The Effectiveness of a Preoperative Use of Misoprostol in Laparoscopically Assisted Vaginal Hysterectomy / 대한산부인과학회지

OBJECTIVE: To investigate the effectiveness of a single preoperative dose of rectal misoprostol in laparoscopically assisted vaginal hysterectomy (LAVH). METHODS: Between October 2003 and July 2004, 63 patients underwent LAVH with a single preoperative dose of rectal misoprostol 400 microgram at Grace women's hospital. To compare efficacy of a single preoperative dose of rectal misoprostol, 63 patients underwent LAVH without misoprostol were sampled during same period at Grace women's hospital. Clinicopathological variables were collected from the review of medical record and compared between two groups. Included variables were age, parity, BMI, uterus weight, largest myoma diameter, operation time, 24 hr Hb change, blood loss during operation, postoperative morbidity and postoperative complication. Associations between variable were studied using paired t-test. RESULTS: There were no significant differences in age, parity, BMI, uterus weight, largest myoma diameter between each groups. Comparing each groups in operative outcomes, estimated blood loss (155.0 +/- 97.8 mL vs 220.1 +/- 82.5 mL) and 24 hr Hb change (1.10 +/- 0.53 g/dL vs 1.57 +/- 0.46 g/dL) were significantly reduced in misoprostol group. CONCLUSION: A single preoperative dose of rectal misoprostol is a simple, reliable method for reducing intraoperative blood loss in LAVH.

A Case of Edward Syndrome with Choroid Plexus Cyst / 대한산부인과학회잡지

Trisomy 18 is the second most common chromosomal anomaly which reach to live birth next to Down syndrome. Several methods were proposed to screen patients on the risk of Edward syndrome like maternal serum levels of total human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP) and unconjugated estriol or free beta hCG with AFP, but the serum screening has only 67% detection rate with a 7.2% of false positive rate. Therefore, in order to overcome the limitations which the serum markers have, detailed ultrasound examination is also necessary and sensitivity of 80% was reported. We report a case of Trisomy 18 fetus in which choroid plexus cyst was the only abnormal sonographic finding.