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.

Diagnosis and Management of Pregnancies Implanted into the Lower Uterine Segment Cesarean Section Scar / 대한산부인과학회잡지

OBJECTIVE: To describe diagnosis and management of Cesarean section scar pregnancy increased at recently due to high Cesarean section rate. METHODS: Eleven cases of pregnancies implanted into the lower uterine segment Cesarean section scar were diagnosed and treated at Daegu Fatima hospital during January 1999 to May 2004. All cases are confirmed by transvaginal ultrasound scan. The management of Cesarean section scar pregnancies included transvaginal evacuation, hysterotomy and medical treatment with methotrexate systemic or local injection into gestational sac. RESULTS: Eleven Cesarean section scar pregnancies were diagnosed. Medical treatment was used in nine women and four women was successful. The success rate were 44% (4/9). Surgical treatment was used in two women included transvaginal evacuation and hysterotomy. Seven women (63%) required blood transfusion and one women (9%) had a hysterectomy. CONCLUSION: Cesarean section scar pregnancies are more common. When the diagnosis is made in early pregnancy the prognosis is good and prevent late pregnancy complication include placenta previa, placental accreta and uterine rupture. The risk of hystrectomy is relatively low.

A Clinical Study of Peritoneal Inclusion Cysts / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to review 6 years' experience of peritoneal inclusion cysts at our hospital. METHODS: A retrospective study of 13 cases of peritoneal inclusion cysts between Jan. 1, 1996 and Dec. 31, 2001 was carried out and then clinical feature, radiologic finding, and treatment method were compared with previous reports. RESULTS: Most of patients were premenopausal. Chief complaints were lower abdominal pain or palpable abdominal mass, and so forth. The majority of patients had history of lapalotomy. Peritoneal inclusion cyst was diagnosed by ultrasonogrphy and CT. Most specific finding is that normal ovary is seen in the cysts. In the past, operation was the main treatment method. Recently sclerotherapy was introduced and available. CONCLUSION: Because peritoneal inclusion cyst is benign and uncommon disease, it had not been interesting part. So, preoperative diagnosis rate was low and surgical resection was main treatment method. Preoperative diagnosis rate has been higher after it's clinical feature and specific radiologic findings were reported. Recently, conservative treatment may substitute for operation.