A Case of Heterotopic Pregnancy after Tubal Reanastomosis / 대한산부인과학회잡지

Heterotopic pregnancy is the coexistence of intrauterine and extrauterine pregnancy. It is a rare obstetrical phenomenon with an incidence rate about 0.003%. The risk factors of heterotopic pregnancy are IUD, PID, endometriosis, tubal surgery, etc resulting in functional and anatomical injury to tubes. Recently, the wide use of ovulation induction and in vitro fertilization has increased the incidence rate. The clinical manifestation are low abdominal pain, adnexal mass, peritoneal irritation signs, vaginal bleeding, etc. Early detecion of heterotopic pregnancy is very difficult. However, recently, due to development of pelviscopy, ultrasonogram and other diagnostic procedures, the diagnostic rate has increased.Because of the high maternal morbidity and mortality resulted from intraabdominal bleeding after rupture of ectopic pregnacy, immediate termination of ectopic pregnancy is required usually by operative methods. We experienced a case of heterotopic pregnancy after tubal reanastomosis and report this case with a brief review of literatures.

One Case of Prenatal diagnosed 48, XXYY / 대한산부인과학회잡지

Despite the rarity of 48, XXYY, having an incidence rate of 1 in 50,000 persons, 1 in 300 persons are reported to have a mental disorder of criminal behavior. The clinical characterics of 48, XXYY are similar to Klinefelter's syndrome such as small testis, tall stature, gynecomastia and can show mental retardation and skeletal anomaly. When the cause of elevated maternal serum AFP is not explained by USG or measurement of amniotic fluid AFP, during the second trimester of pregnancy, it is defined as unexplained elevation of maternal serum AFP. We report a case of 48, XXYY with unexplained elevation of maternal serum AFP which has been experienced in our hospital with brief review of literature.

Two Cases of Hyperemesis Gravidarum Managed by Enteral Feeding via Nasogastric Tube / 대한산부인과학회잡지

Traditionally, total parenteral nutrition(TPN) has been used when patients with hypaemesis gravidarum failed to respond to conservative management, but now many physicians attempt to enteral feeding via nasogastric tube because TPN is expensive and has many complications. Recently, we experienced 2 cases of hyperemesis gravidarum successfully managed by enteral feeding via nasogastric tube, therefore we think that this method may be carefully considered to the patients with hyperemesis gravidarum failed to respond to conservative management. So we report them with brief review of the literatures.

A Case of Cervical Pregnancy treated by Intraamniotic Injection of Methotrexate Guided by Transabdominal Ultrasonography / 대한산부인과학회잡지

Cervical pregnancy is a rare form of ectopic gestation and it can cause serious bleeding, shock and death. Although hysterectomies are still performed due to massive hemorrhages, there are some conservative approaches to cervical pregnancies to conserve fertility. Methotrexate is a very useful agent in the management of trophoblastic disease, and has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of viable cervical pregnancy treated successfully with intraamniotic injection of methotrexate guided by transabdominal ultrasonography.

A Case of Pregnancy-Associated Aplastic Anemia / 대한산부인과학회잡지

Pregnancy-associated aplastic anemia is an uncommon problem and conditions in which an acellular or markedly hypocellular bone marrow results in pancytopenia(anemia, neutropenia, and thrombocytopenia). In most cases, aplastic anemia and pregnancy appear to have been a chance association. We experienced one case of pregnacy-associated aplastic anemia and so we present it with brief review of literature.