal retroperitoneum was diagnosed prenatally using ultrasound and confirmed by ultrasound and computer tomogram after delivery. This mass was removed completely from delivered baby and finally confirmed fetus in fetu by pathologic examination. Solid portion in this mass was composed of vertebral organization with limb bud, well-developed organ system.