A case of CHARGE syndrome diagnosed after delivery: A case report / 대한산부인과학회지

The acronym CHARGE (Coloboma, Heart defects, Atresia choanae, Retarded growth and development, Genital hypoplasia, and Ear abnormalities) was coined by Pagon et al. in 1981. The prevalence of CHARGE syndrome was estimated to be approximately 1/10,000 - 1/15,000. The cause of the CHARGE syndrome remains unknown but several observations support the role of genetic factors and a significantly higher paternal age at conception and several chromosomal abnormalities. The clinical spectrum of this multiple congenital anomaly and mental retardation is broad and variable, therefore the treatment of the CHARGE syndrome was not definitive and conservative. We hereby report, with reviewing other literature, a case of CHARGE syndrome diagnosed after delivery.

Umbilical artery blood gas analysis and its relationship with the placenta to birth weight ratios at birth in preeclampsia and small for gestational age / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to compare the umbilical artery blood gas analysis and assess the relationship between fetal oxygenation and placenta to birth weight ratios in preeclampsia and small for gestational age. METHODS: We compared the results of umbilical artery blood gas analysis and placenta to birth weight ratio in group of preeclampsia (N=28), group of small for gestational age (N=15), group of large for gestational age (N=15), and controls (N=24). And we also divided all of them into 3 groups by placenta to birth weight ratio at birth, 0.25 (N=18). We compared umbilical artery gas analysis in each groups. RESULTS: The placenta to birth weight ratio in PE was significantly lower than control group (p<0.05). Umbilical artery pO2 and O2 saturations in each group of preeclampsia and small for gestational age were significantly lower than group of large for gestational age and controls (p<0.05). But we could not find any differences in other umbilical artery blood gas analysis (pH, pCO2, HCO3-). Umbilical artery pO2 and O2 saturations of higher placenta to birth weight ratio were stepwise lower than those of lower placenta to birth weight ratio but, pCO2 of higher placenta to birth weight ratio was stepwise lower than those of lower placenta to birth weight ratio. But there was no significant difference. CONCLUSION: Our data suggested that fetal oxygenation is significant determinant of fetal growth from small for gestational age and preeclampsia. And it may be related to placental implantaton and growth.

A case of synchronous multiple primary malignant neoplasm of the uterine cervix and endometrium / 대한산부인과학회지

Synchronous multiple primary neoplasm is defined as more than 2 cancers are independently developed in one individual and are diagnosed simultaneously or within 6 months interval. The most common form of synchronous multiple primary neoplasm of female reproductive tract is that of uterine endometrium and ovary. Synchronous multiple primary neoplasm involving uterine cervix and endometrium is rare. Recently we experienced a case of synchronous multiple primary malignant neoplasm of the uterine cervix and endometrium. We report this case with revewing of other literature.

The Correlation of Serum Level of Tumor Marker CA125 and CA19-9 and Severity of Endometriosis / 대한산부인과학회지

OBJECTIVE: The purpose of this study is to evaluate the clinical usefulness of serum level of CA125 and CA19-9 to assess the severity of endometriosis. METHODS: The study was conducted on 80 patients with histologically diagnosed endometriosis and 20 patients in control group. Preoperative serum CA125 and CA19-9 levels were measured by immunoradiometric assay and the severity of disease was staged according to the revised American Fertility Society (1985) classification system. RESULTS: Both serum level of CA125 and CA19-9 in endometriosis patient (81.7+/-120.44 U/mL, 47.1+/-80.74 U/mL, Mean+/-SD) were higher than control group (10.8+/-6.48 U/mL, 11.7+/-8.82 U/mL, Mean+/-SD)(p=0.001, p=0.054). The serum CA125 level increased significantly according to stages (p=0.051), but serum CA19-9 level showed an increasing trend (p>0.05). With the cutoff value of CA125 with 35 U/mL and CA19-9 with 37 U/mL, overall positive rate for CA125, CA19-9, and CA125 combined with CA19-9 was 45.1%, 33.8%, and 52.5%. There was no difference between the positive rate with CA125 combined with CA19-9 (52.5%) and that with CA125 alone (45.1%)(p>0.05). With the cutoff value of CA125 with 15 U/mL and CA19-9 with 9 U/mL, overall positive rate for CA125, CA19-9, and CA125 combined with CA19-9 was 82.5%, 76.3%, and 92.5%, the positive rate with CA125 combined with CA19-9 (92.5%) was higher than that with CA125 alone (82.5%)(p=0.056). CONCLUSION: Because the positive rate with combined serum CA125 and CA19-9 level is not higher than that with serum CA125 alone for the severity assessment of endometriosis, it is recommended to use serum CA125 level alone.

A Case of Large Cystic Myxoid Leiomyoma in Uterine Round Ligament / 대한산부인과학회지

Uterine leiomyomas are the most common benign uterine tumor. They may be subserosal, intramural, or submucosal in location within the uterus or located in the cervix, in the broad ligament, or on a pedicle. But leiomyoma of the round ligament of the uterus is a rare condition occurring predominantly in premenopausal middle-age women, which is usually single and unilateral. In 50% of patients, they are associated with similar lesion of the uterus. Recently we have experienced a case of large cystic myxoid leiomyoma of the round ligament of the uterus misdiagnosed as an ovarian tumor in 32 year-old multiparous woman. We report this case with a brief review of literatures.

Correlation of Progesterone Challenge Test and Endometrial Thickness in Postmenopausal Women / 대한산부인과학회지

OBJECTIVE: The aim of this study is to assess the correlation of progesterone challenge test (PCT) and endometrial thickness as a primary screening test for endometrial pathology in postmenopausal women prior to hormonal replacement therapy (HRT). METHODS: 92 postmenopausal women were measured serum estradiol (E2) level, endometrial thickness by transvaginal ultrasonography, and followed by PCT before HRT. And we compared the results of PCT with endometrial thickness and E2 levels. RESULTS: Women with a positive result of PCT in 32% of case and 75.9% of positive test showed endometrial thickness 4 mm or more. However 60.3% of negative test showed endometrial thickness 4 mm or more. This resulted in a PPV=76%, NPV=40%, sensitivity=37%, and specificity=78%. Mean serum E2 was significantly higher in patient with positive PCT but serum E2 showed no positive correlation with endometrial thichness (CI 95%, P