A Case of Chronic Placental Abruption-Oligohydramnios Sequence at 19 Weeks' Gestation / 대한산부인과학회지

Placental abruption is defined as the early separation of a normal placenta from the wall of the uterus before delivery of the fetus. The incidence of it has been reported to be approximately 1% of all pregnancies and perinatal mortality rates from abruption ranged from 20% to 40% in recent studies. Catastrophic placental abruption occurs infrequently, and 20% of patients will deliver seven days later or longer after abruption. These patients have a diagnosis of chronic abruption. 60% of patients with chronic abruption develop oligohydramnios. Chronic abruption-oligohydramnios sequence (CAOS) is defined by the following criteria: (1) clinically significant vaginal bleeding in the absence of placenta previa or other identifiable source of bleeding, (2) amniotic fluid volume initially documented as normal, and (3) oligohydramnios (amniotic fluid index < or =5) eventually developing without concurrent evidence of ruptured membranes. Recently we have experienced a case of chronic abruption with newly developed oligohydramnios at 19 weeks' gestation and report our case with brief review of the literature.

Diagnostic Efficacy of the Risk of Malignancy Index in Early Detection of Ovarian Cancer / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate the use of a risk of malignancy index (RMI) for early detection of ovarian cancer in patients with adnexal masses. METHODS: The preoperative RMI was obtained from 497 women who have visited our hospital between September 1994 and December 2004. The RMI is based on menopausal status, ultrasonographic findings, and serum CA-125 level. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each variable and the RMI were evaluated to distinguish between malignant and benign pelvic masses. RESULTS: The sensitivity and specificity of RMI was 42.85% and 88.57%. PPV and NPV was 40.74% and 92.11% for the total material. The RMI is more accurate statistically than the menopausal status, serum CA-125 levels separately in diagnosing malignancy, but the ultrasound features is more accurate than RMI in diagnosing malignancy. CONCLUSION: Our results suggests that RMI is not good as a primary screening tool for early detection of ovarian cancer because of its low sensitivity and low NPV than ultrasound. So further study is needed to support the diagnostic efficacy of RMI.

The usefulness of vascular endothelial growth factor as a prognostic factor in uterine cervix cancer / 대한산부인과학회지

OBJECTIVE: This study was designed to determine the relationship between the VEGF (Vascular Endothelial Growth Factor) expression and histopathologic prognostic factors and 5-year survival rate. METHODS: We examined the expression of the VEGF by immunohistochemical staining in 40 specimens collected from invasive uterine cervix cancer patients. We compared the results of relationship between the VEGF expression and several histopathologic prognostic factors by using Fisher exact test for statistical analysis. RESULTS: All specimens showed low or high immunoreactivity. There was no significant correlation between the expression of the VEGF and histopathologic prognostic factors (p>0.05) except for pathological cell types (p<0.05). Parametrial invasion, the stage and age showed statistically significant correlation with 5 year survival rate (p<0.05). There was no statistically significant correlation between the VEGF expression and 5 year survival rate. CONCLUSION: VEGF expression had no relation with prognostic factors except for histopathologic cell types. Its expression may not play an important role in the prognosis of the uterine cervix cancer patients.

A Case of Post-Cesarean Endomyometritis Associated with Myometrial Gas Formation / 대한산부인과학회지

Postpartum endomyometritis is an important cause of maternal morbidity, especially after cesarean delivery. The management of postpartum endomyometritis is primarily medical with surgical intervention only occasionally required. But the gas forming abscess rarely happens, making the medical treatment difficult and needing emergency hysterectomy. We present a case of post-cesarean delivery endomyometritis complicated by intrauterine gas formation penetrating myometrium, which could not be managed by medical treatment, so finally needed emergency hysterectomy.