Prenatal Diagnosis of Congenital Rubella Using Percutaneous Umbilical Blood Sampling in Pregnant Women with Rubella Infection / 대한산부인과학회잡지

OBJECTIVE: To evaluate the usefulness of percutaneous umbilical blood sampling (PUBS) and prevalence of fetal infection in the pregnant women with suspicious fetal rubella infection. METHODS: Between June 1996 and May 2002 in Chonnam National University Hospital, the rubella specific IgG, IgM antibody and RT-PCR were checked in fetal blood obtained from 31 pregnant women with high risk of rubella infection. Eighteen women (58.1%) had rubella specific IgM, 11 women (35.5%) high titer of rubella specific IgG, and 2 women had a history of recent rubella vaccination within 3 months. RESULTS: PUBS was performed in all cases, successful in 27 cases (87.1%) and failed in 4 cases (12.9%). Cardiocentesis was performed in failed cases. Performing the PUBS, fetal bradycardia was observed in 7 cases (25.9%), fetal tachycardia in 1 case (14.8%), and preterm labor in 2 cases (7.4%). Performing cardiocentesis, fetal bradycardia was observed in 1 case (25.0%), fetal tachycardia in 2 cases (50.0%), and preterm labor in 1 case (25.0%). There was no fetal death. All samples of fetal blood were positive for rubella specific IgG but rubella specific IgM was detected in only 1 case. RT-PCR was negative in all cases. CONCLUSION: Fetal blood sampling is relatively safe and a great precaution is necessary before termination of pregnancy with suspicious fetal rubella infection and without typical maternal rash to reduce unnecessary termination of pregnancy. Several tests such as rubella specific IgM and PCR from placental villi, amniotic fluid, and fetal blood should be considered before termination of pregnancy.

A Clinicopathologic Study of 11 Cases with Malignant Transformation Arising in Mature Cystic Teratomas / 대한산부인과학회잡지

OBJECTIVE: There have been few studies concerning the clinical pathology of malignant transformation arising from ovarian mature cystic teratoma. Thus, the objective of this study is to determine clinicopathologic factors affecting survival in this rare tumor. METHODS: From November 1992 to December 2002, 11 patients with malignant transformation arising from ovarian mature cystic teratoma were treated at Departments of Obstetric and Gynecology in Chonnam National University Hospital. Demographic characteristics, symptoms, signs, stage, mode of therapy and results of follow up were reviewed retrospectively. RESULTS: There were 11 cases of the malignant transformation of ovarian mature cystic teratomas out of 637 cases of mature cystic teratomas (1.7%). The average age was 50.6 years. Histologically, 7 out of the 11 cases were squamous cell carcinoma (63.7%). There was no specific clinical symptom but palpable abdominal mass was the most frequent complaint (5 cases, 45.4%). As for the stage of disease, 8 cases were in stage Ia (72.7%) and the other three cases were in stage Ic, IIb and IIc respectively. All the patients received surgery, and 7 of them had chemotherapy and 2 both chemotherapy and radiation therapy at the same time. All patients in stage I survived until the period of follow-up and their average survival time was 31.8 months. One patient in stage IIc died of intestinal obstruction in 9 month from the surgery and the average survival time of two patients in stage II was 8.5 months. CONCLUSION: The mechanism of the malignant formation arising in ovarian mature cystic teratomas is not clear but considering the fact that 80% of mature cystic teratomas are diagnosed during the reproductive age malignant transformation seems to be related to the long-term presence of non-removed mature cystic teratomas in abdomen. Accordingly, it is considered helpful for preventing and early detection of the malignant transformation to have regular ovary examination through pelvic ultrasonogram during the reproductive age.

A Case of Postpartum Ovarian Vein Thrombosis after Cesarean Section / 대한산부인과학회잡지

Postpartum ovarian vein thrombosis has been thought to be a rare disease of which clinical finding is not accurate. Most of postpartum ovarian vein thrombosis presents as symptoms consisting of fever, lower abdominal pain, abdominal mass. If the symptom does not response even with intravenous antibiotics therapy or diagnosis is inaccurate, a ultrasound or a CT scan should be obtained for diagnosis. We report a case of postpartum ovarian vein thrombosis after cesarean section diagnosed and treated, with a brief review of literatures.