Neoadjuvant chemotherapy in cervical carcinoma during pregnancy: Case report / 부인종양

When the cervical cancer is diagnosed in early stage during pregnancy, the treatment can be postponed for fetal viability. This case presents a patient diagnosed as cervical cancer stage Ib1 during her pregnancy. The patient had 2 cycles of neoadjuvant chemotherapy (Paclitaxel-cisplatin) formerly and cesarean section was done at 33rd weeks of intrauterine pregnancy, then radical abdominal hysterectomy with bilateral pelvic lymph node dissection and paraaortic lymph node biopsy was immediately performed right after the delivery. For the baby born, there was neither complication nor congenital anomaly but mild bilateral ventriculomegaly seen on brain CT taken on 3 days after birth. This case offers a better chance for both mother and fetus while conserving fetal viability and managing the early cervical cancer during pregnancy through close follow up.

A case of term delivery in a woman with didelphic uterus after expelling the decidual cast at midtrimester: Case report / 대한산부인과학회지

The passage of decidual cast in pregnancy is rare and mostly associated with some kind of congenital uterine malformation. Since the hemorrhage caused by the passage of decidual cast can easily be mistaken for other causes of the antepartum hemorrhge, it often leads to the premature delivery of the baby which results poor perinatal outcome. Moreover it mostly happened nonpregnant horn in didelphic or bicornuate uterus, although decidual cast was expelled. We have experienced a case of woman with didelphic uterus and past history of two consecutive premature deliveries, who delivered a female baby at 38 gestational weeks through intensive care after expelling decidual cast in pregnant uterus at 30 gestational weeks. We present this case with a brief review of literatures.

Relationship between nRBC counts and fetal hypoxia, perinatal outcome in severe preeclampsia / 대한산부인과학회잡지

OBJECTIVE: To determine the usefulness of neonatal nucleated red blood cell counts (nRBC) as an independent predictor of fetal hypoxia and perinatal outcome in severe preeclampsia. METHODS: One hundred thirty eight patients with severe preeclampsia were studied. Umbilical artery Dopppler velocimetry was performed in all patients, and were divided into two groups, the control group with present umbilical artery end diastolic velocity, and the case group with absent or reversed velocity. The patients were also separately grouped as another control (n=58), acute (n=19), and chronic hypoxia (n=55) according to abnormal Doppler findings, presence of oligohydramnios, intrauterine growth restriction (IUGR), and pattern of fetal heart rate tracings during labor. At delivery, the umbilical cord blood was collected and the levels of nRBC per 100 WBC were measured from the samples along with blood gas analysis. The results were compared between the control and acute groups, and chronic hypoxic fetus. Correlation with perinatal outcomes was also evaluated. Student's t-test, ANOVA, and regression analysis were performed for statistical analysis. RESULTS: Those with absent or reversed end diastolic velocity did not have significantly greater nRBC counts, but had lower platelet counts (p=0.02), lower pO2 (p=0.005), and higher pCO2 saturation levels (p=0.01). There were no significant differences with regard to nRBC counts among the control, acute, and chronic hypoxia groups. Elevated nRBC counts were significantly associated with neonatal intensive care unit stay of more than 28 days (p=0.013), respiratory distress syndrome (p=0.003), disseminated intravascular coagulopathy, or sepsis (p=0.041). CONCLUSION: nRBC counts did not show significant difference according to umbilical artery Doppler velocity. Also we could not find any difference between the control, acute, and chronic hypoxic group, suggesting that nRBC counts does not correlate with both hypoxic status, or duration of hypoxia. Correlation with elevated nRBC counts and neonatal intensive care unit stay of more than 28 days, respiratory distress syndrome, disseminated intravascular coagulopathy, and sepsis was observed. However, the overlapping results and the wide range of nRBC counts according to the complications limits its role as a predictor of poor perinatal outcome.